For 2nd yr students: Lets talk Gram's stain. Firstly in pic : Plenty of pus cells seen, Gram positive cocci in chains suggestive of Streptococcus species. This is the ideal way to interpret your Gram stain when examiner asks (Start with commenting on pus cells first and then 1/n
The organism, so examiner knows you know that seeing pus cells and not merely organism has its significance(indicates inflammation).Never mention d exact species, most students write GPC clusters suggestive of Staphylococcus 'aureus', you cant decide that on Microscopy alone 2/n
Principle of Gram staining:Gram Positive organisms retain primary stain better dan Gram neg organisms. Bas, dats it. Dont start peptidoglycan layer, lipopolysaccharide etc those are the theories of Gram staining, principles is only the one stated above. Then examiner will ask 3/n
Theory of Gram stain then all the points about cell wall, cytoplasm etc.
Applications of Gram stain
a)Empirical Rx
b) Appropriateness of specimen (like sputum vs saliva: more epithelial cells its saliva not useful sample in LRTI, more pus cells ✅️)
c) Spot diagnosis like 4/n
Gas gangrene i.e Absent or very few pus cells (its gangrene so no blood so no pus cells), polymicrobial and Gram Pos bacilli Box cart appearance (s/o Clostridium perfringes)
d)Selection of media (like McConkey if GNB are seen etc)
Any other questions u were asked, shoot here 5/n
Next I ll post a series of Gram stain pics, you will be amazed at how much information you can get with this test which costs less than 15Rs and gives results in 15 mins or so.
Hopefully it also changes ur opinion about importance of Microbiology 6/n
Plenty pus cells, budding yeast cells with pseudohyphae
Budding yeast cells
All the pink structures are Gram neg bacilli, Those safety pin like are Gram positive bacilli with spores which is unstained
Lanceolate shaped Gram positive diplococci with an appreciable halo (capsule), U guessed it right suggestive of Streptococcus pneumoniae (can be confirmed only by culture)
Pus cells and plenty of Gram neg diplococci(not clear in pic) in a urethral discharge. Of course N.gonorrhea (culture confirmatory)
Pus cells, branched Gram positive filamentous bacteria - Nocardia or Actinomyces species. Do modified AFB - Nocardia will be acid fast
Gram positive cocci in long chains - Suggestive of Streptococcus species. End of thread!
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@anujtiwari11@rjVACHAS@drpraveenpsy Finally some1 talked sense! I generally dnt get into such conversations because its similar to patients foulmouthing doctors all the time. In 2018 when I joined as faculty, there were 180 MBBS students in our college, overnight it changed to 250 in 2019, vacant Asst Profs 5 in no
@anujtiwari11@rjVACHAS@drpraveenpsy Apart from MBBS, we have 100 OTPT students, 10 PGDMLT, 100 Nursing and 18 PG(M.D) students.
Not to mention the humongous workload of one of the biggest public hospitals in Mumbai. Basically doing 2 jobs fr salary of 1. Marrow barrow do only teaching n paid much more.
@anujtiwari11@rjVACHAS@drpraveenpsy We hardly get time to focus on academia balancing with the huge workload, most think it is done by SR and JRs but the admin is completely with faculty, inventory execution etc and not to mention facing RTIs. The private tuitions hve made a trend to spread among students
Recent tweets over TB had me thinking a bit. As a Microbiologist I would like to point out d paradigm in diagnosis of TB in last few yrs. There was a time when diagnosis of TB ws mainly based on smear microscopy and culture on LJ medium.Smear microscopy needs a huge bacterial 1/n
Load to come positive(10 raised to 4 to 5). LJ medium takes about 4 weeks(TB is slow growing organism) to grow further 2-4weeks for antibiotic testing (grown in presence of antibiotics).
Enter molecular tests and MGIT. Molecular tests detect as low as 120 bacilli/ml (sputum) 2/n
Newer 'Ultra' version claims detection of even 10 bacilli/ml and the result comes in a day. MGIT gives a result on an average about 10days or so for a positive (depends on initial bacterial load). Thus few yrs ago, giving ATT empirically was justified, in todays era it isnt! 3/n
For 2yr MBBS Micro : Lab diagnosis of infectious diseases.
It can be either for a single organism eg L.D of pulmonary TB or syndrome eg meningitis. Either way these concepts will help not only in your answer but also make you a better clinician. Some are a MUST in your answer 1/n
Firstly write about the clinical features so examiner knows that you know WHEN. Clinician examines and makes a clinical diagnosis to confirm/support which he/she may ask for radiological or lab diagnosis (or other). Time to give differentials 2/n
For syndromic make a chart Bacterial (T.B = special), Viral, Fungal, Parasitic. If you can answer in terms of frequency (Indian scenario) and as per age group then nothing like it! UG Microbiology isnt beyond Bacteria, Viruses, Fungi & Parasites (Protozoan & Helminths) 3/n