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Gram stain:- Very commonly used differential staining is Gram staining, used to differentiate gram-positive & gram-negative bacteria. Developed by Hans Christian Gram in 1884. Gram’s Staining Principle:- 1.   Bacteria having cell walls with a thick layer of peptidoglycan will resist decolorization of primary stain and appear violet or purple. 2.    Bacteria having a thin peptidoglycan layer with lesser cross-linkage lose primary stain during decolorizing and gain counter stain appearing pink orred.  3.    In an aqueous solution of crystal violet dye, their molecules dissociate into CV+ and Cl– ions. These ions easily penetrate the cell wall components of both positive and negative bacteria. 4.  When Gram’s Iodine is added as mordant, the iodine (I) interacts with CV+ion and forms CV-I complex within cytoplasm and cell membrane and cell wall layers. 5.When decolorizing solution (ethanol or a mixture of ethanol and acetone) is added it interacts with lipids in the cell wall. 6.  The outer membrane of the Gram-Negative bacterial cell wall is dissolved exposing the peptidoglycan layer 7.     The peptidoglycan layer is thin with less cross-linking in the Gram-Negative cell wall, hence becoming leaky. This causes cells to lose most of the CVI complexes. 8.Whereas in Gram-Positive bacteria, there is no outer membrane, and the peptidoglycan layer is also thick with higher cross-linkage. 9.So, the decolorizing solution dehydrates the peptidoglycan layer trapping all the CVI complexes inside the cell wall and bacteria retain the purple orviolet color of crystal violet. 10.When counterstain, positively charged safranin, is added, it interacts with the free negatively charged components in Gram-Negative cell wall and membrane and bacteria becomes pink/red. 11.Whereas, there is no space to enter inside the dehydrated Gram-Positive cell wall due to CVI complex and dehydration. Hence, safranin can’t stain themred or pink and Gram-Positive bacteria reveal the purple or violet color. Gram’s Staining Protocol:- •       Flood crystal violet solution over fixed smear •       After 30 – 60 seconds, pour off the Crystal Violet solution and rinse with gentle running water. •       Flood the Gram’s Iodine solution over the smear •       Leave the iodine solution for 30 – 60 seconds and pour off the excess iodine and rinse with gentle running water •       Shake off the excess water over the smear •       Decolorize the smear by passing the decolorizing solution till the solution runs down in clear form. Alternatively, add a few drops of decolorizing solution and shake gently and rinse with distilled water after 5 seconds. •       Rinse with distilled water to wash decolorizer •       Shake off the excess water over the smear •       Pour counter stain over the smear •       Leave for 30 – 60 seconds and wash with gentle running water •       Air-dry or blow-dry the smear.

PULMONARY TUBERCULOSIS :- Pathogen:-      Mycobacterium tuberculae Incubation Period:-      2-10 weeks Symptoms:-Coughing; chest pain and bloody sputum with tuberculin. Epidemiology:-Airborne & Droplet infection Therapy/ Prophylaxis:-Streptomycin, para-amino salicylic acid, rifampicin etc./ BCG vaccine Isolation, Health education DIPHTHERIA:- Pathogen:- Corynebacterium diphtheriae Incubation Period:-     2-6 days Symptoms:-Inflammation of mucosa of nasal chamber, throat etc. respiratory tract blocked. Epidemiology:-Airborne & Droplet infection Therapy/ Prophylaxis:-Diphtheria antitoxins, Penicillin, Erythromycin/ DPT vaccine CHOLERA:- Pathogen:-   Vibrio cholerae Incubation Period:-6 hours to 2 – 3 days Symptoms:-Acute diarrhoea & dehydration. Epidemiology:-Direct & oral (with contaminated food & water) Therapy/Prophylaxis:-Oral rehydration therapy & tetracycline/ Sanitation, boiling of water & cholera vaccine Leprosy:- Pathogen:-Mycobacterium leprae Incubation Period:-  2-5 years Symptoms:-Skin hypopigmentation, nodulated skin, deformity of fingers & toes. Lepromin in skin tests. Epidemiology:-lowest infectious & contagious Therapy/Prophylaxis:-Dapsone, rifampicin, Clofazimine./ Isolation Pertussis(Whooping Cough):- Pathogen:-Bordetella pertussis Incubation period:- 7-14 days Symptoms:-Whoops during inspiration Epidemiology:-Contagious & Droplet infection Therapy/Prophylaxis:-Erythromycin / DPT vaccine Tetanus(Lock Jaw):- Pathogen:-Clostridium tetani Incubation Period:- 3-21 days Symptoms:-Degeneration of motor neurons, rigid jaw muscles, spasm and paralysis Epidemiology:-Through injury Therapy/Prophylaxis:-Tetanus- antitoxins. / ATS and DPT vaccines. Gonorrhoea:- Pathogen:-          Neisseria gonorrhoeae Incubation Period:-   2-10 days Symptoms:-   Inflammation of urinogenital tract. Epidemiology:-   Sexual transmission Therapy/Prophylaxis:-Penicillin & Ampicillin / Avoid prostitution Syphilis:- Pathogen:-Treponema pallidum Incubation period:-3 weeks Symptoms:-Inflammation of urinogenital tract. Epidemiology:-Sexual transmission Therapy/Prophylaxis:-Tetracycline & penicillin. / Avoid prostitution Viral Disease:- Chickenpox(Varicella): Pathogen – Herpes-zoster virus (DNA- virus) Epidemiology – Contagious & Formite borne Incubation Period – 12-20 days Symptoms – Dark red coloured rash or pox changing into vesicles, crusts and falling. Prophylaxis – Now vaccine available, isolation. Therapy – Zoster Immunoglobulins (ZIG). 2. Smallpox(Variolla):- Pathogen – Variola-virus (DNA-Virus) Epidemiology – Contagious & Droplet infection Incubation Period – 12-days Symptoms – Appearance of rash changing into pustules, scabs and falling. Prophylaxis – Smallpox vaccine. Therapy – No case reported after 1978. 3.Poliomyelitis:- Pathogen – Polio-virus (RNA-virus) Epidemiology – Direct & oral Incubation Period – 7-14 days Symptoms – Damages motor neurons causing stiffness of neck, convulsion, paralysis of generally legs. Prophylaxis – ‘Salk’ vaccine and Oral Polio vaccine. Therapy – Physiotherapy. 4. Measles(Rubeolla Disease):- Pathogen – Rubeolla-virus (RNA-virus) Epidemiology – Contagious & Droplet infection Incubation Period – 10 days Symptoms – Rubeolla (skin eruptions), coughing, sneezing etc. Prophylaxis – Edmonston- B-vaccine, isolation Therapy – Antibiotics & sulpha drugs. 5. Mumps:- Pathogen – Mumps-virus (RNA-virus) Epidemiology – Contagious & Droplet infection Incubation Period – 12-26 days Symptoms – Painful enlargement of parotid salivary glands. Prophylaxis – Mumps- vaccine isolation Therapy – Antibiotics. 6. Rabies(Hydrophobia) Pathogen – Rabies-virus (RNA-virus) Epidemiology – Indirect & inoculative (vectors are rabid animals monkeys, cats, dogs) Incubation Period – 10 days to 1- 3 months Symptoms – Spasm of throat & chest muscles, fears from water, paralysis and death. Prophylaxis – Immunization of dogs. Therapy – Pasteur- treatment (14 vaccines in stomach). 7.Trachoma:- Pathogen – Chlamydia trachomatis Epidemiology – Contagious, formite-borne and flies (vectors) Incubation Period – 5-12 days Symptoms – Inflammation of conjunctiva & cornea leading to blindness. Prophylaxis – Isolation Therapy – Tetracycline & sulfonamide. 8.Influenza(Flu):- Pathogen – Myxovirus influenzae (RNA-virus) Epidemiology – Air borne and pandemic Incubation Period – 24-48 Hours Lasts for 4-5 days Symptoms – Bronchitis, sneezing bronchopneumonia, leucopenia, coughing, etc. Prophylaxis – Isolation. Therapy – Antibiotic therapy. 9.Hepatitis(Epidemic Jaundice):- Pathogen – Hepatitis-B virus Epidemiology – Direct & oral (with food and water) Incubation Period – 20-35 days Symptoms – Damage to liver cells releasing bilirubin which causes jaundice. Prophylaxis – Proper sanitation proper coverage of food, water, milk etc. use of chlorinated or boiled water, etc. Therapy – Hepatitis-B vaccine.

MICROBIOLOGY INDEX 1.      Safety measures in the Microbiology Laboratory working area. 2.      Isolation of bacteria 3.      Culture media a.     Introduction and preparation technique of     Culture Media b.    Type of Culture Media       Nutrient Agar       MacConkey Agar        Blood Agar         EMB Agar         XLD Agar          Deoxycholate Citrate Agar          Lowenstein Jensen Acid Medium 4.      Isolation of Bacteria       a.  Inoculation Technique           Streaking Method,     Pouring Method     Spreading Method       Lawn Method b. Incubation of micro-organisms on or in Culture media c.  Study of Bacterial Colony morphology d.   Biochemical identification of microbiology   i.     Catalase Test ii.     Coagulase Test iii.     Oxidase Test iv.     Urease Test v.     Indole Test vi.     Bile Solubility test vii.    Cetrimide test viii.  Decarboxylase test.       e.     Slide preparation of various Specimens f.     Staining Technique  i.     Simple Stain  ii.   Gram’s Stain  iii. AFB or ZN Stain   iv.  Albert Stain   v.     Negative Stain 5.       Cultivation of Fungi 6.       Motility Testing of micro-organisms 7.       Anti-bacterial sensitivity testing 8.       Preparation of VDRL buffer and Antigen emulsion Serology practical index 1.       VDRL Agglutination test for syphilis by Quantitative and Qualitative method 2.       Rapid Plasma Reagin (RPR) test for syphilis 3.       Widal test by Qualitative and quantitative method. 4.       Ring Test 5.       Nepier Aldehyde Test 6.       ASO test by Quantitative and Qualitative 7.       Rheumatoid Arthritis Test (RA Test) 8.       C-Reactive Protein Test (CRP)   9.       Immunologic Pregnancy Test

STERILIZATION:- Sterilization (or sterilisation) refers to any process that eliminates, removes, kills, or deactivates all forms of life and other biological agents.(suchas:- fungi, bacteria, viruses, spore forms, prions, unicellular eukaryotic organisms such as Plasmodium, etc) present in a specified region, such as a surface, a volume of fluid, medication, or in a compound such as biological culture media. Sterilization can be achieved through various means, including: heat, chemicals, irradiation, high pressure, and filtration. Sterilization is distinct from disinfection, sanitization, and pasteurization, in that sterilization kills, deactivates, or eliminates all forms of life and other biological agents which are present.   Sterilization are classified asfollowing:- physical methods of seterilization (i)Sun-Light:- Ultraviolet rays present in the sun-light are responsible for spontaneous sterilization in natural conditions. In tropical countries the sun light is more effective in killing bacteria due to combination of ultraviolet rays and heat. By killing bacteria in suspended water, sunlight provides natural method of disinfection of water bodies such as tanks and lakes. Those articles which cannot withstand high temperature can still be sterilised at lower temperature by prolonging theduration of exposure. (ii)Heat:- It is considered to be the most reliable method of sterilization of articles—that withstand heat. There are two methods of the sterilization: dry heat and moist heat. (A) Dry Heat: It acts by protein denaturation and oxidative damage. Sterilization by dry heat is as follows:-  (a) Red Heat: Articles such as bacteriological loops, straight wires, tips of forceps and searing spatulas are sterilised by holding them in a Bunsen flame, till they become hot red. (b) Flaming: Articles are passed over a Bunsen flame but not heating it to redness. (c) Incineration: Contaminated, materials are destroyed by burning them in incinerator. (d) Hot Air Oven: Articles are exposed to high temperature (160°C) for duration of one hour in an electrically heated oven (method was introduced by Louis Pasteur). (B) Moist Heat: It acts by coagulation and denaturation of proteins. (i)At Temperature below 100°C:   Pasteurization: This process was originally employed by Louis Pasteur. Currently this procedure is employed in food and dairy industry. There are two methods of pasteurization, the holder method (heated at 63oC for 30 minutes) and flash method (heated at 72oC for 15 seconds) followed by quickly cooling to 13oC. Other pasteurization methods include Ultra-High Temperature (UHT), 140oC for 15 sec and 149oC for 0.5 sec. This method is suitable to destroy most milk borne pathogens like Salmonella, Mycobacterium, Streptococci, Staphylococci and Brucella, however Coxiella may survive pasteurization. Efficacy is tested by phosphatase test and methylene blue test. Vaccine bath:- The contaminating bacteria in a vaccine preparation can be inactivated by heating in a water bath at 60oC for one hour. Only vegetative bacteria are killed and spores survive.  Serum bath:- The contaminating bacteria in a serum preparation can be inactivated by heating in a water bath at 56oC for one hour on several successive days.Proteins in the serum will coagulate at higher temperature. Only vegetative bacteria are killed and spores survive. (ii) At Temperature 100°C:- (a)Boiling:- Boiling water (100C°) kills most vegetative bacteria. (b) Steam at 100°C:- Passing the steam at 100°C over articles kills bacteria. Sugars and gelatin in medium may get decomposed by autoclaving. So, these can be sterilised by exposing them to free steaming for 20 minutes for three successive days. This process is known as tyndallisation (after John Tyndall). (iii)At Temperature above   100°C:- (a) Autoclave:- Sterilization can be effectively achieved at a temperature above 100°C using an autoclave. Structure of Autoclave:- A simple autoclave has vertical or horizontal cylindrical body with a heating element, a per-forted tray to keep the articles, a lid that can be fastened by screw clamps, a pressure gauge, a safety valve and a discharge tap (Fig. 1). The lid is closed but the discharge tap is kept open and the water is heated. As the water starts boiling the steam drives air out of the discharge tap, when all the air is displaced and steam starts appearing through the discharge tap, the tap is closed. The pressure inside is allowed to rise up to 15 lbs. per square inch. At this pressure the articles are heated for 15 minutes, after which the heating is stopped and the autoclave is allowed to cool. Once the pressure gauge shows the pressure equal to  atmospheric pressure, the discharged tap is opened to let the air in. The lidis opened and articles are removed. Culture media, dressing, certain equipment’s can be sterilised by autoclave. (iii) Sonic and Ultrasonic Vibrations- Sound waves of frequency 720,000 cycle/second kills bacteria and some viruses exposing for one hour. (iv) Radiation:- Two types of rays are used for sterilization: Non-ionizing and ionizing. (a) Non-Ionizing Rays:- These are low-energy rays with poor penetrative power, e.g., U.V. rays (wavelength 200-280 nms, effective 260 nm). (b) Ionizing Rays:- These are high-energy rays with good penetration power. These are of two types:- Particulate and electromagnetic.Electron beams are particulate while gamma rays are electromagnetic in nature. High speed electrons are produced by a linear accelerator from a heated cathode.Electromagnetic rays such as gamma rays emanate from nuclear disintegration of certain radioactive isotopes (Co60, Cs137). A degree of 2.5 megabrands of electromagnetic rays kills all bacteria, fungi, virus and spores. In some parts of Europe, fruits and vegetable are irradiated to increase their shelf life up to 500 percent. Since radiation does not generate heat, it is called Cold sterilization.  Chemical Methods of Sterilization: Chemicals destroy pathogenic bacteria from inanimatesurfaces and are all also called disinfectants. Liquid:- Alcohols:- E.g., Ethyl alcohol, Isopropyl alcohol and methyl alcohol.  (A 70% solution kills bacteria). Aldehydeles: E.g.,Fomaldehyele,Gluteraldehydele(40% formaldehyde is used for surface disinfection). Phenol:- E.g., 50% phenol, 1-5%cresol, 5% lysol, chloroxylenol (Dettol). Halogens: E.g.,chlorine compounds (chlorine bleach, hydrochloride) and iodine compounds (tincture, iodine, iodophores). Tincture ofiodine (2% iodine in 70% alcohol) is antiseptic. Heavy metals:- E.g., Mercuric chloride, silver nitrate, copper sulfate, organic mercuric salts. Surface active agents: e.g., soaps or detergents. Dyes:- Acridin dyes e.g., acriflavin and aminacrine are bactericidal (interact with bacterial nucleic acids). Gaseous: E.g.Ethylene oxide, formaldehyde gas, highly effective, killing of spores. Physiochemical Methods of Sterilization: A physiochemical method adapts both physical and