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1.
Front Neurol ; 9: 1193, 2018.
Article in English | MEDLINE | ID: mdl-30697188

ABSTRACT

Diagnosis of the aetiological agent in case of acute encephalitic syndrome (AES) continues to pose a challenge in clinical practice as a variety of pathogens are known to cause AES. Here, we report the validation of a Syndrome Evaluation System (SES) developed for simultaneous detection of multiple AES pathogens using a well characterized set of Cerebrospinal fluid (CSF) samples. The validation of the SES was carried out in two phases. In the first phase, the SES was validated using 51 CSF samples obtained from autopsy proven cases and 50 samples obtained from apparently healthy individuals undergoing spinal anesthesia for minor surgeries served as "controls." The SES detected etilogical agent in 48/51 (94.11 %) samples obtained from autopsy proven AES cases while all the 50 CSF samples obtained from "controls" were negative. In the second phase, the SES was validated using well characterized CSF samples obtained from AES patients fulfilling the WHO case definition of AES (Group I; n = 207) and samples that were collected from patients with non-infectious neurological disorder (Group II; n = 90). All the samples were tested using multiple conventional/serological assays and categorized into various groups. Amongst the AES cases fulfilling WHO case definition, the SES detected AES pathogens in 160/207 (77.29%) cases while conventional serological/molecular assays were able to detect AES pathogens only in 77/207 (37.1%) of cases. Further, in 12/83 CSF samples that were positive by SES and negative by conventional serological/molecular tests, the results were additionally confirmed by sequencing the PCR products to rule out non-specific amplification in the SES. In patients with non-infectious neurological disorders the SES detected latent viruses 12/90 CSF samples. These results indicate that the SES, apart being a rapid, sensitive, specific, and cost-effective method provides the major advantage of simultaneous detection of multiple pathogens using as single specimen of CSF.

2.
J Ophthalmic Inflamm Infect ; 3(1): 14, 2013 Jan 15.
Article in English | MEDLINE | ID: mdl-23514352

ABSTRACT

BACKGROUND: The purpose of this study is to look for any possible associations in 58 consecutive cases of Fuchs heterochromic iridocyclitis (FHI) in a South Indian patient population. Fifty-eight consecutive cases (59 eyes) of FHI underwent a detailed ocular and systemic evaluation. Routine laboratory investigations for uveitis including serum angiotensin-converting enzyme and enzyme-linked immunosorbent assay (ELISA) for toxoplasmosis (IgG and IgM) were done in all the cases. Syndrome Evaluation System comprising of multiplex nucleic acid amplification and signature specific hybridization on the aqueous fluid was done in all 59 eyes for herpes simplex virus (HSV), varicella zoster virus, cytomegalovirus (CMV), rubella virus, chikungunya virus, Toxoplasma, and Mycobacterium tuberculosis. The results were statistically assessed using the SPSS (version 15) package. RESULTS: Thirty-three males and 25 females with FHI were included in the study. Systemic sarcoidosis was seen in two cases. Serological tests failed to confirm an association with toxoplasmosis in all the cases. Aqueous fluid analysis showed positivity only to HSV (one case), CMV (one case), and chikungunya virus (one case). CONCLUSIONS: We do see associations of sarcoidosis, HSV, and CMV in FHI in our patient populations as well. The detection of chikungunya virus in a patient with FHI in our series adds to the list of associations with FHI.

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