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BackgroundSevere Corona virus disease (COVID-19) is associated with high mortality. Although single centre intensive care units (ICU) have reported clinical characteristics and outcomes, no large scale multicentric study from India has... more
BackgroundSevere Corona virus disease (COVID-19) is associated with high mortality. Although single centre intensive care units (ICU) have reported clinical characteristics and outcomes, no large scale multicentric study from India has been published. The present retrospective, multi-centre study was aimed to describe the predictors and outcomes of COVID-19 patients requiring ICU admission from COVID-19 Registry of Indian council of Medical Research (ICMR), India.MethodsProspectively collected data from multiple participating institutions was entered in the electronic National Clinical Registry of COVID 19. We enrolled patients aged>18 years with COVID-19 pneumonia requiring ICU admission between March 2020 and August 2021. Exclusion criteria were negative RT PCR, death within 24 hours of ICU admission, or patients with incomplete data in the registry Their demographic characteristics, laboratory variables, ICU severity indices, treatment strategies and outcomes were analysed.Res...
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Abrus precatorius poisoning leading to hemorrhagic gastroduodenitis– a rare experience Abrus precatorius, popularly known as ‘kuch’ or ‘rati’, is used in weighing gold, making jewelry and children’s play. One to two crushed seeds can be... more
Abrus precatorius poisoning leading to hemorrhagic gastroduodenitis– a rare experience Abrus precatorius, popularly known as ‘kuch’ or ‘rati’, is used in weighing gold, making jewelry and children’s play. One to two crushed seeds can be fatal and very often used as cattle poison which mimics viper bite. Human poisoning with ‘kuch’ seeds is rarely reported in literature and almost always lifethreatening without prompt identification and aggressive supportive therapy. The authors here present a case of acute hemorrhagic gastroduodenitis following accidental ingestion of some beans with bright red and black color which was found to be Abrus precatorius. Patient himself identified those seeds as well as corroborated by forensic medicine and toxicology department. Moreover with vigilant monitoring the patient survived without any residual illness.
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Management of severe malaria remains a critical global challenge. In this study, using a multiplexed quantitative proteomics pipeline we systematically investigated the plasma proteome alterations in non-severe and severe malaria... more
Management of severe malaria remains a critical global challenge. In this study, using a multiplexed quantitative proteomics pipeline we systematically investigated the plasma proteome alterations in non-severe and severe malaria patients. We identified a few parasite proteins in severe malaria patients, which could be promising from a diagnostic perspective. Further, from host proteome analysis we observed substantial modulations in many crucial physiological pathways, including lipid metabolism, cytokine signaling, complement, and coagulation cascades in severe malaria. We propose that severe manifestations of malaria are possibly underpinned by modulations of the host physiology and defense machinery, which is evidently reflected in the plasma proteome alterations. Importantly, we identified multiple blood markers that can effectively define different complications of severe falciparum malaria, including cerebral syndromes and severe anemia. The ability of our identified blood ma...
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India contributes to 10% of the annual world incidence of thalassemia. The early onset of symptoms, multiple somatic complaints, frequent transfusions and uncertain prognosis drain the emotional resources of thalassaemic children and... more
India contributes to 10% of the annual world incidence of thalassemia. The early onset of symptoms, multiple somatic complaints, frequent transfusions and uncertain prognosis drain the emotional resources of thalassaemic children and their families. We aim to assess the prevalence of behavioral disturbance in children with transfusion dependant thalassaemics and the relative contribution of sociodemographic and clinical factors to the development of psychopathology and the factors that influence school going behaviour. 49 randomly selected cases and 51 age, sex and socioeconomic status matched controls were assessed using DPCL, ICD 10 based clinical examination and Malin’s Intelligence Scale for Children. Behavioral abnormalities were present in 67.3% of cases, compared to 21.6% of controls (p=0.01). There was an overall effect with the presence of psychopathology in thalassemic children. Presence of psychopathology significantly predicted school dropout - an outcome not affected by...
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Background Point-of-care glucose-6-phosphate dehydrogenase (G6PD) testing has the potential to make the use of radical treatment for vivax malaria safer and more effective. Widespread use of G6PD tests as part of malaria case management... more
Background Point-of-care glucose-6-phosphate dehydrogenase (G6PD) testing has the potential to make the use of radical treatment for vivax malaria safer and more effective. Widespread use of G6PD tests as part of malaria case management has been limited, in part due to due concerns regarding product usability, user training, and supervision. This study seeks to assess how well end users can understand the Standard™ G6PD Test (SD Biosensor, Suwon, South Korea) workflow, result output, and label after training. This will ultimately help inform test registration and introduction. Methods Potential G6PD test users who provide malaria case management at three sites in Brazil, Ethiopia, and India were trained on the use of the SD Biosensor Standard G6PD Test and assessed based on their ability to understand the test workflow and interpret results. The assessment was done through a questionnaire, designed to assess product usability against key technical product specifications and fulfill ...
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Background and Objectives: Human immunodeficiency virus (HIV)-induced endothelial dysfunction leads to premature atherosclerosis, which may manifest as peripheral arterial disease (PAD) of the lower limbs. Studies are not available on the... more
Background and Objectives: Human immunodeficiency virus (HIV)-induced endothelial dysfunction leads to premature atherosclerosis, which may manifest as peripheral arterial disease (PAD) of the lower limbs. Studies are not available on the prevalence of PAD among antiretroviral therapy (ART)-naïve HIV-infected population. The objective was to explore the prevalence of PAD among HIV seropositive cases and to determine the relation of PAD with HIV infectivity and with CD4 count. Materials and Methods: This hospital-based case-control study included 100 newly diagnosed HIV seropositive ART naïve cases (age 20–49 years) and 100 HIV seronegative frequency or group matched controls. Demographic, clinical and routine laboratory parameters, and ankle-brachial pressure index (ABI) were studied. PAD was diagnosed by Doppler study of lower limb arteries. Results: The prevalence of PAD was significantly more among HIV-infected cases (71%) in comparison to HIV-negative controls (P < 0.001). Abnormalities in ABI were present among 75% (53/71) of total PAD cases in our study. Among the cases of PAD, 53% (38/71) patients were asymptomatic. The mean CD4 count among the HIV-positive PAD cases was 220 cells/dl. HIV seropositivity was found to be significantly associated with the development of PAD. Male gender, concurrent tuberculosis, and low CD4 count came out to be individually associated with PAD among HIV seropositive cases in multivariate analysis. Conclusions: The prevalence of symptomatic and asymptomatic PAD was high among ART-naïve HIV-infected cases of relatively younger age group. Future studies should validate the Doppler findings suggestive of PAD among HIV seropositive patients with different inflammatory markers. Prospective studies on Doppler evaluation of endothelial dysfunction among asymptomatic HIV patients should be undertaken to establish or disprove the role of ART.
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Parasitic opportunistic infections (POIs) frequently occur in HIV/AIDS patients and affect the quality of life. This study assessing the standard organisms in the stool of HIV-positive patients, their comparison with HIV-negative... more
Parasitic opportunistic infections (POIs) frequently occur in HIV/AIDS patients and affect the quality of life. This study assessing the standard organisms in the stool of HIV-positive patients, their comparison with HIV-negative controls, their relation with various factors, is the first of its kind in the eastern part of India. hospital-based case-control study. A total of 194 antiretroviral therapy naïve HIV-positive patients (18-60 years) were taken as cases and 98 age- and sex-matched HIV-negative family members as controls. Demographical, clinical, biochemical, and microbiological parameters were studied. Odds ratio, 95% confidence interval, and P (< 0.05 is to be significant) were calculated using Epi Info 7 software. POI was significantly higher among HIV-seropositive cases (61.86%) (P < 0.001). Cryptosporidium was the most common POI in HIV-seropositive patients overall and without diarrhea; Entameba was the most common POI in patients with acute diarrhea, and Isospor...
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In Plasmodium vivax malaria, mechanisms that trigger transition from uncomplicated to fatal severe infections are obscure. In this multi-disciplinary study we have performed a comprehensive analysis of clinicopathological parameters and... more
In Plasmodium vivax malaria, mechanisms that trigger transition from uncomplicated to fatal severe infections are obscure. In this multi-disciplinary study we have performed a comprehensive analysis of clinicopathological parameters and serum proteome profiles of vivax malaria patients with different severity levels of infection to investigate pathogenesis of severe malaria and identify surrogate markers of severity. Clinicopathological analysis and proteomics profiling has provided evidences for the modulation of diverse physiological pathways including oxidative stress, cytoskeletal regulation, lipid metabolism and complement cascades in severe malaria. Strikingly, unlike severe falciparum malaria the blood coagulation cascade was not found to be affected adversely in acute P. vivax infection. To the best of our knowledge, this is the first comprehensive proteomics study, which identified some possible cues for severe P. vivax infection. Our results suggest that Superoxide dismuta...
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Innis BL. Dengue infection complicated by severe hemorrhage and vertical transmission in a parturient woman. Clin Infect Dis 1994; 18: 248–249. 4. Constantinescu AA, Berendes PB and Levin MD. Disseminated intravascular coagulation and a... more
Innis BL. Dengue infection complicated by severe hemorrhage and vertical transmission in a parturient woman. Clin Infect Dis 1994; 18: 248–249. 4. Constantinescu AA, Berendes PB and Levin MD. Disseminated intravascular coagulation and a negative D-dimer test. Neth J Med 2007; 65: 398–400. 5. Shepherd SM. Dengue clinical presentation. Available at: http://emedicine.medscape.com/article/215840-clinical (accessed 10th November 2014). 6. Singh N, Sharma KA, Dadhwal V, Mittal S and Selvi AS. A successful management of dengue fever in pregnancy: report of two cases. Ind J Med Microbiol 2008; 26: 377–380. 7. Swamy N, Patil P and Sruthi T. A case of dengue fever in pregnancy with fatal outcome. IOSR J Dent Med Sci 2014; 13: 71–73. 8. Ohsato K, Takaki A, Takeda S, Katoh H and Hayashida T. A clinical study on surgical patients with disseminated intravascular coagulation: with special reference to the occurrence of major organ failures. Nihon Geka Gakkai Zasshi 1983; 84: 860–864. 9. Tangnararatchakit K, Tirapanich W, Tapaneya-Olarn W, Sumethkul V, Sirachainan N, Watcharananan S, et al. Severe nonfebrile dengue infection in an adolescent after postoperative kidney transplantation: a case report. Transplant Proc 2012; 44: 303–306. 10. Tan FL, Loh DL, Prabhakaran K, Tambyah PA and Yap HK. Dengue haemorrhagic fever after living donor renal transplantation. Nephrol Dial Transplant 2005; 20: 447–448.
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Aim: To assess the uptake of an HIV screening program and therapeutic intervention to minimize the risk of mother to child transmission.Methods: This was a cross‐sectional, observational study with retrospective data obtained from... more
Aim: To assess the uptake of an HIV screening program and therapeutic intervention to minimize the risk of mother to child transmission.Methods: This was a cross‐sectional, observational study with retrospective data obtained from patient medical records. Pregnant women presenting to a tertiary care center in Kolkata, India, from 1 January 2004 – 31 December 2007 underwent HIV serology by rapid test after receiving group counseling. Care was administered using a standard national protocol by a multi‐disciplinary team of health‐care personnel. Main outcome measures were: acceptance of pretest counseling and HIV testing by pregnant women attending antenatal clinic services, post‐test counseling rate, coverage rate of nevirapine to mother–child pairs, and averted HIV infection in children.Results: Of the 52 127 new antenatal booking visits, 49 580 (95.11%) women attended pretest counseling and 47 506 (91.13%) women accepted HIV testing. Eighty‐six women were found to be seropositive...
Research Interests: Obstetrics, Pediatrics, Medicine, India, Pregnancy, and 15 moreHumans, Female, Obstetrics and Gynaecology, Newborn Infant, Retrospective Studies, Hiv seropositivity, Guidance and Counseling Intervention Programs, Observational Study, Seroprevalence, Cross Sectional Studies, Prenatal Care, Nevirapine, mass Screening, Paediatrics and reproductive medicine, and HIV infections
Most urethral strictures arise from iatrogenic, traumatic, or inflammatory causes. We report the familial occurrence of a congenital bulbar urethral stricture in two brothers. Retrograde and voiding cystourethrography was performed. A... more
Most urethral strictures arise from iatrogenic, traumatic, or inflammatory causes. We report the familial occurrence of a congenital bulbar urethral stricture in two brothers. Retrograde and voiding cystourethrography was performed. A Cobb′s collar was diagnosed after radiological and endoscopic evaluation in both cases and was successfully managed with urethroplasty. Cobb′s collar is a rarely recognized cause of a membranous stricture of bulbar urethra that can lead to several urinary problems. In cases of adolescent and young adults presenting with symptoms of progressive urinary obstruction and enuresis with or without urinary tract infection, Cobb′s collar can be seen as a minor constriction in the bulbar urethra, but is not frequently symptomatic, and the familial occurrence of such a stricture is even rarer.
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Research Interests: Hinduism, Demography, Epidemiology, Clinical Trial, Developing Countries, and 15 moreHealth, Adolescent, HIV, Biological Sciences, Comparative studies, Cluster Analysis, AIDS, Hiv Infection, Commercial Sex Workers, Adult, General Population, Confidence Interval, High risk, gonorrhea, and biological effect
Health-related quality of life (QOL) has become a high priority of long-term management of HIV-infected individuals. The newly diagnosed HIV cases were assessed to obtain sociodemographic and clinical findings. Eyesenk Personality... more
Health-related quality of life (QOL) has become a high priority of long-term management of HIV-infected individuals. The newly diagnosed HIV cases were assessed to obtain sociodemographic and clinical findings. Eyesenk Personality Questionnaire (EPQ), World Health Organization Quality of Life Brief (WHOQOL-BREF) for HIV-infected patients, and Beck Depression Inventory (BDI) were used to get data regarding personality traits, QOL, and depression scores. A total of 175 patients were included in the study, 128 (73.1%) men and 47 (26.9%) women. Overall 56% of patients screened positive for depression. Presence of depression and high neuroticism score in the personality profile of HIV-infected patients are significantly associated with poorer QOL. High neuroticism score was a strong predictor of poorer QOL in psychological and spiritual domain. Management of HIV-infected patients therefore needs to address these psychological issues.