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Background & objectives: Data from the National Clinical Registry for COVID-19 (NCRC) were analyzed with an aim to describe the clinical characteristics, course and outcomes of patients hospitalized with COVID-19 in the third wave of the pandemic and compare them with patients admitted earlier. Methods: The NCRC, launched in September 2020, is a multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized COVID-19 patients were captured in an electronic data portal from 38 hospitals across India. Patients enrolled during December 16, 2021 to January 17, 2022 were considered representative of the third wave of COVID-19 and compared with those registered during November 15 to December 15, 2021, representative of the tail end of the second wave. Results: Between November 15, 2021 and January 17, 2022, 3230 patients were recruited in NCRC. Patients admitted in the third wave were significantly younger than those admitted earlier (46.7±20.5 vs. 54.6±18 yr). The patients admitted in the third wave had a lower requirement of drugs including steroids, interleukin (IL)-6 inhibitors and remdesivir as well as lower oxygen supplementation and mechanical ventilation. They had improved hospital outcomes with significantly lower in-hospital mortality (11.2 vs. 15.1%). The outcomes were better among the fully vaccinated when compared to the unvaccinated or partially vaccinated.Interpretation & conclusions: The pattern of illness and outcomes were observed to be different in the third wave compared to the last wave. Hospitalized patients were younger with fewer comorbidities, decreased symptoms and improved outcomes, with fully vaccinated patients faring better than the unvaccinated and partially vaccinated ones.
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Abstract Introduction Auditory neuropathy spectrum disorder (ANSD) features the presence of otoacoustic emissions, poor speech identification score and absent auditory brainstem response. Objective The present study was designed to evaluate the functioning of all six semicircular canals in individuals with ANSD and to compare it with those of normalhearing individuals. Methods A total of 50 individuals participated in the present study, in which Group I comprised25normal-hearingindividuals, and GroupII comprised25individualswithANSD. All of the participants underwent case history, pure tone audiometry, immittance, otoacoustic emissions, auditory evoked response and video head impulse test (vHIT). Results The independent sample t-test revealed significantly lower vestibulo-ocular reflex gain values in individuals with ANSD. A presence of 100% corrective refixation saccades was observed in the same group. The Pearson correlation test revealed no significant correlation between vestibulo-ocular reflex (VOR) gain with duration of hearing loss and pure tone thresholds for any of the three orthogonal planes. The chisquared test revealed no association between the VOR gain values and the presence or absence of saccades in any of the semicircular canals (p>0.05). Conclusion Huge percentages of individuals with ANSD have been found to have associated vestibular dysfunction as well. Therefore, the vHIT can be used as one of the important tests of the vestibular test battery to evaluate all six semicircular canals in individuals with ANSD.
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Background: Chikungunya virus, an alphavirus belonging tothe Togaviridae family, caused large scale outbreaks in severalparts of southern, western and eastern India in 2006. Wereport Chikungunya outbreak in Jamshedpur region in 2011.Objective: To know the seroprevalence and seasonal trendsof Chikungunya infection among the patients of the diseasewho attended to MGM Medical College, Jamshedpur, A tertiarycare hospital during 2011 to 2014.Materials & Methods: Present retrospective observationalstudies were conducted in the Microbiology Department ofMahatma Gandhi Medical College, Jamshedpur from August2011 to December 2014.Result: Serum samples of 323 patients presenting with fever,arthralgia, rash etc. were tested for anti-Chikungunya IgMantibody using MAC ELISA. 148/324 (47.9%) samples werepositive for anti Chikungunya IgM antibody. More males wereaffected compared to females. The most common age groupaffected was 29-49 year. Characteristically, pediatrics agegroup was least affected. The number of cases increased withincreasing age group.Conclusion: Screening for Chikungunya infection in theendemic areas, especially in monsoon season would improvethe quality of arboviral surveillance and potentially aid in clinicalmanagement of the disease.
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Background: Japanese Encephalitis is one of the mostimportant causes of viral encephalitis worldwide, with anestimated 50,000 cases and 15,000 deaths annually. Thepresent study was undertaken to investigate theSeroprevalence and Seasonal Trend of Japanese Encephalitisin Jamshedpur.Methods: It was a hospital-based retrospective studyconducted from August 2011 to December 2017. A total of 571consecutive non-repetitive patients, satisfying the clinical casedefinition of JE as per the WHO guidelines, were included inthe study. Cerebrospinal fluid (CSF) and serum samples weretested for JEV-specific IgM antibodies by the NIV JE IgMCapture ELISA Kit.Results: Out of which 166/571 (29.07%) were JE positivediagnosed by IgM Mac ELISA antibody kit. We have observedthat in a period of six years, the JE positivity rate hassignificantly reduced from 39.84% in 2011 to 7.29% in 2017.Conclusions: A declining trend of JE was seen in this study,however further research work needs to be done to lookfor non-JE causes of JE. Surveillance & effective vaccinationshould be carried out regularly for early detection of animpending outbreak and to initiate timely preventive and controlmeasures.
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Background: Dengue fever and Dengue Haemorrhagic feveris an acute viral disease caused by Dengue virus. The infectionis transmitted by female mosquito- Aedes aegypti. The presentstudy was undertaken to investigate the trend of Dengue andthe seasonal effect associated with it. During late August 2010,outbreak of dengue symptomatic patients was admitted toMGM Medical college hospital Jamshedpur. ELISA for antidengue antibodies confirmed the case as Dengue.Objective: This retrospective study was done to analyze thecirculating dengue virus seroprevalence and seasonal trendamong the patients of the disease who attended to MGMMedical College, Jamshedpur, A tertiary care hospital during2010 to 2015.Methods: It was a hospital-based retrospective studyconducted from September 2010 to December 2015. A total of342 consecutive non-repetitive patients, satisfying the clinicalcase definition of Dengue as per the WHO guidelines, wereincluded in the study. Serum samples were tested for Denguespecific IgM antibodies by NIV Dengue IgM Capture ELISA Kit.Results: Of the 342 patients attended, 110(32.16%) caseswere positive for Dengue IgM antibodies. There was asignificant reduction in the Dengue positivity rate from 31% in2010 to no cases in 2015. The majority of cases occurredduring the monsoon and post-monsoon season.Conclusions: A declining trend of Dengue was seen in thisstudy, however further research work needs to be done to lookfor non-Dengue causes of Dengue fever. Surveillance shouldbe carried out regularly for early detection of an impendingoutbreak and to initiate timely preventive and controlmeasures.
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Chronic obstructive pulmonary disease (COPD) is a group of symptoms, which defined as persistent airflow limitation due to alveolar and airway abnormality which caused by chronic inflammation of airway and lung parenchyma. It is stated that it has leading cause of mortality and morbidity. It is projected to rank third among all causes of death by 2020. It has complex pathology with marked heterogeneity all over India. Now days it is markedly increasing in India due to biomass, occupational and household exposures. COPD leads to variety of intra and extra-pulmonary component and considerable effect of public health incidence are increasing in India mainly Uttar Pradesh and Bihar due to increase dependence to biomass and conventional exposure to noxious agents (Smoke, Biomass fuel, Dust particles).
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BACKGROUND: Valsalva maneuver reduces pain by activating sinoaortic baroreceptor reflex arc. We planned this study to evaluate the role of valsalva in attenuating spinal needle-puncture pain. METHODS: Ninety American Society of Anesthesiologists (ASA) grade I and II enrolled patients undergoing elective surgery were randomized into 3 groups of 30 each. Group I (Control): didn't blow; group II (Distraction): patients blew into rubber tube; Group III (Valsalva): blew into sphygmomanometer tube and raise mercury column up to 30 mmHg for at least 20 seconds. During above procedures, spinal puncture was performed with 25-gauge spinal needle. RESULTS: Eighty-two patient data were analyzed. Incidence of spinal puncture pain was reduced to 10% (3 of 27) in Valsalva group as compared to 100% (28 of 28 in control group and 27 of 27 in Distraction group) observed in other two groups (P 0.05). None patient of all groups had post dural puncture headache (P > 0.05). CONCLUSIONS: Valsalva can be performed routinely in ASA I and II patients undergoing spinal anesthesia as it is safe, painless and non-pharmacological method of pain attenuation.
Subject(s)
Humans , Anesthesia, Spinal , Baroreflex , Incidence , Needles , Post-Dural Puncture Headache , Punctures , Rubber , Skin , Sphygmomanometers , Spinal Puncture , Valsalva Maneuver , Visual Analog ScaleABSTRACT
Adansonia digitata L. (Malvaceae) is commonly known as baobab tree native to Africa. Baobab is a multi-purpose tree which offers protection and provides food, clothing and medicine as well as raw material for many useful items. The fruit pulp, seeds, leaves, flowers, roots, and bark of baobab are edible and they have been studied by scientists for their useful properties. The fruit pulp have very high vitamin C, calcium, phosphorus, carbohydrates, fibers, potassium, proteins and lipids content, which can be used in seasoning as an appetizer and also make juices. Seeds contain appreciable quantities of phosphorus, magnesium, zinc, sodium, iron, manganese, whereas they have high levels of lysine, thiamine, calcium and iron. Baobab has numerous biological properties including antimicrobial, anti-malarial, diarrhoea, anaemia, asthma, antiviral, anti-oxidant and anti-inflammatory activities amongst others. Phytochemical investigation revealed the presence of flavonoids, phytosterols, amino acids, fatty acids, vitamins and minerals. The review summarizes the information on various aspects of traditional information, taxonomic description, medicinal properties and importantly nutritional value.
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Treatment of bovine mastitis caused by Staphylococcus (S.) aureus is becoming very difficult due to the emergence of multidrug-resistant strains. Hence, the search for novel therapeutic alternatives has become of great importance. Consequently, bacteriophages and their endolysins have been identified as potential therapeutic alternatives to antibiotic therapy against S. aureus. In the present study, the gene encoding lysin (LysSA4) in S. aureus phage SA4 was cloned and the nucleotide sequence was determined. Sequence analysis of the recombinant clone revealed a single 802-bp open reading frame encoding a partial protein with a calculated mass of 30 kDa. Results of this analysis also indicated that the LysSA4 sequence shared a high homology with endolysin of the GH15 phage and other reported phages. The LysSA4 gene of the SA4 phage was subsequently expressed in Escherichia coli. Recombinant LysSA4 induced the lysis of host bacteria in a spot inoculation test, indicating that the protein was expressed and functionally active. Furthermore, recombinant lysin was found to have lytic activity, albeit a low level, against mastitogenic Staphylococcus isolates of bovine origin. Data from the current study can be used to develop therapeutic tools for treating diseases caused by drug-resistant S. aureus strains.
Subject(s)
Animals , Base Sequence , Cloning, Molecular , Gene Expression Regulation, Viral/physiology , Mucoproteins/genetics , Phylogeny , Polymerase Chain Reaction/methods , Recombinant Proteins , Staphylococcus Phages/genetics , Staphylococcus aureus/virologyABSTRACT
A large number of potentially pathogenic non-tuberculous mycobacteria [NTM] encountered in the clinical laboratory makes it necessary to identify their species to ensure appropriate treatment. However, labor-intensive conventional methods of speciation are not used in every laboratory, and hence NTM infections are often ignored. Polymerase chain reaction [PCR] restriction analysis [PRA] was applied in this study for early identification and speciation of mycobacterial species on 306 cultures of acid-fast bacilli isolated from patients suspected of suffering from tuberculosis. Mycobacterium tuberculosis was identified in 85.6% of the isolates. The NTM isolated most commonly was Mycobacterium kansasii/gastri group [3.5%], followed by Mycobacterium fortuitum [3.2%]. Four of the M. fortuitum were grown from cultures obtained on the same day, but from samples from different patients and were probably laboratory contaminants. Mycobacterium intracellulare and Mycobacterium avium were identified in 2.94% and 2.28% of the isolates, respectively. Three isolates of M. avium and two isolates of M. intracellulare were obtained in repeated cultures from sputum samples of the same patients and were thus pathogenic. A single isolate of Mycobacterium abscessus was obtained from a breast abscess. A rare pathogen Mycobacterium phocaicum was isolated from one patient with epididymitis. However, whether it was the causative agent of epididymitis in this patient remains doubtful. The results of this study highlight the importance of speciation of mycobacteria for appropriate diagnosis and the importance of including molecular assays to augment conventional methods of diagnosis of mycobacterial diseases for rapid identification of NTM so that these potential pathogens are not overlooked in routine diagnostic procedures.
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The International Health Regulations (IHR 1969), replaced by IHR 2005 had been adopted by the World Health Assembly on 23 May 2005 and came into force on 15 June 2007. IHR 2005 are a legally binding agreement among World Health Organisation (WHO) member states and other states that have agreed to be bound by them. New revision was necessitated by concerns about increasing global health threats and the need to respond with more effective surveillance and control practices. The limitations of IHR 1969, which led to their revision, related to their narrow scope, their dependence on official country notifications, and their lack of a formal internationally coordinated mechanism to contain international disease spread. The IHR 2005, which is firmly based on practical experiences, has broaden the scope of IHR 1969 to cover existing, new and re-emerging diseases, including emergencies caused by non-infectious disease agents.