Unveiling complex interaction of sickle cell hemoglobin with another hemoglobinopathy - A Rare Entity

ABSTRACT Hemoglobinopathies constitute one of the most common inherited hematological disorders in the world with an increasing global disease burden each year. One among them is sickle cell disease with diverse genotypes and wide phenotypic heterogenity. Many subgroups exist within the umbrella of sickle cell disease. Hb S/DPunjab, a rare hemoglobinopathy, is one of them, mimics sickle cell disease, and is discussed in the present study. We describe one such unusual clinical case of a young child who presented with intermittent fever and joint problems. The study case was found to have Hb S/DPunjab by high performance liquid chromatography. Clinical and hematological details of this rare condition is only briefly discussed in the literature. Precise diagnosis can be made using high performance liquid chromatography in conjunction with family studies.

A rare case of advanced abdominal pregnancy with good maternal and fetal outcome

Advanced abdominal pregnancy is an uncommon and potentially precarious variant of ectopic pregnancy in which the fetus develops in the abdominal cavity. A 30-year-old multigravida presented at 33+5 weeks of gestation with abdominal pain. Ultrasonography revealed a single live fetus lying in the abdominal cavity, with the uterus seen separately. Previous ultrasonography done at 15 weeks of gestation was suggestive of intrauterine pregnancy. She underwent emergency laparotomy at 33+6 weeks, which confirmed secondary abdominal pregnancy with the placenta deriving its blood supply from the left uterine artery and omental vessels. A peripartum hysterectomy was performed. The postoperative period was uneventful, and both mother and baby were discharged after one week. Despite notable advancements in prenatal care and medical imaging technologies, abdominal pregnancies, even if advanced, may remain undiagnosed, emphasizing the necessity for healthcare professionals to maintain a heightened level of suspicion regarding this condition. If conservative management has to be sought, the case selection should be done carefully due to the high risk to both the mother’s and fetus’s life. There is a pressing need for the standardisation of treatment protocols in order to optimise maternal and fetal outcomes in abdominal pregnancy.

The role of cerebro placental ratio as a predictor of adverse perinatal outcome in uncomplicated term pregnancies

Background: Aim of the study was to study role of cerebro placental ratio (CPR) as a predictor of adverse perinatal outcome in uncomplicated term pregnancies.Methods: This prospective observational study took place at the Department of Obstetrics and Gynecology in SNMC Agra. We enrolled 140 uncomplicated antenatal cases with gestational age between 37 to 41 weeks, based on specific inclusion and exclusion criteria. Each participant underwent comprehensive assessments, including history-taking, examinations, and ultrasound color Doppler evaluations. We then analyzed perinatal outcomes in correlation with CPR.Results: Adverse perinatal outcomes i.e., asphyxia and NICU admissions were found to be significantly higher in patients with CPR<1. We also observed APGAR<7 at 1 and 5 minutes, cord blood ABG with pH<7.3, pO2<50, PCO2>45 in patients with CPR<1.Conclusions: CPR serves as a noninvasive means to identify fetal compromise in seemingly healthy pregnancies, aiding in the decision-making process regarding the mode of delivery. Clinical significance-CPR can assist in stratifying at risk pregnancies, subsequently influencing decisions regarding the mode and place of delivery.

Safeguarding Agriculture: A Comprehensive Review of Plant Protection Strategies

The rapidly evolving landscape of agriculture faces myriad challenges, including pests, diseases, and environmental factors that jeopardise global food security. The urgency of these challenges necessitates innovative plant protection strategies that are both effective and environmentally sustainable. This review offers a comprehensive examination of the advancements and considerations in plant protection, from traditional methods to modern technological approaches. Traditional practices, although eco-friendly, often fall short in efficacy and scalability. The advent of chemical solutions such as pesticides revolutionised plant protection but brought about environmental and health concerns. Biological controls offer a middle-ground, leveraging natural predators and bio-pesticides to combat agricultural threats. Technology is playing an increasingly critical role in shaping the future of plant protection. Sensor technologies and drones are enabling precision agriculture, enhancing the monitoring and application of protection measures. Genetic engineering holds the promise of creating crops resistant to pests and diseases, albeit amid ethical and safety debates. Integrated Pest Management (IPM), a balanced, eco-friendly approach, is gaining traction, supported by case studies that validate its effectiveness and adaptability. Meanwhile, policy and regulation are evolving to better govern the use of chemicals, promote sustainability, and address the impacts of climate change on agriculture. This review explores future trends, particularly the influence of emerging technologies such as nanotechnology and IoT, and potential shifts in global policies towards more sustainable practices. It argues for the imperative of integrating these multifaceted approaches, guided by robust policies and regulations, to achieve the dual objectives of high agricultural yield and environmental conservation. It aims to provide a holistic understanding and guide future directions in plant protection strategies, emphasising the importance of adaptability, sustainability, and integration in facing the challenges of tomorrow.

Exploring the Significance of Insects in Ecosystems: A Comprehensive Examination of Entomological Studies

The dynamic and expansive field of entomology is poised for transformative changes, thanks to technological advancements and the emergence of new avenues of research. Traditional methodologies like specimen collection and observation are increasingly being complemented by state-of-the-art techniques such as environmental DNA (eDNA) analysis, CRISPR genome editing, remote sensing, and artificial intelligence. The eDNA methodology, for example, offers a non-invasive approach to monitor elusive or endangered insect species, thereby enriching biodiversity databases. Genome editing technologies like CRISPR have enabled nuanced manipulation of insect genes, providing a deeper understanding of their physiology and behavior. Moreover, artificial intelligence and machine learning contribute to automated species identification and predictive modeling of insect populations, offering invaluable insights for conservation efforts. In terms of emerging fields, insect neurobiology, microbiomics, and environmental entomology are gaining prominence. Neurobiological studies are dissecting the neural substrates of insect behaviors, which not only deepen our basic biological understanding but also have implications in robotics and AI. Microbiomics explores the symbiotic relationships between insects and their microbial communities, revealing avenues for novel pest control strategies. Environmental entomology focuses on the impacts of habitat change and climate variability on insect populations, which is crucial for biodiversity conservation. Acknowledging the concerted efforts of researchers, academic institutions, and funding bodies is essential, as these stakeholders shape the field's future direction. Thus, entomology stands at the cusp of a new era, enriched by technological innovations and multidisciplinary approaches. These advancements hold the promise of significantly broadening our understanding of insects' roles in ecosystems, their adaptability, and their importance in maintaining ecological balance. This future direction not only provides exciting prospects for scientific inquiry but also brings forth substantial implications for the sustainable management of ecosystems and conservation policy.

Genetic Variability of Gladiolus (Gladiolus grandifloras L.) Varieties Under Prayagraj, Uttar Pradesh Agro-Climatic Conditions

A study on genetic variability of gladiolus (Gladiolus grandifloras L.) varieties under prayagraj agro-climatic conditions was carried out at Departmental research field of Horticulture, Naini Agriculture Institute during the Rabi season of 2021-2022 with ten cultivars in Randomized Block Design (RBD) with three replications viz.,. Punjab Flame, Source Biscuts, Arka Naveen, White Prosperity, Dhanvantri, Phule Neelrekha, Pusa Srijan, Arka Amar, Priscilla, Yellow Stone were evaluated. Out of these ten cultivars, genetic variability, heritability, phenotypic coefficient of variation (PCV) was higher than the genotypic coefficient of variation (GCV) and genetic correlation for the characters viz., plant height at (30, 60, 90 DAS), number of leaves per plant at (30,60,90 DAS), no. of shoot per plant, days taken for corm sprouting, rachis length, days taken to spike emergence, days taken colour break stage, no. of floret per spike, no. of spike per plant, no. of days taken for first basal open, no. of days taken for last floret open, spike length, floret diameter, weight of daughter corm, weight of mother corm, corm diameter, corm weight, no. of corm per hectare, and corm yield/ plant were observed. for all characters, the highest GCV and PCV were recorded for the characters viz., weight of daughter corm (g) (33.6786 and 47.569), number of leaves per plant at 30 DAS (25.70 and 37.81), number of leaves per plant at harvest (24.73 and 35.25), number of shoots per plant ( 25.47 and 31.19), weight of mother corm (25.18 and 33.90), corm weight (25.11 and 33.38), days taken for corm sprouting (23.7566 and 23.7566) and the lowest GCV and PCV were recorded for floret diameter (17.50 and 40.95).The genotypes Phule Neelrekha followed by Arka Amar were identified as high corm yielding and no. of cormsper hectare and produced more no. of spikes/ plot and also yield per plotwhich indicated that these genotypes have resultedfor higher yield and indicated good response to selection owing to their high heritability, variability and genetic advance showing additive gene effect. These genotypes can be used for improvement of yield and component traits by selection.

Combined Effect of Pelvic Proprioceptive Neuromuscular Facilitation and Core Strengthening on Trunk Control, Balance, and Gait in Individuals with Paraplegia

Background: Paraplegia causes substantially reduced motor and sensory functions in the lower limbs and insufficient control over the trunk and pelvis. Regulating one’s trunk and pelvis is essential for balance and gait. However, among people with paraplegia, poor trunk and pelvic control is a crucial risk factor for immobility and a worsened quality of life (QoL). Despite conventional methods for enhancing trunk and pelvic control, there is a lack of standardized techniques to improve trunk and pelvic control for SCI patients. So, the present study aims to evaluate the combined effects of pelvic proprioceptive neuromuscular facilitation and core strengthening on trunk control, balance, and gait in paraplegic patients.Methods: A quasi-experimental study involving 17 participants (13 males, 4 females) with subacute paraplegia having the neurological level of injury (T6-T12) with ASIA Impairment Scale (ISNCSCI) grades B and C. Intervention was given to the participants for 45 minutes per session, five times/week for four weeks. Before and after the intervention, the participant’s performance was assessed using the trunk control test for SCI, the Berg Balance Scale, the SCI-FAI, and the Walking Index for Spinal Cord Injury II (WISCI).Results: After four weeks of intervention, the comparison between the pre-and post-intervention outcomes of the Trunk Control Test (p=0.001), BBS (p=0.001), SCI-FAI (p=0.001), and WISCI (p=0.001) showed significant differences.Conclusion: The current study concluded that pelvic PNF combined with core strengthening effectively improved trunk control, balance, and gait in subacute paraplegic patients. Both interventions are safe to perform.

Bullous pemphigoid in India: Review of cases registered in an autoimmune bullous disease clinic

Background: Information on bullous pemphigoid in an Indian context is scarce. Aim: To report clinico-demographic profile, associated comorbidities and prescription pattern of bullous pemphigoid patients in India. Methods: This was a retrospective study, where past records of all bullous pemphigoid patients diagnosed and treated between November 2013 and October 2019 were accessed and analysed. Patients having a compatible clinical presentation with either histopathological and/or direct immunofluorescence evidence of bullous pemphigoid were included. Results: There were 96 bullous pemphigoid patients, with a male: female ratio of 1.6:1. The mean age at diagnosis was 62.5 ± 2.2 years, with mean duration of illness 27.5 ± 4.5 months before presentation. Comorbidities were present in 80 (83%) patients, with type 2 diabetes mellitus (38.5%), hypertension (36.4%) and neurological illness (16.7%) being the commonest ones. Clinically, blisters were the predominant presentation in 81 (84.4%) patients. The majority (87.5%) of patients showed a predominant eosinophilic infiltrate on histopathology. Direct immunofluorescence revealed immunoglobulin G deposits with complement C3 in 77 (80.2%) cases. The majority of patients (77.1%) were treated with oral prednisolone, either alone (11.5%) or in combination (65.6%) with other topical and systemic agents. Topical steroids were used in 29.1%, azathioprine in 28%, dapsone in 16.7% and omalizumab in 6.2% of patients. Limitations: The study is retrospective. Immunofluorescence on salt split skin, direct immunofluorescence serration pattern analysis, and immunoblotting were not performed. Hence, there is a possibility that a few included cases were suffering from other subepidermal autoimmune bullous diseases like epidermolysis bullosa acquisita or anti-p200 pemphigoid. Conclusion: Bullous pemphigoid patients in this study had a younger age of onset and showed male preponderance. Comorbidities like type 2 diabetes, hypertension and neurological disorders were freq

Clinical and metabolic characteristics of males with early-onset androgenetic alopecia

Background: Men with early-onset androgenetic alopecia (AGA) often have an abnormal hormonal milieu. Objective: To ascertain the clinico-phenotypic characteristics and the prevalence of hormonal and metabolic changes in men with early-onset AGA. Methods: Consecutive male patients less than 30 years of age with a Norwood-Hamilton grade ?3 AGA were recruited in this comparative cross-sectional study. After endocrine evaluation they were classified into two groups, that is, Group A consisting of subjects with an altered hormonal profile and Group B with normal hormonal profiles. The groups were assessed for differences in disease phenotype and severity (Norwood-Hamilton grade), insulin resistance and parameters of metabolic syndrome (ATP III guidelines). Results: Altered hormonal profiles were seen in 34 of the 100 subjects with AGA, while insulin resistance and metabolic syndrome were noted in 44 and 26 respectively. Altered hormonal profiles were significantly associated with insulin resistance and severe alopecia (grade 4 and above Hamilton-Norwood Scale). Insulin resistant Group A patients had a significantly higher prevalence of severe alopecia (>grade 4) (P = 0.0036). The prevalence of metabolic syndrome was similar in both groups. Limitation: The cross sectional study design was a drawback of this study. Further, a control arm without AGA was not included and the sample size of 100 was selected arbitrarily. Conclusion: An altered hormonal profile and insulin resistance was noted in a third of the males with early-onset AGA. Subjects with altered hormonal profiles had a higher prevalence of insulin resistance and were likely to have severe grades of AGA

A Case Study on the Effect of Physiotherapy on Joint Health and Functional Independence in a Person with Hemophilia who Underwent Upper Limb Fasciotomy

Background and Purpose: Persons with acquired or congenital hemophilia are at risk of developing acute compartment syndrome, which can complicate rehabilitation therapy. However, there is a lack of published literature on the role of physiotherapy in post-fasciotomy hemophilia cases. The study aims to investigate the impact of physiotherapy on post-operative upper limb fasciotomy in improving joint health, functional ability, range of motion and decreasing pain in person with hemophilia. Case Description: The case involves a 22 years old male subject with hemophilia A, diagnosed in 2004 with a factor assay of 1.2%. The subject presented with a history of left forearm pain after an intramuscular hematoma in the left forearm, leading to compartment syndrome and mild Volkmann ischemic contracture. The subject also experienced difficulty in gripping with the left hand and pain. Hemophilia Joint Health Score (HJHS), Functional Independence Score in Hemophilia (FISH), and score of Numeric Pain Rating Scale and Range of Motion were used as outcome measures. The physiotherapeutic interventions were given for 40 minutes for 4 weeks with five therapy sessions per week. Results: The findings of this study demonstrated a significant improvement in the outcome parameters with a decrease in HJHS score (8.8%), increase in score of FISH (15.6%), decrease in NPRS score (40%) and improved range of motion of wrist joint. Conclusion: In conclusion, this case study suggests that basic physiotherapy interventions lead to increased range of motion, improved joint health and decreased pain in post-operative cases of fasciotomy presenting as intramuscular hematoma with compartment syndrome in persons with hemophilia. These improvements contribute to enhanced functional independence.

Binding interaction of laccases from Bacillus Subtilis after industrial dyes exposure: Molecular docking and molecular dynamics simulation studies

Dyes are becoming more widely used around the world wide, but there is no effective bioremediation approach for removing them completely from the environment. Several dyes are mentioned to be degraded through bacteria; however, it's still unknown how the particular enzymes act throughout the dye degradation. The behavior and function of these enzymes in the biodegradation of azo dyes (Textile dyes) had been investigated experimentally by the numbers of the researchers, however, the molecular mechanisms remain unclear. Therefore, the interaction mechanisms of textile dye (methyl orange) with laccase from B. subtilis were explored through molecular docking and molecular dynamics simulations, the three selected dyes (methyl orange, malachite green, and acid blue 62) that interact positively with laccase on the basis of their maximum binding energy, molecular docking results indicate that one of the three dyes is more stable as a target for degradation through Bacillus subtilis laccase. Therefore, subsequent research focused solely on one substrate: methyl orange. Molecular Dynamics simulation study was applied after the molecular docking to determine the interaction between laccases and methyl orange dyes. The trajectory was proved with root mean square deviation and root mean square fluctuation analysis. According to the molecular dynamics simulation results, laccase-methyl orange complexes remain stable during the catalytic reaction. So, this study demonstrates how laccase is involved in methyl orange bioremediation.

Vitamin D dependent rickets type 2: a case-based review of patient with alopecia and rickets

Vitamin D dependent rickets (VDDR) type 2 is a very rare hereditary disease which has an autosomal recessive mode of inheritance. Patients with VDDR type 2 have a mutation in the gene encoding for vitamin D receptor on chromosome 12q12-q14, thus averting normal physiological action of 1,25 vitamin D. It's presents with the developmental delay in motor domain with features of rickets usually in the first year of life. Alopecia totalis has a frequent association with the disease. We are reporting a case of a 5-year-old boy who has a history of difficulty walking since 2 year of life, with a gradually progressive motor weakness course. Patients have a history of alopecia since 2 months of age, which progressed to alopecia totalis. On investigation, serum calcium was 7.2 mg/dl with a very high alkaline phosphate level of 1065 IU/ML with a normal vitamin D level was reported. The initial treatment started with IV calcium followed by 1000mg of oral calcium, along with a high dose of calcitriol. The patient was under periodic follow-up showing improvement in biochemical parameters. We reviewed literature of seven patient out of which 5 patients had alopecia and found 2 patients had enamel hypoplasia and all had features of rickets.

Effect of dexamethasone implant on intraocular cytokines in diabetic macular edema

Purpose: Our primary aim was to evaluate intraocular cytokines (IC) before and after dexamethasone in diabetic macular edema (DME). Our secondary aim was to study the early and late effects of single dexamethasone implant in DME. Methods: This before and after comparative study was conducted at the Department of Ophthalmology and Centre for Nanosciences at a quaternary referral center in Kerala, India, from September 2016 to September 2018. Patients underwent complete ophthalmological examination and cytokine analysis before and after dexamethasone implant. Levels of cytokines at baseline and repeat sample were studied. Results: Twenty?seven eyes (21 patients) were divided into two groups depending on time from baseline to second injection. Group 1 included patients with <3 months between the two samples – 12 (44.4%). Group 2 included patients with >3 months between the two samples –15 (55.6%). Best corrected visual acuity (BCVA) and central macular thickness (CMT) improved significantly post?dexamethasone in group 1, but not in group 2. Interleukin (IL)?4, IL?6, IL?10, vascular endothelial growth factor (VEGF), IL?1?, interferon?gamma inducible protein?10 (IP?10), monocyte chemoattractant protein?1 (MCP?1), and IL?2 decreased post?injection in group 1. But cytokines increased post?dexamethasone in group 2, except IL?10. When compared to baseline, IL?6 reduced to half in group 1 (P?value 0.814) and it tripled in group 2 ( P?value 0.009). The level of VEGF in the first and second samples was not different in either group. Conclusion: Our study suggests that dexamethasone acts more on IC than VEGF in DME. This is significant in the first 3 months with a rebound effect on IL?6 after 3 months. Our study also suggests that repeat injection of DEX in DME should be done at 3 months to prevent deterioration of visual acuity (VA) and worsening of CMT.

Inkk Trial - Intraoperative ketamine for perioperative pain management following total knee endoprosthetic replacement in oncology: a double-blinded randomized trial

Abstract Background There has been a growing interest in the use of ketamine following orthopedic surgeries. We hypothesized that low dose intravenous ketamine during surgery would help in mobilization following total knee replacement (TKR) in oncology patients as assessed by the timed to up and go (TUG) test at 72 hours post-surgery. Our secondary objectives were to compare the opioid requirement at the end of 72 hours, pain scores, satisfaction with pain management, adverse effects, range of joint movement achieved in the post-operative period and the functional recovery at the end of 1 month. Methods After the ethics commitee approval, registration of the trial with the Clinical Trial Registry - India (CTRI), and informed consent, this double-blinded trial was conducted. Using computer generated randomization chart, an independent team randomized the patients into ketamine group which received at induction, a ketamine bolus dose of 0.5 mg.kg-1 before the incision followed by 10 µg.kg-1min-1 infusion which was maintained intraoperatively till skin closure and the saline group received an equivalent volume of saline. Postoperatively, patient controlled morphine pumps were attached and the pain score with morphine usage were recorded for 72 hours. The TUG tests and range of motion were assessed by the physiotherapists until 72 hours. Results Fifty-two patients were enrolled in the trial. Demographics were comparable. No significant intraoperative hemodynamic changes and post-operative adverse events were noted between the groups. A decrease in the TUG test, along with decreased opioid usage with a better range of movements was noted in the ketamine group, but this was not statistically significant. Day of discharge, patient satisfaction score, and functional recovery assessed by Oxford Knee Score (OKS) were comparable between the groups. Conclusion In conclusion, low dose intraoperative ketamine infusion does not provide clinical benefit in perioperative pain management and postoperative rehabilitation following total knee endoprosthetic replacement in oncology.

Evaluation of the heavy metals tolerant UV rays treated bacteria isolated from anthropogenic sites of Chambal region, India

Industrial waste is released into the environment and leads to various types of heavy metal, which are toxic, mutagenic and carcinogenic in nature. Heavy metals are not biodegradable but accumulated by living organisms and cause diseases at even low concentrations. In this study, we selected four anthropogenic sites from Chambal region, isolated bacteria and investigated its heavy metal removal capability. The bacteria was isolated and identified as Escherichia coli (Ag-5), on the basis of biochemical and 16S rRNA gene sequence. Among the five (cadmium, cobalt, lead, nickel and zinc) heavy metals studied, Ni2+ has been observed to be highly toxic with minimum inhibitory concentration score of 200 ppm. E. coli could tolerate Zn2+ (300 ppm), Cd2+ (400 ppm), Co2+ (400 ppm) and Pb+2 (500 ppm). Heavy metal tolerance capability was also evaluated by UV rays treated E. coli (Ag-5) isolate and compared with wild strain Ag-5. The result indicated that the tolerance capability was enhanced by UV rays treated bacterial isolate as compared to wild strain with respect to all tested heavy metals. Atomic absorption spectroscopy results revealed that wild strain removed 78.2% cadmium nitrate, while UV rays 30 and 60 s. exposed strain removed 85.9 and 83% cadmium nitrate. Wild strain removed 64.4% nickel chloride, while UV rays 30 and 60 s exposed strain removed 66.9 and 74.5% nickel chloride. The results indicate that indigenous E. coli treated with UV rays could serve as heavy metal tolerant bacteria and utilized in bioremediation processes.

Municipal solid waste landfill leachate induced cytotoxicity in root tips of Vicia faba: Environmental Risk posed by non-engineered landfill

Landfills are considered the main option for dumping of municipal solid waste (MSW) all over the world, but these landfills are mostly non-engineered. The decomposition of solid waste in the landfill and rainwater penetration into the decomposing waste produces leachate that contains dissolved organic and inorganic compounds, heavy metals, suspended particles, and hazardous substances. Leachate migration in the environment may pose serious health risks to organisms exposed. Hence, the present study explored the cytotoxic potential of landfill leachate collected in different seasons from the Okhla landfill site, Delhi, India. Cytotoxicity of leachate samples was evaluatedby cell apoptosis and ultrastructural observation based on Transmission Electron Microscopy (TEM) of the cells of root tips of vicia faba seedlings treated with the leachates collected in summer, winter and monsoon in a time and dose dependent manner. Leachate collected in all the three seasons induced apoptosis in cells of root tips of vicia faba that increased in a time and dose dependent manner when compared to control. The apoptosis was highest in the samples treated with leachate collected in the summer season, followed by winter and monsoon. It was further confirmed with TEM images that there was induction of apoptotic-like morphological changes in the root cells treated with landfill leachate when compared with the control. The present study indicates that municipal solid waste leachate is very toxic and it should be treated before disposing it to the environment.

Association Between Abo Blood Group And Obesity In Medical Students

Background — Over the past years, there seems to have been good attention paid to the connection between some diseases and the ABO blood group type. To our knowledge, nostudy has been done todetermine the association between obesity and ABO blood group. To find the prevalence of obesity in medical students and to determine theAims — association between obesity and ABO blood group. A cross sectional study was carried outMaterials and methods — among 745 medical students. Height, weight, waist circumference, hip circumference was measured. BMI and waist —hip ratio was determined. Blood group was determined by slide agglutination method The findings of theResults — present study reported that the most prevalent blood group was B+ whereas the blood group AB was least prevalent. 25.5% of the total study subjects were overweight and 7.2%were obese. Overweight and obesity were more common among students with blood group B. It was also observed that WHR statistically associated with ABO Blood group system. Conclusion — Participants with blood group B+ had higher prevalence of overweight and obesity. ABO Blood group system showed statistically significant association with WHR.

Profile of Children with Kawasaki Disease Associated with Tropical Infections

Objective To describe various infectious triggers for Kawasaki disease (KD) in India. Methods A series of 10 children with diagnosed infections who developed KD during their course of illness has been presented. They were diagnosed by the American Heart Association (AHA) 2017 guidelines. Echocardiography was done to check for coronary artery dilation. Treatment was instituted as per standard protocol. Results Kawasaki disease was diagnosed in 8 boys and 2 girls, aged 1 mo to 11 y. These children were being treated for dengue, chikungunya, SARS-CoV-2, hepatitis A, tuberculosis, brucellosis, disseminated staphylococcal sepsis, scrub typhus, and enteric fever. Conclusions Kawasaki disease has been associated with infectious triggers. It should be considered in febrile patients with mucocutaneous involvement or in nonresponsive sepsis, despite adequate therapy.