Severity of respiratory illness among Covid-19-vaccinated and non-vaccinated admitted patients-An observational study from a teaching hospital of Tripura.

Objective: To determine the association between vaccination status and mortality among critically ill patients admitted in a dedicated Covid hospital of Tripura who required invasive mechanical ventilation. Material and Methods: This study was conducted at a dedicated Covid hospital of Tripura for a period of six months, i.e., from June 2021 to November 2021. A total of 304 patients were enrolled for this study. Baseline epidemiological, radiological data along with other information like heart rate, pulse rate, oxygen saturation (SpO2), etc., were collected through patient record sheet in all cases during hospitalization. Statistical analysis was done by using SPSS 25 version. Results: Admission and mortality rates in hospital and advanced oxygen support like bi-level positive airway pressure (BiPAP), high-flow nasal cannula (HFNOC), and ventilator use incidences were higher in non-vaccinated patients (17.1%) in comparison to double-dose-vaccinated (0.98%) and single-dose (2.3%)-vaccinated patients. Conclusion: This retrospective data analysis of Covid-19 positive patients admitted in the dedicated Covid Hospital of Tripura suggests that severe infection, need for invasive and non-invasive ventilation, and death were significantly less in the vaccinated patients as compared to the vaccine-naive one.

Targeting PfProhibitin 2-Hu-Hsp70A1A complex as a unique approach towards malaria vaccine development.

Malaria parasite invasion to host erythrocytes is mediated by multiple interactions between merozoite ligands and erythrocyte receptors that contribute toward the development of disease pathology. Here, we report a novel antigen Plasmodium prohibitin "PfPHB2" and identify its cognate partner "Hsp70A1A" in host erythrocyte that plays a crucial role in mediating host-parasite interaction during merozoite invasion. Using small interfering RNA (siRNA)- and glucosamine-6-phosphate riboswitch (glmS) ribozyme-mediated approach, we show that loss of Hsp70A1A in red blood cells (RBCs) or PfPHB2 in infected red blood cells (iRBCs), respectively, inhibit PfPHB2-Hsp70A1A interaction leading to invasion inhibition. Antibodies targeting PfPHB2 and monoclonal antibody therapeutics against Hsp70A1A efficiently block parasite invasion. Recombinant PfPHB2 binds to RBCs which is inhibited by anti-PfPHB2 antibody and monoclonal antibody against Hsp70A1A. The validation of PfPHB2 to serve as antigen is further supported by detection of anti-PfPHB2 antibody in patient sera. Overall, this study proposes PfPHB2 as vaccine candidate and highlights the use of monoclonal antibody therapeutics for future malaria treatment.

First Report of Anopheles annularis s.l., An. maculatus s.s., and An. culicifacies s.l. as Malaria Vectors and a New Occurrence Record for An. pseudowillmori and An. sawadwongporni in Alipurduar District Villages, West Bengal, India.

A comprehensive entomological survey was undertaken in Alipurduar District, West Bengal, from 2018 to 2020 and in 2022. This study was prompted by reported malaria cases and conducted across nine villages, seven Sub-Centres, and three Primary Health Centres (PHCs). Mosquitoes were hand-collected with aspirators and flashlights from human dwellings and cattle sheds during the daytime. Both morphological and molecular techniques were used for species identification. Additionally, mosquitoes were tested for Plasmodium parasites and human blood presence. Mosquito species such as An. barbirostris s.l., An. hyrcanus s.l., An. splendidus, and An. vagus were morphologically identified. For species like An. annularis s.l., An. minimus s.s., An. culicifacies s.l., and An. maculatus s.s., a combination of morphological and molecular techniques was essential. The mitochondrial cytochrome c oxidase gene subunit 1 (CO1) was sequenced for An. annularis s.l., An. maculatus s.s., An. culicifacies s.l., An. vagus, and some damaged samples, revealing the presence of An. pseudowillmori and An. fluviatilis. The major Anopheles species were An. annularis s.l., An. culicifacies s.l., and An. maculatus s.s., especially in Kumargram and Turturi PHCs. Plasmodium positivity was notably high in An. annularis s.l. and An. maculatus s.s. with significant human blood meal positivity across most species. Morphological, molecular, and phylogenetic analyses are crucial, especially for archived samples, to accurately identify the mosquito fauna of a region. Notably, this study confirms the first occurrence of An. pseudowillmori and An. sawadwongporni in West Bengal and implicates An. maculatus s.s., An. culicifacies s.l., and An. annularis s.l. as significant vectors in the Alipurduar region.

Musculoskeletal manifestations in type-2 diabetic patients attending a tertiary care hospital in a North-Eastern city of India-A cross-sectional observational study.

Background: Musculoskeletal manifestations of diabetes are common and not life threatening, but these are an important cause of morbidity, pain and disability among diabetic patients. In 2004, the National Health Interview Survey determined that 58% of diabetic patients would have musculoskeletal functional disability. This study was designed to estimate the proportion of musculoskeletal manifestations among Type 2 diabetic patients attending a tertiary care hospital in Tripura and also to determine the association of various musculoskeletal manifestations with glycaemic status, body mass index and duration of diabetes mellitus. Methods: This hospital-based cross-sectional study was carried out in a tertiary care hospital in a northeastern state of India from December 2020 to November 2021. All the diabetic patients attending diabetes nutrition clinic of a tertiary care hospital for a period of one year were considered for this study. Diagnosis of musculoskeletal disorder was made based on history, physical examination, laboratory test and imaging test. Quantitative data were expressed as mean and standard deviation. Descriptive data was expressed in percentages and frequencies using charts and tables. Chi-square test was applied to explore any association between variables. Ethical approval for the study was obtained from the institutional ethics committee. Results: Out of four hundred and forty-two diabetic cases and two hundred and thirty-four (52.9%) patients were found with musculoskeletal manifestations, 55% of which belong to 45-59 age group. Conclusion: Physicians treating diabetic patients should be encouraged for regular examination for musculoskeletal complaints. Early diagnosis will facilitate appropriate treatment and thus prevents further complications.

Assessment of serum nitric oxide level and its correlation with anthropometric parameters and lipid profile in diabetic patients: A hospital-based study from Tripura.

Background: Endothelial dysfunction is a well-known finding in hyper-cholesterolaemic patients. Multiple factors including increased inactivation of nitric oxide by radicals and inhibition of nitric oxide formation by different mechanisms contribute to this. Objectives: (i) To estimate serum nitric oxide (NO) levels among diabetic and non-diabetic subjects attending a tertiary care hospital of Tripura and (ii) to determine the correlation of serum nitric oxide with different anthropometric parameters and lipid profile among the study subjects. Methods: This cross-sectional study was conducted during June 2019 to May 2020 among 227 subjects. Anthropometric measurements like weight, body mass index (BMI), body fat percentage, visceral fat percentage were measured by using OMRON Body Composition Monitor (HBF 701). Serum NO levels were measured using standard NO colorimetric assay kit and HbA1C and lipid profile were analyzed by using a Biochemical Autoanalyser. Statistical analysis was performed by using SPSS software version 25. Result: One hundred fifteen (115) diabetics were considered as test group whereas One hundred twelve (112) non-diabetic subjects were included as control. The mean serum level of NO in the diabetic group was 86.91 ± 14.13 mmoles/L whereas in the non-diabetic group it was 33.23 ± 12.90 mmoles/L which is statistically significant. Significant correlation is also found between serum NO level and different anthropometric parameters, namely, age, BMI and visceral fat percentage. Conclusion: In this study, positive correlation is found between serum NO, BMI, and body visceral fat. As NO is considered as a potential biomarker for diabetic patients developing hypertension, BMI, and body visceral fat may be considered as a good prognostic parameter in future development of diabetic complications. While dealing with diabetic patients the family physicians should be aware of these two parameters and besides treating them, physicians should convince the diabetic patients to maintain ideal BMI and body visceral fat by following proper life style.

Assessment of exposure risk among healthcare workers exposed to confirmed cases of COVID-19 working in non-COVID zones of a teaching hospital in Northeast India: A cross-sectional study.

Introduction: Healthcare workers (HCWs) are at increased risk of acquiring the COVID-19 disease, if there is a breach in the personal protection while managing patients. Objectives: 1. To estimate the pattern of risk exposure among healthcare workers exposed to confirmed cases of COVID-19 working in non-COVID zones of a Teaching Hospital, North-East India. 2. To determine the association between pattern of exposure with their COVID-19 status. Materials and Method: This was a hospital-based cross-sectional study conducted among all HCWs who had occupational exposure to laboratory confirmed COVID-19 cases between July and September 2020 in-non COVID zones of a major tertiary care hospital in Tripura. Results: The present study showed that 215 HCWs were exposed to confirmed cases of COVID-19 while working in non-COVID zones of the hospital. Among the exposed, 39.5% of HCWs had high-risk exposure and 8.8% of HCWs were detected as COVID-19 positive. A majority of the study subjects experienced exposure in the hospital wards (66.0%), in surgical departments (19.5%), had close contact (less than one meter distance) with positive COVID-19 cases (73.5%), and had an exposure of more than 15 minutes (51.2%). The COVID status of the exposed HCWs was significantly associated with no source control (P = 0.016), close contact with COVID-19 positive cases (P = 0.026), more duration of exposure (P < 0.05), use of any PPE (P = 0.000). COVID status was also significantly associated with the high-risk exposure of the participants (P = 0.000). Conclusion: Strict enforcement of the infection control measures like universal precautions should be practiced by HCWs to prevent hospital-acquired infections.

Low circulatory Fe and Se levels with a higher IL-6/IL-10 ratio provide nutritional immunity in tuberculosis.

Tuberculosis (TB) patients show dysregulated immunity, iron metabolism, and anemia. In this study, circulatory cytokines, trace metals, and iron-related proteins (hepcidin, ferroportin, transferrin, Dmt1, Nramp1, ferritin, ceruloplasmin, hemojuvelin, aconitase, and transferrin receptor) were monitored in case (active tuberculosis patients: ATB) and control (non-tuberculosis: NTB and healthy) study populations (n = 72, male: 100%, mean age, 42.94 years; range, 17-83 years). Using serum elemental and cytokine levels, a partial least square discriminate analysis model (PLS-DA) was built, which clustered ATB patients away from NTB and healthy controls. Based on the PLS-DA variable importance in projection (VIP) score and analysis of variance (ANOVA), 13 variables were selected as important biosignatures [IL-18, IL-10, IL-13, IFN-γ, TNF-α, IL-5, IL-12 (p70), IL-1ß, copper, zinc, selenium, iron, and aluminum]. Interestingly, low iron and selenium levels and high copper and aluminum levels were observed in ATB subjects. Low circulatory levels of transferrin, ferroportin, and hemojuvelin with higher ferritin and ceruloplasmin levels observed in ATB subjects demonstrate an altered iron metabolism, which partially resolved upon 6 months of anti-TB therapy. The identified biosignature in TB patients demonstrated perturbed iron homeostasis with anemia of inflammation, which could be useful targets for the development of host-directed adjunct therapeutics.

Hypovitaminosis D, Dyslipidemia, and Thyroid Dysfunction among Adolescents and Their Associations with Blood Pressure in a Northeastern City of India.

BACKGROUND: Blood pressure (BP) is associated with serum levels of Vitamin D3, lipid profile, and thyroid hormones among adults. However, limited information is available regarding such associations in adolescents. OBJECTIVES: The objectives of this study were to estimate the prevalence of Vitamin D3 deficiency, dyslipidemia, and thyroid dysfunction among secondary school students of Agartala and to determine their associations with BP. METHODOLOGY: This cross-sectional study was conducted from April 1, 2018, to December 31, 2018, among 1000 secondary-level school students of Agartala municipal corporation area, chosen by multistage sampling ensuring proportionate representation. RESULTS: The prevalence of Vitamin D3 deficiency, thyroid dysfunction, and dyslipidemia was found to be 79.4%, 62.8%, and 37.5%, respectively. Among the respondents, 58.1% had raised BP, 16.7% were overweight, 5.3% were obese, and 48.3% had high waist-hip ratio (WHR). Among them, 70.97% of the fatty participants, 82.27% with high body mass index (BMI), and 69.05% with either low or normal WHR had significantly raised BP (P < 0.05). Out of total, 58.26% of the participants with normal serum D3 level, 59.95% with either euthyroid or hyperthyroid status, and 62.13% with dyslipidemia had raised BP, though these were not significant (P > 0.05). Binary logistic regression model has identified higher BMI, higher body fat content, high WHR, habit of consuming extra salt, and fast food on a regular basis as significant determinants of raised BP in this population (P < 0.05). CONCLUSION: Hypovitaminosis D, thyroid dysfunction, and dyslipidemia are prevalent among adolescents of Northeast India, but they did not emerge as significant determinants of BP in this population.

Role of body visceral fat in hypertension and dyslipidemia among the diabetic and nondiabetic ethnic population of Tripura-A comparative study.

BACKGROUND: Excess fat in the upper part of human body correlates with increased mortality and risk for diabetes, dyslipidemia, and hypertension. In India, there are very limited data available on the association of excess body visceral fat with hypertension and dyslipidemia independent of obesity and diabetes. OBJECTIVE: The objective of this study is to assess the role of body visceral fat percentage in hypertension and dyslipidemia among diabetic and nondiabetic indigenous ethnic population of Tripura. METHODS: Random blood sugar test was done for each of the study subjects with the help of a standard and validated glucometer. Then, blood samples were obtained after an 8-12-h overnight fast using vacutainer. Later on, all the blood samples were transported to the MRU laboratory at Agartala Government Medical College maintaining cold chain for following investigations: (1) FBS, PP by GOD-POD method; (2) HbA1c by immunoturbidimetric method; (3) cholesterol estimation by CHOD-PAP method; and (4) triglyceride estimation by glycerol phosphate oxidase method. RESULTS: In this study, it has been found that 62.5% diabetic subjects having high body visceral fat are suffering from Dyslipidemia, whereas only 42.9% nondiabetic subjects with high body visceral fat percentage are having dyslipidemia. Fisher's exact test showed association between diabetes status and body visceral fat (P = 0.048). It has been also observed that there was significant (P < 0.05) association between hypertension and body visceral fat among local indigenous ethnic population of Tripura. CONCLUSION: Body visceral fat percentage is significantly associated with hypertension, dyslipidemia, and type-2 diabetes among indigenous ethnic population of Tripura.

Associations of obesity and serum leptin level with elevated blood pressure among urban secondary school students of a northeastern city of India: A baseline observation.

BACKGROUND: Elevated blood pressure has been found to be associated with body mass index (BMI) and serum leptin levels among adults. But there is a paucity of reports regarding such associations among adolescents. OBJECTIVES: To estimate the prevalence of prehypertension and hypertension and its associations with BMI and serum leptin levels among the secondary school going students of the Agartala Municipal Corporation area. MATERIALS AND METHODS: This school-based cross-sectional study was conducted from 1st April 2018 to 31st December 2018, among 1,000 students studying in different secondary level schools located in Agartala municipal corporation area chosen by multistage sampling ensuring proportionate representation in the sample. RESULT: Prevalence of prehypertension and hypertension were found to be 42.40% and 15.70%, respectively, 55.20% had normal, 22.80% had low, and 22.00% had high BMI. Serum leptin levels were found to be normal among 54.70% of the students, whereas, 36.70% had high and 8.60% had low levels, respectively. Logistic regression analysis has identified male sex (OR = 0.231, 95% CI = 0.172-0.310, P = 0.000) and high BMI (OR = 4.289, 95% CI = 2.857-6.440, P = 0.000) as the significant determinants of elevated blood pressure, but the effect of serum leptin level and family history of hypertension did not attain the level of statistical significance. CONCLUSION: Prevalence of prehypertension and hypertension among urban school-going adolescents were found to be 42.40% and 15.70%, respectively and were significantly associated with their sex and BMI and serum leptin level, but regression analysis failed to detect any significant effect of serum leptin level in determining the blood pressure of the study subjects.

Whole-Genome Sequence of Drug-Resistant Mycobacterium tuberculosis Strain S7, Isolated from a Patient with Pulmonary Tuberculosis.

Over the past decades, drug-resistant Mycobacterium tuberculosis strains have presented a significant challenge, with inadequate diagnosis of tuberculosis (TB) cases. Here, we report the draft whole-genome sequence of drug-resistant M. tuberculosis strain S7, which was isolated from a patient from Tripura, India, who was diagnosed with pulmonary TB.

Spatio-temporal study of environmental nontuberculous mycobacteria isolated from Wardha district in Central India.

During the last two decades, nontuberculous mycobacteria (NTM) have gained in importance but there is still a paucity of data, particularly for environmental isolates. We studied, over a period of two years, the spatio-temporal features of NTM isolates obtained from different environmental sources in Wardha district, India. A total of 1398 samples (699 each of soil and water) were tested and 170 (12.2%) yielded NTM isolates, including 123 from soil and 47 from water samples. Out of 170 NTM isolates, 107 (63%) belonged to potentially pathogenic mycobacteria (PPM) and 63 (37%) to the less pathogenic mycobacterial (LPM) group. Overall, maximum isolation was obtained in rainy season (20.3%) followed by winter (13.5%), post rainy (8.7%) and summer seasons (5.8%). Mycobacterium fortuitum, Mycobacterium gordonae and Mycobacterium avium complex (MAC) were common isolates followed by Mycobacterium flavescens, Mycobacterium scrofulaceum, Mycobacterium simiae and Mycobacterium marinum. From soil, isolation of NTM was highest from grounds used for community gatherings (42.8%) followed by soil from residential premises (27.7%) and near the wells (26.0%). From drinking water sources, highest NTM isolation was obtained from wells (15.4%) followed by treated water tanks (6.9%), household receptacles (6.3%), hand pumps (5.6%) and tap water supply (3.5%). Isolation from natural canal water was 6.6%, while from drainage and waste water ponds isolation was 8.3%. The results of the study revealed that in Wardha district, NTM are present both in the soil and drinking water. As NTM can be pathogenic, particularly in immune-compromised individuals, these can be of potential risk to the human population.