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Kaur R, Gierke R, McGee L, Gonzalez E, Kobayashi M, Pichichero M. Pneumococci isolated from children in community-based practice differ from isolates identified by population and laboratory-based invasive disease surveillance. J Infect Dis 2024:jiae184. [PMID: 38591247 DOI: 10.1093/infdis/jiae184] [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: 01/08/2024] [Revised: 03/26/2024] [Accepted: 04/05/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Characterizing strains causing noninvasive and invasive pneumococcal disease (IPD) may inform the impact of new pneumococcal conjugate vaccines (PCVs). METHODS During 2011-2019, among children aged 6-36 months, pneumococcal serotype distribution and antibiotic non-susceptibility of nasopharyngeal and middle ear fluid (MEF) isolates collected at onset of acute otitis media (AOM) in Rochester, New York were compared with IPD isolates from Active Bacterial Core surveillance (ABCs) across 10 U.S. sites. RESULTS From Rochester, 400 (nasopharyngeal) and 156 (MEF) pneumococcal isolates were collected from 259 children. From ABCs, 907 sterile-site isolates were collected from 896 children. Non-PCV serotypes 35B and 21 were more frequent among the Rochester AOM cases, while serotypes 3, 19A, 22F, 33F, 10A, and 12F contained in PCVs were more frequent among ABCs IPD cases. The proportion of antibiotic non-susceptible pneumococcal isolates was generally more common among IPD cases. In 2015-2019, serotype 35B emerged as the most common serotype associated with multiclass antibiotic non-susceptibility for both the Rochester AOM and ABCs IPD cases. CONCLUSIONS Pneumococcal isolates from children in Rochester with AOM differ in serotype distribution and antibiotic susceptibility compared to IPD cases identified through U.S. surveillance. Non-PCV serotype 35B emerged as a common cause of AOM and IPD.
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Affiliation(s)
- Ravinder Kaur
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY USA
| | - Ryan Gierke
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Lesley McGee
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Eduardo Gonzalez
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY USA
| | - Miwako Kobayashi
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Michael Pichichero
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY USA
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Martino D, Schultz N, Kaur R, Haren SD, Kresoje N, Hoch A, Diray-Arce J, Lasky Su J, Levy O, Pichichero M. Respiratory Infection- and Asthma-prone, Low Vaccine Responder Children Demonstrate Distinct Mononuclear Cell DNA Methylation Pathways. Res Sq 2024:rs.3.rs-4160354. [PMID: 38645021 PMCID: PMC11030504 DOI: 10.21203/rs.3.rs-4160354/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Background Infants with frequent viral and bacterial respiratory infections exhibit compromised immunity to routine immunisations. They are also more likely to develop chronic respiratory diseases in later childhood. This study investigated the feasibility of epigenetic profiling to reveal endotype-specific molecular pathways with potential for early identification and immuno-modulation. Peripharal immune cells from respiratory infection allergy/asthma prone (IAP) infants were retrospectively selected for genome-wide DNA methylation and single nucleotide polymorphism analysis. The IAP infants were enriched for the low vaccine responsiveness (LVR) phenotype (Fishers Exact p-value = 0.01). Results An endotype signature of 813 differentially methylated regions (DMRs) comprising 238 lead CpG associations (FDR < 0.05) emerged, implicating pathways related to asthma, mucin production, antigen presentation and inflammasome activation. Allelic variation explained only a minor portion of this signature. Stimulation of mononuclear cells with monophosphoryl lipid A (MPLA), a TLR agonist, partially reversing this signature at a subset of CpGs, suggesting the potential for epigenetic remodelling. Conclusions This proof-of-concept study establishes a foundation for precision endotyping of IAP children and highlights the potential for immune modulation strategies using adjuvants for furture investigation.
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Fuji N, Pham M, Kaur R, Pichichero M. Serotype 3 Antibody Response and Antibody Functionality Compared to Serotype 19A Following 13-Valent Pneumococcal Conjugate Immunization in Children. Pediatr Infect Dis J 2024; 43:294-300. [PMID: 38048644 PMCID: PMC10922043 DOI: 10.1097/inf.0000000000004192] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
BACKGROUND Prevention of infections in children vaccinated with 13-valent pneumococcal conjugate vaccine (PCV13) may be less effective against serotype 3 than 19A. OBJECTIVE The aim of this study was to to determine differences in IgG and functional antibody for serotype 3 versus 19A following PCV13 immunization, in IgG antibody levels induced by PCV13 compared to naturally-induced immunity, and assess effectiveness of PCV13 against serotype 3 and 19A in prevention of acute otitis media (AOM) and colonization among 6-36-month-old children. METHODS Samples were from a prospective, longitudinal, observational cohort study conducted in Rochester, NY. Pneumococcal detection was by culture. 713 serum were tested for antibody levels by enzyme-linked immunosorbent assay, 68 for functional antibody by opsonophagocytosis and 47 for antibody avidity by thiocyanate bond disruption. PCV13 effectiveness in preventing AOM and colonization was determined by comparison of pre-PCV13 detection of serotypes 3 and 19A to post-PCV13. RESULTS The proportion of children who reached the antibody threshold of ≧0.35 µg/mL after PCV13 was higher for serotype 19A than serotype 3. Only serotype 19A showed significant increase in PCV13-induced opsonophagocytosis assay titers and antibody avidity. Serotype 3 naturally-induced immune children showed a positive trend of increase in antibody level as children got older, but not PCV13-immunized children. PCV13 effectiveness was not identified in preventing AOM or colonization for serotype 3 but effectiveness of 19A was confirmed. CONCLUSIONS PCV13 elicits lower antibody levels and lower effectiveness to serotype 3 versus serotype 19A. Post-PCV13-induced antibody levels for serotype 3 are likely insufficient to prevent AOM and colonization in most young children.
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Affiliation(s)
- Naoko Fuji
- Rochester General Hospital Research Institute, Center for Infectious Diseases, 1425 Portland Ave, Rochester NY
| | - Minh Pham
- San Francisco State University, 1600 Holloway Ave, San Francisco CA
| | - Ravinder Kaur
- Rochester General Hospital Research Institute, Center for Infectious Diseases, 1425 Portland Ave, Rochester NY
| | - Michael Pichichero
- Rochester General Hospital Research Institute, Center for Infectious Diseases, 1425 Portland Ave, Rochester NY
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Li QY, Lambert EC, Kaur R, Hammer NI, Delcamp JH. Symmetric dicyanobenzothiadiazole (DCBT) dyes with a 1.5 eV excited state reduction potential range. RSC Adv 2024; 14:6521-6531. [PMID: 38390512 PMCID: PMC10880648 DOI: 10.1039/d3ra06575h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Strong molecular photooxidants are important in many disciplines including organic synthesis and renewable energy. In these fields, strongly oxidizing chromophores are employed to drive various transformations from challenging bond formations to energy storage systems. A range of photooxidant strengths are needed to drive these processes. A series of 8 symmetrically bisarylated 5,6-dicyano[2,1,3]benzothiadiazole (DCBT) dyes were studied for their tunability toward breadth of light absorption and photooxidant strength. The dye oxidation strength and light absorption tunability is the result of appending various aryl substituents on the periphery of the DCBT core which shows remarkable tunability of the final chromophore. The dyes are studied via steady-state absorption and emission, time-correlated single photon counting, computational analysis, and cyclic voltammetry. In changing the peripheral aryl substituents via electronics, sterics, and π-conjugation length, a series of dyes are arrived at with a dramatic 1.5 eV range in oxidizing strength and >200 nm (0.95 eV) absorption maxima tunability. Furthermore, two dyes in the series exhibit strong oxidizing strength while still approaching red light absorbance (>650 nm onset) which provides unique opportunities for the use of lower energy light to affect chemical transformations. Ultimately, this series provides options for photooxidations that allow for energetic tuning and selectivity for a given chemical transformation.
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Affiliation(s)
- Qing Yun Li
- Department of Chemistry and Biochemistry, University of Mississippi University, 322 Coulter Hall MS 38677 USA
| | - Ethan C Lambert
- Department of Chemistry and Biochemistry, University of Mississippi University, 322 Coulter Hall MS 38677 USA
| | - Ravinder Kaur
- Department of Chemistry and Biochemistry, University of Mississippi University, 322 Coulter Hall MS 38677 USA
| | - Nathan I Hammer
- Department of Chemistry and Biochemistry, University of Mississippi University, 322 Coulter Hall MS 38677 USA
| | - Jared H Delcamp
- Department of Chemistry and Biochemistry, University of Mississippi University, 322 Coulter Hall MS 38677 USA
- Materials and Manufacturing Directorate, Air Force Research Laboratory 2230 Tenth Street, Wright-Patterson AFB OH 45433 USA
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Choudhary A, Sibia P, Kaur S, Gupta S, Gambhir P, Kaur R. Evaluation of fetal kidney length as a marker for fetal biometry. Arch Gynecol Obstet 2024:10.1007/s00404-024-07374-9. [PMID: 38365961 DOI: 10.1007/s00404-024-07374-9] [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: 11/17/2023] [Accepted: 01/02/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND The precise determination of gestational age is essential for effectively managing and prognosis of all pregnancies. Through careful biometry, timely interventions can be implemented, leading to positive outcomes for both the mother and fetus. In routine fetal biometry, parameters such as biparietal diameter (BPD), femur length (FL), head circumference (HC), and abdominal circumference (AC) have been traditionally used. This study aims to evaluate the usefulness of fetal kidney length (FKL) as a marker for fetal biometry. METHODOLOGY This prospective, observational, and cross-sectional study was conducted in the Radiodiagnosis and Obstetrics and Gynaecology departments, including a diverse group of pregnant women from various socio-economic backgrounds, with adherence to ethical standards. Women with singleton pregnancies between 22 and 40 weeks of gestation who met the inclusion and exclusion criteria were examined through ultrasound. The data collected were subsequently analyzed. RESULT In the current study, 280 participants with an average age of 26.71 ± 3.6 years were included. The agreement between the mean fetal kidney length and standard biometry parameters was almost perfect, with a strength of agreement exceeding 0.99. A strong and statistically significant positive correlation existed between fetal kidney length and the estimated gestational period calculated using DLMP/standard biometric measurements. CONCLUSION Fetal kidney length is a reliable indicator of gestational age and can supplement standard biometric measurements to provide a more precise estimation of gestational age, especially in the later stages when obtaining such standard measurements may be challenging.
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Affiliation(s)
- Archana Choudhary
- Department of Obstetrics and Gynaecology, Government Medical College & Rajindra Hospital, Patiala, India
| | - Preetkanwal Sibia
- Department of Obstetrics and Gynaecology, Government Medical College & Rajindra Hospital, Patiala, India
| | - Sarabhjit Kaur
- Department of Obstetrics and Gynaecology, Government Medical College & Rajindra Hospital, Patiala, India
| | - Saryu Gupta
- Department of Radiodiagnosis, Government Medical College & Rajindra Hospital, Patiala, India
| | - Puneet Gambhir
- Department of Community Medicine, Government Medical College & Rajindra Hospital, Patiala, India.
| | - Ravinder Kaur
- Department of Obstetrics and Gynaecology, Government Medical College & Rajindra Hospital, Patiala, India
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Kaur R, Melgandi W, Rathi AK, Singh K, Rahman F, Mandal S. Epithelial myoepithelial carcinoma: A case report. J Cancer Res Ther 2024:01363817-990000000-00085. [PMID: 38261448 DOI: 10.4103/jcrt.jcrt_2721_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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/14/2023] [Indexed: 01/25/2024]
Abstract
ABSTRACT Epithelial myoepithelial carcinoma is a rare tumor with the parotid gland being the most common primary site of origin. The tumor may also very rarely originate in minor salivary glands of the soft palate. Due to the rarity of its occurrence and histogenesis, clear-cut therapeutic guidelines are not defined. The present report describes the case of a 56-year-old female patient who was diagnosed to have epithelial myoepithelial carcinoma (EMC) of the minor salivary gland of the soft palate, Stage T2 N0 M0 (Stage group II). The patient was treated with radical radiotherapy followed by adjuvant chemotherapy and is alive with no evidence of disease after 12 months following the end of treatment.
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Affiliation(s)
- Ravinder Kaur
- Department of Radiation Oncology, Maulana Azad Medical College, New Delhi, India
| | - Wineeta Melgandi
- Department of Radiation Oncology, Maulana Azad Medical College, New Delhi, India
| | - Arun Kumar Rathi
- Department of Radiation Oncology, Maulana Azad Medical College, New Delhi, India
| | - Kishore Singh
- Department of Radiation Oncology, Maulana Azad Medical College, New Delhi, India
| | - Fazlu Rahman
- Department of Radiation Oncology, Maulana Azad Medical College, New Delhi, India
| | - Shramana Mandal
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
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Gautam G, Satija S, Kaur R, Kumar A, Sharma D, Dhakad MS. Insight into the Burden of Antimicrobial Resistance among Bacterial Pathogens Isolated from Patients Admitted in ICUs of a Tertiary Care Hospital in India. Can J Infect Dis Med Microbiol 2024; 2024:7403044. [PMID: 38223353 PMCID: PMC10787651 DOI: 10.1155/2024/7403044] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/20/2023] [Accepted: 12/26/2023] [Indexed: 01/16/2024]
Abstract
Intensive care unit (ICU) patients are prone to develop infections by hospital prevalent organisms. The aim of the study was to determine the bacteriological profiles and their drug resistance pattern among different infections in ICU patients of a tertiary care hospital. The record-based retrospective data of culture reports of the patients admitted to all the ICUs of a tertiary care hospital during the period from January 2020 to May 2022 were analyzed. A total of 3,056 samples were obtained from 2308 patients. The infection rate among ICU patients was found to be 53.40%. Isolates belonged equally to males (50.86%) and females (49.14%). The most common culture-positive clinical specimen received was blood (39.08%) followed by respiratory samples (29.45%). Acinetobacter sp. (33.02%) was the most common organism isolated from various clinical specimens, followed by Klebsiella pneumoniae (20.89%), and Escherichia coli (13.8%). More than 80% of Acinetobacter species were found to be resistant to third-generation cephalosporins, aminoglycosides, and carbapenems, whereas minocycline (56.31% S) and colistin (100% S) were the most effective drugs. Klebsiella sp. was found to be more resistant than E.coli, and the least resistance was observed to be tetracycline (43.97%) and doxycycline (55.84%). Among Staphylococcus aureus, 82.78% of strains were methicillin-resistant (MRSA). Vancomycin-resistant Enterococci (VRE) sp. accounted for 16.67% of the isolates. Evidence-based knowledge regarding the local bacterial organisms and their antimicrobial resistance pattern is pivotal in deciding empirical drug therapy, ultimately leading to the management of antimicrobial resistance (AMR).
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Affiliation(s)
| | - Shweta Satija
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi 110001, India
| | - Ravinder Kaur
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi 110001, India
| | - Anil Kumar
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi 110001, India
| | - Divakar Sharma
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi 110001, India
| | - Megh Singh Dhakad
- Department of Microbiology, Maulana Azad Medical College and Associated Hospitals, New Delhi 110002, India
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Narang S, Pandey AK, Kaur G, Giran M, Saxena SK, Moudgil S, Walia DK, Handa U, Meena VK, Kaur R, Astrahan M. Iodine-125 brachytherapy for choroidal melanoma by using Ocuprosta seeds with indigenous non-collimated plaques: Our initial experience. Indian J Ophthalmol 2024; 72:S90-S95. [PMID: 38131548 PMCID: PMC10833169 DOI: 10.4103/ijo.ijo_1694_23] [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: 06/28/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Brachytherapy is the gold-standard treatment for choroidal melanoma. This study evaluated iodine-125 brachytherapy by using Ocuprosta seeds with indigenous non-collimated plaques in Asian patients. METHODS Retrospective single-center study in a tertiary care hospital of 12 eyes with choroidal melanoma in 12 Asian patients who underwent brachytherapy with Ocuprosta seeds fixed on non-collimated plaques and had a follow-up of at least 32 months (mean: 42.4 ± 9.5 months; median: 40 months). Radiotherapy was planned after developing the digital 3D model of the tumor within the eye by using radiological images and clinical pictures. Ocuprosta iodine-125 seeds were used on indigenous non-collimated gold plaques to deliver the radiation for precalculated time. "Successful outcome" was taken as a decrease in the volume of the tumor, and "unsuccessful outcome" was defined as no change in the tumor volume or increase in the tumor volume at 24 months after brachytherapy. RESULTS The mean decrease in tumor volume was 21% (914.5 ± 912.2 mm3 to 495.7 ± 633.6 mm3) after brachytherapy, which correlated with the baseline volume of the tumor. Ten eyes (83.3%) showed a reduction in tumor volume, whereas two eyes showed an increase in the volume of the tumor after brachytherapy. One of the cases with a reduction in tumor size developed neovascular glaucoma. Enucleation was done in three eyes. A globe salvage rate of 75% and tumor regression rate of 83% were seen in the present study using Ocuprosta seeds. CONCLUSIONS Iodine-125 brachytherapy with uncollimated indigenous gold plaques is an effective treatment modality for choroidal melanomas in Asian patients.
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Affiliation(s)
- Subina Narang
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Awadesh K Pandey
- Department of Radiotherapy, Government Medical College and Hospital, Chandigarh, India
| | - Gurbir Kaur
- Department of Radiotherapy, Government Medical College and Hospital, Chandigarh, India
| | - Mannat Giran
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Sanjay K Saxena
- Radiopharmaceuticals Division, Radiochemistry and Isotope Group, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
| | - Sandeep Moudgil
- Department of Radiology, Government Medical College and Hospital, Chandigarh, India
| | - Dinesh K Walia
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Uma Handa
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Vijay K Meena
- CSIR-Central Scientific Instruments Organisation (CSIO), Chandigarh, India
| | - Ravinder Kaur
- Department of Radiology, Government Medical College and Hospital, Chandigarh, India
| | - Melvin Astrahan
- Department of Radiation Oncology, University of Southern California, Los Angeles, California, USA
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Sriramajayam L, Kaur R, Dhakad MS, Gulati A. Antifungal Resistance Profile of Fungal Isolates from Fungal Rhinosinusitis Patients: A Study from Tertiary Care Hospital. J Lab Physicians 2023; 15:488-492. [PMID: 37780889 PMCID: PMC10539057 DOI: 10.1055/s-0043-1764484] [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: 10/25/2022] [Accepted: 01/16/2023] [Indexed: 04/07/2023] Open
Abstract
Objective Fungal rhinosinusitis is on the rise worldwide and it is endemic especially in North India. The main purpose of this study was to determine the antifungal resistance profile of fungal isolates from the cases of fungal rhinosinusitis. Methods Antifungal susceptibility testing of isolated fungi to fluconazole, amphotericin B, itraconazole, and voriconazole was determined by standard CLSI broth microdilution method. Results Sixty-eight fungal isolates of Aspergillus spp . ( n = 49), Rhizopus spp. ( n = 9), Candida spp . ( n = 4), Penicillium spp . ( n = 2), Mucor spp . ( n = 2), Bipolaris spp . ( n = 1), and Alternaria spp . ( n = 1) were obtained from 60 different clinical samples as exudate from nasal mucosa ( n = 28), allergic mucin ( n = 8), nasal lavage ( n = 2), tissue biopsy from nasal polyps ( n = 14), and intraoperative nasal mucosa ( n = 8). Of the 68 isolates, 75% were resistant to fluconazole, 13.23% were resistant to itraconazole, 2.94% to amphotericin B, and none were resistant to voriconazole. Aspergillus flavus (5%) was the only fungi found resistant to amphotericin B, while against itraconazole, A. flavus (7.5%) and A. niger (100%) were found resistant. All the isolates of A. flavus , A. fumigatus , A. niger , and Penicillium spp. were resistant to fluconazole. Conclusion Although amphotericin B stills remains to be the most effective drug, more prospective studies are needed for the requirement of knowledge of the sensitivity pattern for optimal treatment and reduction in morbidity in the long run.
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Affiliation(s)
- Lavanya Sriramajayam
- Department of Microbiology, Maulana Azad Medical College, New Delhi, India
- Department of Microbiology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Ravinder Kaur
- Department of Microbiology, Maulana Azad Medical College, New Delhi, India
- Department of Microbiology, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India
| | - Megh Singh Dhakad
- Department of Microbiology, Maulana Azad Medical College, New Delhi, India
- Department of Microbiology, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India
| | - Achal Gulati
- Department of ENT, Maulana Azad Medical College & Associated Hospitals, New Delhi, India
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Bhatia H, Agarwal P, Kaur R, Pol S. Congenital Peri-Lymphatic Fistula: is CT Imaging Enough? Indian J Otolaryngol Head Neck Surg 2023; 75:4148-4150. [PMID: 37974808 PMCID: PMC10645794 DOI: 10.1007/s12070-023-03893-0] [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: 04/13/2023] [Accepted: 05/17/2023] [Indexed: 11/19/2023] Open
Abstract
Congenital SNHL patients uncommonly present with radiologically evident anomalies. While inner ear malformations are found in a small percentage of such cases, congenital peri-lymphatic fistula is an even rarely reported entity. We present such a case of a two-year old child who was diagnosed with both the entities on comprehensive imaging with CT as well as MRI. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03893-0.
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Affiliation(s)
- Harsimran Bhatia
- Department of Radiodiagnosis and Imaging, Post graduate Institute of Medical Education and Research, Chandigarh, India
| | - Purnima Agarwal
- Department of Radiodiagnosis and Imaging, Government Medical College and Hospital, sector 32, Chandigarh, India
| | - Ravinder Kaur
- Department of Radiodiagnosis and Imaging, Government Medical College and Hospital, sector 32, Chandigarh, India
| | - Shashikant Pol
- Department of ENT and head neck surgery Dr. Vasant Rao Pawar Medical College and Research Centre, Nashik, India
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Ghosh A, Goyal K, Singh R, Lakshmi PVM, Kaur R, Kumar V, Muralidharan J, Puri GD, Ram J, Singh MP. High prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies among unvaccinated children of Chandigarh, Northwest India, in a household-based paediatric serosurvey post-second wave of pandemic (June to July 2021). Public Health 2023; 225:160-167. [PMID: 37931485 DOI: 10.1016/j.puhe.2023.10.010] [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: 06/13/2023] [Revised: 09/05/2023] [Accepted: 10/04/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE Current national severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination policy covers children aged >12 years. Unvaccinated, uninfected children remain susceptible to SARS-CoV-2 and play a role in community transmission, as paediatric infection is mostly mild or asymptomatic. To estimate the proportion of susceptible children in a community for public health measures, there is a need to assess the extent of natural infection. STUDY DESIGN We performed a cross-sectional household serosurvey of SARS-CoV-2 antibodies in unvaccinated children aged between 6 and 18 years after the second COVID-19 wave. METHODS Anti-SARS-CoV-2 immunoglobin G (IgG) testing in serum was done using chemiluminescence immunoassay. We used a logistic regression model to investigate predicted factors of seropositivity. RESULTS We observed a high prevalence (weighted average: 68.3%) of anti-SARS-CoV-2 IgG in 2700 enrolled children. Logistic regression for predictors of IgG seropositivity showed lower odds in households with completely vaccinated adults (adjusted odds ratio [OR]: 0.43, 95% confidence interval [CI]: 0.26-0.71, P = 0.0011) compared with households with unvaccinated adults. Other factors for low seropositivity included frontline workers as family members (adjusted OR: 0.69, 95% CI: 0.52-0.91, P = 0.0091) and non-crowded households (adjusted OR: 0.74, 95% CI: 0.61-0.89, P = 0.0019). CONCLUSION A high SARS-CoV-2 IgG prevalence in unvaccinated children was indicative of previous exposure to potentially infected contacts. This implies in-person academic activities for children can be continued during future community transmission. Comparatively lower seropositivity in children of completely vaccinated households or frontline workers suggests decreased transmission due to vaccination-induced immunity of family members. Vaccination will still be required in these children to maintain protective IgG levels, particularly in low seroprevalence groups.
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Affiliation(s)
- A Ghosh
- Department of Virology, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - K Goyal
- Department of Virology, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - R Singh
- Department of Community Medicine & School of Public Health, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - P V M Lakshmi
- Department of Community Medicine & School of Public Health, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - R Kaur
- Department of Virology, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - V Kumar
- Department of Virology, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - J Muralidharan
- Advanced Pediatric Centre, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - G D Puri
- Department of Anaesthesiology & Critical Care, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - J Ram
- Department of Ophthalmology, Post-graduate Institute of Medical Education & Research, Chandigarh, India
| | - M P Singh
- Department of Virology, Post-graduate Institute of Medical Education & Research, Chandigarh, India.
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Banga A, Aulakh R, Kumar P, Kaur R, Kaur J. Does ensuring optimum vitamin D levels result in early resolution of neurocysticercosis? Int J Neurosci 2023; 133:1285-1294. [PMID: 35574655 DOI: 10.1080/00207454.2022.2078207] [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: 12/09/2021] [Revised: 03/29/2022] [Accepted: 05/11/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Neurocysticercosis is a leading cause of acquired epilepsy. Calcified granulomas are known to cause seizure recurrence. Researchers have reported that vitamin D deficiency is associated with brain calcification and reduction in calcification occurs with vitamin D receptor agonist calcitriol through upregulation of SLC20A2. Based on these observations, a hypothesis was proposed that the occurrence of calcification could be reduced by optimizing vitamin D levels, resulting in early resolution of neurocysticercosis. METHODOLOGY A case-control (retrospective and prospective) study on 60 children with solitary intraparenchymal neurocysticercosis, 20 new cases prior to starting cysticidal therapy and other 40 resolved cases was carried out. Among new cases, children deficient in vitamin D were given megadose of vitamin D and vitamin D levels were rechecked after 30 days. Children having normal vitamin D were taken as cases and the deficient ones were taken as controls. Standard treatment for neurocysticercosis was given. Three monthly MRI scans were done. Outcome was evaluated as resolution/persistence of neurocysticercosis at 3, 6, 9 and 12 months. STATISTICS AND RESULTS Pearson chi square/Fisher's exact test was used along with Kaplan Meier and log rank test. Of 60 patients, at 6 months 3 cases and 4 controls (p value 0.43), at 9 months 2 cases and 6 controls (p value 0.037) and at 12 months 3 cases and 6 controls (p value 0.029) had complete resolution of NCC. CONCLUSION The results do not show that adequate vitamin D levels result in early resolution of neurocysticercosis.
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Affiliation(s)
- Akshay Banga
- Department of Pediatrics, Government Medical College and Hospital Sector 32, Chandigarh, India
| | - Roosy Aulakh
- Department of Pediatrics, Government Medical College and Hospital Sector 32, Chandigarh, India
| | - Pankaj Kumar
- Department of Pediatrics, Government Medical College and Hospital Sector 32, Chandigarh, India
| | - Ravinder Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital Sector 32, Chandigarh, India
| | - Jasbinder Kaur
- Department of Biochemistry, Government Medical College and Hospital Sector 32, Chandigarh, India
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Pichichero ME, Xu L, Gonzalez E, Pham M, Kaur R. Variability of Vaccine Responsiveness in Young Children. J Infect Dis 2023:jiad524. [PMID: 37992188 DOI: 10.1093/infdis/jiad524] [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: 07/11/2023] [Revised: 10/04/2023] [Accepted: 11/20/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Variability in vaccine responsiveness among young children is poorly understood. METHODS Nasopharyngeal secretions were collected in the first weeks of life for measurement of cytokines/chemokines seeking a biomarker, and blood samples collected at age one year to identify vaccine responsiveness status, defined as low vaccine responder (LVR), normal (NVR) and high (HVR), to test for vaccine antigen-induced immune memory, and for antigen presenting cell (APC) function. RESULTS Significantly lower specific cytokine/chemokine levels as biosignatures, measurable in nasopharyngeal secretions at infant age 1-3 weeks old, predicted LVR status compared to NVR and HVR children. Antibiotic exposures were correlated with increased occurrence of LVR. At age 1 year old, LVRs had fewer CD4+ T-helper-1 and T-helper-2 memory cells responsive to specific vaccine antigens. APC responses observed among LVRs, both at rest and in response to TLR7/8 stimulation by R848 were suboptimal, suggesting that altered innate immunity may contribute to immune deficiency in LVRs. CONCLUSION Cytokine biosignatures in the first weeks of life may predict vaccine responsiveness in children during the first year of life. Antibiotic exposure associates with LVR in children. CD4+ T-cell memory induction and APC deficiencies occur in LVR children.
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Affiliation(s)
- Michael E Pichichero
- Center for Infectious Diseases and Immunology, Research Institute, Rochester General Hospital, Rochester, NY, USA
| | - Lei Xu
- Center for Infectious Diseases and Immunology, Research Institute, Rochester General Hospital, Rochester, NY, USA
| | - Eduardo Gonzalez
- Center for Infectious Diseases and Immunology, Research Institute, Rochester General Hospital, Rochester, NY, USA
| | - Minh Pham
- San Francisco State University, San Francisco CA, USA
| | - Ravinder Kaur
- Center for Infectious Diseases and Immunology, Research Institute, Rochester General Hospital, Rochester, NY, USA
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Kaur R, Gonzalez E, Pham M, Pichichero M. Naturally-induced serum antibody levels in children to pneumococcal polysaccharide 15B that correlate with protection from nasopharyngeal colonization but anti-serotype 15B antibody has low functional cross-reactivity with serotype 15C. Vaccine 2023; 41:7265-7273. [PMID: 37925318 DOI: 10.1016/j.vaccine.2023.10.054] [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: 08/03/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Serotypes 15B and 15C have been added to new different pneumococcal-conjugate vaccines (PCV20 and V116, respectively). We determined a serum anti-15B antibody level that would be a correlate of protection (COP) against nasopharyngeal colonization and assessed functional cross-reactivity against serotype 15B and 15C in children following natural immunization. METHOD IgG-antibody to serotype 15B polysaccharide was measured by ELISA in 341 sera from 6 to 36 month old children collected before, at the time of, and after pneumococcal colonization caused by serotypes 15B and 15C. 155 age-matched controls who had no detected colonization caused by serotype 15B or 15C strains were used as controls. A two-step method was used for construction of COP models: a generalized estimating equation followed by logistic-regression. Opsonophagocytic (OPA) assays assessed functional cross-reactivity between serotypes 15B and 15C. RESULTS The derived COP for prevention of colonization was 1.18 µg/ml for serotype 15B and 0.63 µg/ml for serotype 15C, with a predictive probability of 80 %. Antibody levels did not correlate with OPA titers. 30 % of child samples, with moderate to high amounts of ELISA-measured antibody, showed no OPA titer against either serotype 15B or 15C. For remaining samples, very low or no functional cross-reactivity between serotypes 15B and 15C was measured. CONCLUSIONS A COP for prevention of colonization in young children based on naturally-induced antibody levels was derived for serotypes 15B and 15C that differed. Antibody levels correlated poorly with OPA titers and low functional cross-reactivity between serotypes 15B and 15C in child sera was observed.
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Affiliation(s)
- Ravinder Kaur
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY, United States.
| | - Eduardo Gonzalez
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY, United States
| | - Minh Pham
- San Francisco State University, 1600 Holloway Ave, San Francisco, CA, United States
| | - Michael Pichichero
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY, United States
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Mishra C, Abbey P, Anand R, Singh V, Kaur R. Cystic lung tuberculosis in children: A series of five cases. SA J Radiol 2023; 27:2725. [PMID: 37794948 PMCID: PMC10546250 DOI: 10.4102/sajr.v27i1.2725] [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: 05/28/2023] [Accepted: 07/28/2023] [Indexed: 10/06/2023] Open
Abstract
Frequent imaging manifestations of pulmonary tuberculosis are airspace or interstitial nodules with or without tree-in-bud nodules, consolidation, cavitation, ground glass opacity, miliary nodules, lymphadenopathy and pleural effusion. It is unusual to encounter cystic changes in patients with pulmonary tuberculosis, and these findings should be differentiated from other cystic lung diseases. This case series describes five cases of cystic lung disease in children with tuberculosis (TB) with illustrative chest radiography and CT findings. Contribution The manuscript highlights the need to consider tuberculosis as a possible cause of acquired cystic lung disease in appropriate clinical settings, particularly in endemic regions.
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Affiliation(s)
- Chetna Mishra
- Department of Radiology, Lady Hardinge Medical College, New Delhi, India
| | - Pooja Abbey
- Department of Radiology, Lady Hardinge Medical College, New Delhi, India
| | - Rama Anand
- Department of Radiology, Lady Hardinge Medical College, New Delhi, India
| | - Varinder Singh
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
| | - Ravinder Kaur
- Department of Microbiology, Lady Hardinge Medical College, New Delhi, India
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16
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Gupta V, Singh H, Sandhu MR, Kaur R, Singh A, Gupta S. The RIGHT Scoring System for the Medicolegal Classification of Head Injury. Neurol India 2023; 71:953-958. [PMID: 37929433 DOI: 10.4103/0028-3886.388122] [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] [Indexed: 11/07/2023]
Abstract
Background In India, in case of an allegation of assault, the medical officer is required to classify the nature of injury into simple, grievous, and dangerous based upon the Indian Penal Code, which is outdated and has numerous gray areas. Objective The aim of this study is twofold: first, to formulate an objective scoring system for the medicolegal classification of head injuries and Second to validate the proposed scoring system on patients with head injury. Methods and Material A panel of experts consisting of neurosurgeons, radiologists, and forensic specialists came up with an objective scoring system, coined as the RIGHT (radiological-intervention-Glasgow Coma Scale (GCS)-based head trauma) scoring system consisting of three parameters, namely, the motor subscore of the GCS, computerized tomography image findings, and management of the patient. This was used to classify head injuries-into simple, grievous, and dangerous. A single-centre pilot study was planned-including patients with head trauma reporting to the emergency department. Medicolegal nature of the head injury was classified according to the proposed RIGHT score. A 6-month follow-up was performed using the Glasgow Outcome Score (GOS). Results In total, 130 patients with head injury reported to the emergency department. There was a significant correlation between the RIGHT score assigned upon admission and the GOS at 6 months (P < 0.001). Conclusions As the scoring system could be applied objectively and a significant correlation between nature of injury given by RIGHT score and 6-month outcome was present; therefore, the RIGHT scoring system proved to be an effective method in unambiguously classifying the nature of head injury for medicolegal opinions.
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Affiliation(s)
- Vipin Gupta
- Department of Neurosurgery, Government Medical College and Hospital, Chandigarh, India
| | - Hargunbir Singh
- Intern, Government Medical College and Hospital, Chandigarh, India
| | | | - Ravinder Kaur
- Department of Radiology, Government Medical College and Hospital, Chandigarh, India
| | - Amandeep Singh
- Department of Forensic Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Soumya Gupta
- Student, Government Medical College and Hospital, Chandigarh, India
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Li QY, Kaur R, Meador WE, Roy JK, Leszczynski J, Delcamp JH. Fused Double Donor Design with a Cross-Conjugated Dibenzosilin for Dye-Sensitized Solar Cells. ACS Omega 2023; 8:29234-29246. [PMID: 37599963 PMCID: PMC10433491 DOI: 10.1021/acsomega.3c02571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023]
Abstract
Dye-sensitized solar cells (DSCs) can provide a clean energy solution to growing energy demands. In order to have devices of high performance, sensitizers that are able to absorb in the near-infrared region (NIR) are needed. Stronger electron donors are needed for intramolecular charge-transfer sensitizers to access longer wavelength photons. Thus, two novel organic dyes with a cross-conjugated dibenzosilin double donor design are studied herein. The double donor delocalizes multiple filled orbitals across both amine donors due to the fused design that planarizes the donor as observed computationally, which improves intramolecular charge-transfer strength. The dyes are studied via density functional theory (DFT), optical spectroscopy, electrochemistry, and in DSC devices. The studies indicate that the dye design can reduce recombination losses, allowing for improved DSC device performances relative to a single arylamine donor. The reduction in recombination losses is attributed to the six alkyl chains that are incorporated into the donor, which offer good surface protection.
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Affiliation(s)
- Qing Yun Li
- Department
of Chemistry and Biochemistry, University
of Mississippi, 322 Coulter Hall, University, Mississippi 38677, United States
| | - Ravinder Kaur
- Department
of Chemistry and Biochemistry, University
of Mississippi, 322 Coulter Hall, University, Mississippi 38677, United States
| | - William E. Meador
- Department
of Chemistry and Biochemistry, University
of Mississippi, 322 Coulter Hall, University, Mississippi 38677, United States
| | - Juganta K. Roy
- Interdisciplinary
Center for Nanotoxicity, Department of Chemistry, Physics and Atmospheric
Sciences, Jackson State University, Jackson, Mississippi 39217, United States
| | - Jerzy Leszczynski
- Interdisciplinary
Center for Nanotoxicity, Department of Chemistry, Physics and Atmospheric
Sciences, Jackson State University, Jackson, Mississippi 39217, United States
| | - Jared H. Delcamp
- Department
of Chemistry and Biochemistry, University
of Mississippi, 322 Coulter Hall, University, Mississippi 38677, United States
- Materials
and Manufacturing Directorate, Air Force
Research Laboratory, 2230 Tenth Street, Wright-Patterson AFB, Ohio 45433, United States
- UES
Inc., 4401 Dayton-Xenia
Road, Dayton, Ohio 45432, United States
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Kaur R, Mangiafesto J, Pryharski K, Rasam S, Zagursky R, Pichichero M. Expression conditions and characterization of a novelly constructed lipoprotein intended as a vaccine to prevent human Haemophilus influenzae infections. J Biol Chem 2023; 299:105031. [PMID: 37437888 PMCID: PMC10407732 DOI: 10.1016/j.jbc.2023.105031] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/16/2023] [Accepted: 07/01/2023] [Indexed: 07/14/2023] Open
Abstract
Bacterial lipoproteins are structurally divided into two groups, based on their lipid moieties: diacylated (present in Gram-positive bacteria) and triacylated (present in some Gram-positive and most Gram-negative bacteria). Diacylated and triacylated lipid moieties differ by a single amide-linked fatty acid chain. Lipoproteins induce host innate immune responses by the mammalian Toll-like receptor 2 (TLR2). In this study, we added a lipid moiety to recombinant OMP26, a native nonlipidated (NL) membrane protein of Haemophilus influenzae, and characterized it extensively under different expression conditions using flow cytometry, LC/MS, and MALDI-TOF. We also investigated the ability of NL and lipidated (L) OMP26 to induce in vitro stimulation of HEK Blue-hTLR2-TR1 and hTLR-TLR6 cells. Our L-OMP26 was predominantly expressed in diacylated form, so we employed an additional gene copy of apolipoprotein N-acetyltransferase enzyme (Lnt)-rich Escherichia coli strain that further acylates the diacyl lipoproteins to enhance the production of triacylated L-OMP26. The diacyl and triacyl versions of L-OMP26, intended as a vaccine for use in humans, were characterized and evaluated as protein vaccine components in a mouse model. We found that the diacyl and triacyl L-OMP26 protein formulations differed markedly in their immune-stimulatory activity, with diacylated L-OMP26 stimulating higher adaptive immune responses compared with triacylated L-OMP26 and both stimulating higher adaptive immune response compared to NL-OMP26. We also constructed and characterized an L-OMP26φNL-P6 fusion protein, where NL-P6 protein (a commonly studied H. influenzae vaccine candidate) was recombinantly fused to L-OMP26. We observed a similar pattern of lipidation (predominantly diacylated) in the L-OMP26φNL-P6 fusion protein.
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Affiliation(s)
- Ravinder Kaur
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York, USA.
| | - Jill Mangiafesto
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York, USA
| | - Karin Pryharski
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York, USA
| | - Sailee Rasam
- Department of Biochemistry, State University of New York at Buffalo, New York, USA
| | - Robert Zagursky
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York, USA
| | - Michael Pichichero
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York, USA.
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Gupta R, Singh S, Kapoor A, Soni A, Mehta R, Kaur R, Masih GD. Comparison of "ligamentization" process between preserved insertion hamstring tendon autograft and bone-patellar tendon-bone autograft. J Orthop Sci 2023:S0949-2658(23)00191-4. [PMID: 37516643 DOI: 10.1016/j.jos.2023.06.014] [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] [Received: 10/16/2022] [Revised: 06/07/2023] [Accepted: 06/24/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Ligamentization is a complex process and effect of preservation of hamstring tendon graft insertion on this process is not well studied. Present study was conducted to analyze and compare the ligamentization of semitendinosus gracilis graft with preserved tibial insertion (STGPI) and bone-patellar tendon-bone (BPTB) autografts. METHODS A total of 50 sportspeople who underwent ACL reconstruction using either BPTB (group A; n = 25) or STGPI (group B; n = 25) autografts were included in the study. Contrast enhanced MRI was done at 8 months and 14 months post-ACL reconstruction to evaluate the ligamentization using Signal noise quotient (SNQ), graft intensity and enhancement index. Clinical outcomes (Lysholm score) and knee laxity were also assessed at 8 months and 14 months. RESULTS 18/23 (78%) patients in group A and 14/23 (61%) patients in group B had hyperintense graft signal at 8 months (n.s.) and at 14 months, 1/23 patients in group A and none of the patients in group B had hyperintense graft. SNQ at 8 months was 3.6 ± 2 and 3.7 ± 2 in group A and B respectively (n.s.) and at 14 months, SNQ was 2.5 ± 1.5 in group A and 2.4 ± 1.3 in group B (n.s.). Enhancement index at 8 months was 1.5 ± 0.3 and 1.2 ± 0.3 in group A and B respectively (p = 0.0001). Enhancement index at 14 months was 1.21 ± 0.2 in group A and 1.07 ± 0.2 in group B (p = 0.003). Functional outcomes and knee laxity were comparable in both the groups at 8 and 14 months (n.s.). CONCLUSION Both the grafts i.e. BPTB and STGPI are similar in terms of rate and extent of ligamentization. Clinical outcomes and knee laxity are also comparable between two grafts.
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Affiliation(s)
- Ravi Gupta
- Director Orthopaedics, Fortis Hospital, Mohali, Punjab, India.
| | - Sandeep Singh
- Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.
| | - Anil Kapoor
- Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.
| | - Ashwani Soni
- Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.
| | - Rohil Mehta
- Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.
| | - Ravinder Kaur
- Department of Radio-Diagnosis, Government Medical College Hospital, Chandigarh, India.
| | - Gladson David Masih
- Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.
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20
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Kaur R, GholamHosseini H. Analyzing the Impact of Image Denoising and Segmentation on Melanoma Classification Using Convolutional Neural Networks. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083686 DOI: 10.1109/embc40787.2023.10340135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Early skin cancer detection and its treatment are crucial for reducing death rates worldwide. Deep learning techniques have been used successfully to develop an automatic lesion detection system. This study explores the impact of pre-processing steps such as data augmentation, contrast enhancement, and segmentation on improving the convolutional neural network (CNN) performance for lesion classification. The classification network was designed from scratch by uniquely organizing its layers and using a different number of kernels, depth of the network, size, and hyperparameters. In addition, the network's performance was improved by pre-processing and segmentation steps. The proposed network was compared with the current state-of-the-art to demonstrate its best performance on the benchmark HAM10000 lesion dataset. The experimental study revealed that the classification network using denoised+segmented data achieved an accuracy (ACC), precision (PRE), recall (REC), specificity (SPE), and F-score of 93.40%, 93.45%, 94.51%, 92.08%, and 93.98%, respectively. To conclude, classification performance can be improved by incorporating pre-processing and segmentation steps.
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21
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Kaur M, Sharma R, Kapoor K, Kaur R, Arora KS. Fetal Humeral Diaphyseal Length in the Second Trimester - A Radiographic Observational Study among Indian Population. J Pharm Bioallied Sci 2023; 15:S1239-S1243. [PMID: 37694073 PMCID: PMC10485506 DOI: 10.4103/jpbs.jpbs_147_23] [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: 02/15/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 09/12/2023] Open
Abstract
Objectives The present study was performed to provide a normal reference range for humerus diaphysis length at the second trimester of pregnancy in an Indian population. Materials and Methods This cross-sectional study was performed on 25 radiographs of aborted normal human fetuses of gestational age (GA) between 13th and 28th weeks. The radiographs were used to measure the maximum length of the humerus using a vernier calliper. Data were collected, tabulated, and statistically analyzed. Results The mean diaphyseal length of humerus at the fourth lunar month was 22.18 ± 6.59 mm, and at the seventh lunar month, it was 41.39 ± 10.08 mm. Simple linear regression analysis shows a strongly significant linear relationship of humerus length with GA, biparietal diameter, head circumference, and abdomen circumference. Conclusion We have provided a normal reference range for humerus diaphysis length at the second trimester of pregnancy in an Indian population.
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Affiliation(s)
- Maninder Kaur
- Department of Anatomy, Government Medical College and Hospital, Amritsar, Punjab, India
| | - Ravikant Sharma
- Department of Anatomy, Government Medical College and Hospital, Amritsar, Punjab, India
| | - Kanchan Kapoor
- Department of Anatomy, Government Medical College and Hospital, Chandigarh, India
| | - Ravinder Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
| | - Karandeep S. Arora
- Department of Oral Medicine and Radiology, Bhojia Dental College and Hospital, Bhud, Baddi, Himachal Pradesh, India
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22
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Chaurasia S, Anand P, Sharma A, Nangia S, Sivam A, Jain K, Gaind R, Kaur R, Sastry AS, Kapil A, Bhatt M, Salhan M, Dudeja A, Plakkal N, Verma A, Jain M, Saxena S, Mohapatra S, Kashyap A, Goel S, Sivanandan S, Arya S, Saini S, Pande T, Saluja S, Sharma M, Vishnubhatla S, Chellani H, Sankar MJ, Agarwal R. Procalcitonin for Detecting Culture-Positive Sepsis in Neonates: A Prospective, Multicenter Study. Neonatology 2023; 120:642-651. [PMID: 37336195 DOI: 10.1159/000529640] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 02/05/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION It is unclear if serum procalcitonin (PCT) estimated at sepsis suspicion can help detect culture-positive sepsis in neonates. We evaluated the diagnostic performance of PCT in culture-positive sepsis in neonates. METHODS This was a prospective study (February 2016 to September 2020) conducted in four level-3 units in India. We enrolled neonates suspected of sepsis in the first 28 days of life. Neonates with birth weight <750 g, asphyxia, shock, and major malformations were excluded. Blood for PCT assay was drawn along with the blood culture at the time of suspicion of sepsis and before antibiotic initiation. The investigators labeled the neonates as having culture-positive sepsis or "no sepsis" based on the culture reports and clinical course. PCT assay was performed by electrochemiluminescence immunoassay, and the clinicians were masked to the PCT levels while assigning the label of sepsis. Primary outcomes were the sensitivity, specificity, and likelihood ratios to identify culture-positive sepsis. RESULTS The mean birth weight (SD) and median gestation (IQR) were 2,113 (727) g and 36 (32-38) weeks, respectively. Of the 1,204 neonates with eligible cultures, 155 (12.9%) had culture-positive sepsis. Most (79.4%) were culture-positive within 72 h of birth. The sensitivity, specificity, and positive and negative likelihood ratios at 2 ng/mL PCT threshold were 52.3% (95% confidence interval: 44.1-60.3), 64.5% (60.7-68.1), 1.47 (1.23-1.76), and 0.74 (0.62-0.88), respectively. Adding PCT to assessing neonates with 12.9% pretest probability of sepsis generated posttest probabilities of 18% and 10% for positive and negative test results, respectively. CONCLUSION Serum PCT did not reliably identify culture-positive sepsis in neonates.
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Affiliation(s)
- Suman Chaurasia
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Pratima Anand
- Department of Pediatrics, Safdarjung Hospital and VMMC, New Delhi, India
| | - Akash Sharma
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India,
| | - Sushma Nangia
- Department of Pediatrics, Kalawati Saran Children's Hospital, LHMC, New Delhi, India
| | - Adhi Sivam
- Department of Neonatology, JIPMER, Puducherry, India
| | - Kajal Jain
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Rajni Gaind
- Department of Microbiology, Safdarjung Hospital and VMMC, New Delhi, India
| | - Ravinder Kaur
- Department of Microbiology, Lady Hardinge Medical College (LHMC), New Delhi, India
| | | | - Arti Kapil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Meenakshi Bhatt
- Department of Pediatrics, Safdarjung Hospital and VMMC, New Delhi, India
| | - Meetu Salhan
- Department of Pediatrics, Safdarjung Hospital and VMMC, New Delhi, India
| | - Ajay Dudeja
- Department of Pediatrics, Kalawati Saran Children's Hospital, LHMC, New Delhi, India
| | | | - Ankit Verma
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Manisha Jain
- Department of Microbiology, Safdarjung Hospital and VMMC, New Delhi, India
| | - Sonal Saxena
- Department of Microbiology, Lady Hardinge Medical College (LHMC), New Delhi, India
| | - Sarita Mohapatra
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Archana Kashyap
- Department of Pediatrics, Safdarjung Hospital and VMMC, New Delhi, India
| | - Srishti Goel
- Department of Pediatrics, Kalawati Saran Children's Hospital, LHMC, New Delhi, India
| | | | - Sugandha Arya
- Department of Pediatrics, Safdarjung Hospital and VMMC, New Delhi, India
| | - Savita Saini
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Tapish Pande
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sumita Saluja
- Department of Hematology, Safdarjung Hospital and VMMC, New Delhi, India
| | - Monica Sharma
- Department of Hematology, Safdarjung Hospital and VMMC, New Delhi, India
| | | | - Harish Chellani
- Department of Pediatrics, Safdarjung Hospital and VMMC, New Delhi, India
| | - M Jeeva Sankar
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ramesh Agarwal
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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23
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Raghav N, Vashisth C, Mor N, Arya P, Sharma MR, Kaur R, Bhatti SP, Kennedy JF. Recent advances in cellulose, pectin, carrageenan and alginate-based oral drug delivery systems. Int J Biol Macromol 2023:125357. [PMID: 37327920 DOI: 10.1016/j.ijbiomac.2023.125357] [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: 08/05/2022] [Revised: 06/05/2023] [Accepted: 06/10/2023] [Indexed: 06/18/2023]
Abstract
Polymers-based drug delivery systems constitute one of the highly explored thrust areas in the field of the medicinal and pharmaceutical industries. In the past years, the properties of polymers have been modified in context to their solubility, release kinetics, targeted action site, absorption, and therapeutic efficacy. Despite the availability of diverse synthetic polymers for the bioavailability enhancement of drugs, the use of natural polymers is still highly recommended due to their easy availability, accessibility, and non-toxicity. The aim of the review is to provide the available literature of the last five years on oral drug delivery systems based on four natural polymers i.e., cellulose, pectin, carrageenan, and alginate in a concise and tabulated manner. In this review, most of the information is in tabulated form to provide easy accessibility to the reader. The data related to active pharmaceutical ingredients and supported components in different formulations of the mentioned polymers have been made available.
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Affiliation(s)
- Neera Raghav
- Chemistry Department, Kurukshetra University, Kurukshetra, Haryana 136119, India.
| | - Chanchal Vashisth
- Chemistry Department, Kurukshetra University, Kurukshetra, Haryana 136119, India
| | - Nitika Mor
- Chemistry Department, Kurukshetra University, Kurukshetra, Haryana 136119, India
| | - Priyanka Arya
- Chemistry Department, Kurukshetra University, Kurukshetra, Haryana 136119, India
| | - Manishita R Sharma
- Chemistry Department, Kurukshetra University, Kurukshetra, Haryana 136119, India
| | - Ravinder Kaur
- Chemistry Department, Kurukshetra University, Kurukshetra, Haryana 136119, India
| | | | - John F Kennedy
- Chembiotech laboratories Ltd, Tenbury Wells, WR15 8FF, United Kingdom.
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24
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Yadav A, Azad C, Kaur R, Guglani V, Gupta S, Mitra S. Neuroimaging Findings in Vitamin B 12-Deficient Infants With Neurologic Features. J Child Neurol 2023; 38:161-168. [PMID: 37093759 DOI: 10.1177/08830738231169411] [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: 04/25/2023]
Abstract
Background:Vitamin B12 deficiency causes serious neurologic problems among infants. However, its neuroradiologic correlate is still largely obscure. Methodology: This prospective study was conducted on patients aged 6 months to 2 years. All children with proven vitamin B12 deficiency were planned to undergo magnetic resonance imaging (MRI) and magnetic resonance spectroscopy of the brain. Results: A total of 35 patients (63% female) were enrolled. Twenty-six (74%) patients had significant findings on brain MRI scan, commonest of which were thinning of corpus callosum and prominence of extra-axial spaces in 28.6% children, cerebral atrophy in 17%, and diffuse symmetrical hyperintensity of white matter in 5.7% patients. Using logistic regression, it was found that odds of abnormal neuroimaging findings were higher in children below 12 months, in females, and in patients with developmental regression, but none of them were statistically significant. Conclusion: Most of the infants with vitamin B12 deficiency have abnormal neuroimaging findings.
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Affiliation(s)
- Anjali Yadav
- Department of Pediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Chandrika Azad
- Department of Pediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Ravinder Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
| | - Vishal Guglani
- Department of Pediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Seema Gupta
- Department of Biochemistry, Government Medical College and Hospital, Chandigarh, India
| | - Sukanya Mitra
- Department of Anaesthesia, Government Medical College and Hospital, Chandigarh, India
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25
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Cook A, Ferreras-Antolin L, Adhisivam B, Ballot D, Berkley JA, Bernaschi P, Carvalheiro CG, Chaikittisuk N, Chen Y, Chibabhai V, Chitkara S, Chiurchiu S, Chorafa E, Dien TM, Dramowski A, de Matos SF, Feng J, Jarovsky D, Kaur R, Khamjakkaew W, Laoyookhong P, Machanja E, Mussi-Pinhata MM, Namiiro F, Natraj G, Naziat H, Ngoc HTB, Ondongo-Ezhet C, Preedisripipat K, Rahman H, Riddell A, Roilides E, Russell N, Sastry AS, Tasimwa HB, Tongzhen J, Wadula J, Wang Y, Whitelaw A, Wu D, Yadav V, Yang G, Stohr W, Bielicki JA, Ellis S, Warris A, Heath PT, Sharland M. Neonatal invasive candidiasis in low- and middle-income countries: Data from the NeoOBS study. Med Mycol 2023; 61:myad010. [PMID: 36881725 PMCID: PMC10026246 DOI: 10.1093/mmy/myad010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/11/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
Neonatal invasive candidiasis (NIC) has significant morbidity and mortality. Reports have shown a different profile of those neonates affected with NIC and of fluconazole-resistant Candida spp. isolates in low- and middle-income countries (LMICs) compared to high-income countries (HICs). We describe the epidemiology, Candida spp. distribution, treatment, and outcomes of neonates with NIC from LMICs enrolled in a global, prospective, longitudinal, observational cohort study (NeoOBS) of hospitalized infants <60 days postnatal age with sepsis (August 2018-February 2021). A total of 127 neonates from 14 hospitals in 8 countries with Candida spp. isolated from blood culture were included. Median gestational age of affected neonates was 30 weeks (IQR: 28-34), and median birth weight was 1270 gr (interquartile range [IQR]: 990-1692). Only a minority had high-risk criteria, such as being born <28 weeks, 19% (24/127), or birth weight <1000 gr, 27% (34/127). The most common Candida species were C. albicans (n = 45, 35%), C. parapsilosis (n = 38, 30%), and Candida auris (n = 18, 14%). The majority of C. albicans isolates were fluconazole susceptible, whereas 59% of C. parapsilosis isolates were fluconazole-resistant. Amphotericin B was the most common antifungal used [74% (78/105)], followed by fluconazole [22% (23/105)]. Death by day 28 post-enrollment was 22% (28/127). To our knowledge, this is the largest multi-country cohort of NIC in LMICs. Most of the neonates would not have been considered at high risk for NIC in HICs. A substantial proportion of isolates was resistant to first choice fluconazole. Understanding the burden of NIC in LMIC is essential to guide future research and treatment guidelines.
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Affiliation(s)
- Aislinn Cook
- Centre for Neonatal and Paediatric Infection, St. George's University of London, London, UK
| | - Laura Ferreras-Antolin
- Centre for Neonatal and Paediatric Infection, St. George's University of London, London, UK
- MRC Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Bethou Adhisivam
- Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India
| | - Daynia Ballot
- School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - James A Berkley
- Clinical Research Department, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The Childhood Acute Illness & Nutrition (CHAIN) Network, Nairobi, Kenya
| | - Paola Bernaschi
- Microbiology Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Cristina G Carvalheiro
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - Yunsheng Chen
- Clinical Laboratory, Shenzhen Children's Hospital, Shenzhen, China
| | - Vindana Chibabhai
- Department of Clinical Microbiology & Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- NHLS Microbiology Laboratory, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Shweta Chitkara
- Lady Hardinge Medical College & Associated SSK & KSC Hospitals, New Delhi, India
| | - Sara Chiurchiu
- Academic Hospital Paediatric Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Elisavet Chorafa
- Infectious Diseases Unit, 3rd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University and Hippokration General Hospital, Thessaloniki, Greece
| | - Tran Minh Dien
- Vice Director Vietnam National Children's Hospital, Hanoi, Vietnam
- Department of Surgery, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Angela Dramowski
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - Jinxing Feng
- Department of Neonatology, Shenzhen Children's Hospital, Shenzhen, China
| | | | - Ravinder Kaur
- Lady Hardinge Medical College & Associated SSK & KSC Hospitals, New Delhi, India
| | | | | | - Edwin Machanja
- Department of Microbiology, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Marisa M Mussi-Pinhata
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Flavia Namiiro
- Mulago Specialised Women and Neonatal Hospital, Kampala, Uganda
| | - Gita Natraj
- Seth G. S. Medical College & KEM Hospital, Mumbai, India
| | - Hakka Naziat
- Child Health Research Foundation, Dhaka, Bangladesh
| | - Hoang Thi Bich Ngoc
- Department of Microbiology, Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Claude Ondongo-Ezhet
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Amy Riddell
- Centre for Neonatal and Paediatric Infection, St. George's University of London, London, UK
| | - Emmanuel Roilides
- Infectious Diseases Unit, 3rd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University and Hippokration General Hospital, Thessaloniki, Greece
| | - Neal Russell
- Centre for Neonatal and Paediatric Infection, St. George's University of London, London, UK
| | - Apurba S Sastry
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India
| | | | - Ji Tongzhen
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University,Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jeannette Wadula
- National Health Laboratory Services, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Yajuan Wang
- Department of Neonatology, Children's Hospital, Capital Institute of Pediatrics, 2# Yabao Road, Chaoyang District, Beijing, China
- Department of Neonatology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Andrew Whitelaw
- Division of Medical Microbiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| | - Dan Wu
- Department of Neonatology, Children's Hospital, Capital Institute of Pediatrics, 2# Yabao Road, Chaoyang District, Beijing, China
| | - Varsha Yadav
- Seth G. S. Medical College & KEM Hospital, Mumbai, India
| | - Gao Yang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University,Beijing, China
- National Health Laboratory Services, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Wolfgang Stohr
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Julia Anna Bielicki
- Centre for Neonatal and Paediatric Infection, St. George's University of London, London, UK
| | - Sally Ellis
- Global Antibiotic Research & Development Partnership (GARDP), Geneva, Switzerland
| | - Adilia Warris
- MRC Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Paul T Heath
- Centre for Neonatal and Paediatric Infection, St. George's University of London, London, UK
| | - Michael Sharland
- Centre for Neonatal and Paediatric Infection, St. George's University of London, London, UK
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William A, Kaur R, Rawat D, Mendiratta V, Das S. Ulceration by Nocardia Otitidiscaviarum: A case study. Trop Doct 2023; 53:293-298. [PMID: 36744366 DOI: 10.1177/00494755231155230] [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: 02/07/2023]
Abstract
Nocardiosis is an acute, subacute or chronic infectious disease that occurs in cutaneous, pulmonary and disseminated forms. We present a case of Nocardiosis in a post-COVID-19 patient with cutaneous ulceration due to Nocardia otitidiscaviarum, managed with cotrimoxazole and linezolid. Early diagnosis and management proved crucial in preventing dissemination of the organism and improving the patient's outcome.
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Affiliation(s)
- Ashish William
- 28856Senior Resident, Department of Microbiology, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India
| | - Ravinder Kaur
- 28856Director Professor & Head, Department of Microbiology, Lady Hardinge Medical College & Associated hospitals, New Delhi, India
| | - Deepti Rawat
- 28856Professor, Department of Microbiology, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India
| | - Vibhu Mendiratta
- 28856Director Professor & Head, Department of Dermatology & STD, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India
| | - Sudeshna Das
- 28856Postgraduate Resident, Department of Microbiology, Lady Hardinge Medical College & Associated hospitals, New Delhi, India
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Abstract
BACKGROUND Contemporary, quantitative data are needed to inform recommendations and decision-making regarding referral and surgeon endorsement of tympanostomy tube placement in young children with recurrent acute otitis media (AOM). METHODS A prospective, observational cohort study of 286 children in a primary care pediatric practice setting, who had at least 1 AOM (range 1-8). Children were followed longitudinally from 6 to 36 months old. AOMs were microbiologically confirmed by tympanocentesis for diagnostic accuracy. A window of susceptibility (WOS) was defined as AOMs closely spaced in time with no gap in occurrence >6 months. For prediction of total number of AOMs, we used a quasi-poisson generalized linear model. RESULTS Eighty percent of AOMs occurred during child age 6 to 21 months old. Seventy two percent of WOS intervals were <5 months and 97% were <10 months. Clinically applicable models were developed to predict which children would benefit most from tympanostomy tubes. Significant predictors were child age at the first AOM (P < .001) and daycare attendance (P = .03). The age of a child when 2, 3, or 4 AOMs had occurred allowed prediction of the number of additional AOMs that might occur. After insertion of tympanostomy tubes, 16 (52%) of 31 children had no additional AOMs. CONCLUSIONS Recurrent AOM occurs in a narrow WOS and number of AOMs can be predicted at time of AOM based on child age and daycare attendance. Insertion of tympanostomy tubes likely occurs in many children after the WOS to recurrent AOM has passed or only 1 more AOM may be prevented at most.
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Affiliation(s)
- Peter Bajorski
- School of Mathematical Sciences, College of Science, Rochester Institute of Technology, Rochester, New York
| | - Naoko Fuji
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York
| | - Ravinder Kaur
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York
| | - Michael E. Pichichero
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York
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28
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Jones SP, Cook KH, Holmquist ML, Almekinder LJ, Delaney AM, Charles R, Labbe N, Perdue J, Jackson N, Pichichero ME, Kaur R, Michel LV, Gleghorn ML. Vaccine target and carrier molecule nontypeable Haemophilus influenzae protein D dimerizes like the close Escherichia coli GlpQ homolog but unlike other known homolog dimers. Proteins 2023; 91:161-170. [PMID: 36065600 DOI: 10.1002/prot.26418] [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: 06/15/2022] [Revised: 08/17/2022] [Accepted: 08/26/2022] [Indexed: 01/11/2023]
Abstract
We have determined the 1.8 Å X-ray crystal structure of nonlipidated (i.e., N-terminally truncated) nontypeable Haemophilus influenzae (NTHi; H. influenzae) protein D. Protein D exists on outer membranes of H. influenzae strains and acts as a virulence factor that helps invade human cells. Protein D is a proven successful antigen in animal models to treat obstructive pulmonary disease (COPD) and otitis media (OM), and when conjugated to polysaccharides also has been used as a carrier molecule for human vaccines, for example in GlaxoSmithKline Synflorix™. NTHi protein D shares high sequence and structural identify to the Escherichia coli (E. coli) glpQ gene product (GlpQ). E. coli GlpQ is a glycerophosphodiester phosphodiesterase (GDPD) with a known dimeric structure in the Protein Structural Database, albeit without an associated publication. We show here that both structures exhibit similar homodimer organization despite slightly different crystal lattices. Additionally, we have observed both the presence of weak dimerization and the lack of dimerization in solution during size exclusion chromatography (SEC) experiments yet have distinctly observed dimerization in native mass spectrometry analyses. Comparison of NTHi protein D and E. coli GlpQ with other homologous homodimers and monomers shows that the E. coli and NTHi homodimer interfaces are distinct. Despite this distinction, NTHi protein D and E. coli GlpQ possess a triose-phosphate isomerase (TIM) barrel domain seen in many of the other homologs. The active site of NTHi protein D is located near the center of this TIM barrel. A putative glycerol moiety was modeled in two different conformations (occupancies) in the active site of our NTHi protein D structure and we compared this to ligands modeled in homologous structures. Our structural analysis should aid in future efforts to determine structures of protein D bound to substrates, analog intermediates, and products, to fully appreciate this reaction scheme and aiding in future inhibitor design.
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Affiliation(s)
- Seth P Jones
- School of Chemistry and Materials Science, Rochester Institute of Technology, Rochester, New York, USA
| | - Kali H Cook
- School of Chemistry and Materials Science, Rochester Institute of Technology, Rochester, New York, USA
| | - Melody L Holmquist
- National Technical Institute for the Deaf, Rochester Institute of Technology, Rochester, New York, USA
| | - Liam J Almekinder
- School of Chemistry and Materials Science, Rochester Institute of Technology, Rochester, New York, USA
| | - Annie M Delaney
- School of Chemistry and Materials Science, Rochester Institute of Technology, Rochester, New York, USA
| | - Ryhl Charles
- School of Chemistry and Materials Science, Rochester Institute of Technology, Rochester, New York, USA
| | - Natalie Labbe
- School of Chemistry and Materials Science, Rochester Institute of Technology, Rochester, New York, USA
| | - Janai Perdue
- School of Chemistry and Materials Science, Rochester Institute of Technology, Rochester, New York, USA
| | - Niaya Jackson
- School of Chemistry and Materials Science, Rochester Institute of Technology, Rochester, New York, USA
| | - Michael E Pichichero
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York, USA
| | - Ravinder Kaur
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, New York, USA
| | - Lea V Michel
- School of Chemistry and Materials Science, Rochester Institute of Technology, Rochester, New York, USA
| | - Michael L Gleghorn
- School of Chemistry and Materials Science, Rochester Institute of Technology, Rochester, New York, USA
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Kaur R, Pichichero M. Colonization, density, and antibiotic resistance of Streptococcus pneumoniae, Haemophilus Influenzae, and Moraxella catarrhalis among PCV13 vaccinated infants in the first six months of life in Rochester, New York: a cohort study. J Pediatric Infect Dis Soc 2023; 12:135-142. [PMID: 36645216 DOI: 10.1093/jpids/piad004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 09/01/2022] [Accepted: 01/13/2023] [Indexed: 01/17/2023]
Abstract
BACKGROUND Streptococcus pneumoniae (Spn), Haemophilus influenzae (Hflu) and Moraxella catarrhalis (Mcat) nasopharyngeal colonization precedes disease pathogenesis and varies among settings and countries. We sought to assess colonization prevalence, density, Spn serotypes and antibiotic resistance in children in the first 6 months of life in pediatric primary care settings. METHODS Prospective cohort study in Rochester, NY during 2018-2020. Nasopharyngeal swabs were collected from 101 children at age 1, 2 and 3 weeks, then 1, 2, 4, 6, 9, 12, 15, 18 and 24 months. Spn serotypes were determined by Quellung. Oxacillin resistance for Spn and β-lactamase production by Hflu and Mcat was tested. All children received PCV13 vaccine according to U.S. recommended-schedule. RESULTS Spn, Hflu and Mcat colonization was detected in only 5% of infants before age 2 months old. Cumulative prevalence was 34% for Spn, 10% for Hflu and 53% for Mcat in children </=6 months of age. Nasopharyngeal bacterial density of Spn, Hflu and Mcat (x=2.71 log) in children </=6 months of age was lower than at 7-24 months of age (x=3.15 log, p<0.0001). Predominant serotypes detected </=6 months of age were 23B (16.7%), 22F (12.9%), 15B/C (11%) and 16F (9.2%). 14.8% of Spn isolates were oxacillin resistant and 66.7% of Hflu isolates were β-lactamase-producing. CONCLUSION Spn, Hflu and Mcat nasopharyngeal colonization was uncommon and of low density among children </=6 months old, especially among children <2 months of age. Non-PCV13 serotypes predominated and a different serotype distribution was observed in </=6 months olds compared to 7-24 month olds.
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Affiliation(s)
- Ravinder Kaur
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY
| | - Michael Pichichero
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY
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30
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Abstract
AIMS Considerable number of studies in the existing literature indicate the existence of stigma related to many diseases, disabilities, and disorders, but less attention has been given to diabetes-related stigma. This narrative review of literature aims to explore the existence of stigma surrounding type 1 diabetes mellitus (T1DM). METHODS Literature were searched using search engines, Google Scholar, PubMed, and Scopus electronic databases published from year 2000 to 2020. Both qualitative and quantitative studies focusing on the stigma associated with T1DM were included. A total of 21 articles met the inclusion criteria. Thematic analysis of collected research material was done. RESULTS Results provided substantial evidence that stigma associated with T1DM was experienced by T1DM patients and their caregivers at some point in their lives and it had affected their lives in different domains such as difficulty finding a spouse, discrimination at employment opportunities, educational institutions, management of disease, being misjudged as a druggie, poor quality of life of the patient and caregiver, depressive symptoms among parents of patients, constant worrying of their child's disease management, and so on. CONCLUSION Stigma related to T1DM is experienced by individuals suffering from it, and it is widespread. It not only affects the sufferers but their loved ones also. To reduce and cope-up with stigma, there is a need to increase public education and awareness at a mass level. Further research and awareness will serve to build our understanding of the experience of diabetes-related stigma.
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Affiliation(s)
- R Kaur
- Research Scholar (UGC-SRF), Department of Anthropology, Panjab University, Chandigarh 160014, India
| | - A K Sinha
- Professor, Department of Anthropology, Panjab University, Chandigarh, India
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31
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Sharma A, Arif MAR, Shamshad M, Rawale KS, Brar A, Burgueño J, Shokat S, Kaur R, Vikram P, Srivastava P, Sandhu N, Singh J, Kaur S, Chhuneja P, Singh S. Preliminary Dissection of Grain Yield and Related Traits at Differential Nitrogen Levels in Diverse Pre-Breeding Wheat Germplasm Through Association Mapping. Mol Biotechnol 2023; 65:116-130. [PMID: 35908127 DOI: 10.1007/s12033-022-00535-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/28/2021] [Accepted: 07/14/2022] [Indexed: 01/11/2023]
Abstract
Development of nutrient efficient cultivars depends on effective identification and utilization of genetic variation. We characterized a set of 276 pre-breeding lines (PBLs) for several traits at different levels of nitrogen application. These PBLs originate from synthetic wheats and landraces. We witnessed significant variation in various traits among PBLs to different nitrogen doses. There was ~ 4-18% variation range in different agronomic traits in response to nitrogen application, with the highest variation for the biological yield (BY) and the harvest index. Among various agronomic traits measured, plant height, tiller number, and BY showed a positive correlation with nitrogen applications. GWAS analysis detected 182 marker-trait associations (MTAs) (at p-value < 0.001), out of which 8 MTAs on chromosomes 5D, 4A, 6A, 1B, and 5B explained more than 10% phenotypic variance. Out of all, 40 MTAs observed for differential nitrogen application response were contributed by the synthetic derivatives. Moreover, 20 PBLs exhibited significantly higher grain yield than checks and can be selected as potential donors for improved plant nitrogen use efficiency (pNUE).
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Affiliation(s)
- Achla Sharma
- Punjab Agricultural University, Ludhiana, India.
| | - Mian A R Arif
- Nuclear Institute for Agriculture and Biology, Faisalabad, 38000, Pakistan
| | - M Shamshad
- Punjab Agricultural University, Ludhiana, India
| | | | | | - Juan Burgueño
- CIMMYT, Carretera México Veracruz Km. 45, El Batán, 56237, Texcoco, CP, Mexico
| | - Sajid Shokat
- Nuclear Institute for Agriculture and Biology, Faisalabad, 38000, Pakistan
| | | | - Parsahnt Vikram
- International Center for Biosaline Agriculture, Academic City, Dubai, UAE
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32
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Chhabra S, Narang S, Bhattacharyya A, Kaur R. Concomitant multiple subretinal cysticerci in neurocysticercosis. Trop Parasitol 2023; 13:65-67. [PMID: 37415752 PMCID: PMC10321581 DOI: 10.4103/tp.tp_17_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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 12/28/2022] [Accepted: 01/21/2023] [Indexed: 07/08/2023] Open
Abstract
We present a unique case of asymptomatic NCC that was accidently diagnosed on radiological investigations after a road traffic accident. An Ophthalmologic consult was sought to rule out intraocular or optic nerve cysticercosis. Fundoscopy showed multiple white-pale yellow lesions in the right eye which on ultrasonography confirmed cyst lined by a cyst wall consistent with subretinal cysticercosis. The patient was treated with diode laser photocoagulation. A high index of suspicion is required to diagnose NCCin endemic areas. In the right eye which on ultrasonography confirmed cyst lined by a cyst wall consistent with subretinal cysticercosis. The patient was treated with diode laser photocoagulation.
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Affiliation(s)
- Simran Chhabra
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Subina Narang
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Anusuya Bhattacharyya
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India
| | - Ravinder Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
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Pichichero M, Malley R, Kaur R, Zagursky R, Anderson P. Acute otitis media pneumococcal disease burden and nasopharyngeal colonization in children due to serotypes included and not included in current and new pneumococcal conjugate vaccines. Expert Rev Vaccines 2023; 22:118-138. [PMID: 36565291 DOI: 10.1080/14760584.2023.2162506] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 12/25/2022]
Abstract
INTRODUCTION Despite the introduction of effective pneumococcal conjugate vaccines (PCV), Streptococcus pneumoniae remains a major cause of acute otitis media (AOM) worldwide. New, higher valency vaccines that offer broader serotype coverage have been recently developed and others are in development. However, given the capsular serotypes expressed by pneumococci causing AOM, it is unclear to what extent differing or higher valency PCVs will provide additional protection. AREAS COVERED We conducted a systematic literature search of the MEDLINE database to identify articles published from January 2016 to September 2021 in 4 low and middle income and 10 high-income countries. We searched PubMed with terms: (Streptococcus pneumoniae) OR pneumococcal AND serotype AND (conjugate vaccine). We evaluated serotype distribution and the actual or projected coverage of pneumococcal serotypes by PCV10 (GlaxoSmithKline), PCV13 (Pfizer), PCV10SII (Serum Institute of India) PCV15 (Merck) and PCV20 (Pfizer). EXPERT OPINION Our review highlights the important epidemiological differences in serotype distribution and coverage by existing and higher valency vaccines to protect against AOM in children. These data provide support for further evaluation of serotype-independent vaccines for optimal control of pneumococcal AOM disease worldwide.
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Affiliation(s)
- Michael Pichichero
- Rochester General Hospital Research Institute, Center for Infectious Diseases, Rochester, NY, USA
| | - Richard Malley
- Boston Children's Hospital, Division of Infectious Diseases, Boston Massachusetts, USA
| | - Ravinder Kaur
- Rochester General Hospital Research Institute, Center for Infectious Diseases, Rochester, NY, USA
| | - Robert Zagursky
- Rochester General Hospital Research Institute, Center for Infectious Diseases, Rochester, NY, USA
| | - Porter Anderson
- Boston Children's Hospital, Division of Infectious Diseases, Boston Massachusetts, USA
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Michel LV, Kaur R, Gleghorn ML, Holmquist M, Pryharski K, Perdue J, Jones SP, Jackson N, Pilo I, Kasper A, Labbe N, Pichichero M. Haemophilus influenzae Protein D antibody suppression in a multi-component vaccine formulation. FEBS Open Bio 2022; 12:2191-2202. [PMID: 36263849 PMCID: PMC9714371 DOI: 10.1002/2211-5463.13498] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/20/2022] [Accepted: 10/19/2022] [Indexed: 01/25/2023] Open
Abstract
Nontypeable Haemophilus influenzae (NTHi) has emerged as a dominant mucosal pathogen causing acute otitis media (AOM) in children, acute sinusitis in children and adults, and acute exacerbations of chronic bronchitis in adults. Consequently, there is an urgent need to develop a vaccine to protect against NTHi infection. A multi-component vaccine will be desirable to avoid emergence of strains expressing modified proteins allowing vaccine escape. Protein D (PD), outer membrane protein (OMP) 26, and Protein 6 (P6) are leading protein vaccine candidates against NTHi. In pre-clinical research using mouse models, we found that recombinantly expressed PD, OMP26, and P6 induce robust antibody responses after vaccination as individual vaccines, but when PD and OMP26 were combined into a single vaccine formulation, PD antibody levels were significantly lower. We postulated that PD and OMP26 physiochemically interacted to mask PD antigenic epitopes resulting in the observed effect on antibody response. However, column chromatography and mass spectrometry analysis did not support our hypothesis. We postulated that the effect might be in vivo through the mechanism of protein vaccine immunologic antigenic competition. We found when PD and OMP26 were injected into the same leg or separate legs of mice, so that antigens were immunologically processed at the same or different regional lymph nodes, respectively, antibody levels to PD were significantly lower with same leg vaccination. Different leg vaccination produced PD antibody levels quantitatively similar to vaccination with PD alone. We conclude that mixing PD and OMP26 into a single vaccine formulation requires further formulation studies.
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Affiliation(s)
- Lea V. Michel
- School of Chemistry and Materials ScienceRochester Institute of TechnologyNYUSA
| | - Ravinder Kaur
- Center for Infectious Diseases and ImmunologyRochester General Hospital Research InstituteNYUSA
| | - Michael L. Gleghorn
- School of Chemistry and Materials ScienceRochester Institute of TechnologyNYUSA
| | - Melody Holmquist
- National Technical Institute for the DeafRochester Institute of TechnologyNYUSA
| | - Karin Pryharski
- Center for Infectious Diseases and ImmunologyRochester General Hospital Research InstituteNYUSA
| | - Janai Perdue
- School of Chemistry and Materials ScienceRochester Institute of TechnologyNYUSA
| | - Seth P. Jones
- School of Chemistry and Materials ScienceRochester Institute of TechnologyNYUSA
| | - Niaya Jackson
- School of Chemistry and Materials ScienceRochester Institute of TechnologyNYUSA
| | - Isabelle Pilo
- School of Chemistry and Materials ScienceRochester Institute of TechnologyNYUSA
| | - Anna Kasper
- School of Chemistry and Materials ScienceRochester Institute of TechnologyNYUSA
| | - Natalie Labbe
- School of Chemistry and Materials ScienceRochester Institute of TechnologyNYUSA
| | - Michael Pichichero
- Center for Infectious Diseases and ImmunologyRochester General Hospital Research InstituteNYUSA
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Fuji N, Pichichero M, Kaur R. Pathogenesis of Streptococcus pneumoniae serotype 3 during natural colonization and infections among children and its IgG correlate of protection in a mouse model. Vaccine 2022; 40:6412-6421. [PMID: 36192274 DOI: 10.1016/j.vaccine.2022.09.062] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 09/07/2022] [Accepted: 09/20/2022] [Indexed: 01/27/2023]
Abstract
Current licensed pneumococcal conjugate vaccines (PCVs) are effective against pneumococcal diseases caused by the serotypes contained in the PCvs However; several studies evaluating pneumococcal colonization and acute otitis-media (AOM) prevention in young children vaccinated with PCV13, observed less effectiveness against serotype-3. One possible reason for less effectiveness may be release of the capsular polysaccharide (CPS) of serotype-3 (CPS-3) as an immune evasion mechanism. Here we evaluated free CPS-3 levels released from 6 clinical isolates from young children compared to WU2 strain and to serotype-19A CPS (CPS-19A) released in vitro when interacting with nasopharyngeal, middle-ear and lung cell-lines. Clinical serotype-3 strains showed greater release of CPS than WU2 with the interaction to 2 cell-lines and all 6 clinical serotype-19A strains. We next evaluated CPS-3 vs CPS-19A levels in middle-ear fluid (MEF) and the nasopharynx (NP) of young children and found higher levels of CPS-3 compared to CPS-19A in MEF during AOM but not in NP secretions during colonization. With anti-CPS-3 IgG in MEF and NP secretions at time of health and onset of AOM, a significant negative correlation (r = -0.75, p < 0.05) between unbound anti-CPS-3 IgG levels and free- anti-CPS-3 in MEF were found, and a significant lower detection of unbound anti-CPS-3 IgG in NP at the time of health with serotype-3 SPN (p < 0.05) compared to irrelevant SPN serotypes were found. In a mouse model of AOM and pneumonia, we sought a correlate of protection against serotype-3 infection using human serum-derived anti-CPS-3 IgG. We conclude that serotype-3 clinical isolates from children release more capsule than WU2 strains or 19A strains during in vitro testing; release more capsule in the MEF of children during AOM than serotype 19A; unbound anti-CPS-3 IgG levels negatively correlate with free-anti-CPS-3; and a level of 2.8 µg/ml anti-CPS-3 antibody protects mice from AOM and pneumonia but not colonization.
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Affiliation(s)
- Naoko Fuji
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY, United States
| | - Michael Pichichero
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY, United States
| | - Ravinder Kaur
- Center for Infectious Diseases and Immunology, Rochester General Hospital Research Institute, Rochester, NY, United States.
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William A, Kaur R, Rawat D, Kumar P. P089 Candidemia: prevalence, species characterization ,and the antibiotic susceptibility profile from a tertiary care hospital in north india. Med Mycol 2022. [PMCID: PMC9509865 DOI: 10.1093/mmy/myac072.p089] [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: 11/14/2022] Open
Abstract
Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objectives The aim of this study was to characterize the Candida spp. isolated from blood cultures and determine the antifungal susceptibility pattern of the Candida species prevalent in a tertiary care hospital in North India. Methods This retrospective study was conducted in Department of Microbiology of a tertiary care hospital in North India from April 2020 to March 2022. All blood cultures received in the department during this period were included in the study. Candida species isolated were identified and antifungal susceptibility testing was performed by VITEK as per standard protocol, The susceptibility pattern of 50 isolates was also performed by the broth microdilution method as per Clinical and Laboratory Standards Institute guidelines (CLSI) and the results were compared with VITEK results. Results Out of 21 804 blood cultures received during this period, 177 grew Candida species. Therefore, the overall prevalence of Candida species was 0.81% in our study. The incidence of bloodstream infection caused by non-albicans Candida species (80%) was higher than C. albicans (20%). Among NAC species, C. tropicalis (45%) was the most common, followed by C. pelliculosa (15%). Candidemia was predominantly observed in ICU patients. Resistance was seen in 14.1% isolates to voriconazole and fluconazole, 4.2% to flucytosine and 3.9% to caspofungin and amphotericin-B. No resistance was seen to micafungin. A total of 15% of the isolates were resistant to more than one drug. Conclusion There was a predominance of non-albicans Candida over C. albicans. Maximum resistance was seen to voriconazole followed by fluconazole. Continuous surveillance is necessary to follow trends and monitor changes in epidemiological and resistance patterns in different geographical regions, especially in critically ill patients.
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Affiliation(s)
- Ashish William
- Lady Hardinge Medical College and Associated Hospitals , New Delhi , India
| | - Ravinder Kaur
- Lady Hardinge Medical College and Associated Hospitals , New Delhi , India
| | - Deepti Rawat
- Lady Hardinge Medical College and Associated Hospitals , New Delhi , India
| | - Pradeep Kumar
- Lady Hardinge Medical College and Associated Hospitals , New Delhi , India
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William A, Kaur R, Rawat D, Kandir NSS, Sharma A. Reply to Comment on ‘Necrotizing fasciitis in neonate by Lichtheimia ramosa: A case study’. Access Microbiol 2022; 4:acmi000452. [DOI: 10.1099/acmi.0.000452] [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] [Received: 04/12/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ashish William
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Ravinder Kaur
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Deepti Rawat
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Neelam S. S. Kandir
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Akanksha Sharma
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
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Yadav A, Gupta S, Kaur R. Curious Case of a Vanishing Dural Mass Lesion. Neurol India 2022; 70:2209-2210. [PMID: 36352646 DOI: 10.4103/0028-3886.359177] [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: 11/05/2022]
Affiliation(s)
- Arushi Yadav
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
| | - Shreya Gupta
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
| | - Ravinder Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
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Kaur R, Mishra S, Nevolin I, Roy Choudhury D, Singh M. Nutritional anemia: Patent landscape. World Patent Information 2022. [DOI: 10.1016/j.wpi.2022.102123] [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: 10/17/2022]
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Gupta R, Jhatiwal S, Kapoor A, Kaur R, Soni A, Singhal A. Narrow Notch Width and Low Anterior Cruciate Ligament Volume Are Risk Factors for Anterior Cruciate Ligament Injury: A Magnetic Resonance Imaging-Based Study. HSS J 2022; 18:376-384. [PMID: 35846265 PMCID: PMC9247593 DOI: 10.1177/15563316211041090] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The relationship between anterior cruciate ligament (ACL) injury and anatomical structures is still a topic of debate. PURPOSE The aim of this study was to compare knee geometry in demographically matched ACL-injured and ACL-intact athletes. METHODS We conducted a case-control study comparing 2 groups, each consisting of 55 professional athletes (44 men and 11 women): 1 group with complete ACL tears (cases) and 1 group with intact ACLs (controls). The groups were compared using magnetic resonance imaging (MRI) in terms of intercondylar notch geometry, tibial plateau characteristics, and ACL volume. RESULTS Among cases and controls, we found the cases had lower notch width (20.24 ± 2.68 mm vs. 22.04 ± 2.56 mm, respectively) and notch width index (0.29 ± 0.03 vs. 0.31 ± 0.03, respectively). The mean ACL volume in the cases (1181.63 mm3 ± 326 mm3) was also lower than in controls (1352.61 mm3 ± 279.84 mm3). The parameters of tibial slope geometry were comparable between groups. In addition, women had lower ACL volume than men (1254 ± 310 mm3 vs. 890 ± 267 mm3, respectively) and higher medial posterior tibial slope (4.76 ± 2.6 vs. 6.63 ± 1.83, respectively). Among cases, women had narrower notch width than men (16.9 ± 2.42 mm vs. 21.08 ± 2.03 mm). However, notch width index was comparable between male (0.3 ± 0.02) and female (0.28 ± 0.03) cases. CONCLUSION Our findings suggest that narrow notch width and low ACL volume may enhance the risk of ACL injury among athletes. There was no association found between posterior tibial slope and ACL injury between athletes with injured ACLs and controls. Further study is indicated.
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Affiliation(s)
- Ravi Gupta
- Department of Orthopaedics, Government
Medical College & Hospital, Chandigarh, India
| | - Sanjay Jhatiwal
- Department of Orthopaedics, Government
Medical College & Hospital, Chandigarh, India,Sanjay Jhatiwal, Senior Resident,
Department of Orthopaedics, Government Medical College & Hospital, D-block
Level 3, Orthopaedic Office, GMCH-32, Chandigarh, India.
| | - Anil Kapoor
- Department of Orthopaedics, Government
Medical College & Hospital, Chandigarh, India
| | - Ravinder Kaur
- Department of Orthopaedics, Government
Medical College & Hospital, Chandigarh, India
| | - Ashwani Soni
- Department of Orthopaedics, Government
Medical College & Hospital, Chandigarh, India
| | - Akash Singhal
- Department of Orthopaedics, Government
Medical College & Hospital, Chandigarh, India
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Kaur R, Garg AK, Gupta DK, Singla L, Aggarwal K. Effect of Twin Block Therapy Versus Fixed Functional Appliances on Pharyngeal Airway Space in Skeletal Class II Patients: A Prospective Cephalometric Study. Clin Ter 2022; 173:306-315. [PMID: 35857047 DOI: 10.7417/ct.2022.2439] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Class II malocclusion is one of the most common malocclusion with varied prevalence. Functional therapy with appliances like Twin Block or Fixed functional appliances forms the mainstay of treatment in growing Class II patients. These patients might demonstrate narrow airway due to the retrognathic position of the mandible. This study investigated the effects of twin block and fixed functional appliance therapy (Forsus™ FRD) on the pharyngeal airway space in skeletal Class II patients. METHODS Forty patients with Class II malocclusion were selected and divided into two equal groups of 20 patients each for both Twin block and Forsus group. Lateral cephalograms were obtained before and after the functional appliance therapy. Evaluation was done for changes in hyoid bone position, pharyngeal airway dimensions and tongue position. RESULTS The variables of the study showed better hyoid position in both the groups. In Twin Block group, an increase in hy-apw2 and hy-PoFH suggested anterior positioning of hyoid and a decrease in H-MP and hy-ML indicated superior positioning. In Forsus group an increase in H-H', hy-FH, hy-ML, hy-NL, hy-NSL and hy-OL suggested inferior positioning of hyoid, while an increase in hy-apw2, hy-CVT, hy-PoFH, hy-RL and hy'-tgo indicated anterior positioning of hyoid bone after functional therapy. CONCLUSION Both the twin block and Forsus™ FRD improved the position of the hyoid bone after the functional appliance therapy however the changes were not statistically significant. Twin block and Forsus™ had similar effect on the hyoid bone position, pharyngeal dimensions and the tongue position.
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Affiliation(s)
- R Kaur
- Consultant Orthodontist and Former PG Resident, Department of Orthodontics and Dentofacial Orthopedics, Panjab University Chandigarh, India
| | - A K Garg
- Associate Professor, Department of Orthodontics and Dentofacial Orthopedics, Panjab University Chandigarh, India
| | - D K Gupta
- rofessor, Department of Orthodontics and Dentofacial Orthopedics, Panjab University Chandigarh, India
| | - L Singla
- Senior Lecturer, Department of Orthodontics and Dentofacial Orthopedics, Panjab University Chandigarh, India
| | - K Aggarwal
- Consultant Orthodontist and Former PG Resident, Department of Orthodontics and Dentofacial Orthopedics, Panjab University Chandigarh, India
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McGinnity G, Perdue J, Labbe N, Kaur R, Holmquist M, Michel L. Probing the potential interactions between two protein vaccine candidates from Nontypeable
Haemophilus influenzae. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r2217] [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: 11/11/2022]
Affiliation(s)
| | | | | | | | | | - Lea Michel
- Rochester Institute of TechnologyRochesterNY
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Singh GB, Nair M, Kaur R. Is there fungal infestation in paediatric chronic otitis media - Mucosal disease? Am J Otolaryngol 2022; 43:103435. [PMID: 35398742 DOI: 10.1016/j.amjoto.2022.103435] [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: 02/15/2022] [Accepted: 04/02/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To determine the prevalence of fungal infestation in paediatric chronic otitis media (COM)-mucosal disease and to study the various factors that might influence the said infestation. METHODS A cross-sectional study was done on the cited subject in a sample size of 66 paediatric patients [Age group: 1-18 years] suffering from active COM-mucosal disease. In all we had 75 ears from which swab samples were taken as some patients had bilateral disease. Clinical record was documented in each case. Three sample swabs were analysed for aerobic, anaerobic and fungal infection respectively from the discharging ear. Fungal infection was diagnosed by culture. The data was tabulated and statistically analysed for any correlation of fungal infestation with age, sex, background, duration of COM, previous antibiotic/steroid usage and intractable otorrhoea. RESULTS We recorded a prevalence of 32% for fungal colonization of COM-mucosal disease in paediatric population i.e., 24 out of 75 ears. There was no association observed between fungal infestation and specific paediatric age group, sex, background or duration of the disease. However, a distinct statistical correlation was present between fungal infestation and previous antibiotic/steroid usage and intractable otorrhoea. CONCLUSION Findings of this study lead us to conclude that all cases of paediatric COM-mucosal disease should be analysed for fungal colonization, especially those with intractable otorrhoea and there should be judicious use of antibiotics and steroid ear drops in COM-mucosal disease.
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Affiliation(s)
- Gautam Bir Singh
- Department of Otorhinolaryngology-Head & Neck Surgery, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi 110001, India.
| | - Meenukrishnan Nair
- Department of Otorhinolaryngology-Head & Neck Surgery, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi 110001, India
| | - Ravinder Kaur
- Department of Microbiology, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi 110001, India
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Singh H, Gupta P, Kaur R, Sharma C. Comparison of clinical with CT based evaluation for tibial torsion. J Clin Orthop Trauma 2022; 29:101875. [PMID: 35510146 PMCID: PMC9058954 DOI: 10.1016/j.jcot.2022.101875] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/28/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Tibial torsion is important to be factored in during calculations of angular deformities of the lower extremity. Three methods are commonly used, thigh foot angle, measurement of transmalleolar axis with proximal tibia or knee as a reference, and Computerized tomography. The purpose of the current study was to find out the effectiveness of clinical methods and compare CT based method for tibial torsion. METHODS A total of 68 limbs (34 subjects) were included. Tibial torsion was measured using thigh foot angle, transmalleolar axis in relation to knee forward position (Knee ankle axis) and CT based evaluation using Jend method. RESULTS Pearson correlation coefficient showed strong correlation between CT values and thigh foot angle (r = 0.848) as well as between CT values and Knee ankle axis (r = 0.889). Scatter plots also showed a linear distribution. CONCLUSION Both thigh foot angle and Knee ankle axis provide reliable alternative to ionizing CT in measuring tibial torsion.
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Affiliation(s)
| | - Parmanand Gupta
- Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India,Corresponding author.
| | - Ravinder Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
| | - Cury Sharma
- Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India
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Gautam G, Rawat D, Kaur R, Nathani M. Candidemia: Changing dynamics from a tertiary care hospital in North India. Curr Med Mycol 2022; 8:20-25. [PMID: 36340431 PMCID: PMC9548083 DOI: 10.18502/cmm.8.1.9210] [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] [Received: 09/01/2021] [Revised: 01/12/2022] [Accepted: 03/02/2022] [Indexed: 12/01/2022] Open
Abstract
Background and Purpose: Routine identification of Candida species and knowledge of antibiotic susceptibility patterns can prevent diagnostic delays and help clinicians choose appropriate empirical therapies.
This study aimed to identify and speciate Candida isolates from bloodstream infections and evaluate their epidemiological profile and antibiotic
susceptibility pattern in a tertiary care hospital in North India. Materials and Methods: Blood samples were cultured in the Department of Microbiology of a tertiary care hospital from January 2019 to May 2021, and the samples which
showed growth of Candida species (spp.) were included in this study. Candida isolates were initially characterized by conventional techniques.
Further identification and antifungal susceptibility testing were performed using Vitek 2 compact automated system. Data analysis was performed using the SPSS software (Version 25.0). Results: Candida spp. were isolated from a total of 116 blood samples, 60.92% of which belonged to males. The majority (43.10%) of isolates were
obtained from 0-1-month-old neonates, followed by infants (16.38%) and children in the age range of 1-17 years (16.38%).
Only 6.89% of isolates were obtained from adults older than 18 years. Candida tropicalis (26.72%) was the most common species,
followed by Candida pelliculosa (19.83%), Candida albicans (17.24%), Candida parapsilosis (14.66%), Candida famata (9.48%), and Candida krusei (9.48%).
Other isolated species included Candida lusitaniae, Candida sphaerica, and Candida inconspicua. Out of 116 isolates, 101 isolates were
subjected to Vitek 2 susceptibility testing. Overall, 21.78% (22/101) of Candida isolates were found to be resistant/intermediate.
Among C. albicans isolates, resistance was observed only against voriconazole (20%) and fluconazole (5%); however, among non- albicans Candida species (NAC),
resistance was observed against flucytosine (16.04%), followed by fluconazole (14.81%), voriconazole (3.70%), and caspofungin (3.70%). Conclusion: Non-albicans Candida spp. predominated over Candida albicans in causing bloodstream infections and were found to be more resistant to antifungals.
Continuous surveillance is necessary to monitor changes in epidemiological and resistance patterns.
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Affiliation(s)
- Garima Gautam
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Deepti Rawat
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Ravinder Kaur
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Masoom Nathani
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
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Basha MI, Kaur R, Chawla D, Kaur N. Evaluation of double lung point sign as a marker for transient tachypnoea of the newborn in preterm. Pol J Radiol 2022; 87:e220-e225. [PMID: 35582603 PMCID: PMC9093210 DOI: 10.5114/pjr.2022.115719] [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: 08/28/2020] [Accepted: 04/14/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose The study was conducted to diagnose transient tachypnoea of the newborn (TTN) in the early stage using ultrasonography and to estimate the sensitivity and specificity of double lung point (DLP) sign in diagnosing TTN. Material and methods The study population included premature neonates with respiratory distress, admitted in the neonatal intensive care unit from December 2017 to June 2019, who fulfilled the inclusion criteria. A total of 100 patients were included in the study, and they underwent lung ultrasonography within 6 hours of birth. Inclusion criteria were as follows: preterm babies born < 37 weeks of gestation presenting with respiratory distress within 6 hours, clinically diagnosed with TTN and other causes like respiratory distress syndrome and pneumonia. Term neonates and neonates with congenital malformations and trauma were excluded from the study. Preterms with respiratory distress were enrolled in the study. Based on the clinical findings and laboratory investigations, clinical diagnosis was made by the paediatrician. After obtaining informed consent, ultrasonography of bilateral chest was performed using a Philips HD7 XE and a Sonoscape S2 portable ultrasound machine with a linear transducer (6-12 MHz) within 6 hours of birth. Results The mean gestational age was 33.0 ± 1.9 weeks. Double lung point sign was present in 55 preterm neonates in our study. It was most common in bilateral posterior lung fields. The sensitivity and specificity of DLP in diagnosing TTN was 85% and 100%, respectively. Conclusions It was found in our study that double lung point sign is the primary ultrasonographic characteristic of TTN, and ultrasonography can almost accurately diagnose TTN in early stages.
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Affiliation(s)
| | - Ravinder Kaur
- Government Medical College and Hospital, Chandigarh, India
| | - Deepak Chawla
- Government Medical College and Hospital, Chandigarh, India
| | - Narinder Kaur
- Government Medical College and Hospital, Chandigarh, India
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William A, Kaur R, Rawat D, Kandir NSS, Sharma A. Necrotizing fasciitis in neonate by Lichtheimia ramosa : A case study. Access Microbiol 2022; 4:000327. [PMID: 35693464 PMCID: PMC9175980 DOI: 10.1099/acmi.0.000327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/11/2022] [Indexed: 11/18/2022] Open
Abstract
Zygomycetes have been known to cause life-threatening infections in humans which are often difficult to treat. We present a rare case of cutaneous mucormycosis in a premature neonate admitted with neonatal sepsis and necrotizing fasciitis. He was diagnosed with Lichtheimia ramosa infection and managed surgically along with Amphotericin B. Low birth weight, prematurity, respiratory distress, administration of corticosteroid and broad spectrum antibiotics were identified as the potential risk factors in this case which had led to the fungal infection. Early diagnosis and prompt management is critical in prevention of morbidity and mortality associated with the disease.
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Affiliation(s)
- Ashish William
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
- *Correspondence: Ashish William,
| | - Ravinder Kaur
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Deepti Rawat
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Neelam S. S. Kandir
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Akanksha Sharma
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
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Pathania V, Guglani V, Azad C, Jain S, Kaur R, Singh DK. Disability and Mortality in Convulsive Status Epilepticus in Children at 3 Months' Follow-Up: A Prospective Study from India. J Neurosci Rural Pract 2022; 13:211-217. [PMID: 35694062 PMCID: PMC9187372 DOI: 10.1055/s-0042-1743212] [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] [Indexed: 11/13/2022] Open
Abstract
Background
Convulsive status epilepticus (CSE) is a common neurological emergency with high mortality, morbidity, and poor quality of life. There is a paucity of follow-up studies from developing nations in pediatric age group.
Objectives
This article looks for clinico-etiological profile of CSE and estimates the immediate and short-term mortality in children with CSE and its predictive factors.
Methodology
This prospective longitudinal study was done at a tertiary care institute of Northern India. The patients between the ages of 1 and 16 years with CSE were enrolled after informed consent, they were observed in the hospital, and survived patients were followed till 3 months after discharge.
Results
A total of 200 patients (58% males) were enrolled. Acute symptomatic (63.5%) was the most common etiology. Twenty-five (12.5%) patients died during hospital stay; at discharge, 160 (80%) had good recovery and rest had a varying range of disability. The predictive factors for poor outcome were female gender, duration of CSE > 1 hour at presentation, generalized seizures, Glasgow Coma Scale < 8 at presentation, refractory status epilepticus, need for critical care support, and acute symptomatic etiology. On follow-up, two patients died at 1-month and one at 3-month follow-up, the cause of death was probably seizures in two patients and feed aspiration in one patient. Seven patients deteriorated from good recovery scoring to moderate disability during the time interval between first and second follow-up, none of them reported apparent repeat seizures.
Conclusion
Pediatric CSE is associated with immediate poor outcome; risk of death and new disabilities persist after discharge thus proper follow-up is essential.
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Affiliation(s)
- Vansha Pathania
- Department of Paediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Vishal Guglani
- Department of Paediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Chandrika Azad
- Department of Paediatrics, Government Medical College and Hospital, Chandigarh, India
| | - Suksham Jain
- Department of Neonatology, Government Medical College and Hospital, Chandigarh, India
| | - Ravinder Kaur
- Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh, India
| | - Dharmendra Kumar Singh
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Kumar P, Dua S, Kaur R, Kumar M, Bhatt G. Correction: A review on advancements in carbon quantum dots and their application in photovoltaics. RSC Adv 2022; 12:6432. [PMID: 35427084 PMCID: PMC8982237 DOI: 10.1039/d2ra90018a] [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] [Received: 02/17/2022] [Accepted: 02/17/2022] [Indexed: 11/21/2022] Open
Abstract
[This corrects the article DOI: 10.1039/D1RA08452F.].
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Affiliation(s)
- Pawan Kumar
- Department of Electronic Science, South Campus University of Delhi New Delhi-110021 India
| | - Shweta Dua
- Bhaskarcaharya College of Applied Sciences, University of Delhi New Delhi-110075 India
| | - Ravinder Kaur
- Deen Dayal Upadhyaya College, University of Delhi New Delhi-110075 India
| | - Mahesh Kumar
- CSIR-National Physical Laboratory (NPL) New Delhi-110012 India
| | - Geeta Bhatt
- Non-Collegiate Women's Education Board, University of Delhi New Delhi-110007 India
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Singh C, Sharma S, Jaglan S, Aphesteguy JC, Jacobo S, Abdel-Latif I, Albargi HB, Kaur R, Singh J, Sharma S. Elucidation of Structural, Morphological, Electrical Parameters and Anti-bacterial Activity of Polyaniline-Nanocomposite: New Paradigm of Controlling Bacterial Activity. IEEE Trans Nanobioscience 2022; PP. [DOI: 10.1109/tnb.2022.3220573] [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: 11/11/2022]
Affiliation(s)
- Charanjeet Singh
- School of Electronics and Electrical Engineering, Lovely Professional University, Phagwara, Punjab, India
| | - Sandeep Sharma
- Department of Medical Laboratory Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Sundeep Jaglan
- Department of Microbiology, CSIR-Indian Institute of Integrative Medicine, Canal Road Jammu, India
| | - Juan C. Aphesteguy
- LaQuiMMAI-IQAI, Facultad de Ingeniería, UBA. Av. Paseo Colón 850, Buenos Aires, Argentina
| | - Silvia Jacobo
- LaQuiMMAI-IQAI, Facultad de Ingeniería, UBA. Av. Paseo Colón 850, Buenos Aires, Argentina
| | - I.A. Abdel-Latif
- Physics Department, College of Science, Najran University, Najran, P.O. Box 1988, Najran, Saudi Arabia
| | - Hasan B Albargi
- Physics Department, College of Science, Najran University, Najran, P.O. Box 1988, Najran, Saudi Arabia
| | - Ravinder Kaur
- Department of Mechanical Engineering, Indian Institute of Technology, Ropar, Punjab, India
| | - Jasbir Singh
- Department of Electronics and Communication Engineering, Yadavindra department of Engineering, Punjabi University Guru Kashi Campus, Talwandi Sabo, Punjab, India
| | - Sarika Sharma
- Department of Life Sciences, Arni University. Kathgarh, Indora, Kangra, H.P, (India)
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