Respiratory viruses in returning Hajj & Umrah pilgrims with acute respiratory illness in 2014-2015

Background & objectives: Respiratory tract infections are common among Hajj and Umrah pilgrims which pose a public health risk of spread of respiratory infections. Influenza has been reported from Indian Hajj and Umrah returning pilgrims, but data on other respiratory pathogens are sparse in India. Here we report the presence of common respiratory viral pathogens in returning Hajj and Umrah pilgrims suffering from acute respiratory illness (ARI) in 2014-2015. Methods: Respiratory specimens (nasopharyngeal and throat swabs) were collected from 300 consenting pilgrims with ARI in the past one week and tested for influenza and Middle East Respiratory Syndrome coronavirus (MERS-CoV) and other respiratory viruses using in-house standardized quantitative real-time reverse-transcription polymerase chain reaction. Clinical features among the pathogen positive and negative patients were compared. The patients received symptomatic treatment and antivirals where appropriate and were followed telephonically to collect data on illness outcome. Results: Ninety seven (32.3%) of the 300 participants were tested positive for any virus, most common being influenza viruses (n=33, 11%). Other respiratory viruses that were detected included human coronaviruses [n=26, 8.7%; OC43 (n=19, 6.3%) and C229E (n=7, 2.3%)], rhinovirus (n=20, 6%), adenoviruses (n=8, 2.6%), parainfluenza viruses (n=7, 2.3%), respiratory syncytial virus (n=3, 1%) and bocaviruses (n=2, 0.6%). Clinical features observed in pathogen positive and pathogen negative patients did not differ significantly. Eighteen influenza positive patients were treated with oseltamivir. Interpretation & conclusions: Pilgrims returning from mass gatherings are often afflicted with respiratory pathogens with a potential to facilitate transmission of respiratory pathogens across international borders. The study reinforces the need for better infection prevention and control measures such as vaccination, health education on cough etiquette and hand hygiene.

Performance of rapid influenza diagnostic tests (QuickVue) for Influenza A and B Infection in India.

Background: Rapid point-of-care (POC) tests provide an economical alternative for rapid diagnosis and treatment of infl uenza, especially in public health emergency situations. Objectives: To test the performance of a rapid infl uenza diagnostic test, QuickVue (Quidel) as a POC test against a real-time polymerase chain reaction (RT-PCR) assay for detection of infl uenza A and B in a developing country setting. Study Design: In a prospective observational design, 600 patients with infl uenza-like illness (ILI) or with severe acute respiratory illness (SARI) who were referred to the Infl uenza Clinic of a tertiary care hospital in Srinagar, India from September 2012 to April 2013, were enrolled for diagnostic testing for infl uenza using QuickVue or RT-PCR. All infl uenza A-positive patients by RT-PCR were further subtyped using primers and probes for A/H1pdm09 and A/H3. Results: Of the 600 patients, 186 tested positive for infl uenza A or B by RT-PCR (90 A/ H1N1pdm09, 7 A/H3 and 89 infl uenza B), whereas only 43 tested positive for infl uenza (infl uenza A = 22 and infl uenza B = 21) by QuickVue. Thus, the sensitivity of the QuickVue was only 23% (95% confi dence interval, CI: 17.3-29.8) and specifi city was 100% (95% CI: 99.1-100) with a positive predictive value (PPV) of 100% (95% CI 91.8-100) and a negative predictive value (NPV) of 74.3% (95% CI: 70.5-77.9) as compared to RT-PCR. Conclusions: The high specifi city of QuickVue suggest that this POC test can be a useful tool for patient management or triaging during a public health crisis but a low sensitivity suggests that a negative test result need to be further tested using RT-PCR.

role of inflammatory mediators in the pathogenesis of Alzheimer's disease

Alzheimer's disease [AD], a neurodegenerative disorder associated with advanced age, is the most common cause of dementia globally. AD is characterised by cognitive dysfunction, deposition of amyloid plaques, neurofibrillary tangles and neuro-inflammation. Inflammation of the brain is a key pathological hallmark of AD. Thus, clinical and immunopathological evidence of AD could be potentially supported by inflammatory mediators, including cytokines, chemokines, the complement system, acute phase proteins and oxidative mediators. In particular, oxidative mediators may actively contribute to the progression of AD and on-going inflammation in the brain. This review provides an overview of the functions and activities of inflammatory mediators in AD. An improved understanding of in?ammatory processes and their role in AD is needed to improve therapeutic research aims in the field of AD and similar diseases

Ovarian hormones correlate antomical cyclic changes in teenage girls

Changes in the levels of steroid hormones and the size of ovarian contents during menstrual cycle of 102 healthy teenage girls investigated. Serum progesterone and estradiol levels were measured by their respective serozyme EIA method and the corresponding anatomical cyclic changes were visualized through ultrasonography. Like other studies, serum progesterone levels were found to be high during the luteal phase, whereas mean estradiol level before ovulation was 105.8 pg/ml and after ovulation, 91.8 pg/ml. size of follicle increased during proliferative phase, thus had positive correlation with estradiol level in the first phase [correlation co-efficient 0.7and covariance 42]. While corpus luteum was seen during secretory phase and had fairly good correlation with concurrent serum progesterone level in the same phase [correlation co-efficient 0.8 and covariance 35]. Hence, it concluded that estradiol level can correlate well with the structural changes in the follicle during the first phase and progesterone level coincides with the size of corpus luteum during the second phase of the menstrual cycle in teenage girls. Besides, minimum level of estradiol on day 13 [68 pg/ml] required for ovulation and indicating ovulation respectively in our community

Effedt of menopause on fertility hormones and associated biochemical parameters

Serum calcium, cholesterol and fertility hormones of fifty two healthy women before and after menopause were investigated. Women who had gone through menopause had elevated levels of Leuteinizing Hormone [LH] [P< 0.0001], and Follicle Stimulating Hormone [FSH] [P< 0.0001], and lower serum Estradio [P< 0.0001]. Mean Progesterone level was 0.6 +/- 0.1 mg/ml during the follicular phase of normal menstrual cycle in premenopausal women and 0.5 +/- 0.1 mg/ml in postmenopausal women. Besides, the serum concentrations of both calcium [P< 0.0001] and cholesterol [P< 0.05] were found higher after menopause. Hence, it is concluded that the pattern of fertility hormones and associated biochemical parameters as observed in our study was identical in trends with corresponding conventional normal values

Alternations in plasma fibrinogen during life events in women

Changes in plasma fibrinogen levels were observed in women during pregnancy, labour, postmenopause and after taking oral contraceptives. Mean fibrinogen level was highest at delivery, higher during pregnancy and high in postmenopausal women. Women who ceased menstruation with contraceptive drugs had lower values of plasma fibrinogen than control group

survey of malarial parasites in Abbottabad

A survey of malarial parasite was carried out in five localities around Abbottabad during August - December, MI. Giemsa stained thick and thin blood smears of 760 persons were examined. All the smears were negative for malarial parasite. Our study indicates that the locality of Abbottabad and its suburbs have very little or no incidence of malaria parasite infection during the months of August to December

Changing levels of progesterone in human breast milk

Breast milk of 30 mothers was analysed for progesterone at various time intervals during the first postpartum year. A progressive decrease in progesterone level was observed showing inverse relationship with lactation period. However, an abrupt increase in its concentration was found in repregnant mothers. It is concluded that milk of pregnant mothers has greater amount of progesterone as compared to non pregnant mothers

Chemical and gross microbial quality of milk marketed in abbottabad

Eighty four milk samples from twenty eight randomly selected shops, were analyzed during July-September, 1989 to study their chemical and microbiological composition. It was observed that milk samples of different areas varied widely in their chemical composition. The average per cent values of water content 89, acidity 0.177, protein 3.75, casein 3.0, fat 3.5, total solids 11 and solid-non-fat 7.5 were observed. Mean specific gravity was found to be 1.031. Microbial examination revealed that about 66% samples were contaminated. Out of all the contaminated samples, 57% had Gram-positive coed, 57% contained Gram-negative bacilli and 60% had fungal growth, Most of the milk samples were of poor quality having higher water content and lower fat, total solids and solid-non-fat concentration as against recommended values. Bacterial and fungal flora were also found to be quite high

Antibiogram of pathogenic organisms in the hospital environment

A survey of bacterial organisms during January - June, 1991 was carried out at District Headquarters Teaching Hospital, Abbottabad and their sensitivity was tested against commonly used antibiotics. It was observed that pathogenic organism count in the hospital environment was quite high as compared to clean area outside the hospital. These micro-organisms were isolated from hands, clothes, nose, ear and throat of various staff members and at different places and accessories of the hospital. The predominant organisms found were Staphylococcus aureus, Escherichia coli, Pseudomonas aeroginosa and B-Haemolytic streptococci. Antibiotic sensitivity test was performed on the isolated organisms. Gentamicin and minocin were found to be effective drugs against majority of the strains of most of the organisms

Study of foetal hemoglobin [HbF] and glucose-6-phosphate dehydrogenase [G6PD] in children of hilly areas of Abbottabad

Two hundred and thirty apparently healthy children [150 males and 80 females] and 120 refractory anaemic children [70 males and 50 females] of different age groups were investigated for Foetal Haemoglobin [HbF], HbA2 and Glucose-6-Phosphate Dehydrogenase [G6PD] for a period of 18 months. Age ranged between 8 months to 14 ears. The mean Hb of healthy and anaemic children was 13.9 g/dl and 6.4 g/dl respectively. The mean HbF levels were 0.917, in healthy and 13.6% in anaemic children. Twenty four percent of anaemic children had elevated HbF wind most of them showed associated increase of HbA2. Ten cases of thalassaemia major and 19 cases of thalassemia minor were identified. Among the healthy children, three males and one female were found to be CdFPD deficient, while in anaemic children, 8 males and 4 females had G6PD deficiency. No relationship was observed between HbF and G6PD. However, an unusual case was found who had inherited G6PD deficiency from father and beta thalassaemia from the mother's side

Correlation of haemoglobin level with intestinal parasites in school children of Peshawar University

Parasitic infection and Hb level of 230 school children at Peshawar University were observed during October, 1992 to May, 1993.The overall infection rate was 29.1% of which 6% showed mixed infection. Among positive cases Ascaris lumbricoides was the commonest [38.8%], followed by Hymenolepis nana [26.9%]. E. Coli was present in 10.4% cases, G. Lambliain 9% cases and E. Histolytica in 6% cases. However, the prevalence rate each for T. saginate and E. Vermiculeris was 3%, while T. Trichiure and Hookworm each was found in 1.5% cases. The mean haemoglobin in healthy subject was 13.6 g/dl, while in infected subjects it was 11.4 g/dl. the difference was statistically significant [P<0.05]

Effect of superimposed pregnancy on milk composition and progesterone level

Milk composition and progesterone level were studied in 18 cows at various stages of lactation. Progesterone was below 2 ng/ml in non-pregnant cows, rose steadily to 20 ng/ml on 17th day after insemination which was maintained during pregnancy. In non fertilized cows this level dropped rapidly to basal level. The fats and protein contents were also increased gradually during lactation showing relationship with the milk progesterone level. Lactose level was found constant throughout lactation

Pathogenic organisms in the environment of a teaching hospital

A survey of bacterial organisms was carried out at District Headquarter teaching Hospital, Abbottabad. It was observed that pathogenic organisms in the hospital environment were quite high as compared to clean area outside the hospital. These micro-organisms were isolated from hands, clothes, nose, ear and throat of various staff members and at different places and accessories of the hospital. The predominant organisms found were Staphylococcus aureus, Staphylococcus albus and Escherichia-coli

survey of urinalysis in Hazara population

Urine of 11600 subjects of Hazara Division were analysed between October, 1989 and November, 1990. Age range was 10-70 years. Physical, chemical and microscopic composition were observed. Most of the samples were pale yellow, had a volume of 1-1.5 1/24 hrs and few of them were turbid. pH and specific gravity were found in the range of 5-8 and 1.018-1.026 respectively. 369 cases of albuminuria, 205 cases of glycosuria and 93 cases of ketonuria were detected. Jaundice was detected only in few individuals. The abnormal leukocytes, RBC, Epithelial cells, Amorphous urates, Calcium oxalate crystals and Uric acid crystals were found in less than 12% subjects. Different types of casts observed were negligible

G6PD deficiency and beta-thalassaemia in the same patient

A report of 8 months old female child with a rare combination is presented who had inherited G6PD deficiency from father and Beta-Thalassaemia from mother