Analysis of Clinical Characteristics and Outcome of Pulmonary Thromboembolism in a Tertiary Care Hospital

Introduction: Pulmonary embolism is a potentially lethalcondition that is frequently underdiagnosed. The severityand clinical presentation of PE are variable, hence clinchingthe correct diagnosis is difficult. Prompt diagnosis of PE isessential to reduce morbidity and mortality. Current researchaimed to study the clinical characteristics, risk factors andclinical outcomes of patients diagnosed with pulmonarythromboembolism.Material and Methods: In this retrospective study data werecollected from baseline clinical characteristics, presentingsigns and symptoms, results of echocardiography and imagingstudies, therapeutic modality and in-hospital course.Results: 52 cases of Pulmonary embolism were reportedwith an incidence of 0.33%. Male predominance (58%) wasnoted. Associated comorbid conditions like HT was presentin 24 patients and DM was present in15 patients. The mostcommon symptom at presentation was dyspnea (31 patients).The overall mortality rate was 3.8% (2 patients).Conclusion: The outcome of PE is improving; however, itremains an important risk factor for mortality in hospitalizedpatients.

Knowledge and beliefs of parents of asthmatic children presenting to the outpatient department in Kovai medical centre and hospital, Tamil Nadu, India

Background: Childhood asthma has a major impact on a child's quality of life and that of their parents. To assess the level of understanding and beliefs by parents of asthmatic children about causation, pathophysiology, treatment, and prognosis.Methods: The study was conducted in Kovai medical centre and hospital Coimbatore in 2017. Totally 101 asthmatic children were included in the study. Asthmatic children aged 6 years to 15 years. A total of 101 parents participated in this study. The sex and age of the informant, mother's literacy and mother's occupation were noted. The socio-economic status of the family was computed using modified Kuppuswamy scale 2016.Results: In present study among the 101 children, 38.61% are in the school age (5-8 years), 38.61% are in the tweens (9-12 years) and 22.78% are teenagers. 45.54% of the children are from the rural area. Half of the children are experiencing the disease for more than 6 years now, the other half less than 6 years. 5.94% of the parents interviewed were not aware of the diagnosis. 71.29% thought that asthma is a hereditary condition.Conclusions: A wide gap exists between recommendations and the actual practice. Hence by improving parents' knowledge about asthma, their attitude and practice can be positively affected.

Optimisation and analysis of polymerase chain reaction based DNA sequencing for genotyping polyoma virus in renal transplant patients: A report from South India.

Purpose: To optimise a polymerase chain reaction (PCR) based DNA sequencing technique for genotyping polyoma virus in clinical specimens obtained from renal transplant patients. Materials and Methods: A hundred and thirty (106 peripheral blood and 24 urine) clinical specimens collected from renal transplant patients were included in the study for detecting the presence of DNA of BK virus (BKV), JC virus (JCV) by PCR targeting the viral protein 1 (VP1) gene. PCR based DNA sequencing was performed to determine the genotypes of polyoma virus and subjected to bioinformatics analysis to determine the amino acid sequences and screen for mutations in the VP1 gene. Results: Polyoma virus was detected in 23 (17.69%) specimens of which 19 (82.60%) were positive for BK virus, 3 (13.04%) for JC virus and 1 for both BK and JC virus. PCR based DNA sequencing detected BK virus genotype I in 12 (50%), genotype IV in 8 (33.3%) and JC virus in 4 (16.6%) clinical specimens. BKV genotype I was the predominant genotype (64.2% in peripheral blood and 33.33% in urine) prevalent in south India. Six novel mutations were found – at position 29, 30 to 47 of BKV genotype I; at position 11 and 15 of BKV genotype IV and at position 2 and 30 of JCV. Conclusion: BKV genotype I is the prominent genotype in India and novel mutations detected in the VP1 gene of BKV and JCV are being reported for the fi rst time in literature.

First case series of emerging Rickettsial neonatal sepsis identified by polymerase chain reaction-based deoxyribonucleic acid sequencing.

Purpose: To detect and identify the aetiological agent in the peripheral blood from the cases of neonatal sepsis. Materials and Methods: Four neonates from geographically different regions of South India presented with signs of neonatal sepsis and all the routine clinical and laboratory investigations were performed. Blood culture by Bac T Alert 3D was negative. To establish the aetiology, polymerase chain reaction (PCR) for eubacterial genome and subsequent amplifi cation with Gram positive and Gram negative primers were performed followed by deoxyribonucleic acid (DNA) sequencing. Results: PCR for the detection of eubacterial genome was positive in all the four neonates and further amplifi cation with designed Gram positive and Gram negative primers revealed the presence of Gram negative bacteria. The amplicons were identifi ed as Orientia tsutsugamushi in three neonates and Coxiella burnetti in the other neonate. Multalin analysis was done to further characterise the strain variation among the three strains. Conclusion: PCR-based DNA sequencing is a rapid and reliable diagnostic tool to identify the aetiological agents of neonatal sepsis. This is the fi rst case series of emerging Rickettsial neonatal sepsis in India.