ABSTRACT
Background & objectives: Serosurvey of COVID-19 provides a better estimation of people who have developed antibodies against the infection. Undertaking such a serosurvey in certain districts of India which are densely populated with prominent tribes can provide valuable information regarding seropravelance of SARS-CoV-2 antibodies among such indigenous populations. In this context, two rounds of population-based, cross-sectional serosurveys for SARS-CoV-2 IgG antibody were carried out in Jharkhand, a tribal-dominated State of India, to compare the seroprevalence of SARS-CoV-2 infection and to determine the associated demographic risk factors. Methods: The surveys were carried out in June 2020 and February 2021 in ten districts of the State of Jharkhand. Blood samples were collected from the residents of the selected districts by random sampling and tested for anti-SARS-CoV-2 antibodies using an automated chemiluminescence immunoassay platform. A total of 4761 and 3855 eligible participants were included in round 1 and round 2, respectively. Results: The age- and gender-standardized seroprevalence for COVID-19 during round 1 was 0.54 per cent (0.36-0.80) that increased to 41.69 per cent (40.16-43.22) during round 2 with a gap of eight months in between. The seropositivity among male and female participants was 0.73 and 0.45 per cent, respectively, during the first round and 51.35 and 33.70 per cent, respectively, during the second round. During the first round, 17.37 per cent of the participants were tribal with seropositivity of 0.24 per cent (0.02-0.87), and during the second round, 21.14 per cent were tribal with seropositivity of 39.14 per cent (35.77-42.59). Compared to tribal group, non-tribal participants had an adjusted odds of 1.24 (95% confidence interval=1.04-1.48) for SARS-CoV-2 seropositivity. Interpretation & conclusions: COVID-19 seroprevalence was found to be low during the first round (0.54%) of the survey, possibly due to the travel restrictions during lockdown better adherence to social distancing and wearing of face masks among the people. Understanding the dynamics of SARS-CoV-2 transmission and the susceptibility to infection at the individual as well as community level will inform decision and help policy makers to design and implement effective public health strategies to mitigate the pandemic in this State.
ABSTRACT
Purpose: To elucidate the clinico?epidemiologic characteristics of optic neuritis based on the status of serum aquaporin?4 antibody (AQP4?Ab) in patients with optic neuritis (ON). Methods: Medical records of 106 patients with ON and a follow?up of 3 years were reviewed. For each patient, the following data were extracted: medical history, findings of the ocular examination, brain, orbital or spinal MRI, and serological tests for AQP4. The ON was classified as typical or atypical based on disc examination and improvement in vision after intravenous methylprednisolone (IVMP). The clinical findings (typical or atypical), disease course, and outcomes were analyzed according to the serostatus of the ON. Results: 10 patients ((9.4%) were seropositive for AQP4?Ab; all had atypical ON. 96 patients (91%) were seronegative for AQP4?Ab: 36 atypical ON and 60 typical ON. Profound visual impairment at presentation was seen in all patients. However, at the end of the study period, seropositive and seronegative atypical ON had poor visual outcomes as compared to seronegative typical ON (P = 0.002). Five seropositive and four seronegative patients with atypical ON developed transverse myelitis. Bilateral disease with relapse was more in seropositive patients (80%); however, seronegative with atypical ON also had bilateral presentation and relapse in 42% and 41%, respectively. Conclusion: AQP4?Ab seropositive patients mostly present with atypical features such as bilateral recurrent ON, poor visual outcome, and increased incidence of transverse myelitis. However, atypical clinical features can also be seen in seronegative ON with a poor visual outcome and a recalcitrant course.
ABSTRACT
Remitting seronegative symmetrical synovitis with pitting edema(RS3PE),the inflammatory arthritis attacking mainly elderly males,is characterized by symmetrical synovitis with pitting edema of the dorsum of hands and feet and the absence of rheumatoid factor.RS3PE commonly accompanies malignant tumor,infections and other diseases.Here we report a case of RS3PE associated with lung malignancy and review other six cases to summarize the clinical features,treatment and prognosis.
Subject(s)
Aged , Humans , Male , Edema/etiology , Lung Neoplasms/complications , Syndrome , Synovitis/drug therapyABSTRACT
We aimed to emphasise the role of screening beyond conventional serological markers (HBsAg and Anti HCV antibodies for chronic viral hepatitis B and C respectively) in patients with cirrhosis. Patients with cirrhosis of liver are often labelled as having cryptogenic cirrhosis (CC), if no etiology is found. In chronic viral hepatitis B and C (CHB and CHC) induced cirrhosis, HBsAg and Anti HCV antibodies respectively are usually done to rule out the viral infections however their absence have been documented in subset of patients having these infections. In this regard, we hereby present a case labelled as CC and developed HCC; later on, further evaluation turned out to be having both CHB and CHC. A 51-year-old male with diabetes presented with index episode of hemetemesis. On further evaluation he was diagnosed to have cirrhosis of liver. No etiology was found and he was labeled as cirrhosis secondary to Non-alcoholic steatohepatitis (NASH)/cryptogenic cirrhosis. Later on, he developed hepatocellular carcinoma (HCC). We evaluated the patient with HBV DNA and HCV RNA levels keeping possibility of occult hepatitis B (OBI)/ seronegative hepatitis C infection despite HBsAg and Anti HCV antibodies being negative. Both levels were found to be raised and we attributed cirrhosis to dual hit by CHB and CHC. Patient was managed with antiviral drugs successfully with no recurrence of HCC and control of blood sugar levels. We hereby stress that screening beyond the HBsAg and Anti HCV antibodies should be done in all cases of liver cirrhosis in which etiology is not found on initial screening.
ABSTRACT
Background: Celiac disease (CD) is a genetically determined gluten-sensitive enteropathy resulting in nutrient malabsorption, can have extra gastrointestinal tract (GIT) presentations, short stature may be the only presenting clinical feature, even in the absence of gastrointestinal symptoms. The aim and objective of this study was toMethods: This cross-sectional study was performed on 1000 children between ages 5 to 10 year of different schools, in Jaipur, district of Rajasthan. An anthropometric measurement (height, weight) was done for all children. Serum samples were analyze for IgA antibodies to human tissue transglutaminase (tTG) with lower detection limit of 1.0 U/ml and 15 U/ml. Positive samples for tTG antibodies were reanalyzed human endomysial autoantigens (EmA).Results: Out 1000 children screened, six were seropositive, of those four were females and two were males. The serological proportion of CD in this population was 1:166. These Six seropositive group tends to have lower height, weight than the seronegative group, but the difference was only significant for height (P=<0.01).Conclusions: Although gastrointestinal manifestations are important presentation of celiac disease, nevertheless short stature alone or in combination with other symptoms of celiac disease has been present.
ABSTRACT
Aim of the study. To characterize clinical features and quality of life in patients with acute anterior uveitis (AAU) associated with seronegative spondyloarthropathies (SpA). Material and Methods. 68 SpA patients with or without AAU were included in the prospective clinical study. VF-14 questionnaire, macula OCT, lens opacities using LOCS III were assessed. Results. Macula was thicker in uveitic (279.31 (53.64) μm) compared to fellow eyes (261.52 (43.714) μm), p<0.05. More patients without AAU were treated with methotrexate, p<0.05. VF-14 values differed between LOCS III grade P1 (93.29 (11.21)) and P3 (80.36 (8.18)); C1 (92.79 (11.79)) and C2 (85.92 (17.17)) and C3 (74.05 (11.89)); NO1 (92.06 (14.17)) and NO3 (84.82 (9.22) scores), p<0.05. Conclusions. Maculae thickness in uveitic eyes was increased. More patients without AAU were treated with methotrexate. VF-14 scores were lower for patients with higher LOCS III grade and recurrent AAU.
ABSTRACT
Objective:To observe the clinical efficacy of aspirin combined with modified Yupingfeng San on patients with recurrent spontaneous abortion and Seronegative antiphospholipid syndrome. Method:From December 2016 to March 2018, 109 cases of recurrent spontaneous abortion patients with seronegative antiphospholipid syndrome in Affiliated Hospital of Nanjing University of Chinese Medicine were selected as the study objects. According to the random number table, they were divided into three groups:blank group, control group and study group. The blank group was treated with folic acid tablets, 1 pill/time, qd, as placebo, the control group was treated with folic acid tablets, 1 pill/time, qd, Danshen pills, 4 pills/time, tid, and aspirin, 1 pill/time, tid, and the study group was treated with folic acid tablets, 1 pill/time, qd, aspirin, 1 pill/time, tid, and modified Yupingfeng San, 150 mL/time, bid. These patients were all asked for pregnancy preparation for 1 year and treated with aspirin, 1 pill/time, tid, and progesterone pills, 1 pill/time, tid, since the beginning of pregnancy until 13 weeks or abortion. The pregnancy rate, miscarriage rate, coagulation index before and after treatment, traditional Chinese medicine (TCM) symptom score as well as months of abortion were all observed and compared. Result:The coagulation index and TCM symptom score of the study group were significantly lower than those before treatment (PPPPPConclusion:The data proved that the combination of anti-coagulation medicine with either single herb or herbal compound can improve the curative effect of the patients, and traditional Chinese herbal compound can regulate the immune system, reduce the thrombosis and improve the symptoms of TCM, which made the curative efficacy more prominent. However, more samples were needed for further research. Because the time of fetal protection may not change the outcome of pregnancy, the therapy should be maintained at least until the end of the early pregnancy.
ABSTRACT
Objective • To investigate diagnostic value of anti-phosphatidylserine/prothrombin antibody (aPS/PT), IgA anti-cardiolipin antibody (aCL), and IgA anti-β2-glycoprotein antibody (aβ2-GPI) in seronegative antiphospholipid (SNAPS). Methods • Serum samples were collected from 86 patients with antiphospholipid (APS) (APS group), 48 patients with SNAPS (SNAPS group), 79 patients with systemic lupus erythematosus (SLE) (SLE group), and 85 healthy donors (healthy control group, HC group) for aPS/PT (IgG and IgM), aCL (IgA) and aβ2-GPI (IgA) detected by ELISA. The sensitivity and specificity of the four antibodies for the diagnosis of SNAPS were calculated, and the ROC curves were analyzed. The correlation between the four antibodies and the clinical manifestations of SNAPS was also analyzed.Results • A total of 25 (52.1%) SNAPS patients were positive in aPS/PT (IgG/IgM), including 29.2% patients positive in aPS/PT (IgG) and 35.4% positive in aPS/PT (IgM). There were 16.7% SNAPS patients positive in aβ2-GPI (IgA), but none was aCL (IgA) positive. The positive rates of aPS/PT (IgG and IgM) and aβ2-GPI (IgA) were statistically higher in SNAPS group than those in HC group (P=0.000). The area under curve (AUC) of aPS/PT (IgG) (AUC=0.753) for SNAPS diagnosis was the biggest among the four antibodies, and the second was aβ2-GPI (IgA) (AUC=0.725). A positive correlation was found in SNAPS group between presence of venous thrombosis and aPS/PT (IgG) (OR=5.54, 95% CI 1.67-17.33, P=0.003) or aβ2-GPI (IgA) (OR=3.43, 95% CI 0.86-11.53, P=0.041), and also found between pregnancy loss and aPS/PT (IgM) (OR=5.11, 95% CI 1.31-21.29, P=0.004). Conclusion • aPS/PT (IgG/IgM) and aβ2-GPI (IgA) can be used as potential complementary indicators for laboratory diagnosis of SNAPS, and aPS/PT (IgG/IgM) is also valuable for clinical evaluation of the risk of thrombosis and pregnancy loss in SNAPS patients.
ABSTRACT
Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome is a rare condition that occurs in elderly individuals. It is characterized by sudden onset of bilateral symmetrical distal tenosynovitis that accompanied by obvious swelling of the hand with pitting edema and absence of rheumatoid factor (RF). This disease entity sometimes presented as overlap syndrome with other rheumatic diseases and needed to be differentiated from those. However, if the diagnosis is confirmed, the response to steroid is good. The purpose of this report is to describe the case of RS3PE syndrome presented with bilateral hand dorsum edema in a middle-aged woman.
Subject(s)
Aged , Female , Humans , Diagnosis , Edema , Hand , Polymyalgia Rheumatica , Rheumatic Diseases , Rheumatoid Factor , Synovitis , TenosynovitisABSTRACT
Resumen: En pediatría, la hepatitis autoinmune y la colangitis esclerosante son patologías de afección hepática cuyo mecanismo de daño es inmunológico. La hepatitis autoinmune es una enfermedad de etiología desconocida, caracterizada por hepatitis de interfase, hipergammaglobulinemia, autoanticuerpos circulantes y una respuesta favorable a la inmunosupresión. Es una enfermedad eminentemente pediátrica, con una afección prevalente hacia mujeres jóvenes. La terapia debe ser instituida con prontitud para prevenir el deterioro rápido, promover la remisión de la enfermedad y la supervivencia a largo plazo. La falta persistente de respuesta o la falta de adherencia al tratamiento dan como resultado una enfermedad hepática terminal. Los pacientes que desarrollan esta patología, y aquellos con insuficiencia hepática fulminante en el momento del diagnóstico, requerirán trasplante hepático.
Abstract: In pediatrics, autoimmune hepatitis and sclerosing cholangitis are liver disorders with an immunological damage mechanism. Autoimmune hepatitis is a disease of unknown etiology characterized by interface hepatitis, hypergammaglobulinemia, circulating autoantibodies and a favorable response to immunosuppression. It is an eminently pediatric disease with a prevalent condition in young women. Therapy should be instituted promptly to prevent rapid deterioration, promote remission of disease and long-term survival. The persistent lack of response or lack of adherence to treatment results in terminal liver failure; these patients, and those with fulminant hepatic insufficiency at the time of diagnosis, will require liver transplantation.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Liver Failure, Acute/etiology , Hepatitis, Autoimmune/epidemiology , Immunosuppressive Agents/therapeutic use , Autoantibodies/immunology , Liver Transplantation/methods , Patient Compliance , Liver Failure, Acute/therapy , Hepatitis, Autoimmune/immunology , Hepatitis, Autoimmune/therapyABSTRACT
Background: Blood transfusion safety commences with healthy donor recruitment. The threat of transfusion transmitted infections is greatly minimized by serological tools but not entirely eliminated. Recently, nucleic-acid testing for blood donor screening has virtually eliminated this jeopardy. Methods: This prospective study was conducted from February 2015 to February 2016. Samples from seronegative donors were run on multiplex assay (Cobas, S-201 system platform, Roche) in a batch of six [MP-NAT]. In case of reactive pool, tests were run on every individual sample [IDNAT]. Results: Of 16957 donors, 16836 (99.2%) were replacement donors and the remaining 121 (0.7%) were voluntary donors, with a mean age of 29.09 ± 7.04 years. After serologic screening of all 16957 donors, 955 (5.6%) were found to be reactive; 291(1.71%) were reactive for hepatitis-B surface antigen, 361 (2.12%) for antibody to hepatitis C virus (anti-HCV), 14 (0.08%) for antibody to human immunodeficiency virus, 287 (1.69%) for syphilis and 2 (0.01%) for malaria. 14 (0.08%) NAT reactive donors were identified after testing the 16002 seronegative donors, with an overall NAT yield of one reactivity out of 1143 blood donations; 10 donors for HBV-DNA (HBV NAT yield-1:1600) and remaining 4 for HCV-RNA (HCV-NAT yield-1:4000). None were HIV positive. Conclusion: NAT has improved the safety attributes in blood products. Although the positivity rate for NAT testing is low but in view of the high prevalence of transfusion transmitted infections in our country, we recommend the parallel use of both serology and NAT screening of all donated blood.
ABSTRACT
The seronegative spondyloarthropathies are a heterogenous groups of inflammatory diseases which may present with sacroilitis, inflammatory arthritis, spondylitis and enthesitis, as well as extra-articular manifestations of inflammation most commonly involving the eye, skin and gastrointestinal tract. There is a familial preponderance to these conditions, and an association with the HLA-B27 gene. The new ASAS classification system for these conditions aims to classify patients into 2 broad categories based on the predominant site of their symptoms. The diagnosis of early spondyloarthropathy relies on a detailed history and physical examination as radiographic changes occur late, and blood work-up may be normal. Management of these chronic diseases requires a holistic multidisciplinary approach with both pharmacological and non-pharmacological interventions in recent years, many newer therapies, especially biologic agents have become available for treatment of these conditions.
ABSTRACT
ABSTRACT:Objective To investigate the clinical features of seronegative rheumatoid arthritis (RA)in western China and its outcomes after one-year treatment with disease modifying anti-rheumatoid drugs (DMARDs) so as to provide evidence for effective therapy.Methods We made a retrospective analysis of 240 RA patients treated in our department from May 2013 to June 2014.We compared the 47 seropositive and 25 seronegative RA patients in clinical features,laboratory parameters and outcomes after one-year DMARDs medication.Results The percentage of seronegative RA was 10.4% (25/240).The number of swollen small joints was significantly smaller in seronegative RA group (P<0 .0 1 ).Compared with those in seropositive RA,the level of hemoglobin was lower,the level of platelets was higher,and the level of alkaline phosphatase was lower in seronegative RA (P<0 .0 5 ).The remission rate was higher in seronegative RA group than in seropositive RA group after one-year DMARDs administration (P<0.05).Conclusion Seronegative RA is not rare in clinic.Even though seronegative RA patients often present fewer swollen small joints, it is difficult to distinguish between seronegative and seropositve RA just based on the clinical features.Besides,hematological damage is more severe in some patients with seronegative RA.Only after one-year treatment with DMARDs,the remission rate is higher in seronegative RA patients than in seropositve RA ones.
ABSTRACT
La criptocococis meníngea es la infección fúngica más frecuente del sistema nervioso central; generalmente se presenta en pacientes VIH seropositivos, aunque existe una proporción considerable de paciente VIH seronegativos, siendo en estos casos su presentación más agresiva. Esta infección tiene manifestaciones neurológicas variables que son secundarias al aumento de la presión intracraneal. La ventriculitis con hidrocefalia secundaria es una de las complicaciones de mayor morbi-mortalidad especialmente en pacientes VIH seronegativos. Presentamos un reporte de caso de criptocococis meníngea género Neoformans subtipo Grubbi con ventriculitis e hidrocefalia secundaria en paciente VIH seronegativo confirmado por histopatología.
Meningeal criptocococis is the most common fungal infection of the central nervous system, occuring in HIV seropositive patients, although there is a significant proportion of HIV seronegative patients, in whom the presentation is more aggresive. This infection has variable clinical manifestations secondary to increased intracranial pressure. Ventriculitis with hydrocephalus is one of the complications with the poorest outcome and mortality especially in HIV seronegative patients. We present a case report of meningeal criptocococis Neoformans subtype Grubbi with ventriculitis and secondary hydrocephalus in HIV seronegative patient confirmed by histopathology.
Subject(s)
HIV Seronegativity , Cryptococcosis , Cerebral Ventriculitis , HydrocephalusABSTRACT
No abstract available.
Subject(s)
Arthritis, Rheumatoid , Headache , Post-Traumatic HeadacheABSTRACT
Seronegative arthropathies or spondyloarthropathy belong to a group of diseases that share clinical and genetic characteristics associated strongly with major histocompatibility complex class I HLA-B27. We report a case of a female patient of 39 years old with nightly back pain, morning stiffness and diffuse lumbar pain in the right buttock. In the immunological study observed negative rheumatoid factor and radiographic study observed right sacroiliitis. The final diagnosis is an enteric spondyloarthropathy...
Las artropatías seronegativas o espondiloartropatías corresponden a un grupo de enfermedades que comparten características clínicas y genéticas, asociadas fuertemente con el complejo mayor de histocompatibilidad clase I HLA-B27. Se presenta el caso de una paciente de 39 años con dolor lumbar nocturno, rigidez matutina lumbar y dolor difuso en la región glútea derecha.En el estudio inmunológico se observa factor reumatoídeo negativo, y al estudio radiológico se constata sacroileítis derecha. El diagnóstico final es una espondiloartropatía entérica...
Subject(s)
Humans , Adult , Female , Spondylarthropathies/complications , Spondylarthropathies/diagnosis , Arthritis, Reactive , Enteritis , Spondylarthropathies/therapy , Spondylitis, AnkylosingABSTRACT
Objective To identify proteomic biomarkers in serum samples and to construct a pro-teomic model for diagnosis of anti-SSA and anti-SSB negative primary Sj?gren′s syndrome ( pSS) .Methods Serum proteomic spectra were generated by using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) in combination with weak cation exchange (WCX) magnetic beads. The proteomic data were analyzed by Ciphergen ProteinChip and BioMarker Wizard software .The protein peaks were further analyzed by Biomarker Patterns Software to screen the representative proteomic biomark -ers, which were to be used to construct a decision tree model for the diagnosis of anti -SSA and anti-SSB neg-ative pSS.Results Ten mass-to-charge (m/z) peaks with significant difference were identified among sub-jects with antibody-negative pSS and antibody-positive pSS (P<0.05).Among them, the protein peaks with the m/z value of 6625 .004 and 27993 .280 were selected as potential biomarkers to construct the diag-nostic decision tree model .The sensitivity and specificity of the model were 77.8%and 90.9%respectively as indicated by a double blind study .Conclusion The potential protein biomarkers for seronegative pSS could be identified by MALDI-TOF-MS in combination with WCX magnetic beads .A proteomic model for the diagnosis of seronegative pSS was successfully constructed with an advantage of good sensibility and specifici -ty based on the protein peaks with m/z value of 6625 .004 and 27993 .280 .
ABSTRACT
Remitting Seronegative Symmetrical Synovitis with Pitting Edema is a rare clinical entity described as an acute onset polyarthritis with edema affecting geriatric population particularly males. The etiopathogenesis of disease is still elusive but clinical, radiological and immunological characteristics separate it from the more common disease like Rheumatoid arthritis and Polymyalgia rheumatica. Disease has an excellent prognosis with low dose steroids and patients undergo long-term remission even after withdrawal of drugs. We hereby describe a case of 90 year old female presented to us with polyarthritis and pitting edema of hands that we diagnosed as RS3PE.
ABSTRACT
Introduction: Personality of sero-positive and sero-negative pregnant mothers was defined after considering factors like Total productivity, locations, determinants and contents. Seropositive personality shows low productivity, increased reaction time, rejection of more plates, lower number of human responses, higher number of animal responses, colour shock, high F+%, shading and narrow content categories on Rorschach ink-blot test. This suggests depressive tendencies. Method: Rorschach test was administered to sero-positive pregnant women (n=50) and sero-negative pregnant women (n=50) in this study. Result : Sero-negative personality also shows less productivity, increased reaction time and response, less whole response, more detailed responses which suggest anxiety and some sero-negative mothers showing depression. Rejection of plates was less as compared to sero-positive pregnant mothers, the human responses are less, high F+%, shading responses are not seen, and colour shock is absent, popular responses are expectedly more.
ABSTRACT
Coxiella burnetii is the agent of Q fever , an emergent worldwide zoonosis of wide clinical spectrum. Although C. burnetii infection is typically associated with acute infection, atypical pneumonia and flu-like symptoms, endocarditis, osteoarticular manifestations and severe disease are possible, especially when the patient has a suppressed immune system; however, these severe complications are typically neglected. This study reports the sequencing of the repetitive element IS1111 of the transposase gene of C. burnetii from blood and bronchoalveolar lavage (BAL) samples from a patient with severe pneumonia following methotrexate therapy, resulting in the molecular diagnosis of Q fever in a patient who had been diagnosed with active seronegative polyarthritis two years earlier. To the best of our knowledge, this represents the first documented case of the isolation of C. burnetii DNA from a BAL sample.