ABSTRACT
Context: Dengue virus (DENV) causes acute febrile illness in tropical and subtropical countries. In India there is a steady increase in incidence since 1950s which could be attributed to emergence of new serotype or lineage\clade shifts in circulating DENV. Aims: We aimed to perform molecular characterisation and phylogenetic analysis on samples from the recent outbreak (August–October 2017). Settings and Design: Retrospective epidemiological analysis of dengue outbreak. Subjects and Methods: Samples positive for non-steroidal 1 antigen by enzyme-linked immunosorbent assay (n = 147) were included. The study was approved by our institute ethics committee (JIP/IEC/2018/496). Five hundred and eleven base pair of capsid and pre-membrane encoding genes (CprM) region was amplified using Lanciotti primers, followed by second round of polymerase chain reaction using serotype specific primers. Samples which were positive by second round (n = 68) were sequenced and genotyped using Basic Local Alignment Search Tool analysis and phylogenetic tree was constructed by MEGA7 software. Results: Phylogenetic analysis of CprM sequences identified all 4 serotypes in circulation during this outbreak. We observed both single (n = 50) and concurrent infections (n = 18), with DENV4 as the major contributor (64%). Within Genotype I of DENV4 we observed a distinct new clade (Clade E) which was 2.6% ± 0.9%–5.5% ± 1.1% divergent from the other clades. Among the concurrent infection, DENV 4 and DENV 2 combination was observed to form the majority (77.8%). Conclusions: Overall this study documents the emergence of DENV4 as the major serotype in circulation, replacing DENV1, 2 and 3 which had been previously reported from Tamil Nadu and Puducherry. This substantiates the need for continuous monitoring in endemic countries like India, where such data may impact the formulation of vaccine policy for dengue.
ABSTRACT
The purpose of this study was to develop a short tool for the assessment of home environment and psychosocial development of preschool children, based on the data collected on a sample of one hundred and fifty children in the age range of 2 years 10 months to 3 years 8 months. Co-relation analysis was used in identifying home environment and psychosocial development variables for the development of the tool.
Subject(s)
Adaptation, Psychological , Child Development , Child, Preschool , Developing Countries , Humans , India , Male , Neuropsychological Tests/statistics & numerical data , Personality Assessment/statistics & numerical data , Psychometrics , Rural Population , Social Adjustment , Social Environment , Urban PopulationABSTRACT
Thirty nine patients with neuroparalytic accidents due to the use of Semple-type antirabies vaccine were studied. The mean age of the patients was 25.8 +/- 13.2 years. The suspected source of infection was the bite of a dog in 36 (92.3%) cases. The mean interval between the first dose of ARV and the onset of neurological deficits was 14.4 +/- 8.7 days. The number of doses was 7 or less in 28 (71.8%) and more than 7 in 11 (28.2%) cases. With regard to neurological deficits, 5 (12.8%) had encephalopathy, 1 (2.6%) had encephalomyeloradiculopathy, 12 (30.7%) had cervical myeloradiculopathy, 4 (10.3%) had dorsolumbar myeloradiculopathy and 17 (43.6%) had polyradiculopathy. Lumbar cerebrospinal fluid analysis was done in 31 (79.5%) cases and was abnormal in 15 (48.4%), in the form of pleocytosis or raised protein or both. Electroencephalogram was done in 24 (61.5) cases and was abnormal in 7 (29.2%); in 6 (85.7%) of theme the abnormalities were subclinical. Electroneuromyography was done in 15 (38.5%) patients and was abnormal in 13 (72.2%). Visual evoked potentials were studied in 11 (28.2%) cases and were abnormal in 2 (18.2%). Thirty six (92.3%) cases received steroids and 25 (64.1%) received cyclophosphamide in addition. The therapeutic results were better in those who received cyclophosphamide. Three patients died; One died due to respiratory failure and two due to unrelated causes while on respirator. The latter two were autopsied, and findings in the brain were unremarkable.