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Dey M, Mishra B, Mohapatra PR, Mohakud S, Behera B. Microbiological profile of long COVID and associated clinical and radiological findings: a prospective cross-sectional study. Lab Med 2024:lmae010. [PMID: 38520687 DOI: 10.1093/labmed/lmae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVE To study the frequency of microbiological etiology of respiratory infections in patients with long COVID and their associated clinical and radiological findings. METHODS Nasopharyngeal swabs and sputum specimens were collected from 97 patients with respiratory illness stemming from long COVID. The specimens were assessed for their microbiological profile (bacteria and virus) and their association with the overall clinical and radiological picture. RESULTS In total, 23 (24%) patients with long COVID had viral infection (n = 12), bacterial infection (n = 9), or coinfection (n = 2). Microorganisms were detected at significantly higher rates in hospitalized patients, patients with moderate COVID-19, and patients with asthma (P < .05). Tachycardia (65%) was the most common symptom at presentation. A statistically significant number of patients with long COVID who had viral infection presented with cough and myalgia; and a statistically significant number of patients with long COVID who had bacterial infection presented with productive coughing (P < .05). Post-COVID fibrotic changes were found in 61% of cohort patients (31/51). CONCLUSION A decreasing trend of respiratory pathogens (enveloped viruses and bacteria) was found in long COVID. An analysis including a larger group of viral- or bacterial-infected patients with long COVID is needed to obtain high-level evidence on the presenting symptoms (cough, myalgia) and their association with the underlying comorbidities and severity.
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Affiliation(s)
- Monalisa Dey
- Departments of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Baijayantimala Mishra
- Departments of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Prasanta Raghab Mohapatra
- Departments of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sudipta Mohakud
- Departments of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Bijayini Behera
- Departments of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
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Bagaria DK, Gupta S, Pandey S, Choudhary N, Priyadarshini P, Kumar A, Alam J, Mishra B, Sagar S, Kumar S, Gupta A. Abdominal wall reconstruction (AWR) for post-trauma laparotomy ventral hernia and follow-up assessment of functional quality of life (QOL): experience of a level-1 trauma centre in India. Hernia 2024:10.1007/s10029-024-02978-1. [PMID: 38388814 DOI: 10.1007/s10029-024-02978-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024]
Abstract
PURPOSE The aim of this study was to examine the postoperative outcomes and follow-up QOL of patients after AWR at a level-1 trauma centre in India. METHODS The study cohort included AWR patients treated between January 2011 and July 2022. The Activities Assessment Scale (AAS) was used to measure QOL, and the Ventral Hernia Recurrence Inventory (VHRI) was used to determine the occurrence of recurrence. In patients suspected of having recurrence, thorough clinical examination and relevant imaging were performed to confirm or rule out recurrence. RESULTS Out of 89 patients, 35 patients whose complete perioperative and follow-up data were available were enrolled. The mean age of the patients was 28 (SD, 9) years. The mean defect size was 14. 9 (SD, 7) cm. The mean time from laparotomy to AWR surgery was 21 months. During the postoperative course, 37% of patients developed complications, such as SSI and seroma. The mean follow-up time was 53 (SD, 43) months. Upon comparing procedures involving the mesh placed in the sublay position with procedures involving the mesh placed in other positions, no statistically significant difference in the recurrence rate (one in each group, p = 0.99), surgical complication rate (33% v/s 66%, p = 0.6), or mean AAS QOL score (94.7 v/s 98, p = 0.4) was observed. The specificity of the VHRI for diagnosing recurrence was 79%. CONCLUSION Overall, the recurrence rate was low in these patients despite the presence of large hernia defects. Long-term QOL was not affected by the specific procedure used. Timely planning and execution are more important than the specific repair approach for post-trauma laparotomy ventral hernia.
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Affiliation(s)
- D K Bagaria
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - S Gupta
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - S Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - N Choudhary
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
| | - P Priyadarshini
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - A Kumar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - J Alam
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - B Mishra
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - S Sagar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - S Kumar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - A Gupta
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
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Misra P, Singh AK, Mishra B, Behera B, Patro BK, Medigeshi GR, Joshi HS, Ahmad M, Chaturvedi PK, Chinnakali P, Haldar P, Bairwa M, Kharya P, Dhodapkar R, Rath R, Guleria R, Rai SK, Kar SS, Kant S, Sarkar S, Baidya S, Meena S, Mandal S, Kishore S, Majumder T, Hada V. Anti-SARS-CoV-2 antibody kinetics up to 6 months of follow-up: Result from a nation-wide population-based, age stratified sero-epidemiological prospective cohort study in India. PLoS One 2023; 18:e0287807. [PMID: 38079384 PMCID: PMC10712846 DOI: 10.1371/journal.pone.0287807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Repeated serological testing tells about the change in the overall infection in a community. This study aimed to evaluate changes in antibody prevalence and kinetics in a closed cohort over six months in different sub-populations in India. The study included 10,000 participants from rural and urban areas in five states and measured SARS-CoV-2 antibodies in serum in three follow-up rounds. The overall seroprevalence increased from 73.9% in round one to 90.7% in round two and 92.9% in round three. Among seropositive rural participants in round one, 98.2% remained positive in round two, and this percentage remained stable in urban and tribal areas in round three. The results showed high antibody prevalence that increased over time and was not different based on area, age group, or sex. Vaccinated individuals had higher antibody prevalence, and nearly all participants had antibody positivity for up to six months.
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Affiliation(s)
- Puneet Misra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Arvind Kumar Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | - Baijayantimala Mishra
- Department Microbiology, All India Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | - Bijayini Behera
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | - Binod Kumar Patro
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhubaneshwar, Odisha, India
| | | | - Hari Shanker Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Mohammad Ahmad
- World Health Organization, WHO Country Office, New Delhi, India
| | | | - Palanivel Chinnakali
- Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Partha Haldar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Mohan Bairwa
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Pradeep Kharya
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Rahul Dhodapkar
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ramashankar Rath
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | | | - Sanjay Kumar Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sitanshu Sekhar Kar
- Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sonali Sarkar
- Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Subrata Baidya
- Department of Community Medicine, Agartala Government Medical College, Agartala, India
| | - Suneeta Meena
- Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Suprakash Mandal
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | | | - Tapan Majumder
- Department of Microbiology, Agartala Government Medical College, Agartala, India
| | - Vivek Hada
- Department of Microbiology, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
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Mohanty M, Mishra B, Satapathy AK, Gulla KM, Das RR, Dwibedi B, Gupta K, Mamidi P, Panda S. Human Bocavirus infection in childhood acute respiratory infection: Is it an innocent bystander? Indian J Med Microbiol 2023; 46:100436. [PMID: 37945128 DOI: 10.1016/j.ijmmb.2023.100436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/08/2023] [Accepted: 07/20/2023] [Indexed: 09/18/2023]
Abstract
PURPOSE Acute respiratory infection (ARI) is one of the major attributing factors of under-five mortality and morbidity all over the world. Viruses are the most common cause of ARI. Due to the availability of molecular techniques, new viruses are getting isolated from children with ARI. With the above background, the present study was conducted to enlighten on the pathogenic role of human bocavirus (HBoV) in children with ARI. METHODOLOGY This retrospective study was conducted over a period of >3 years duration. The clinical and laboratory data of the patients with signs and symptoms of ARI were retrieved and analyzed. Clinical profiles and outcome of the patients detected of having HBoV mono or co-infections were further analyzed in details. RESULTS A total of 237 respiratory samples were subjected to respiratory panel by fast track diagnosis (FTD) multiplex polymerase chain reaction (multiplex PCR), of which 10 samples (mono-infection = 4) were detected with the presence of HBoV. The clinical details of 8 cases were studied in details (details of rest 2 cases were missing). All the children were less than 3 years of age, with different co-morbid conditions such as low birth weight (n = 4), cholestatic jaundice (n = 1), operated case of congenital diaphragmatic hernia (n = 1), pancytopenia (n = 1), and primary immune deficiency (n = 1). Their clinical course did not improve following antibiotic administration, 2 succumbed to death while the rest 6 cases were discharged. CONCLUSION The present study highlights the fact that HBoV may not be an innocent bystander in the childhood ARI. Larger studies employing appropriate diagnostic modalities are needed to emboss it as a true pathogen and not merely a bystander.
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Affiliation(s)
- Monalisa Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Amit Kumar Satapathy
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Krishna Mohan Gulla
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Rashmi Ranjan Das
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Bhagirathi Dwibedi
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Kavita Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Prabhudutta Mamidi
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
| | - Sailendra Panda
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, 751019, Odisha, India.
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Rath S, Jain M, Mohanty M, Naik S, Mishra B. Long-segment Continuous Multi-level Spinal Tuberculosis without Bony Destruction Leading to Rapid Paraplegia in an Immunocompetent Patient. J Orthop Case Rep 2023; 13:95-98. [PMID: 37885633 PMCID: PMC10599386 DOI: 10.13107/jocr.2023.v13.i10.3950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/20/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction Spinal tuberculosis (STB) accounts for 1% of all tuberculosis (TB) cases and 50% of skeletal TB. The classic presentation is a paradiscal involvement leading to the destruction of bodies, progressive kyphosis that can end with neurological weakness. The advent of magnetic resonance imaging (MRI) has made detection early but at the same time, we find multilevel involvement which can be continuous/noncontinuous. Case Report A 26-year-old male, non-alcoholic, non-smoker presented with complete paraplegia involving the bladder and bowel. His clinical examination did not show any gibbus. He was started on empirical antitubercular therapy and then referred to us as he failed to show improvement. An MRI of the spine showed extensive long-segment continuous spinal involvement with epidural abscess. The patient was taken for surgery with posterior decompression and instrumentation which was proven to be TB. He received complete treatment of 1 year and had complete recovery of his sensory and incomplete recovery of motor of lower limbs (became a wheelchair ambulator) with regain of bowel and bladder control at the end of treatment. Conclusion This case report revealed that long-segment continuous STB without extensive destruction is atypical presentation. The clinical findings of paraplegia helped us to evaluate and clinch the diagnosis on MRI. However, the prognosis of rapid paraplegia remains guarded and patient had partial recovery of motor so he could become wheel chair ambulator only.
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Affiliation(s)
- Sutapa Rath
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mantu Jain
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha India
| | - Monalisa Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Gunasekaran PK, Shanmugasundaram D, Santhanam S, Verma S, Singh K, Dwibedi B, Awasthi S, Singh H, Sangappa M, Mondal N, Sreenivasan P, Saradakutty G, Malik S, Jain M, Viswanathan R, Sapkal G, Tripathi S, Patel B, Jain MK, Naganur SH, Baranwal A, Rohit MK, Deora S, Sharma A, Anantharaj A, Pillai LS, Kumar A, Ramasamy S, Rajendran PP, Singh MP, Ratho RK, Nag V, Gadepalli R, Mishra B, Som TK, Jain A, Devara SM, Vannavada SR, Munivenkatappa A, Abraham AM, Dhodapkar R, Ali S, Biswas D, Pratkeye D, Bavdekar A, Prakash J, Ray J, Murhekar M. Profile of cardiac lesions among laboratory confirmed congenital rubella syndrome (CRS) infants: a nationwide sentinel surveillance, India, 2016-22. Lancet Reg Health Southeast Asia 2023; 16:100268. [PMID: 37662056 PMCID: PMC10474486 DOI: 10.1016/j.lansea.2023.100268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 07/26/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023]
Abstract
Background The phenotypical profile of cardiovascular malformations in patients with congenital rubella syndrome (CRS) is varied. We aimed to describe the profile of cardiac defects among CRS patients detected in the sentinel CRS surveillance in India during 2016-22. Methods Sentinel sites enrolled infants with suspected CRS based on presence of cardiac defects, hearing impairment, eye signs, or maternal history of febrile rash illness. Suspected CRS cases underwent detailed systemic examination, including echocardiography and serological investigation for rubella. Cardiac defects were categorized as 'Simple' or 'Complex' as per the National Heart, Lung, and Blood Institute classification. We compared the distribution of cardiac defects among laboratory confirmed CRS cases and seronegative discarded cases. Findings Of the 4578 suspected CRS cases enrolled by 14 sites, 558 (12.2%) were laboratory confirmed. 419 (75.1%) laboratory confirmed cases had structural heart defects (simple defects: n = 273, 65.2%, complex defects: n = 144, 34.4%), with ventricular septal defect (42.7%), atrial septal defect (39.4%), patent ductus arteriosus (36.5%), and tetralogy of Fallot as the commonest defects (4.5%). Laboratory confirmed CRS cases had higher odds of left to right shunt lesions (OR = 1.58, 95% CI: 1.15-2.17). This was mainly on account of a significant association of PDA with CRS (OR = 1.77, 95% CI: 1.42-2.21). Mortality was higher among CRS patients with complex heart defects (HR = 2.04, 95% CI: 1.26-3.30). Interpretation Three-fourths of the laboratory confirmed CRS cases had structural heart defects. CRS patients with complex cardiac defects had higher mortality. Detecting CRS infection early and providing timely intervention for cardiovascular defects is critical for the management of CRS patients. Funding Ministry of Health and Family Welfare, Govt of India, through Gavi, the Vaccine Alliance.
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Affiliation(s)
| | | | | | - Sanjay Verma
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kuldeep Singh
- All India Institute of Medical Sciences, Jodhpur, India
| | | | | | | | | | - Nivedita Mondal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | | | | | - Shikha Malik
- All India Institute of Medical Sciences, Bhopal, India
| | - Manish Jain
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, India
| | | | | | | | | | | | | | - Arun Baranwal
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manoj K Rohit
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Akhil Sharma
- King George's Medical University, Lucknow, India
| | - Avinash Anantharaj
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | | | - Amber Kumar
- All India Institute of Medical Sciences, Bhopal, India
| | | | | | - Mini P. Singh
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radha Kanta Ratho
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | | | - Amita Jain
- King George's Medical University, Lucknow, India
| | | | | | | | | | - Rahul Dhodapkar
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Syed Ali
- Government Medical College, Trivandrum, India
| | | | | | | | - Jayant Prakash
- Indira Gandhi Institute of Medical Sciences, Patna, India
| | - Jaydeb Ray
- Institute of Child Health, Kolkata, India
| | - Manoj Murhekar
- ICMR – National Institute of Epidemiology, Chennai, India
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Mohapatra PR, Mishra B. Integrating clinical judgment, advanced radiology, and molecular diagnosis: the modern ways of pneumonia management. Eur J Emerg Med 2023; 30:300-301. [PMID: 37387634 DOI: 10.1097/mej.0000000000000986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
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Sahu DP, Singh AK, Mishra B, Behera B, Patro BK, Kunjanpillai JS, Nair J, Panigrahi MK, Mohanty MK, Behera P, Mohapatra PR, Barik S, Mohanty S, Sahu S, Singh SR, Tripathy S. Health system factors related to COVID-19 mortality in Eastern India: Hospital-based cross-sectional study. J Family Med Prim Care 2023; 12:1331-1335. [PMID: 37649740 PMCID: PMC10465061 DOI: 10.4103/jfmpc.jfmpc_1956_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/03/2023] [Accepted: 03/23/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Mortality from coronavirus disease 2019 (COVID-19) pandemic has left footprints across all ages and socio-economic strata. The deaths because of COVID-19 are usually multi-factorial. The study aimed to assess the health system factors related to COVID-19-related deaths. Materials and Methods A hospital-based retrospective study was conducted at a tertiary care hospital of eastern India. A total of 272 COVID-19 deaths that occurred between April and November 2020 were investigated. Data were extracted from Medical Record Department, and telephonic interviews were conducted to assess the different delays related to death. Data were analysed using Statistical Package for Social Sciences. Travel time, travel distance, delay in testing, and delay in receiving quality care were presented as median with inter-quartile range. Results Complete information could be collected from 243 COVID deaths of the 272 deaths (89.3%). The duration of hospital stay was 1-7 days for 42% of the deceased. The median travel time was 120 min, and the median distance travelled was 60 km. The median time to receive first attention of health care workers was 10 minutes. There was hardly any delay in reporting of test results, whereas the median time from symptoms to test and the median time from symptoms to admission were 4 days each. Conclusion Health system factors related to death of COVID-19 need to be addressed to avoid the avoidable deaths during the pandemic situation. The resilience of the health system can be helpful in reducing death toll in a low-resource country like India.
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Affiliation(s)
- Dinesh Prasad Sahu
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Arvind Kumar Singh
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bijayini Behera
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Binod Kumar Patro
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | | | - Jyolsna Nair
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Manoj Kumar Panigrahi
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Manoj Kumar Mohanty
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Priyamadhaba Behera
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Prasanta Raghav Mohapatra
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sadananda Barik
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sachidanand Mohanty
- Medical Superintendent, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Subhakanta Sahu
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sudipta Ranjan Singh
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Swagata Tripathy
- Department of Anaesthesiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Behera B, Mohanty S, Mishra B, Mohapatra PR. Letter in Response to "Melioidosis in a Tertiary Care Center from South India: A 5-year Experience. Indian J Crit Care Med 2023; 27:368-369. [PMID: 37214114 PMCID: PMC10196643 DOI: 10.5005/jp-journals-10071-24466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 04/04/2021] [Indexed: 05/24/2023] Open
Abstract
How to cite this article: Behera B, Mohanty S, Mishra B, Mohapatra PR. Letter in Response to "Melioidosis in a Tertiary Care Center from South India: A 5-year Experience. Indian J Crit Care Med 2023;27(5):368-369.
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Affiliation(s)
- Bijayini Behera
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Srujana Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Prasanta Raghab Mohapatra
- Department of Pulmonary and Critical Care Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Shanmugasundaram D, Verma S, Singh K, Dwibedi B, Awasthi S, Mahantesh S, Singh H, Santhanam S, Mondal N, S G, Sreenivasan P, Malik S, Jain M, Viswanathan R, Tripathi S, Patel B, Sapkal G, Sabarinathan R, Singh MP, Ratho R, Nag V, Gadepalli R, Som TK, Mishra B, Jain A, Ashok M, Madhuri DS, Rani VS, Abraham AM, John D, Dhodapkar R, Syed Ali A, Biswas D, Pratyeke D, Bavdekar A, Prakash J, Singh V, Prasad N, Ray J, Majumdar A, Dutta S, Gupta N, Murhekar M, Sharma A, Ghosh A, Alexander A, Baranwal A, Anantharaj A, Bethou A, Shekhawat DS, Kiruthika G, Ram J, Gupta M, Gowda M, Rohit MK, Dash N, Sankhyan N, Kaushal N, Shivanna NH, Kasturi N, Kumar PP, Gupta PC, Gunasekaran PK, Singh P, Kumar P, Munjal SK, Agarwal S, Manasa S, Shukla S, Nehra U, Verghese VP, Vyas V, Gupta V. Congenital rubella syndrome surveillance in India, 2016-21: Analysis of five years surveillance data. Heliyon 2023; 9:e15965. [PMID: 37251844 PMCID: PMC10209330 DOI: 10.1016/j.heliyon.2023.e15965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 04/19/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Background In India, facility-based surveillance for congenital rubella syndrome (CRS) was initiated in 2016 to estimate the burden and monitor the progress made in rubella control. We analyzed the surveillance data for 2016-2021 from 14 sentinel sites to describe the epidemiology of CRS. Method We analyzed the surveillance data to describe the distribution of suspected and laboratory confirmed CRS patients by time, place and person characteristics. We compared clinical signs of laboratory confirmed CRS and discarded case-patients to find independent predictors of CRS using logistic regression analysis and developed a risk prediction model. Results During 2016-21, surveillance sites enrolled 3940 suspected CRS case-patients (Age 3.5 months, SD: 3.5). About one-fifth (n = 813, 20.6%) were enrolled during newborn examination. Of the suspected CRS patients, 493 (12.5%) had laboratory evidence of rubella infection. The proportion of laboratory confirmed CRS cases declined from 26% in 2017 to 8.7% in 2021. Laboratory confirmed patients had higher odds of having hearing impairment (Odds ratio [OR] = 9.5, 95% confidence interval [CI]: 5.6-16.2), cataract (OR = 7.8, 95% CI: 5.4-11.2), pigmentary retinopathy (OR = 6.7, 95 CI: 3.3-13.6), structural heart defect with hearing impairment (OR = 3.8, 95% CI: 1.2-12.2) and glaucoma (OR = 3.1, 95% CI: 1.2-8.1). Nomogram, along with a web version, was developed. Conclusions Rubella continues to be a significant public health issue in India. The declining trend of test positivity among suspected CRS case-patients needs to be monitored through continued surveillance in these sentinel sites.
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Affiliation(s)
| | - Sanjay Verma
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kuldeep Singh
- All India Institute of Medical Sciences, Jodhpur, India
| | | | | | - S. Mahantesh
- Indira Gandhi Institute of Child Health, Bengaluru, India
| | | | | | - Nivedita Mondal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Geetha S
- Government Medical College, Trivandrum, India
| | | | - Shikha Malik
- All India Institute of Medical Sciences, Bhopal, India
| | - Manish Jain
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, India
| | | | | | | | | | | | - Mini P. Singh
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R.K. Ratho
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | | | - Amita Jain
- King George's Medical University, Lucknow, India
| | - M. Ashok
- ICMR-National Institute of Virology, Pune, India
| | | | | | | | - Deepa John
- Christian Medical College, Vellore, India
| | - Rahul Dhodapkar
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - A. Syed Ali
- Government Medical College, Trivandrum, India
| | | | | | | | - Jayant Prakash
- Indira Gandhi Institute of Medical Sciences, Patna, India
| | - Varsha Singh
- Indira Gandhi Institute of Medical Sciences, Patna, India
| | - Nidhi Prasad
- Indira Gandhi Institute of Medical Sciences, Patna, India
| | - Jaydeb Ray
- Institute of Child Health, Kolkata, India
| | - Agniva Majumdar
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shanta Dutta
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | | | | | - Akhil Sharma
- King George's Medical University, Lucknow, India
| | | | - Arun Alexander
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Arun Baranwal
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Avinash Anantharaj
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Adhisivam Bethou
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | | | - G. Kiruthika
- ICMR–National Institute of Epidemiology, Chennai, India
| | - Jagat Ram
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhu Gupta
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mamatha Gowda
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Manoj K Rohit
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nabaneeta Dash
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naveen Sankhyan
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nidhi Kaushal
- All India Institute of Medical Sciences, Jodhpur, India
| | | | - Nirupama Kasturi
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - P. Prem Kumar
- Indira Gandhi Institute of Child Health, Bengaluru, India
| | - Parul Chawla Gupta
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Praveen Kumar
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Suhani Manasa
- Indira Gandhi Institute of Child Health, Bengaluru, India
| | | | - Urvashi Nehra
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Varuna Vyas
- All India Institute of Medical Sciences, Jodhpur, India
| | - Vikas Gupta
- All India Institute of Medical Sciences, Bhopal, India
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11
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Ramamoorthy S, Garg S, Mishra B, Radotra BD, Saikia UN. Coxsackievirus and Adenovirus Receptor (CAR) Expression in Autopsy Tissues: Organ-Specific Patterns and Clinical Significance. Cureus 2023; 15:e37138. [PMID: 37153286 PMCID: PMC10159945 DOI: 10.7759/cureus.37138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2023] [Indexed: 05/09/2023] Open
Abstract
Coxsackievirus and adenovirus receptor (CAR) homologs have been identified in many species, and their proteins appeared to be highly conserved in evolution. While most of the human studies are about pathological conditions, the animal studies were more about the physiological and developmental functions of receptors. The expression of CAR is developmentally regulated, and its tissue localization is complex. Hence, we planned to study CAR expression in five different human organs at autopsy in different age groups. CAR expression was analyzed in the pituitary, heart, liver, pancreas, and kidney by immunohistochemistry, and CAR mRNA expression in the heart and pituitary by real-time PCR. In the current study, CAR expression was strong in cells of the anterior pituitary, hepatocytes, and bile ducts in the liver, acini, and pancreas and distal convoluted tubule/collecting duct in the kidney, with uniform expression in all age groups. We have noted high CAR expression in fetuses and infantile hearts, which get reduced drastically in adults due to its presumed developmental role in intrauterine life studied in animal models. In addition, the receptor was expressed in glomerular podocytes around the period of fetus viability (37 weeks) but not in early fetuses and adults. We have hypothesized that this intermittent expression could be responsible for the intercellular contact normally formed between the podocytes during the developmental phase. Pancreatic islets also showed increased expression after the emergence of the viability period but not in early fetuses and adults, which might be related to an increase in fetal insulin secretion at that particular age group.
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Affiliation(s)
| | - Sumit Garg
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Bishan Dass Radotra
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
| | - Uma Nahar Saikia
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, IND
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12
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Jain M, Rath S, Mohanty M, Mishra B, Mohapatra PR. Knowledge, Attitude, and Practices Among Healthcare Practitioners in the Context of Multidrug Resistance Tuberculosis: An Appraisal to Disease Elimination. Cureus 2023; 15:e36788. [PMID: 37123664 PMCID: PMC10134086 DOI: 10.7759/cureus.36788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Tuberculosis (TB) remains one of the leading infectious causes of death worldwide, and India is among the countries with the highest TB burden. TB control is facing several roadblocks in our country with the rapid development of multidrug-resistant (MDR) as well as extensively drug-resistant TB (XDR) and as an after-effect of the global COVID-19 pandemic. With the target of TB elimination by 2025 (National Tuberculosis Elimination Program, NTEP), there is a need that treating physicians in our country be well aware of MDR-TB and be able to diagnose and treat it at an appropriate time. The present study is conducted to explore the knowledge levels, attitudes, and practices concerning MDR-TB amongst healthcare professionals working in different healthcare sectors. METHODS A total of 250 allopathic medical practitioners (Bachelor of Medicine and Bachelor of Surgery [MBBS], specialists, and superspecialists) working in any sector (private or government), who are directly involved in managing any form of TB patient and are willing to undertake the assessment, were included in this online questionnaire-based survey that was circulated using various social media platforms like WhatsApp, Facebook, Linked In, and Gmail. Responses to the questionnaires created in Google Forms were analyzed by capturing data in a Microsoft Excel® spreadsheet for further statistical analysis. The data were analyzed using multiple measures of dispersion and cross-tabulations. RESULTS Among the 250 participants, most of the participants had encountered MDR-TB in their clinical practice, and the majority believe that MDR-TB is a rising problem. Although 88% of the participants did a GeneXpert assay before the start of anti-tubercular therapy (ATT), three-fourths of the participants knew that the assay detects the MTB genome and rifampicin resistance. MDR-TB was suspected in participants after no clinical improvement was observed after 3-6 weeks of a trial of ATT. Two-thirds of the participants knew that linezolid is currently being used as a second-line drug for the treatment of MDR- TB. The respondents in our survey mostly do not themselves treat MDR-TB and refer the patients to an MDR-TB center or a pulmonary medicine specialist. CONCLUSION Healthcare practitioners (HCPs) with good knowledge levels can diagnose and treat TB patients appropriately, thus decreasing the rising MDR-TB problem, and they can educate patients and the general population about TB and the emerging MDR-TB situation. With the current level of knowledge about MDR-TB management, there is certainly an urgent need for educational and persuasive measures for the training of doctors in both the public and private sectors so as to achieve TB elimination by 2025.
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Abstract
The incessant occurrence of devastating health-related events, either on a large scale, such as pandemics, or in a local community in the form of sporadic outbreaks due to infectious agents, warrants a rapid, target-oriented, well-organized response team to combat the demonic consequences. While the world has been recovering from the clutches of the recent disastrous COVID-19 pandemic, the struggles against novel emerging and re-emerging pathogens such as monkeypox (mpox), newer evolving strains of influenza, Ebola, Zika, and the yellow fever virus continue to date. Therefore, a multisectoral, intercontinental, collaborative, interdisciplinary, and highly dedicated approach should always be implemented to achieve optimal health and avert future threats.
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14
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Tripathy SK, Pradhan SK, Barik B, Naik Z, Mishra B. Evolution of Generalized Brans–Dicke Parameter within a Superbounce Scenario. Symmetry (Basel) 2023. [DOI: 10.3390/sym15040790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
We studied a superbounce scenario in a set up of the Brans–Dicke (BD) theory. The BD parameter was considered to be time-dependent and was assumed to evolve with the Brans–Dicke scalar field. In the superbounce scenario, the model bounced at an epoch corresponding to a Big Crunch provided the ekpyrotic phase continued until that time. Within the given superbounce scenario, we investigated the evolution of the BD parameter for different equations of state. We chose an axially symmetric metric that has an axial symmetry along the x-axis. The metric was assumed to incorporate an anisotropic expansion effect. The effect of asymmetric expansion and the anisotropic parameter on the evolving and non-evolving parts of the BD parameter was investigated.
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15
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Arjun MC, Singh AK, Roy P, Ravichandran M, Mandal S, Pal D, Das K, Gajjala A, Venkateshan M, Mishra B, Patro BK, Mohapatra PR, Subba SH. Long COVID following Omicron wave in Eastern India-A retrospective cohort study. J Med Virol 2023; 95:e28214. [PMID: 36224705 PMCID: PMC9874641 DOI: 10.1002/jmv.28214] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 01/27/2023]
Abstract
Long coronavirus disease (COVID) or postacute sequelae of coronavirus disease of 2019 (COVID-19) is widely reported but the data of long COVID after infection with the Omicron variant is limited. This study was conducted to estimate the incidence, characteristics of symptoms, and predictors of long COVID among COVID-19 patients diagnosed during the Omicron wave in Eastern India. The cohort of COVID-19 patients included were adults (≥18 years) diagnosed as severe acute respiratory syndrome coronavirus 2 positive with Reverse Transcription Polymerase Chain Reaction. After 28 days of diagnosis; participants were followed up with a telephonic interview to capture data on sociodemographic, clinical history, anthropometry, substance use, COVID-19 vaccination status, acute COVID-19 symptoms, and long COVID symptoms. The long COVID symptoms were self-reported by the participants. Logistic regression was used to determine the predictors of long COVID. The median follow-up of participants was 73 days (Interquartile range; 67-83). The final analysis had 524 participants' data; among them 8.2% (95% Confidence Interval [CI]: 6%-10.9%) self-reported long COVID symptoms. Fatigue (34.9%) was the most common reported symptom followed by cough (27.9%). In multivariable logistic regression only two predictors were statistically significant-number of acute COVID-19 symptoms ≥ five (Adjusted odds ratio (aOR) = 2.95, 95% CI: 1.30-6.71) and past history of COVID-19 (aOR = 2.66, 95% CI: 1.14-6.22). The proportion of self-reported long COVID is considerably low among COVID-19 patients diagnosed during the Omicron wave in Eastern India when compared with estimates during Delta wave in the same setting.
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Affiliation(s)
- M. C. Arjun
- Department of Community Medicine and Family MedicineAll India Institute of Medical Sciences BhubaneswarBhubaneswarIndia
| | - Arvind K. Singh
- Department of Community Medicine and Family MedicineAll India Institute of Medical Sciences BhubaneswarBhubaneswarIndia
| | - Payel Roy
- Department of Community Medicine and Family MedicineAll India Institute of Medical Sciences BhubaneswarBhubaneswarIndia
| | - Mythry Ravichandran
- Department of Community Medicine and Family MedicineAll India Institute of Medical Sciences BhubaneswarBhubaneswarIndia
| | - Srijani Mandal
- Department of Community Medicine and Family MedicineAll India Institute of Medical Sciences BhubaneswarBhubaneswarIndia
| | - Debkumar Pal
- Department of Community Medicine and Family MedicineAll India Institute of Medical Sciences BhubaneswarBhubaneswarIndia
| | - Kajal Das
- Department of Community Medicine and Family MedicineAll India Institute of Medical Sciences BhubaneswarBhubaneswarIndia
| | - Alekhya Gajjala
- Department of Community Medicine and Family MedicineAll India Institute of Medical Sciences BhubaneswarBhubaneswarIndia
| | | | - Baijayantimala Mishra
- Department of MicrobiologyAll India Institute of Medical Sciences BhubaneswarBhubaneswarIndia
| | - Binod K. Patro
- Department of Community Medicine and Family MedicineAll India Institute of Medical Sciences BhubaneswarBhubaneswarIndia
| | - Prasanta R. Mohapatra
- Department of Pulmonary Medicine and Critical CareAll India Institute of Medical Sciences BhubaneswarOdishaIndia
| | - Sonu H. Subba
- Department of Community Medicine and Family MedicineAll India Institute of Medical Sciences BhubaneswarBhubaneswarIndia
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16
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Datta A, Mohapatra PR, Bhuniya S, Mishra B. TB treatment regimen for children: is a 4-month regimen really better than the 6-month regimen? Int J Tuberc Lung Dis 2022; 26:1197. [PMID: 36447324 DOI: 10.5588/ijtld.22.0375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- A Datta
- Department of Pulmonary Medicine & Critical Care, Bhubaneswar, India
| | - P R Mohapatra
- Department of Pulmonary Medicine & Critical Care, Bhubaneswar, India
| | - S Bhuniya
- Department of Pulmonary Medicine & Critical Care, Bhubaneswar, India
| | - B Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
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17
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Rath S, Mishra B, Mohapatra PR, Datta A, Durgeshwar G, Vedala M, Panigrahi MK, Bhuniya S. Tuberculosis and COVID-19: An epidemic submerged in the pandemic: A case series and review of current literature. J Family Med Prim Care 2022; 11:6576-6580. [PMID: 36618133 PMCID: PMC9810857 DOI: 10.4103/jfmpc.jfmpc_258_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/28/2022] [Accepted: 04/12/2022] [Indexed: 11/11/2022] Open
Abstract
Tuberculosis (TB), the leading infectious cause of death worldwide, like coronavirus disease 2019 (COVID-19), is mainly transmitted through the respiratory route and affects the lungs. Though TB-COVID co-infection is not common, but might be missed due to similar clinical presentation. Therefore, a high index of suspicion of co-infections is needed so that there is prompt diagnosis and appropriate treatment. A higher mortality of 13% in cases of co infections is alarming. Here we are reporting a case series of SARS-CoV-2 - TB co-infection from Eastern India.
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Affiliation(s)
- Sutapa Rath
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Prasanta R. Mohapatra
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India,Address for correspondence: Prof. Prasanta R. Mohapatra, Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar - 751 019, Odisha, India. E-mail:
| | - Ananda Datta
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Gopal Durgeshwar
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Manoharacharyulu Vedala
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Manoj K. Panigrahi
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sourin Bhuniya
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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18
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Mohapatra PR, Mishra B, Dutta A, Bhuniya S. Responding to WHO´s 4-month regimen for drug-susceptible pulmonary TB. Int J Tuberc Lung Dis 2022; 26:898-899. [PMID: 35996294 DOI: 10.5588/ijtld.22.0313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- P R Mohapatra
- Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
| | - B Mishra
- Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
| | - A Dutta
- Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
| | - S Bhuniya
- Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
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19
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Mohapatra S, Das PK, Mishra B, Panigrahi A. Clinical review of COVID-19 in children and adolescents with cancer: Experience from a tertiary care center in East India. Pediatr Hematol Oncol 2022; 39:517-528. [PMID: 35156866 DOI: 10.1080/08880018.2022.2025963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Children with underlying cancer are often immunocompromised. Data on severity of coronavirus disease 2019 (COVID-19) in children with cancer and its outcomes is emerging. Treatment protocols of specific cancers are decided based on the infrastructure, availability of supportive-care, and logistic issues of the locality. The purpose of the study was clinical analysis of COVID-19 in children and adolescents with cancer. The retrospective observational study was conducted at a tertiary healthcare-center in East India. Children and adolescents (aged 0-19 years) with cancer and under treatment with reverse-transcriptase-polymerase-chain-reaction (RT-PCR) confirmed COVID-19 between 5-July-2020 and 5-December-2020 were studied. Median age of the 68 identified patients was six years. Acute leukemia was the most common (66%) diagnosis. COVID-19 was asymptomatic/mildly symptomatic in 91% and moderate to severe in only 9% of patients. Fever (87%) was the commonest symptom, followed-by cough/coryza (75%). Three patients with acute myeloid leukemia (AML) and severe/critical COVID-19 and associated neutropenic sepsis were required transfer to the intensive-care-unit (ICU) for management. Three (4.4%) patients succumbed with COVID-19. Delay in treatment was observed in 63.2% of patients, and the median duration of delay was 28 days after acquiring COVID-19. Median time to attain negative COVID-19 RT-PCR was 16 days, and eight patients were repeat positives. While pediatric and adolescent cancer patients on active treatment may have a higher risk of mortality from severe COVID-19 than their healthy counterparts, the risk may be much lower than deemed. It is essential to continue cancer therapy in these children. Delay in treatment remains a concern.
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Affiliation(s)
- Sonali Mohapatra
- Department of Medical Oncology/Hematology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Prabodh Kumar Das
- Department of Medical Oncology/Hematology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Ashutosh Panigrahi
- Department of Medical Oncology/Hematology, All India Institute of Medical Sciences, Bhubaneswar, India
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20
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Abstract
Melioidosis is a complex tropical disease linked with many complications. It is increasingly diagnosed in India. The clinical mimicry of this disease with several other common causes of pneumonia has kept the clinicians in ignorance. Usually, the diagnosis and appropriate management get delayed. The organism closely resembles the common contaminant Pseudomonas and is easily misidentified in microbiology laboratories. The diagnosis is often missed because of poor diagnostic sensitivity of blood culture, the gold standard of the diagnosis. All this contributes to increased morbidity and mortality. The rampant use of high-end broad-spectrum antibiotics like ceftazidime and meropenem at suboptimal dose and duration suppresses the diagnosis without eradicating the disease, leaving the chance of recurrence from its latency even after years. As an infectious disease, the cure and prevention depend on early diagnosis and treatment. An awareness of its peculiar presentations and history can differentiate clinically and suspect the condition much easily from other mimickers of tuberculosis to sepsis. Ultimately, the prevention of melioidosis remains the critical strategy. Increasing the number of cases and intricated management of this fatal but potentially curable disease had prompted us to take up the mission of preventing the disease by spreading knowledge and awareness.
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Affiliation(s)
- Prasanta Raghab Mohapatra
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India,Address for correspondence: Dr. Prasanta Raghab Mohapatra, Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha - 751 019, India. E-mail:
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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21
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Mohanty M, Mishra B, Sirka CS, Mohapatra PR. Case Report: Multiple Scalp Abscesses due to Mycobacterium abscessus Infection Following Triamcinolone Injection in an Immunocompetent Person. Am J Trop Med Hyg 2022; 107:tpmd220126. [PMID: 35940200 PMCID: PMC9490647 DOI: 10.4269/ajtmh.22-0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/03/2022] [Indexed: 11/07/2022] Open
Abstract
Mycobacterium abscessus complex is a group of nontuberculous mycobacteria (NTM). The NTM may involve skin, soft tissue, and other organs like the eye and central nervous system. Clinically may mimic multidrug resistance. Here, we present a case of a 29-year man with a history of multiple scalp swellings with mild symptoms. He had undergone multiple triamcinolone acetonide injections on his scalp to stop hair fall and baldness 2 months prior. As there was a history of injections on the scalp and lesions associated with minimal symptoms, we suspected the possibility of NTM and fungal infections. As a part of treatment and obtaining a sample for investigation, lesions were aspirated with a needle. The swellings contained gelatinous material, which was sent for microscopic examination, and revealed the presence of acid-fast bacilli (AFB). Xpert MTB/RIF assay was negative for mycobacteria (MTB complex), but culture revealed NTM, identified as M. abscessus complex by line probe assay. Based on the diagnosis, the patient was treated with an injection of amikacin, moxifloxacin, and azithromycin. The lesions improved. The patient has completed over a year of follow-up with no recurrence noted. Mycobacterium abscessus, a rapidly growing NTM, has been occasionally reported to cause cutaneous soft tissue infection when injected with nonsterile medicine or needles. Therefore, a high index of suspicion for NTM infection is warranted in patients with cutaneous scalp abscess following scalp injections for hair loss.
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Affiliation(s)
- Monalisa Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Chandra Sekhar Sirka
- Department of Dermatology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Prasanta Raghab Mohapatra
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Proietti M, Romiti GF, Vitolo M, Harrison SL, Lane DA, Fauchier L, Marin F, Näbauer M, Potpara TS, Dan GA, Maggioni AP, Cesari M, Boriani G, Lip GYH, Ekmekçiu U, Paparisto V, Tase M, Gjergo H, Dragoti J, Goda A, Ciutea M, Ahadi N, el Husseini Z, Raepers M, Leroy J, Haushan P, Jourdan A, Lepiece C, Desteghe L, Vijgen J, Koopman P, Van Genechten G, Heidbuchel H, Boussy T, De Coninck M, Van Eeckhoutte H, Bouckaert N, Friart A, Boreux J, Arend C, Evrard P, Stefan L, Hoffer E, Herzet J, Massoz M, Celentano C, Sprynger M, Pierard L, Melon P, Van Hauwaert B, Kuppens C, Faes D, Van Lier D, Van Dorpe A, Gerardy A, Deceuninck O, Xhaet O, Dormal F, Ballant E, Blommaert D, Yakova D, Hristov M, Yncheva T, Stancheva N, Tisheva S, Tokmakova M, Nikolov F, Gencheva D, Shalganov T, Kunev B, Stoyanov M, Marchov D, Gelev V, Traykov V, Kisheva A, Tsvyatkov H, Shtereva R, Bakalska-Georgieva S, Slavcheva S, Yotov Y, Kubíčková M, Marni Joensen A, Gammelmark A, Hvilsted Rasmussen L, Dinesen P, Riahi S, Krogh Venø S, Sorensen B, Korsgaard A, Andersen K, Fragtrup Hellum C, Svenningsen A, Nyvad O, Wiggers P, May O, Aarup A, Graversen B, Jensen L, Andersen M, Svejgaard M, Vester S, Hansen S, Lynggaard V, Ciudad M, Vettus R, Muda P, Maestre A, Castaño S, Cheggour S, Poulard J, Mouquet V, Leparrée S, Bouet J, Taieb J, Doucy A, Duquenne H, Furber A, Dupuis J, Rautureau J, Font M, Damiano P, Lacrimini M, Abalea J, Boismal S, Menez T, Mansourati J, Range G, Gorka H, Laure C, Vassalière C, Elbaz N, Lellouche N, Djouadi K, Roubille F, Dietz D, Davy J, Granier M, Winum P, Leperchois-Jacquey C, Kassim H, Marijon E, Le Heuzey J, Fedida J, Maupain C, Himbert C, Gandjbakhch E, Hidden-Lucet F, Duthoit G, Badenco N, Chastre T, Waintraub X, Oudihat M, Lacoste J, Stephan C, Bader H, Delarche N, Giry L, Arnaud D, Lopez C, Boury F, Brunello I, Lefèvre M, Mingam R, Haissaguerre M, Le Bidan M, Pavin D, Le Moal V, Leclercq C, Piot O, Beitar T, Martel I, Schmid A, Sadki N, Romeyer-Bouchard C, Da Costa A, Arnault I, Boyer M, Piat C, Fauchier L, Lozance N, Nastevska S, Doneva A, Fortomaroska Milevska B, Sheshoski B, Petroska K, Taneska N, Bakrecheski N, Lazarovska K, Jovevska S, Ristovski V, Antovski A, Lazarova E, Kotlar I, Taleski J, Poposka L, Kedev S, Zlatanovik N, Jordanova S, Bajraktarova Proseva T, Doncovska S, Maisuradze D, Esakia A, Sagirashvili E, Lartsuliani K, Natelashvili N, Gumberidze N, Gvenetadze R, Etsadashvili K, Gotonelia N, Kuridze N, Papiashvili G, Menabde I, Glöggler S, Napp A, Lebherz C, Romero H, Schmitz K, Berger M, Zink M, Köster S, Sachse J, Vonderhagen E, Soiron G, Mischke K, Reith R, Schneider M, Rieker W, Boscher D, Taschareck A, Beer A, Oster D, Ritter O, Adamczewski J, Walter S, Frommhold A, Luckner E, Richter J, Schellner M, Landgraf S, Bartholome S, Naumann R, Schoeler J, Westermeier D, William F, Wilhelm K, Maerkl M, Oekinghaus R, Denart M, Kriete M, Tebbe U, Scheibner T, Gruber M, Gerlach A, Beckendorf C, Anneken L, Arnold M, Lengerer S, Bal Z, Uecker C, Förtsch H, Fechner S, Mages V, Martens E, Methe H, Schmidt T, Schaeffer B, Hoffmann B, Moser J, Heitmann K, Willems S, Willems S, Klaus C, Lange I, Durak M, Esen E, Mibach F, Mibach H, Utech A, Gabelmann M, Stumm R, Ländle V, Gartner C, Goerg C, Kaul N, Messer S, Burkhardt D, Sander C, Orthen R, Kaes S, Baumer A, Dodos F, Barth A, Schaeffer G, Gaertner J, Winkler J, Fahrig A, Aring J, Wenzel I, Steiner S, Kliesch A, Kratz E, Winter K, Schneider P, Haag A, Mutscher I, Bosch R, Taggeselle J, Meixner S, Schnabel A, Shamalla A, Hötz H, Korinth A, Rheinert C, Mehltretter G, Schön B, Schön N, Starflinger A, Englmann E, Baytok G, Laschinger T, Ritscher G, Gerth A, Dechering D, Eckardt L, Kuhlmann M, Proskynitopoulos N, Brunn J, Foth K, Axthelm C, Hohensee H, Eberhard K, Turbanisch S, Hassler N, Koestler A, Stenzel G, Kschiwan D, Schwefer M, Neiner S, Hettwer S, Haeussler-Schuchardt M, Degenhardt R, Sennhenn S, Steiner S, Brendel M, Stoehr A, Widjaja W, Loehndorf S, Logemann A, Hoskamp J, Grundt J, Block M, Ulrych R, Reithmeier A, Panagopoulos V, Martignani C, Bernucci D, Fantecchi E, Diemberger I, Ziacchi M, Biffi M, Cimaglia P, Frisoni J, Boriani G, Giannini I, Boni S, Fumagalli S, Pupo S, Di Chiara A, Mirone P, Fantecchi E, Boriani G, Pesce F, Zoccali C, Malavasi VL, Mussagaliyeva A, Ahyt B, Salihova Z, Koshum-Bayeva K, Kerimkulova A, Bairamukova A, Mirrakhimov E, Lurina B, Zuzans R, Jegere S, Mintale I, Kupics K, Jubele K, Erglis A, Kalejs O, Vanhear K, Burg M, Cachia M, Abela E, Warwicker S, Tabone T, Xuereb R, Asanovic D, Drakalovic D, Vukmirovic M, Pavlovic N, Music L, Bulatovic N, Boskovic A, Uiterwaal H, Bijsterveld N, De Groot J, Neefs J, van den Berg N, Piersma F, Wilde A, Hagens V, Van Es J, Van Opstal J, Van Rennes B, Verheij H, Breukers W, Tjeerdsma G, Nijmeijer R, Wegink D, Binnema R, Said S, Erküner Ö, Philippens S, van Doorn W, Crijns H, Szili-Torok T, Bhagwandien R, Janse P, Muskens A, van Eck M, Gevers R, van der Ven N, Duygun A, Rahel B, Meeder J, Vold A, Holst Hansen C, Engset I, Atar D, Dyduch-Fejklowicz B, Koba E, Cichocka M, Sokal A, Kubicius A, Pruchniewicz E, Kowalik-Sztylc A, Czapla W, Mróz I, Kozlowski M, Pawlowski T, Tendera M, Winiarska-Filipek A, Fidyk A, Slowikowski A, Haberka M, Lachor-Broda M, Biedron M, Gasior Z, Kołodziej M, Janion M, Gorczyca-Michta I, Wozakowska-Kaplon B, Stasiak M, Jakubowski P, Ciurus T, Drozdz J, Simiera M, Zajac P, Wcislo T, Zycinski P, Kasprzak J, Olejnik A, Harc-Dyl E, Miarka J, Pasieka M, Ziemińska-Łuć M, Bujak W, Śliwiński A, Grech A, Morka J, Petrykowska K, Prasał M, Hordyński G, Feusette P, Lipski P, Wester A, Streb W, Romanek J, Woźniak P, Chlebuś M, Szafarz P, Stanik W, Zakrzewski M, Kaźmierczak J, Przybylska A, Skorek E, Błaszczyk H, Stępień M, Szabowski S, Krysiak W, Szymańska M, Karasiński J, Blicharz J, Skura M, Hałas K, Michalczyk L, Orski Z, Krzyżanowski K, Skrobowski A, Zieliński L, Tomaszewska-Kiecana M, Dłużniewski M, Kiliszek M, Peller M, Budnik M, Balsam P, Opolski G, Tymińska A, Ozierański K, Wancerz A, Borowiec A, Majos E, Dabrowski R, Szwed H, Musialik-Lydka A, Leopold-Jadczyk A, Jedrzejczyk-Patej E, Koziel M, Lenarczyk R, Mazurek M, Kalarus Z, Krzemien-Wolska K, Starosta P, Nowalany-Kozielska E, Orzechowska A, Szpot M, Staszel M, Almeida S, Pereira H, Brandão Alves L, Miranda R, Ribeiro L, Costa F, Morgado F, Carmo P, Galvao Santos P, Bernardo R, Adragão P, Ferreira da Silva G, Peres M, Alves M, Leal M, Cordeiro A, Magalhães P, Fontes P, Leão S, Delgado A, Costa A, Marmelo B, Rodrigues B, Moreira D, Santos J, Santos L, Terchet A, Darabantiu D, Mercea S, Turcin Halka V, Pop Moldovan A, Gabor A, Doka B, Catanescu G, Rus H, Oboroceanu L, Bobescu E, Popescu R, Dan A, Buzea A, Daha I, Dan G, Neuhoff I, Baluta M, Ploesteanu R, Dumitrache N, Vintila M, Daraban A, Japie C, Badila E, Tewelde H, Hostiuc M, Frunza S, Tintea E, Bartos D, Ciobanu A, Popescu I, Toma N, Gherghinescu C, Cretu D, Patrascu N, Stoicescu C, Udroiu C, Bicescu G, Vintila V, Vinereanu D, Cinteza M, Rimbas R, Grecu M, Cozma A, Boros F, Ille M, Tica O, Tor R, Corina A, Jeewooth A, Maria B, Georgiana C, Natalia C, Alin D, Dinu-Andrei D, Livia M, Daniela R, Larisa R, Umaar S, Tamara T, Ioachim Popescu M, Nistor D, Sus I, Coborosanu O, Alina-Ramona N, Dan R, Petrescu L, Ionescu G, Popescu I, Vacarescu C, Goanta E, Mangea M, Ionac A, Mornos C, Cozma D, Pescariu S, Solodovnicova E, Soldatova I, Shutova J, Tjuleneva L, Zubova T, Uskov V, Obukhov D, Rusanova G, Soldatova I, Isakova N, Odinsova S, Arhipova T, Kazakevich E, Serdechnaya E, Zavyalova O, Novikova T, Riabaia I, Zhigalov S, Drozdova E, Luchkina I, Monogarova Y, Hegya D, Rodionova L, Rodionova L, Nevzorova V, Soldatova I, Lusanova O, Arandjelovic A, Toncev D, Milanov M, Sekularac N, Zdravkovic M, Hinic S, Dimkovic S, Acimovic T, Saric J, Polovina M, Potpara T, Vujisic-Tesic B, Nedeljkovic M, Zlatar M, Asanin M, Vasic V, Popovic Z, Djikic D, Sipic M, Peric V, Dejanovic B, Milosevic N, Stevanovic A, Andric A, Pencic B, Pavlovic-Kleut M, Celic V, Pavlovic M, Petrovic M, Vuleta M, Petrovic N, Simovic S, Savovic Z, Milanov S, Davidovic G, Iric-Cupic V, Simonovic D, Stojanovic M, Stojanovic S, Mitic V, Ilic V, Petrovic D, Deljanin Ilic M, Ilic S, Stoickov V, Markovic S, Kovacevic S, García Fernandez A, Perez Cabeza A, Anguita M, Tercedor Sanchez L, Mau E, Loayssa J, Ayarra M, Carpintero M, Roldán Rabadan I, Leal M, Gil Ortega M, Tello Montoliu A, Orenes Piñero E, Manzano Fernández S, Marín F, Romero Aniorte A, Veliz Martínez A, Quintana Giner M, Ballesteros G, Palacio M, Alcalde O, García-Bolao I, Bertomeu Gonzalez V, Otero-Raviña F, García Seara J, Gonzalez Juanatey J, Dayal N, Maziarski P, Gentil-Baron P, Shah D, Koç M, Onrat E, Dural IE, Yilmaz K, Özin B, Tan Kurklu S, Atmaca Y, Canpolat U, Tokgozoglu L, Dolu AK, Demirtas B, Sahin D, Ozcan Celebi O, Diker E, Gagirci G, Turk UO, Ari H, Polat N, Toprak N, Sucu M, Akin Serdar O, Taha Alper A, Kepez A, Yuksel Y, Uzunselvi A, Yuksel S, Sahin M, Kayapinar O, Ozcan T, Kaya H, Yilmaz MB, Kutlu M, Demir M, Gibbs C, Kaminskiene S, Bryce M, Skinner A, Belcher G, Hunt J, Stancombe L, Holbrook B, Peters C, Tettersell S, Shantsila A, Lane D, Senoo K, Proietti M, Russell K, Domingos P, Hussain S, Partridge J, Haynes R, Bahadur S, Brown R, McMahon S, Y H Lip G, McDonald J, Balachandran K, Singh R, Garg S, Desai H, Davies K, Goddard W, Galasko G, Rahman I, Chua Y, Payne O, Preston S, Brennan O, Pedley L, Whiteside C, Dickinson C, Brown J, Jones K, Benham L, Brady R, Buchanan L, Ashton A, Crowther H, Fairlamb H, Thornthwaite S, Relph C, McSkeane A, Poultney U, Kelsall N, Rice P, Wilson T, Wrigley M, Kaba R, Patel T, Young E, Law J, Runnett C, Thomas H, McKie H, Fuller J, Pick S, Sharp A, Hunt A, Thorpe K, Hardman C, Cusack E, Adams L, Hough M, Keenan S, Bowring A, Watts J, Zaman J, Goffin K, Nutt H, Beerachee Y, Featherstone J, Mills C, Pearson J, Stephenson L, Grant S, Wilson A, Hawksworth C, Alam I, Robinson M, Ryan S, Egdell R, Gibson E, Holland M, Leonard D, Mishra B, Ahmad S, Randall H, Hill J, Reid L, George M, McKinley S, Brockway L, Milligan W, Sobolewska J, Muir J, Tuckis L, Winstanley L, Jacob P, Kaye S, Morby L, Jan A, Sewell T, Boos C, Wadams B, Cope C, Jefferey P, Andrews N, Getty A, Suttling A, Turner C, Hudson K, Austin R, Howe S, Iqbal R, Gandhi N, Brophy K, Mirza P, Willard E, Collins S, Ndlovu N, Subkovas E, Karthikeyan V, Waggett L, Wood A, Bolger A, Stockport J, Evans L, Harman E, Starling J, Williams L, Saul V, Sinha M, Bell L, Tudgay S, Kemp S, Brown J, Frost L, Ingram T, Loughlin A, Adams C, Adams M, Hurford F, Owen C, Miller C, Donaldson D, Tivenan H, Button H, Nasser A, Jhagra O, Stidolph B, Brown C, Livingstone C, Duffy M, Madgwick P, Roberts P, Greenwood E, Fletcher L, Beveridge M, Earles S, McKenzie D, Beacock D, Dayer M, Seddon M, Greenwell D, Luxton F, Venn F, Mills H, Rewbury J, James K, Roberts K, Tonks L, Felmeden D, Taggu W, Summerhayes A, Hughes D, Sutton J, Felmeden L, Khan M, Walker E, Norris L, O’Donohoe L, Mozid A, Dymond H, Lloyd-Jones H, Saunders G, Simmons D, Coles D, Cotterill D, Beech S, Kidd S, Wrigley B, Petkar S, Smallwood A, Jones R, Radford E, Milgate S, Metherell S, Cottam V, Buckley C, Broadley A, Wood D, Allison J, Rennie K, Balian L, Howard L, Pippard L, Board S, Pitt-Kerby T. Epidemiology and impact of frailty in patients with atrial fibrillation in Europe. Age Ageing 2022; 51:6670566. [PMID: 35997262 DOI: 10.1093/ageing/afac192] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Frailty is a medical syndrome characterised by reduced physiological reserve and increased vulnerability to stressors. Data regarding the relationship between frailty and atrial fibrillation (AF) are still inconsistent. OBJECTIVES We aim to perform a comprehensive evaluation of frailty in a large European cohort of AF patients. METHODS A 40-item frailty index (FI) was built according to the accumulation of deficits model in the AF patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Association of baseline characteristics, clinical management, quality of life, healthcare resources use and risk of outcomes with frailty was examined. RESULTS Among 10,177 patients [mean age (standard deviation) 69.0 (11.4) years, 4,103 (40.3%) females], 6,066 (59.6%) were pre-frail and 2,172 (21.3%) were frail, whereas only 1,939 (19.1%) were considered robust. Baseline thromboembolic and bleeding risks were independently associated with increasing FI. Frail patients with AF were less likely to be treated with oral anticoagulants (OACs) (odds ratio 0.70, 95% confidence interval 0.55-0.89), especially with non-vitamin K antagonist OACs and managed with a rhythm control strategy, compared with robust patients. Increasing frailty was associated with a higher risk for all outcomes examined, with a non-linear exponential relationship. The use of OAC was associated with a lower risk of outcomes, except in patients with very/extremely high frailty. CONCLUSIONS In this large cohort of AF patients, there was a high burden of frailty, influencing clinical management and risk of adverse outcomes. The clinical benefit of OAC is maintained in patients with high frailty, but not in very high/extremely frail ones.
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Affiliation(s)
- Marco Proietti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Translational and Precision Medicine, Sapienza - University of Rome, Italy
| | - Marco Vitolo
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stephanie L Harrison
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBER-CV, Murcia, Spain
| | - Michael Näbauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- University of Medicine, 'Carol Davila', Colentina University Hospital, Bucharest, Romania
| | - Aldo P Maggioni
- ANMCO Research Center, Heart Care Foundation, Florence, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Singh AK, Panigrahi MK, Pradhan SK, Pal D, Subba SH, Patro BK, Behera BK, Mishra B, Behera B, Mohapatra PR, Bhuniya S, Bal SK, Sarkar S, Pillai JSK, Mohanty S, Gitanjali B. Clinico-Epidemiological Characteristics of Healthcare Workers with SARS-CoV-2 Infection during the First and Second Waves in a Teaching Hospital from Eastern India: A Comparative Analysis. Hosp Top 2022:1-12. [PMID: 35852422 DOI: 10.1080/00185868.2022.2096523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In this retrospective observational study, we have performed a comparative analysis of the demographic, clinical and epidemiological characteristics of the HCWs affected with SARS-CoV-2 infection during first two waves in India. The overall prevalence of SARS-CoV-2 infection among HCWs was found to be 15.24% (14.20-16.33) and 23.38% (22.14-25.65) during first and second waves respectively. The second wave showed an adjusted odds ratio of 0.04(0.02-0.07) and 2.09(1.49-2.93) for hospitalization and being symptomatic, respectively. We detected significantly higher level of C-reactive protein (CRP) among admitted HCWs during the second wave (5.10 -14.60 mg/dl) as compared to the first wave (2.00 - 2.80 mg/dl). Our study found the relative risk of SARS-CoV-2 reinfection among HCWs during the second wave to be 0.68 [0.57-0.82, p < 0.001)]. Although, the prevalence of SARS CoV-2 infection and risk of being symptomatic was higher during second wave, the risk of hospitalization was less when compared with the first wave.
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Affiliation(s)
- Arvind Kumar Singh
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Manoj Kumar Panigrahi
- Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Somen Kumar Pradhan
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Debkumar Pal
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sonu H Subba
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Binod Kumar Patro
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Binod Kumar Behera
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Bijayini Behera
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Prasanta Raghab Mohapatra
- Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sourin Bhuniya
- Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Shakti Kumar Bal
- Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Saurav Sarkar
- Department of Ear Nose Throat, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Jawahar S K Pillai
- Department of Hospital Administration, All India Institute of Medical Sciences, Bhubaneswar, India
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Abstract
Melioidosis is caused by the environmental bacterium Burkholderia pseudomallei. South Asia is estimated to have 44% of the global disease burden. Among South Asian countries, Bangladesh and Sri Lanka are considered endemic for melioidosis; a few cases have been reported from Nepal, and a few imported cases from Pakistan have also been reported. India has experienced an increase in numbers of melioidosis cases in the recent years. The bacteria is inherently present in the soil and enters the human body via skin abrasions, inhalation, or ingestion. As clinicians are often ignorant about the similar characteristics of this disease and several other common tropical diseases, it causes a major delay in the timely diagnosis and management. The organism is easily mistaken as Pseudomonas spp in microbiology laboratories and may be dismissed as a common laboratory contaminant. The poor diagnostic sensitivity of blood culture also leads to missed diagnosis. Hence, both clinical ignorance and missed laboratory diagnosis have misrepresented melioidosis as a rare entity. The key preventive interventions are avoiding contact with loose and muddy soils of meliodosis-endemic areas, and provision of safe drinking water. The present article describes the various possible attributes for melioidosis underdiagnosis and the challenges of improving the diagnosis in conjunction with viable solutions. Funding None.
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Affiliation(s)
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India-751019
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Naik S, Bhoi SK, Deep N, Mohakud S, Mishra B, Dey A, Kumar R, Saharia GK, Kumar M. Vascular Manifestations of Tuberculous Meningitis: MR Angiography and Venography Study. J Neurosci Rural Pract 2022; 13:529-536. [PMID: 35946000 PMCID: PMC9357502 DOI: 10.1055/s-0042-1748175] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose
The purpose of this study is to evaluate magnetic resonance (MR) angiography (MRA) and venography (MRV) findings in tuberculous meningitis (TBM).
Methods
Thirty consecutive patients of clinically diagnosed TBM were enrolled. Apart from T2-weighted imaging, T1-weighted imaging (T1WI), diffusion-weighted imaging, susceptibility-weighted imaging, fluid-attenuated inversion recovery, and postcontrast T1WI, time-of-flight (TOF) MRA and postcontrast MRV were done in all the patients. MRV was done after intravenous administration of gadolinium-based contrast agent followed by postcontrast T1WI. MRA and MRV findings were analyzed.
Results
Mean age of the patients was 33.13 ± 14.93 years. Duration of symptom was 34.90 ± 33.82 (range: 10–150) days. Out of 30 patients, 11 were categorized as definite TBM and 19 probable TBM. Eighteen (60%) were grade I, 7 (23%) grade II, and 5 (16%) grade III TBM based on severity. MR abnormalities were in varying combinations of leptomeningeal enhancement in 24 (80%), pachymeningeal in 2, both in 3, tuberculomas in 13 (43.3%), ventriculitis in 1, hydrocephalus in 16 (53.3%), and infarcts in 10 (33.3%) patients out of which the tubercular zone infarct in 9 patients. TOF MRA showed arterial abnormality in 13 patients. Anterior cerebral artery and middle cerebral artery have commonly involved vessels. Dural sinus thrombosis was noted in two patients. Both were female. One patient had subacute thrombus in the posterior part of superior sagittal sinus, left transverse sinus, and proximal right transverse sinus. The second patient had a filling defect in the transverse sinus.
Conclusion
In TBM, there is predominant arterial involvement causing infarcts which are usually seen in the tubercular zone. However, occasionally, there may be venous involvement causing cerebral venous sinus thrombosis.
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Affiliation(s)
- Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari Deep
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Anupam Dey
- Department of Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rajesh Kumar
- Department of Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Gautom Kumar Saharia
- Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mukesh Kumar
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Behera B, Radhakrishnan A, Mohapatra S, Mishra B. Melioidosis in Children, Brazil, 1989–2019. Emerg Infect Dis 2022. [DOI: 10.3201/2805.211473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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27
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Niraula A, Lamsal M, Lal Das B, Sherchand O, Mishra B. M102 Laboratory errors in clinical biochemistry: The quality of laboratory testing in B.P. Koirala institute of health sciences, Nepal. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Behera B, Radhakrishnan A, Mohapatra S, Mishra B. Melioidosis in Children, Brazil, 1989-2019. Emerg Infect Dis 2022; 28:1081-1082. [PMID: 35450564 PMCID: PMC9045445 DOI: 10.3201/eid2805.211473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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29
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Mishra B, Ranjan J, Purushotham P, Kar P, Payal P, Saha S, Deshmukh V, Das S. Comparison of Cycle Threshold and Clinical Status Among Different Age Groups of COVID-19 Cases. Cureus 2022; 14:e24194. [PMID: 35592201 PMCID: PMC9110806 DOI: 10.7759/cureus.24194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The COVID-19 pandemic has shaken the entire world ever since its emergence in March 2020. The disease manifestation of COVID-19 has been more severe, with a high degree of mortality in the elderly than in the young population. The cycle threshold (Ct ) value obtained in the real-time polymerase chain reaction (RT-PCR) has been used as the surrogate marker of viral load. Therefore, assessing Ct value and clinical status among different age groups with SARS-CoV-2 infection is required to understand the viral kinetics and to assess the transmission potential of that particular age group. Purpose The aim of this study was to compare the viral load and clinical status among different age groups with COVID-19 infection. Methods and materials A retrospective cross-sectional study was carried out to analyze the Ct values of SARS-CoV-2 positive samples reported from April 2020 till May 2021. The results of 13,820 RT-PCR (reverse transcriptase-polymerase chain reaction) positive samples were included for analysis of Ct values. Ct values of confirmatory genes were taken into consideration, and Ct values below 25, >25 to 30, and >30 were categorized as high, moderate, and low viral load, respectively. Age group was stratified into ≤18 years (young), 18-60 years (adult), and >60 years (elderly). The data were analyzed using SPSS Windows Version 25.0. Results The mean Ct values were 27.9, 26, and 26.2 in the young, adult, and elderly age groups, respectively. The mean Ct values of young patients were significantly higher as compared to adult and elderly patients (p<0.05). The percentage of high viral load (Ct<25) was found to be significantly higher in adults and elderly (44.6% & 43.7%) as compared to young (32.2%) (p<0.001). Majority of the COVID-19 positive cases younger than 18 years (75.9%) were asymptomatic as compared to 64.5% and 59.7% in the adult and elderly age groups, respectively. Conclusion This study observed a significantly high proportion of viral load in the adult and elderly population, which plays a substantial contribution to SARS-CoV-2 transmission, whereas the majority of the young population being asymptomatic plays a major role as silent transmitters. The study reemphasizes the need for strict adherence to COVID-appropriate behaviors.
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30
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Purohit G, Mishra B, Sahoo S, Mahapatra A. Granulicatella adiacens as an Unusual Cause of Empyema: A Case Report and Review of Literature. J Lab Physicians 2022; 14:343-347. [PMID: 36119420 PMCID: PMC9473932 DOI: 10.1055/s-0042-1744236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Granulicatella adiacens
, a nutritionally variant
Streptococcus
(NVS), is part of the normal commensal flora of human mouth, genital, and intestinal tracts and rarely causes disease. It has been mostly reported from bacteremia and endocarditis cases, but rarely can cause vertebral osteomyelitis, pancreatic abscess, otitis media, and endovascular, central nervous system, ocular, oral, bone and joint, and genitourinary infections. Due to requirement of fastidious culture conditions and non-specific colony morphology, serious diagnostic difficulties may arise in cases of NVS infections. Here, we are reporting a rare fatal infection of
G. adiacens
presented with empyema complicated to sepsis and necrotizing fasciitis.
Clinicians should be aware of the pathogenic potential of
Granulicatella adiacens
(a normal commensal flora of human mouth, genital and intestinal tracts). Appropriate supplemented media and a reliable detection system should be used to identify these fastidious organisms. We present this rare case to bring awareness among clinicians regarding such a rare but potentially fatal infection.
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Affiliation(s)
- Geetarani Purohit
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
- Department of Microbiology and Infection Control, Vikash Multispeciality Hospital, Bargarh, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Satyajeet Sahoo
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Ashoka Mahapatra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
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Das S, Mishra B, Mohapatra PR, Preetam C, Rath S. Clinical presentations of nontuberculous mycobacteria as suspected and drug-resistant tuberculosis: Experience from a tertiary care center in Eastern India. Int J Mycobacteriol 2022; 11:167-174. [PMID: 35775549 DOI: 10.4103/ijmy.ijmy_68_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Nontuberculous mycobacteria (NTM) are on the rise worldwide. The diagnosis and treatment of NTM disease create a dilemma for physicians as their clinical features often overlap with that of tuberculosis (TB). The present study aims to report a series of NTM infections presenting as suspected TB. Methods It was a prospective observational study starting from December 2018 to January 2022. . A total of 1850 suspected TB patients (pulmonary = 522 and extrapulmonary = 1328) were included in this study. Clinical features, radiological findings, microbiological diagnosis, treatment, and outcome were recorded. Clinical specimens were processed for Ziehl-Neelsen staining, GeneXpert MTB/Rif assay by cartridge-based nucleic acid amplification test, and culture. The culture-positive isolates were categorized as Mycobacterium tuberculosis complex or NTM depending on the detection of MPT64 antigen by immunochromatographic test. The NTM isolates were speciated by line probe assay using GenoType® Mycobacterium common mycobacteria kit. The criteria of the American Thoracic Society/Infectious Diseases Society of America were applied to confirm NTM disease. Results Of 1850 suspected TB patients, NTM disease was diagnosed in 20 patients (pulmonary = 9, nonpulmonary = 11). Eight NTM cases presented as suspected drug-resistant-TB with a history of antitubercular therapy. Among pulmonary NTM cases, Mycobacterium scrofulaceum (n = 7) was the most common species followed by Mycobacterium kansasii (n = 1) and Mycobacterium intracellulare (n = 1). In nonpulmonary cases, Mycobacterium abscessus (n = 8) was involved in majority of cases followed by Mycobacterium fortuitum (n = 3). Cavitary lung disease and laparoscopic port site infections were most frequent pulmonary and non-pulmonary manifestations respectively. Conclusion Hence, there is an urgent need for better diagnostic and drug susceptibility testing facility along with standardized treatment protocol for NTM disease.
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Affiliation(s)
- Sivasankar Das
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Prasanta Raghab Mohapatra
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Chappity Preetam
- Department of Ear, Nose and Throat, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sutapa Rath
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Mohanty M, Mishra B, Jain M, Karaniveed Puthiyapura L. Diagnostic role of Xpert-MTB RIF assay in osteoarticular tuberculosis: A retrospective study. World J Orthop 2022; 13:289-296. [PMID: 35317258 PMCID: PMC8935335 DOI: 10.5312/wjo.v13.i3.289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/11/2021] [Accepted: 01/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Osteoarticular tuberculosis (OATB) is a severe form of extrapulmonary tuberculosis (TB), which causes notable morbidity and warrants a high index of suspicion for prompt management. The diagnosis of OATB poses a challenge, because of the difficulty of collecting the samples and, secondarily, the paucibacillary nature of lesion, which gives poor sensitivity and reproducibility, with long turnaround time of routine/conventional laboratory tests and the requirement for invasive procedures and expertise. The Xpert MTB/RIF assay has been approved by the World Health Organization as a rapid diagnostic tool for diagnosing pulmonary and extrapulmonary TB.
AIM To emphasize the diagnostic efficiency of gene Xpert for OATB in suspected patients in a tertiary care hospital of Eastern India.
METHODS This retrospective study was conducted in the Department of Microbiology and Orthopaedics by analyzing the data of the gene Xpert assay over a 3-year duration from January 2018 to February 2021. Demographic and clinical data were recorded. The diagnostic efficiency of gene Xpert was evaluated against the composite reference standard (CRS).
RESULTS A total of 37 cases fell into positive, probable, and possible categories of osteoarticular TB out of 112 patients included in the study by CRS; gene Xpert result was positive in 35 out of the 37 different CRS categorized cases. Of the 112 cases, culture was put in 40 cases, and, of these cultures, 5 cases showed the growth of MTB. Of these, 4 cases were included in the 35 cases diagnosed by gene Xpert. Smear microscopy was positive in 6 out of 37 CRS categorized cases. When compared with CRS, the sensitivity of gene Xpert assay, culture, and smear was found to be 94.6%, 13.5%, and 16.2%, respectively, while specificity in all the three types of tests was 100%. When kappa statistics were applied, the percentage of agreement gene Xpert, culture, and microscopy with CRS was found to be 95%, 20%, and 22.6%, respectively. Follow-up of the gene Xpert positive patients after getting anti-tubercular treatment revealed improved conditions.
CONCLUSION Gene Xpert could detect 31 extra cases with a low and very low mycobacterial load that were missed by the routine culture methods. Hence, more samples should be processed for molecular diagnostic methods like gene Xpert along with other conventional methods for the validation of the molecular test prospectively for the timely diagnosis of osteoarticular TB.
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Affiliation(s)
- Monalisa Mohanty
- Department of Microbiology, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
| | | | - Mantu Jain
- Department of Orthopaedics, AIIMS Bhubaneswar, Bhubaneswar 751019, Odisha, India
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Mishra B, Purushotham P, Kar P, Payal P, Saha S, Ranjan J, Das S, Deshmukh V. Comparison of Cycle Threshold and Clinical Status Among Different Age Groups of COVID-19 Cases. Int J Infect Dis 2022. [PMCID: PMC8884758 DOI: 10.1016/j.ijid.2021.12.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose Aim of the study was to compare the viral load and clinical status among different age groups with COVID-19 infection Methods & Materials A retrospective cross-sectional study was carried out to analyse the Ct values of positive samples reported during April 2020 till May 2021. Result of 13,820 number of RT-PCR positive samples were included for analysis of Ct values. Ct values of confirmatory genes were taken into consideration and Ct values below 25, >25 to 30 and >30 was categorized as high, moderate and low viral load respectively. Age group was stratified into ≤18 years, 18-60 and >60 years as young, adult and elderly respectively. The data was analysed using SPSS windows version 25.0. Results The Mean Ct value was 27.9, 26, and 26.2 in young, adult and elderly age group respectively. Mean Ct value of young patients were significantly higher as compared to adult and elderly patients (p<0.05). The percentage of high viral load (Ct<25) was found to be significantly higher in adults and elderly (44.6% & 43.7%) as compared to young (32.2%) (p<0.001). Majority of the covid 19 positive cases belonging to <18 years age (75.9%) were asymptomatic as compared to 64.5% and 59.7% in adult and elderly age groups respectively. Conclusion Present study observed a significantly high proportion of viral load in the adult and elderly population which plays a substantial contribution to SARS CoV-2 transmission, whereas the majority of the young population being asymptomatic play major role as silent transmitters. The study reemphasizes the need for strict adherence to COVID appropriate behaviours.
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Mishra B, Rath S, Mohapatra P, Dutta A, Durgeshwar G, Vedala M, Panigrahi M, Bhuniya S. Tuberculosis and COVID 19: An epidemic submerged in the pandemic: A case series from Eastern India. Int J Infect Dis 2022. [PMCID: PMC8884738 DOI: 10.1016/j.ijid.2021.12.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Behera B, Tripathy S, Venkateshan M, Mahapatra A, Mohanty S, Gupta K, Mishra B, Rao PB, Mitra JK, Mohapatra PR, Panigrahi MK, Bhuniya S, Bal SK. Spectrum of Bacterial Pathogens in Critical COVID-19 Patients Admitted in Intensive Care Units of a Tertiary Care Hospital During the First and Second Wave of the Pandemic. J Assoc Physicians India 2022; 70:11-12. [PMID: 35436819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study intends to compare the clinical characteristics and the prevalence and spectrum of bacterial pathogens in COVID-19 patients admitted to ICU during the first and second waves at a tertiary care, teaching and referral hospital of eastern India. METHOD This is a hospital-based retrospective study which analysed demographic details, clinical profile and bacterial culture results of severe and critically ill COVID-19 patients admitted in intensive care units (ICU) during April -Oct 2020 (1st wave) and April -July 2021 (2nd wave). RESULT The patients admitted during the 2nd wave were comparatively older and had multiple comorbidities compared to the 1st wave. (23.8%) (45/189) and 50% (173/346) of the COVID-19 patients admitted to ICU developed bacterial infection during the 1st and 2nd wave respectively. Overall, there was predominance of multidrug resistant Gram negative bacilli in both the waves. There was increased isolation of intrinsic colistin resistant microorganisms. CONCLUSION Multidrug resistant Gram negative bacterial infections, remain a dreaded complication in severe and critically ill hospitalised COVID-19 patients requiring ICU care and high usage of colistin spirals the emergence and spread of pathogens intrinsically resistant to colistin.
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Affiliation(s)
- Bijayini Behera
- Additional Professor, Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha; Corresponding Author
| | - Swagata Tripathy
- Additional Professor, Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha
| | - Mahalingam Venkateshan
- Additional Professor, Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha
| | - Ashoka Mahapatra
- Additional Professor, Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha
| | - Srujana Mohanty
- Additional Professor, Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha
| | - Kavita Gupta
- Assistant Professor, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha
| | - Baijayantimala Mishra
- Professor, Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha
| | - P Bhaskar Rao
- Additional Professor, Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha
| | - Jayanta Kumar Mitra
- Additional Professor, Department of Anaesthesiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha
| | | | - Manoj Kumar Panigrahi
- Additional Professor, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha
| | - Sourin Bhuniya
- Additional Professor,All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha
| | - Shakti Kumar Bal
- Assistant Professor, Department of Pulmonary and Critical Care Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha
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Mishra B, Pandit AK, Miyachi S, Ohshima T, Kawaguchi R, Vishnu VY, Misra S, Srivastava MVP, Srivastava AK, Kale SS, Phalak M. Clinical Utility of Intravascular Ultrasound (IVUS) in Carotid Artery Interventions: A Systematic Review and Meta-analysis. J Endovasc Ther 2021; 29:678-691. [PMID: 34955053 DOI: 10.1177/15266028211064824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Carotid plaque morphology plays an important role in determining outcome of carotid artery stenting (CAS). Intravascular ultrasound (IVUS) and its extension VH (Virtual Histology)-IVUS evaluate plaque characteristics in real time and guide decision making during stenting. To date, there is no consensus about indications of IVUS and its validated methods. This systematic review and meta-analysis aims to evaluate the clinical utility of IVUS in carotid artery interventions (CAS) and develop a future consensus for research and practice parameters. METHODS A systematic review and meta-analysis was performed of the English literature articles published till February 2021. Studies reporting on IVUS parameters and findings and also its performance compared with other imaging modalities were included in review. Pooled prevalence with 95% confidence intervals (CI) was calculated. The statistical analysis was conducted in R version 3.6.2. RESULTS A total of 2015 patients from 29 studies were included. Proportional meta-analysis was performed on 1566 patients from 11 studies. In 9 studies, stroke/transient ischemic attack (TIA) had a pooled prevalence of 4% (95% CI 3%-5%) while asymptomatic stroke had a pooled prevalence of 46% (95% CI 31%-62%) in 4 studies following IVUS. Two studies reported that IVUS detected more plaque protrusion compared with angiography (n=33/396 vs 11/396). IVUS led to stent type or size change in 8 of 48 cases which were missed on angiography in 3 other studies. Concordance between VH-IVUS and true histology was good at 80% to 85% reported in 2 studies. CONCLUSIONS This systematic review and meta-analysis showed, though IVUS fared better to computed tomography (CT)/magnetic resonance (MR) angiography for better stent selection during CAS, with low to moderate risk of bias in the studies included. However, large scale, preferably randomized controlled studies are needed to predict its role in determining clinical outcome.
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Affiliation(s)
- B Mishra
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - A K Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - S Miyachi
- Department of Neurological Surgery, Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Japan
| | - T Ohshima
- Department of Neurological Surgery, Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Japan
| | - R Kawaguchi
- Department of Neurological Surgery, Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Japan
| | - V Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - S Misra
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - M V P Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - A K Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - S S Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - M Phalak
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Chhabra G, Das B, Mishra S, Mishra B. Rapid screening of dengue fever using research parameters from new generation hematological analyzers. Int J Lab Hematol 2021; 44:477-482. [DOI: 10.1111/ijlh.13782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Gaurav Chhabra
- Department. of Pathology and Laboratory Medicine AIIMS Bhubaneswar India
| | - Bismay Das
- Department. of Pathology and Laboratory Medicine AIIMS Bhubaneswar India
- Department. of Pathology United Medical College Prayagraj India
| | - Shruti Mishra
- Department. of Pathology and Laboratory Medicine AIIMS Bhubaneswar India
- Bone Marrow Transplant and Stem Cell Research Centre IMS, BHU Varanasi India
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Behera B, Satapathy AK, Ranjan J, Chandrasekar S, Patel S, Mishra B, Mahapatro S, Das RR. Profile of Scrub Typhus Meningitis/Meningoencephalitis in Children with and without Scrub Typhus IgM Antibody in CSF. J Neurosci Rural Pract 2021; 12:786-791. [PMID: 34737516 PMCID: PMC8559072 DOI: 10.1055/s-0041-1734003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aim of this article was to study the spectrum of scrub typhus meningitis/meningoencephalitis (STM) cases in children. Children ≤14 years of age with acute undifferentiated febrile illness were included. Immunoglobulin M (IgM) enzyme-linked immunosorbent assay was done in blood and cerebrospinal fluid (CSF) of children with suspected STM. Demographic, clinical, and laboratory details were expressed as descriptive statistics. Factors associated with neurological involvement were identified on univariate analysis. A total of 76 children had ST during the study period (meningitis/meningoencephalitis = 8 [10.5%], of which 5 [62.5%] had detectable ST IgM antibodies in CSF). The included children were 4 to 12 years of age with boys > girls. Headache and vomiting were common in those with STM, whereas hyponatremia and thrombocytopenia were common in those without STM. All children with STM recovered with sequelae in one child (right lateral rectus palsy). There was no mortality. STM has an incidence of 10.5% in children with ST from Eastern India. Headache and vomiting were significant predictors of STM, whereas hyponatremia and thrombocytopenia were significant predictor of non-STM.
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Affiliation(s)
- Bijayini Behera
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Amit Kumar Satapathy
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Jai Ranjan
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Shyam Chandrasekar
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Subhakanta Patel
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Samarendra Mahapatro
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rashmi Ranjan Das
- Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Ranjan J, Ravindra A, Mishra B. Gender and genetic factors impacting COVID-19 severity. J Family Med Prim Care 2021; 10:3956-3963. [PMID: 35136752 PMCID: PMC8797126 DOI: 10.4103/jfmpc.jfmpc_769_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/08/2021] [Accepted: 07/10/2021] [Indexed: 11/04/2022] Open
Abstract
COVID-19 pandemic is a cause of global concern and is impacting lives and economy globally. Infection due to SARS-CoV-2 leads to varied clinical manifestations, which can vary from asymptomatic to severe acute respiratory syndrome and death. The clinical features are proposed to depend upon various host factors, namely, gender and genetic factors. The significantly high mortality among males has revealed the role of gender, androgens, age, genetics, and risk factors in determining the severity of COVID-19 among the population. The interplay of various host factors and their association with clinically severe infections is crucial for our understanding of COVID-19 pathogenesis. A PubMed and Google scholar search was made using keywords such as "COVID-19 + sex differences," "COVID-19 + androgens," "COVID-19 + ACE2 receptor," and "COVID-19 + smoking alcoholism pregnancy." The articles which highlight the association of gender and genetic factors to COVID-19 were selected and included in our study. It is mainly the primary care or family physicians who act as the first contact of COVID-19 patients. With the recent increase in SARS-CoV-2 infections in the Indian subcontinent and probability of upcoming surges, it has become imperative to understand its interaction with the various gender and genetic factors to devise effective triage and management protocols. Our review highlights the possible mechanisms by which these factors impact the severity of COVID-19. A better understanding of these factors will be of immense help to primary care physicians.
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Affiliation(s)
- Jai Ranjan
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Akshatha Ravindra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
- Address for correspondence: Dr. Baijayantimala Mishra, Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar - 751 019, Odisha, India. E-mail:
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Sahoo DP, Singh AK, Sahu DP, Pradhan SK, Patro BK, Batmanabane G, Mishra B, Behera B, Das A, Dora GS, Anand L, Azhar SM, Nair J, Panigrahi S, Akshaya R, Sahoo BK, Sahu S, Sahoo S. Hospital-Based Contact Tracing of Patients With COVID-19 and Health Care Workers During the COVID-19 Pandemic in Eastern India: Cross-sectional Study. JMIR Form Res 2021; 5:e28519. [PMID: 34596569 PMCID: PMC8534486 DOI: 10.2196/28519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/15/2021] [Accepted: 09/18/2021] [Indexed: 02/06/2023] Open
Abstract
Background The contact tracing and subsequent quarantining of health care workers (HCWs) are essential to minimizing the further transmission of SARS-CoV-2 infection and mitigating the shortage of HCWs during the COVID-19 pandemic situation. Objective This study aimed to assess the yield of contact tracing for COVID-19 cases and the risk stratification of HCWs who are exposed to these cases. Methods This was an analysis of routine data that were collected for the contact tracing of COVID-19 cases at the All India Institute of Medical Sciences, Bhubaneswar, in Odisha, India. Data from March 19 to August 31, 2020, were considered for this study. COVID-19 cases were admitted patients, outpatients, or HCWs in the hospital. HCWs who were exposed to COVID-19 cases were categorized, per the risk stratification guidelines, as high-risk contacts or low-risk contacts Results During contact tracing, 3411 HCWs were identified as those who were exposed to 360 COVID-19 cases. Of these 360 cases, 269 (74.7%) were either admitted patients or outpatients, and 91 (25.3%) were HCWs. After the risk stratification of the 3411 HCWs, 890 (26.1%) were categorized as high-risk contacts, and 2521 (73.9%) were categorized as low-risk contacts. The COVID-19 test positivity rates of high-risk contacts and low-risk contacts were 3.8% (34/890) and 1.9% (48/2521), respectively. The average number of high-risk contacts was significantly higher when the COVID-19 case was an admitted patient (number of contacts: mean 6.6) rather than when the COVID-19 case was an HCW (number of contacts: mean 4.0) or outpatient (number of contacts: mean 0.2; P=.009). Similarly, the average number of high-risk contacts was higher when the COVID-19 case was admitted in a non–COVID-19 area (number of contacts: mean 15.8) rather than when such cases were admitted in a COVID-19 area (number of contacts: mean 0.27; P<.001). There was a significant decline in the mean number of high-risk contacts over the study period (P=.003). Conclusions Contact tracing and risk stratification were effective and helped to reduce the number of HCWs requiring quarantine. There was also a decline in the number of high-risk contacts during the study period. This indicates the role of the implementation of hospital-based, COVID-19–related infection control strategies. The contact tracing and risk stratification approaches that were designed in this study can also be implemented in other health care settings.
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Affiliation(s)
- Durgesh Prasad Sahoo
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Arvind Kumar Singh
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Dinesh Prasad Sahu
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Somen Kumar Pradhan
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Binod Kumar Patro
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | | | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bijayini Behera
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ambarish Das
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - G Susmita Dora
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - L Anand
- College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - S M Azhar
- College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Jyolsna Nair
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sasmita Panigrahi
- College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - R Akshaya
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bimal Kumar Sahoo
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Subhakanta Sahu
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suchismita Sahoo
- College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Mishra B, Behera B, Singh AK, Mohapatra PR, Patro BK, Panigrahi MK, Pillai JSK, Barik S, Mahapatra A, Mohanty S, Hallur V, Gupta K, Batmanabane G. Seroprevalence of SARS-CoV-2 antibodies among healthcare workers in a teaching hospital in Eastern India. J Family Med Prim Care 2021; 10:2974-2979. [PMID: 34660434 PMCID: PMC8483124 DOI: 10.4103/jfmpc.jfmpc_2486_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/21/2021] [Accepted: 03/12/2021] [Indexed: 12/13/2022] Open
Abstract
Statement of the Problem: Healthcare workers (HCW) are the most vulnerable group for contracting SARS-CoV-2. Assessment of seroprevalence of SARS-CoV-2 antibodies among HCW, thus can provide important data on pathogen exposure, infectivity, and adherence to personal protective equipment (PPE). The present study aimed at assessing SARS-CoV-2 seroprevalence among HCW and exploring associations with demographics, category of exposure to COVID-19 patients, preventive measures taken and relation with COVID-19 symptoms. Method of Study: HCWs with a minimum gap 2 weeks from last duty were eligible to participate in the study. The enrolled HCW were categorized into high-risk and low-risk category based on work in COVID-19 areas. HCWs SARS-CoV-2 specific IgG and IgM antibodies were detected using rapid immunochromatography test. Results: Out of 821 randomly selected HCWs, either IgM or IgG antibody was detected in 32 HCWs (32/821, 3.9%). Only IgM antibodies were detected in 14 (1.7%), only IgG was detected in 9 (1.0%), and both IgM and IgG antibodies were present in 9 HCWs. Seropositivity was significantly higher in high-risk category (5.7% vs. 2.2.%), HCWs who ever had COVID-19 related symptoms in last 3 months (5.6% vs. 2.8%), and those who had earlier tested positive for SARS-CoV-2 with real-time reverse transcriptase PCR (36.6% vs. 3.5%). Seroprevalence was highest (6.9%) among housekeeping and sanitation staff. Conclusions: Overall, low seroprevalence of SARS-CoV-2 antibodies in our HCWs is an indicator of effective infection control practice. HCW posted in dedicated COVID ward need more stringent implementation of infection prevention measures.
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Affiliation(s)
| | - Bijayini Behera
- Department of Microbiology, AIIMS, Bhubaneswar, Odisha, India
| | - Arvind K Singh
- Department of Community and Family Medicine, AIIMS, Bhubaneswar, Odisha, India
| | - Prasanta R Mohapatra
- Department of Pulmonary Medicine and Critical Care, AIIMS, Bhubaneswar, Odisha, India
| | - Binod K Patro
- Department of Community and Family Medicine, AIIMS, Bhubaneswar, Odisha, India
| | - Manoj K Panigrahi
- Department of Pulmonary Medicine and Critical Care, AIIMS, Bhubaneswar, Odisha, India
| | - Jawahar S K Pillai
- Department of Hospital Administration, AIIMS, Bhubaneswar, Odisha, India
| | - Sadanand Barik
- Department of Trauma and Emergency Medicine, AIIMS, Bhubaneswar, Odisha, India
| | | | - Srujana Mohanty
- Department of Microbiology, AIIMS, Bhubaneswar, Odisha, India
| | | | - Kavita Gupta
- Department of Microbiology, AIIMS, Bhubaneswar, Odisha, India
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Das S, Mishra B, Mohapatra PR, Preetam C. Prevalence and Species Spectrum of Nontuberculous Mycobacteria among Patients with Suspected Tuberculosis: A Study from Eastern India. Indian J Med Microbiol 2021. [DOI: 10.1016/j.ijmmb.2021.08.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Radhakrishnan A, Behera B, Mishra B, Mohapatra PR, Kumar R, Singh AK. Clinico-microbiological description and evaluation of rapid lateral flow immunoassay and PCR for detection of Burkholderia pseudomallei from patients hospitalized with sepsis and pneumonia: A twenty-one months study from Odisha, India. Acta Trop 2021; 221:105994. [PMID: 34118206 DOI: 10.1016/j.actatropica.2021.105994] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 05/18/2021] [Accepted: 05/31/2021] [Indexed: 12/26/2022]
Abstract
Establishing a diagnosis of melioidosis based on clinical grounds is difficult in hospitalized patients with sepsis or community acquired pneumonia (CAP). We aimed to ascertain the prevalence, clinico-epidemiological and laboratory profile of melioidosis in hospitalized patients with sepsis or CAP, and to evaluate the diagnostic utility of rapid lateral flow immunoassay (LFI) and PCR in comparison with culture. In all patients with sepsis or CAP, blood, sputum/throat swab, and urine sample were subjected to culture along with other samples based on clinical presentation. In addition, PCR assay targeting the type III secretion system 1 (TTS1) and LFI was performed. Thirty-three (33/196, 17%) out of the total 196 cases were diagnosed as melioidosis by culture. The prevalence of melioidosis in patients who had only sepsis without CAP, had both sepsis and CAP, had CAP without sepsis was 31% (26/84), 22 % (4/18) and 3%(3/94) respectively. All the LFI or PCR positive cases were culture positive from at least one or more samples (blood/sputum/urine/pus). The sensitivity, specificity, positive predictive value and negative predictive value of TTS1 PCR was 78% (18/23 melioidosis patients), 100% (34/34 non-melioidosis patients), 100% (18/18 melioidosis patients) and 87% (34/39 non-melioidosis patients). The sensitivity, specificity, positive predictive value and negative predictive value of Rapid LFI was 91% (21/23 melioidosis patients), 100% (22/22 non-melioidosis patients), 100% (21/21 melioidosis patients) and 91% (22/24 non-melioidosis patients). On sample wise stratification of LFI and TTS1 with respect to culture, plasma/serum samples showed the highest discordance by PCR (9/55, 16.3%) and LFI (11/35, 31.4%). The lowest discordance was noted in respiratory tract samples (2/32, 6.2%) by PCR and pus/body fluids samples (2/14, 14.2%) by LFI and these findings are in line with previous published literature. The clinical utility of PCR and LFI needs to be further validated in a large scale study for early diagnosis of septicaemic melioidosis.
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Affiliation(s)
| | - Bijayini Behera
- Department of Microbiology, AIIMS, Bhubaneswar, Odisha, India.
| | | | | | - Rajesh Kumar
- Department of General Medicine, AIIMS, Bhubaneswar Odisha, India.
| | - Arvind Kumar Singh
- Department of Community and Family Medicine, AIIMS, Bhubaneswar, Odisha, India.
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Radhakrishnan A, Behera B, Mishra B, Mohapatra PR. Clinico-microbiological analysis of hospitalized melioidosis cases with sepsis and/or pneumonia: A single -center, Pro- spective study from Eastern India. Indian J Med Microbiol 2021. [DOI: 10.1016/j.ijmmb.2021.08.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Saha S, Das RR, Das A, Mishra B, Ravindra A, Mohanty M, Payal P, Ranjan J, Dwibedi B. Clinical Profile of Covid-19 in Children: A single centre, retrospective study from Eastern India. Indian J Med Microbiol 2021. [PMCID: PMC8594299 DOI: 10.1016/j.ijmmb.2021.08.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Payal P, Mishra B, Prashanth P, Behera B, Saha S, Kar P, Rath S, Mohanty MN. Influence of temperature, humidity on COVID positivity in Odisha. Indian J Med Microbiol 2021. [PMCID: PMC8594312 DOI: 10.1016/j.ijmmb.2021.08.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Ravindra A, Mishra B, Rath S, Mohanty M, Ranjan J, Hallur VK, Behera B, Mohanty S, Mahapatra A. Comparability of the Sensitivity of Different real time PCR kits Used in the Detection of SARS CoV -2. Indian J Med Microbiol 2021. [PMCID: PMC8594302 DOI: 10.1016/j.ijmmb.2021.08.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mishra B, Ranjan J, Purushotham P, Saha S, Payal P, Kar P, Das S, Deshmukh V. High proportion of low cycle threshold value as an early indicator of COVID-19 surge. J Med Virol 2021; 94:240-245. [PMID: 34460115 PMCID: PMC8661879 DOI: 10.1002/jmv.27307] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/05/2021] [Accepted: 08/26/2021] [Indexed: 12/23/2022]
Abstract
Many countries in the world are experiencing a recent surge in COVID‐19 cases. This is mainly attributed to the emergence of new SARS‐CoV‐2 variants. Genome sequencing is the only means to detect the evolving virus mutants and emerging variants. Cycle threshold values have an inverse relationship with viral load and lower Ct values are also found to be associated with increased infectivity. In this study, we propose to use Ct values as an early indicator for upcoming COVID‐19 waves. A retrospective cross‐sectional study was carried out to analyze the Ct values of positive samples reported during the first wave and second wave (April 2020–May 2021). Median Ct values of confirmatory genes were taken into consideration for comparison. Ct values below 25, >25–30, and >30 were categorized as high, moderate, and low viral load respectively. Our study found a significantly higher proportion of positive samples with a low Ct value (<25) across age groups and gender during the second wave of the COVID‐19 pandemic. A higher proportion of positive samples with a low Ct value (high viral load) may act as an early indicator of an upcoming surge. A surge in COVID‐19 cases is predominantly due to emergence of new SARS‐CoV‐2 variants. Cycle threshold values have an inverse relationship with viral load and also associated with infectivity. Our study found a significantly higher proportion of positive samples with low Ct value (<25) across age groups and gender during the second wave of COVID‐19 pandemic. Higher proportion of positive samples with low Ct value (high viral load) may act as an early indicator of an upcoming surge.
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Affiliation(s)
- Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Jai Ranjan
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Prashanth Purushotham
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Swarnatrisha Saha
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Poesy Payal
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Punyatoya Kar
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sivasankar Das
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Vaishnavi Deshmukh
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Meh C, Sharma A, Ram U, Fadel S, Correa N, Snelgrove JW, Shah P, Begum R, Shah M, Hana T, Fu SH, Raveendran L, Mishra B, Jha P. Trends in maternal mortality in India over two decades in nationally representative surveys. BJOG 2021; 129:550-561. [PMID: 34455679 PMCID: PMC9292773 DOI: 10.1111/1471-0528.16888] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess national and regional trends and causes-specific distribution of maternal mortality in India. DESIGN Nationally representative cross-sectional surveys. SETTING All of India from 1997 to 2020. SAMPLE About 10 000 maternal deaths among 4.3 million live births over two decades. METHODS We analysed trends in the maternal mortality ratio (MMR) from 1997 through 2020, estimated absolute maternal deaths and examined the causes of maternal death using nationally representative data sources. We partitioned female deaths (aged 15-49 years) and live birth totals, based on the 2001-2014 Million Death Study to United Nations (UN) demographic totals for the country. MAIN OUTCOME MEASURES Maternal mortality burden and distribution of causes. RESULTS The MMR declined in India by about 70% from 398/100 000 live births (95% CI 378-417) in 1997-98 to 99/100 000 (90-108) in 2020. About 1.30 million (95% CI 1.26-1.35 million) maternal deaths occurred between 1997 and 2020, with about 23 800 (95% CI 21 700-26 000) in 2020, with most occurring in poorer states (63%) and among women aged 20-29 years (58%). The MMRs for Assam (215), Uttar Pradesh/Uttarakhand (192) and Madhya Pradesh/Chhattisgarh (170) were highest, surpassing India's 2016-2018 estimate of 113 (95% CI 103-123). After adjustment for education and other variables, the risks of maternal death were highest in rural and tribal areas of north-eastern and northern states. The leading causes of maternal death were obstetric haemorrhage (47%; higher in poorer states), pregnancy-related infection (12%) and hypertensive disorders of pregnancy (7%). CONCLUSIONS India could achieve the UN 2030 MMR goals if the average rate of reduction is maintained. However, without further intervention, the poorer states will not. TWEETABLE ABSTRACT We estimated that 1.3 million Indian women died from maternal causes over the last two decades. Although maternal mortality rates have fallen by 70% overall, the poorer states lag behind.
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Affiliation(s)
- C Meh
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - A Sharma
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - U Ram
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - S Fadel
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - N Correa
- Department of Internal Medicine, Western University, London, Ontario, Canada
| | - J W Snelgrove
- Department of Obstetrics & Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - P Shah
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - R Begum
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - M Shah
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - T Hana
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - S H Fu
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - L Raveendran
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - P Jha
- Centre for Global Health Research, Unity Health Toronto and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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