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Thazhe Poyil NJ, Vadakkekuttical RJ, Radhakrishnan C. Correlation of periodontal inflamed surface area with glycated hemoglobin, interleukin-6 and lipoprotein(a) in type 2 diabetes with retinopathy. World J Diabetes 2024; 15:686-696. [PMID: 38680698 PMCID: PMC11045419 DOI: 10.4239/wjd.v15.i4.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/19/2024] [Accepted: 03/01/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND The two-way relationship between periodontitis and type 2 diabetes mellitus (T2DM) is well established. Prolonged hyperglycemia contributes to increased periodontal destruction and severe periodontitis, accentuating diabetic complications. An inflammatory link exists between diabetic retinopathy (DR) and periodontitis, but the studies regarding this association and the role of lipoprotein(a) [Lp(a)] and interleukin-6 (IL-6) in these conditions are scarce in the literature. AIM To determine the correlation of periodontal inflamed surface area (PISA) with glycated Hb (HbA1c), serum IL-6 and Lp(a) in T2DM subjects with retinopathy. METHODS This cross-sectional study comprised 40 T2DM subjects with DR and 40 T2DM subjects without DR. All subjects were assessed for periodontal parameters [bleeding on probing (BOP), probing pocket depth, clinical attachment loss (CAL), oral hygiene index-simplified, plaque index (PI) and PISA], and systemic parameters [HbA1c, fasting plasma glucose and postprandial plasma glucose, fasting lipid profile, serum IL-6 and serum Lp(a)]. RESULTS The proportion of periodontitis in T2DM with and without DR was 47.5% and 27.5% respectively. Severity of periodontitis, CAL, PISA, IL-6 and Lp(a) were higher in T2DM with DR group compared to T2DM without DR group. Sig-nificant difference was observed in the mean percentage of sites with BOP between T2DM with DR (69%) and T2DM without DR (41%), but there was no significant difference in PI (P > 0.05). HbA1c was positively correlated with CAL (r = 0.351, P = 0.001), and PISA (r = 0.393, P ≤ 0.001) in study subjects. A positive correlation was found between PISA and IL-6 (r = 0.651, P < 0.0001); PISA and Lp(a) (r = 0.59, P < 0.001); CAL and IL-6 (r = 0.527, P < 0.0001) and CAL and Lp(a) (r = 0.631, P < 0.001) among study subjects. CONCLUSION Despite both groups having poor glycemic control and comparable plaque scores, the periodontal parameters were higher in DR as compared to T2DM without DR. Since a bidirectional link exists between periodontitis and DM, the presence of DR may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of DR.
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Affiliation(s)
- Nusreen Jamal Thazhe Poyil
- Department of Periodontics, Government Dental College (Affiliated to Kerala University of Health Sciences), Calicut 673008, Kerala, India
| | - Rosamma Joseph Vadakkekuttical
- Department of Periodontics, Government Dental College (Affiliated to Kerala University of Health Sciences), Calicut 673008, Kerala, India
| | - Chandni Radhakrishnan
- Department of Medicine, Government Medical College (Affiliated to Kerala University of Health Sciences), Calicut 673008, Kerala, India
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As AK, Sahay RR, Radhakrishnan C, P S, Kandath S, Patil DY, Shete AM, M S, Ramakrishnan G, Moorkoth AP, Gupta N, Yadav PD, Godbole S, Ramakrishnan LV, Vadekkandiyil S, Ekkalayil D, V N, Balakrishnan A, Pullor NK, Asokan N, Joseph RK, Nair PR, Purayil SM, Mathew T, Kizhakkekandiyil R, Poovullathil JK, Ps KS, Pt U, George K, Rahim A, Kumar S, S S, Mohandas S, Rajan LS, Ramachandran SP, Thampi SP, Ashadevi, Anish TS, Chandran P, Mohan A, Vadakkayil B, Koroth SC, Hafeez N, Sasi RR, Abraham M. Clinico-epidemiological presentations and management of Nipah virus infection during the outbreak in Kozhikode district, Kerala state, India 2023. J Med Virol 2024; 96:e29559. [PMID: 38529536 DOI: 10.1002/jmv.29559] [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: 12/23/2023] [Revised: 02/09/2024] [Accepted: 03/13/2024] [Indexed: 03/27/2024]
Abstract
India experienced its sixth Nipah virus (NiV) outbreak in September 2023 in the Kozhikode district of Kerala state. The NiV is primarily transmitted by spillover events from infected bats followed by human-to-human transmission. The clinical specimens were screened using real-time RT-PCR, and positive specimens were further characterized using next-generation sequencing. We describe here an in-depth clinical presentation and management of NiV-confirmed cases and outbreak containment activities. The current outbreak reported a total of six cases with two deaths, with a case fatality ratio of 33.33%. The cases had a mixed presentation of acute respiratory distress syndrome and encephalitis syndrome. Fever was a persistent presentation in all the cases. The Nipah viral RNA was detected in clinical specimens until the post-onset day of illness (POD) 14, with viral load in the range of 1.7-3.3 × 104 viral RNA copies/mL. The genomic analysis showed that the sequences from the current outbreak clustered into the Indian clade similar to the 2018 and 2019 outbreaks. This study highlights the vigilance of the health system to detect and effectively manage the clustering of cases with clinical presentations similar to NiV, which led to early detection and containment activities.
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Affiliation(s)
| | - Rima R Sahay
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | | | - Shihabudheen P
- Iqraa International Hospital and Research Centre, Kozhikode, Kerala, India
| | | | - Deepak Y Patil
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Anita M Shete
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Shamsudheen M
- Iqraa International Hospital and Research Centre, Kozhikode, Kerala, India
| | | | | | | | - Pragya D Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Sheela Godbole
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | | | | | | | - Nithasha V
- Iqraa International Hospital and Research Centre, Kozhikode, Kerala, India
| | - Anukumar Balakrishnan
- Indian Council of Medical Research-National Institute of Virology, Kerala Unit, Alappuzha, Kerala, India
| | | | | | - Reena Kalathil Joseph
- Public Health Department of Kerala, Directorate of Health Services (IDSP), Thiruvananthapuram, Kerala, India
| | - Priyanka R Nair
- Iqraa International Hospital and Research Centre, Kozhikode, Kerala, India
| | | | - Thomas Mathew
- Director of Medical Education, Thiruvananthapuram, Kerala, India
| | - Rajaram Kizhakkekandiyil
- Public Health Department of Kerala, Directorate of Health Services (IDSP), Thiruvananthapuram, Kerala, India
| | | | - Kannan Sabarinath Ps
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Ullas Pt
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | | | - Asma Rahim
- Government Medical College, Kozhikode, Kerala, India
| | - Surendra Kumar
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Siba S
- Indian Council of Medical Research-National Institute of Virology, Kerala Unit, Alappuzha, Kerala, India
| | - Sreelekshmy Mohandas
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Lekshmi S Rajan
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Shamin Punnath Ramachandran
- Public Health Department of Kerala, Directorate of Health Services (IDSP), Thiruvananthapuram, Kerala, India
| | | | - Ashadevi
- Government Medical College, Kozhikode, Kerala, India
| | | | | | - Anuja Mohan
- Government Medical College, Kozhikode, Kerala, India
| | | | - Shaji Cheriya Koroth
- Public Health Department of Kerala, Directorate of Health Services (IDSP), Thiruvananthapuram, Kerala, India
| | - Nimin Hafeez
- Government Medical College, Kozhikode, Kerala, India
| | | | - Minu Abraham
- Public Health Department of Kerala, Directorate of Health Services (IDSP), Thiruvananthapuram, Kerala, India
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Mangaly AJ, Radhakrishnan C. Alternate Biochemical Markers in Organophosphate Poisoning. J Assoc Physicians India 2023; 71:11-12. [PMID: 37651250 DOI: 10.59556/japi.71.0325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
In India, organophosphates are the most widely used pesticides for suicide by poisoning. Early recognition of the diagnosis and its severity will help in achieving a better outcome. In poisoning by organophosphorus compounds, serum acetylcholinesterase (AChE) and pseudocholinesterase are currently widely accepted as biochemical markers for estimating the severity. A wide array of alternate, cheap, and easily available markers are explored in this review and using a combination of these markers may be better in terms of early identification of severe poisoning. In peripheral centers without access to costly investigations, these cheap markers may help in guiding an early referral to higher centers for severely poisoned patients. A comprehensive study comparing all these different markers has not been done so far, thereby emphasizing the need for the same. This review identified various new, cheaper, and easily available biochemical markers as having the potential to act as surrogates for assessing the severity of organophosphate poisoning, and there is a scope for future studies to understand its utility.
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Affiliation(s)
| | - Chandni Radhakrishnan
- Professor of Medicine and Head, Department of Emergency Medicine, Government Medical College, Kozhikode, Kerala, India
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Tom J, Thomas EK, Sooraj A, Uthaman SP, Tharayil HM, S L A, Radhakrishnan C. Need for social work interventions in the emergency department. Soc Work Health Care 2023; 62:302-319. [PMID: 37523327 DOI: 10.1080/00981389.2023.2238017] [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] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/14/2023] [Indexed: 08/02/2023]
Abstract
This paper reports findings from a qualitative study conducted on the Need for Social work interventions in the Emergency Department (ED) at a large tertiary care center in India. The emergency department is an important social work intervention point for individuals with various psychiatric, medical, and social needs who have little or no additional interaction with social services. Social workers are specially trained to understand the impact of social factors on health outcomes and provide interventions that address social barriers to improving health and accessing community resources; social workers are well prepared to provide services in the emergency department. However, limited research is available to understand the impact of psychosocial services in the emergency department. We aimed to identify areas which require integrated social work services and coordination to address the psychosocial issues within the ED. Interviews with 10 healthcare workers are analyzed thematically. Recurring themes throughout the interviews confirm the need for providing social work interventions to ensure the medical, psychological, and social care needs in the emergency department.
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Affiliation(s)
- Jobin Tom
- Department of Psychiatric Social Work, Institute of Mental Health Neurosciences, Kozhikode, India
| | - Elizabeth K Thomas
- Department of Psychiatric Social Work, Institute of Mental Health Neurosciences, Kozhikode, India
| | - A Sooraj
- Department of Emergency Medicine, Government of Medical College, Kozhikode, India
| | - Seema P Uthaman
- Department of Psychiatric Social Work, Institute of Mental Health Neurosciences, Kozhikode, India
| | - Harish M Tharayil
- Department of Psychiatric Social Work, Institute of Mental Health Neurosciences, Kozhikode, India
| | - Akhil S L
- Department of Psychiatry, Government of Medical College, Thrissur, India
- Emergency Medicine, Government Medical College, Kozhikode
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5
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Pattayil S, Vadakkekuttical RJ, Radhakrishnan C, Kanakkath H, Hrishi TS. Proportional relationship between periodontal inflamed surface area, clinical attachment loss, and glycated hemoglobin level in patients with type 2 diabetes mellitus on insulin therapy and on oral antidiabetic therapy. J Periodontol 2023; 94:31-40. [PMID: 35716397 DOI: 10.1002/jper.22-0085] [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: 02/08/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Treatment of diabetes includes oral antidiabetic drugs (OAD), insulin, or their combinations. Insulin can achieve faster glycemic control and have anabolic action on bone. This study was undertaken to assess the prevalence and severity of periodontitis, and to estimate the proportional relationship between periodontal inflamed surface area, clinical attachment loss, and glycated hemoglobin (HbA1c) level in patients with type 2 diabetes (T2DM) on OAD therapy and on insulin therapy. METHODS This cross-sectional study comprised 130 patients with T2DM on OAD therapy (OAD group) and 130 patients with T2DM on insulin therapy (INSULIN group). All patients were assessed for sociodemographic, behavioral characteristics, clinical history, periodontal parameters (bleeding on probing, probing depth, clinical attachment loss [Clinical AL], Oral Hygiene Index-simplified, plaque index, and periodontal inflamed surface area [PISA]), and biochemical variables (HbA1c, fasting plasma glucose, postprandial plasma glucose). RESULTS Prevalence, extent, and severity of periodontitis and PISA were lower in the INSULIN group as compared with the OAD group. A proportional relationship was observed between HbA1c and PISA and between HbA1c and Clinical AL. A unit increase in HbA1c is associated with an increase in PISA of 130.47 mm2 and an increase in Clinical AL of 0.182 mm. CONCLUSION A proportional relationship was observed between PISA, clinical attachment loss, and HbA1c level in patients with type 2 diabetes mellitus on insulin therapy and OAD therapy. Despite comparable oral hygiene status and glycemic control between the two groups, the periodontal parameters were lesser in the INSULIN group as compared with the OAD group.
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Affiliation(s)
- Simna Pattayil
- Department of Periodontics, Government Dental College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India
| | - Rosamma Joseph Vadakkekuttical
- Department of Periodontics, Government Dental College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India
| | - Chandni Radhakrishnan
- Department of Emergency Medicine, Government Medical College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India
| | - Harikumar Kanakkath
- Department of Periodontics, Government Dental College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India
| | - Thayyil Sivaraman Hrishi
- Department of Periodontics, Government Dental College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India
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Radhakrishnan S, Afsal EM, Anitha PM, Perumbally HA, Ajitha BK, Pulloor NK, Rafeeq Ali KP, Ajayan KV, Kanyadath AM, Verkoli AS, Sukumaran C, Nazeer HA, Sherif M, Navya V, Nishitha NK, Sabir VT, Kottayi S, Suchina EK, Thashreefa TK, Vaheed KA, Kulooth F, Suvanish Kumar VS, Chandran P, Thekkedath U, Radhakrishnan C. Performance & clinical utility of oropharyngeal versus nasopharyngeal swabs in COVID-19. Indian J Med Res 2022; 156:478-483. [PMID: 36510889 PMCID: PMC10101371 DOI: 10.4103/ijmr.ijmr_2275_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background & objectives The oropharyngeal (OP) and nasopharyngeal (NP) swab samples are the most recommended clinical specimens for detecting SARS-CoV-2 in an individual through the quantitative real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR) method. The primary objective of this study was to compare the performance of NP and OP swabs for the diagnosis of COVID-19 among 2250 concomitant samples (1125 NP + 1125 OP) using rRT-PCR test. Methods This study was conducted at a tertiary care hospital in southern India. The study compared the specificity and efficacy of the two samples (NP & OP swabs) in 1125 individuals suspected having COVID-19 infection. The rRT-PCR values from all the samples were compared based on gender, age group and viral load. The differences between unmatched proportion and matched proportion were analysed. Agreement between the two methods was assessed using Kappa statistic. Absolute sensitivity, specificity, positive and negative predictive values (PPV and NPV) for OP and NP swabs were analysed. Results The study identified a fair degree of agreement between OP and NP swabs in diagnosis of COVID-19 (kappa = 0.275, P <0.001). There was also a fair degree of agreement between NP and OP swabs irrespective of gender, age or duration of symptoms. NP swabs had better sensitivity and NPV as compared to OP swabs, however, specificity and PPV were 100 per cent for both. Interpretation & conclusions The present study showed that both OP and NP swabs had similar sensitivity and specificity for predicting the presence of SARS-CoV-2.
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Affiliation(s)
- Suma Radhakrishnan
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Kerala, India
| | - E Muhammed Afsal
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Kerala, India
| | - P M Anitha
- Microbiology, Government Medical College, Manjeri, Kerala, India
| | | | - B K Ajitha
- Department of Statistics, Government Medical College, Kozhikode, Kerala, India
| | | | - K P Rafeeq Ali
- Department of Otorhinolaryngology, General Hospital, Manjeri, Kerala, India
| | - K V Ajayan
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Kerala, India
| | | | | | - Chinchu Sukumaran
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Kerala, India
| | - Hafeefa Abdul Nazeer
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Kerala, India
| | - Mohammed Sherif
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Kerala, India
| | - V Navya
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Kerala, India
| | - N K Nishitha
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Kerala, India
| | - V T Sabir
- Department of Otorhinolaryngology, General Hospital, Manjeri, Kerala, India
| | - Shakeeber Kottayi
- Department of Otorhinolaryngology, General Hospital, Manjeri, Kerala, India
| | - E K Suchina
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Kerala, India
| | - T K Thashreefa
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Kerala, India
| | - K Abdul Vaheed
- Department of Otorhinolaryngology, General Hospital, Manjeri, Kerala, India
| | - Fathima Kulooth
- Department of Otorhinolaryngology, Government Medical College, Manjeri, Kerala, India
| | | | - Praseeda Chandran
- Community Medicine, Government Medical College, Manjeri, Kerala, India
| | - Usha Thekkedath
- UCSF Surgical Innovation, University of California, San Francisco, California, USA
| | - Chandni Radhakrishnan
- Department of Emergency Medicine, Government Medical College, Kozhikode, Kerala, India
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Radhakrishnan C, Asokan R. An intelligent multivariate block steganography framework with enhanced PSO based on chaos mapping. IFS 2022. [DOI: 10.3233/jifs-221093] [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: 11/15/2022]
Abstract
To safeguard private information, image steganography is extensively used. Research is focused on ways to enhance steganographic technologies so that they may increase compression ratio while maintaining steganography image integrity. Because of its essential qualities such as security, scalability, and robustness, Steganography is a preferred way of communicating protected secret information to prevent hacking and misuse. This proposed research offers a steganography approach based on Enhanced Chaotic Particle Swarm Optimization (ECPSO), which uses chaos theory to determine the optimal pixel positions in the cover picture to hide confidential information when keeping the steganography quality in the images. Both the cover and secret pictures are separated into blocks to increase hiding capacity, with each component storing a sufficient quantity of secret data by mapping the pixels. The suggested ECPSO-Stegano system has better results with the criteria of Mean Square Error (MSE) of 0.00018%, Peak-Signal-to-Noise-Ratio (PSNR) of 79.66%, Bit Error Rate (BER) of 0.45% in average, and Structural Similarity Index (SSI) of 0.98 in average for various input size. It’s also robust to statistical threats.
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Affiliation(s)
- C. Radhakrishnan
- Computer Science and Engineering, Kongunadu College of Engineering and Technology, Thottiam, Trichy
| | - R. Asokan
- Electronics and Communication Engineering, Kongunadu College of Engineering and Technology, Thottiam, Trichy
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8
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Dhanasooraj D, Viswanathan P, Saphia S, Jose BP, Parambath FC, Sivadas S, Akash NP, Vimisha TV, Nair PR, Mohan A, Hafeez N, Poovullathi JK, Vadekkandiyil S, Govindan SKK, Khobragade R, Aravindan KP, Radhakrishnan C. Genomic surveillance of SARS-CoV-2 by sequencing the RBD region using Sanger sequencing from North Kerala. Front Public Health 2022; 10:974667. [PMID: 36091505 PMCID: PMC9454329 DOI: 10.3389/fpubh.2022.974667] [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: 06/21/2022] [Accepted: 08/08/2022] [Indexed: 01/21/2023] Open
Abstract
Next Generation Sequencing (NGS) is the gold standard for the detection of new variants of SARS-CoV-2 including those which have immune escape properties, high infectivity, and variable severity. This test is helpful in genomic surveillance, for planning appropriate and timely public health interventions. But labs with NGS facilities are not available in small or medium research settings due to the high cost of setting up such a facility. Transportation of samples from many places to few centers for NGS testing also produces delays due to transportation and sample overload leading in turn to delays in patient management and community interventions. This becomes more important for patients traveling from hotspot regions or those suspected of harboring a new variant. Another major issue is the high cost of NGS-based tests. Thus, it may not be a good option for an economically viable surveillance program requiring immediate result generation and patient follow-up. The current study used a cost-effective facility which can be set up in a common research lab and which is replicable in similar centers with expertise in Sanger nucleotide sequencing. More samples can be processed at a time and can generate the results in a maximum of 2 days (1 day for a 24 h working lab). We analyzed the nucleotide sequence of the Receptor Binding Domain (RBD) region of SARS-CoV-2 by the Sanger sequencing using in-house developed methods. The SARS-CoV-2 variant surveillance was done during the period of March 2021 to May 2022 in the Northern region of Kerala, a state in India with a population of 36.4 million, for implementing appropriate timely interventions. Our findings broadly agree with those from elsewhere in India and other countries during the period.
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Affiliation(s)
- Dhananjayan Dhanasooraj
- Multidisciplinary Research Unit, Government Medical College, Kozhikode, Kerala, India,Dhananjayan Dhanasooraj
| | - Prasanth Viswanathan
- Virus Research and Diagnostic Laboratory, Government Medical College, Kozhikode, Kerala, India
| | - Shammy Saphia
- Multidisciplinary Research Unit, Government Medical College, Kozhikode, Kerala, India
| | - Beena Philomina Jose
- Department of Microbiology, Government Medical College, Kozhikode, Kerala, India
| | | | - Saritha Sivadas
- Virus Research and Diagnostic Laboratory, Government Medical College, Kozhikode, Kerala, India
| | - N. P. Akash
- Virus Research and Diagnostic Laboratory, Government Medical College, Kozhikode, Kerala, India
| | - T. V. Vimisha
- Virus Research and Diagnostic Laboratory, Government Medical College, Kozhikode, Kerala, India
| | | | - Anuja Mohan
- Virus Research and Diagnostic Laboratory, Government Medical College, Kozhikode, Kerala, India
| | - Nimin Hafeez
- Virus Research and Diagnostic Laboratory, Government Medical College, Kozhikode, Kerala, India
| | | | - Shameer Vadekkandiyil
- Department of General Medicine, Government Medical College, Kozhikode, Kerala, India
| | | | - Rajan Khobragade
- Department of Health and Family Welfare, Government of Kerala, Thiruvananthapuram, India
| | | | - Chandni Radhakrishnan
- Department of Emergency Medicine, Government Medical College, Kozhikode, Kerala, India,*Correspondence: Chandni Radhakrishnan
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9
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Yadav PD, Sahay RR, Balakrishnan A, Mohandas S, Radhakrishnan C, Gokhale MD, Balasubramanian R, Abraham P, Gupta N, Sugunan AP, Khobragade R, George K, Shete A, Patil S, Thankappan UP, Dighe H, Koshy J, Vijay V, Gayathri R, Kumar PJ, Rahim A, Naveen A, Nair S, Rajendran VR, Jayasree V, Majumdar T, Jain R, Viswanathan P, Patil DY, Kumar A, Nyayanit DA, Sarkale P, Waghmare A, Baradkar S, Gawande P, Bodke P, Kalele K, Yemul J, Dhaigude S, Holepannawar M, Gopale S, Chopade G, Ray S, Waghmare P, Narayan J, Mathapati B, Kadam M, Kumar A, Suryawanshi A, Jose BP, Sivadas S, Akash NP, Vimisha TV, Keerthi KV. Nipah Virus Outbreak in Kerala State, India Amidst of COVID-19 Pandemic. Front Public Health 2022; 10:818545. [PMID: 35252095 PMCID: PMC8891450 DOI: 10.3389/fpubh.2022.818545] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/03/2022] [Indexed: 12/29/2022] Open
Abstract
We report here a Nipah virus (NiV) outbreak in Kozhikode district of Kerala state, India, which had caused fatal encephalitis in a 12-year-old boy and the outbreak response, which led to the successful containment of the disease and the related investigations. Quantitative real-time reverse transcription (RT)-PCR, ELISA-based antibody detection, and whole genome sequencing (WGS) were performed to confirm the NiV infection. Contacts of the index case were traced and isolated based on risk categorization. Bats from the areas near the epicenter of the outbreak were sampled for throat swabs, rectal swabs, and blood samples for NiV screening by real-time RT-PCR and anti-NiV bat immunoglobulin G (IgG) ELISA. A plaque reduction neutralization test was performed for the detection of neutralizing antibodies. Nipah viral RNA could be detected from blood, bronchial wash, endotracheal (ET) secretion, and cerebrospinal fluid (CSF) and anti-NiV immunoglobulin M (IgM) antibodies from the serum sample of the index case. Rapid establishment of an onsite NiV diagnostic facility and contact tracing helped in quick containment of the outbreak. NiV sequences retrieved from the clinical specimen of the index case formed a sub-cluster with the earlier reported Nipah I genotype sequences from India with more than 95% similarity. Anti-NiV IgG positivity could be detected in 21% of Pteropus medius (P. medius) and 37.73% of Rousettus leschenaultia (R. leschenaultia). Neutralizing antibodies against NiV could be detected in P. medius. Stringent surveillance and awareness campaigns need to be implemented in the area to reduce human-bat interactions and minimize spillover events, which can lead to sporadic outbreaks of NiV.
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Affiliation(s)
- Pragya D. Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune, India
- *Correspondence: Pragya D. Yadav
| | - Rima R. Sahay
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Anukumar Balakrishnan
- Indian Council of Medical Research-National Institute of Virology, Kerala Unit, Alappuzha, India
| | | | | | - Mangesh D. Gokhale
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - R. Balasubramanian
- Indian Council of Medical Research-National Institute of Virology, Kerala Unit, Alappuzha, India
| | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Nivedita Gupta
- Epidemiology and Communicable Diseases Division, Indian Council of Medical Research, New Delhi, India
| | - A. P. Sugunan
- Indian Council of Medical Research-National Institute of Virology, Kerala Unit, Alappuzha, India
| | - Rajan Khobragade
- Health and Family Welfare Department, Government of Kerala, Thiruvananthapuram, India
| | - Kalpana George
- Department of Microbiology, Government Medical College, Kozhikode, India
| | - Anita Shete
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Savita Patil
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | | | - Hitesh Dighe
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Jijo Koshy
- Indian Council of Medical Research-National Institute of Virology, Kerala Unit, Alappuzha, India
| | - Vivek Vijay
- Indian Council of Medical Research-National Institute of Virology, Kerala Unit, Alappuzha, India
| | - R. Gayathri
- Department of Medicine, Government Medical College, Kozhikode, India
| | - P. Jayesh Kumar
- Department of Medicine, Government Medical College, Kozhikode, India
| | - Asma Rahim
- Department of Community Medicine, Government Medical College, Kozhikode, India
| | - A. Naveen
- National Health Mission, Kozhikode, India
| | | | | | - V. Jayasree
- District Medical Office of Health, Health Department, Kozhikode, India
| | - Triparna Majumdar
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Rajlaxmi Jain
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | | | - Deepak Y. Patil
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Abhinendra Kumar
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Dimpal A. Nyayanit
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Prasad Sarkale
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Ashwini Waghmare
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Shrikant Baradkar
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Pranita Gawande
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Poonam Bodke
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Kaumudi Kalele
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Jyoti Yemul
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Sachin Dhaigude
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | | | - Sanjay Gopale
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Ganesh Chopade
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Shilpa Ray
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Priyanka Waghmare
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Jitendra Narayan
- Epidemiology and Communicable Diseases Division, Indian Council of Medical Research, New Delhi, India
| | - Basavaraj Mathapati
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Manoj Kadam
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Abhimanyu Kumar
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | | | | | - Saritha Sivadas
- Department of Microbiology, Government Medical College, Kozhikode, India
| | - N. P. Akash
- Department of Microbiology, Government Medical College, Kozhikode, India
| | - T. V. Vimisha
- Department of Microbiology, Government Medical College, Kozhikode, India
| | - K. V. Keerthi
- Department of Microbiology, Government Medical College, Kozhikode, India
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10
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Unni A, Hidayathulla P, Kavitha K, Paloth MN, Nair PR, Kumar P J, Radhakrishnan C. A fulminant pneumonia due to Mycoplasma pneumoniae – Case report and literature review. IDCases 2022; 29:e01552. [PMID: 35832783 PMCID: PMC9271957 DOI: 10.1016/j.idcr.2022.e01552] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/23/2022] [Indexed: 12/03/2022] Open
Abstract
Fulminant pneumonia due to Mycoplasma pneumoniae [MP] is quite rare even though there is a high prevalence of Mycoplasma species infection in the general population. We report a case of an atypical pneumonia with Acute Respiratory Distress Syndrome (ARDS) due to Mycoplasma pneumoniae in a young female and the clinical challenges encountered along with the current literature review.
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Affiliation(s)
- Athira Unni
- Department of Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India
| | - P.K. Hidayathulla
- Department of Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India
| | - K.P. Kavitha
- Department of Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India
| | - Mohammed Niyas Paloth
- Department of Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India
| | | | - Jayesh Kumar P
- Department of Medicine, Government Medical College, Kozhikode 673008, Kerala, India
| | - Chandni Radhakrishnan
- Department of Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India
- Correspondence to: Emergency Medicine, Government Medical College, Kozhikode 673008, Kerala, India.
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11
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Anil K, Vadakkekuttical RJ, Radhakrishnan C, Parambath FC. Correlation of periodontal inflamed surface area with glycemic status in controlled and uncontrolled type 2 diabetes mellitus. World J Clin Cases 2021; 9:11300-11310. [PMID: 35071560 PMCID: PMC8717502 DOI: 10.12998/wjcc.v9.i36.11300] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/25/2021] [Accepted: 08/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The bidirectional link between periodontitis and diabetes mellitus (DM) has been established. Periodontitis causes systemic inflammatory burden through inflammatory mediators. The currently utilized tools [clinical attachment loss (CAL) and probing pocket depth (PPD)] are linear measurements, that do not exactly quantify the inflammatory burden of periodontitis. Periodontal inflamed surface area (PISA) quantifies the surface area of bleeding pocket epithelium and estimates the inflammatory burden. Studies relating to the periodontal status of diabetic patients with and without microvascular complications are scarce. This study assessed the proportion of periodontitis and correlation of PISA with glycemic status in controlled, uncontrolled type 2 DM (T2DM) with and without microvascular complications.
AIM To assess the proportion of periodontitis and correlation of PISA with glycemic status in controlled, and uncontrolled T2DM with and without microvascular complications.
METHODS This study comprised 180 T2DM patients. Based on glycated hemoglobin (HbA1c) levels, they were grouped into: (1) Controlled T2DMgroup: (HbA1c ≤ 7%); (2) Uncontrolled T2DM group: (HbA1c > 7%) without microvascular complications; and (3) Uncontrolled T2DM group: (HbA1c > 7%) with microvascular complications. Each group comprised 60 patients. All patients were assessed for periodontal parameters (Bleeding on Probing, PPD, CAL, Oral hygiene index simplified and PISA), and systemic parameters (HbA1c, fasting plasma glucose and post prandial plasma glucose).
RESULTS The proportion of periodontitis among controlled T2DM group, uncontrolled T2DM group without microvascular complications, uncontrolled T2DM group with microvascular complications was 75%, 93.4% and 96.6% respectively. Extent and severity of periodontitis were high in the uncontrolled T2DM group. A significant positive correlation was found between PISA and HbA1c among all patients (r = 0.393, P < 0.001). The dose–response relationship between PISA and HbA1c was observed. An increase of PISA with 168 mm2 was associated with a 1.0% increase of HbA1c.
CONCLUSION High proportion and severity of periodontitis, and increased inflamed surface area in uncontrolled T2DM may have contributed to the poor glycemic control and microvascular complications.
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Affiliation(s)
- Krishna Anil
- Department of Periodontics, Government Dental College (Affiliated to Kerala University of Health Sciences), Calicut 673008, Kerala, India
| | - Rosamma Joseph Vadakkekuttical
- Department of Periodontics, Government Dental College (Affiliated to Kerala University of Health Sciences), Calicut 673008, Kerala, India
| | - Chandni Radhakrishnan
- Department of Medicine, Government Medical College (Affiliated to Kerala University of Health Sciences), Calicut 673008, Kerala, India
| | - Fairoz Cheriyalingal Parambath
- Department of Microbiology, Government Medical College (Affiliated to Kerala University of Health Sciences), Calicut 673008, Kerala, India
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12
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Radhakrishnan C, Sankar UV, Rajendran VR, Devi A, Jayasree V, Saritha RL, Beevi AR, Kumar NS. Psychosocial impacts of quarantine among survivors of the Nipah virus infection: a qualitative study. Journal of Global Health Reports 2021. [DOI: 10.29392/001c.28993] [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: 11/08/2022] Open
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13
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Adhenkavil Radhakrishnan R, Joseph Vadakkekuttical R, Radhakrishnan C. Proportion and severity of periodontitis and correlation of periodontal inflamed surface area with glycemic status in patients with type 2 diabetic neuropathy with and without diabetic foot. J Periodontol 2021; 93:687-696. [PMID: 34460108 DOI: 10.1002/jper.21-0174] [Citation(s) in RCA: 3] [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: 04/01/2021] [Revised: 07/30/2021] [Accepted: 08/23/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND The association between diabetic neuropathy with and without diabetic foot and periodontitis remains unaddressed in the literature. The present study was conducted to evaluate the frequency of patients with periodontitis and its severity, and to correlate clinical attachment loss (AL) and periodontal inflamed surface area (PISA) with HbA1c in Type 2 Diabetic Neuropathy (T2DN) patients with and without diabetic foot. METHODS In this cross-sectional study 310 patients with type 2 diabetic neuropathy (T2DN) were randomly selected, and the study comprised of 120 patients with T2DN with diabetic foot and 155 patients with T2DN without diabetic foot. All patients were assessed for periodontal parameters (bleeding on probing, probing depth, clinical AL, oral hygiene index-simplified), plaque index, and PISA) and systemic parameters (HbA1c, fasting blood glucose, post prandial blood glucose, urinary albumin creatine ratio, erythrocyte sedimentation rate, and high-sensitivity C-reactive protein).Unpaired t-test and Chi-Square test were used to analyze quantitative data and qualitative data, respectively. RESULTS The frequency of patients with periodontitis in patients with T2DN with and without diabetic foot was 91.7% and 88.4%, respectively. The severity of periodontitis, PISA, and clinical AL were higher in the diabetic foot group. Clinical AL and PISA were significantly related with HbA1c in patients with T2DN with and without diabetic foot. CONCLUSIONS Percentage of patients with periodontitis and the severity of periodontal destruction were high in type 2 diabetic neuropathy with diabetic foot. A significant correlation of PISA, clinical AL with glycemic status was found in patients with T2DN with and without diabetic foot.
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14
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Radhakrishnan C, Divakar MK, Jain A, Viswanathan P, Bhoyar RC, Jolly B, Imran M, Sharma D, Rophina M, Ranjan G, Sehgal P, Jose BP, Raman RV, Kesavan TN, George K, Mathew S, Poovullathil JK, Keeriyatt Govindan SK, Nair PR, Vadekkandiyil S, Gladson V, Mohan M, Parambath FC, Mangla M, Shamnath A, Sivasubbu S, Scaria V. Initial Insights Into the Genetic Epidemiology of SARS-CoV-2 Isolates From Kerala Suggest Local Spread From Limited Introductions. Front Genet 2021; 12:630542. [PMID: 33815467 PMCID: PMC8010186 DOI: 10.3389/fgene.2021.630542] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/12/2021] [Indexed: 12/04/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) rapidly spread from a city in China to almost every country in the world, affecting millions of individuals. The rapid increase in the COVID-19 cases in the state of Kerala in India has necessitated the understanding of SARS-CoV-2 genetic epidemiology. We sequenced 200 samples from patients in Kerala using COVIDSeq protocol amplicon-based sequencing. The analysis identified 166 high-quality single-nucleotide variants encompassing four novel variants and 89 new variants in the Indian isolated SARS-CoV-2. Phylogenetic and haplotype analysis revealed that the virus was dominated by three distinct introductions followed by local spread suggesting recent outbreaks and that it belongs to the A2a clade. Further analysis of the functional variants revealed that two variants in the S gene associated with increased infectivity and five variants mapped in primer binding sites affect the efficacy of RT-PCR. To the best of our knowledge, this is the first and most comprehensive report of SARS-CoV-2 genetic epidemiology from Kerala.
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Affiliation(s)
| | - Mohit Kumar Divakar
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Abhinav Jain
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | | | - Rahul C. Bhoyar
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Bani Jolly
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Mohamed Imran
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Disha Sharma
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Mercy Rophina
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Gyan Ranjan
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Paras Sehgal
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | | | | | | | | | | | | | | | | | | | | | | | | | - Mohit Mangla
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Afra Shamnath
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
| | | | - Sridhar Sivasubbu
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Vinod Scaria
- Council of Scientific and Industrial Research (CSIR)-Institute of Genomics and Integrative Biology, New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
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15
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Yadav P, Shete A, Radhakrishnan C, Pardeshi P, Jain R, Sahay R, Sugunan AP. Antibody response in symptomatic & asymptomatic Nipah virus cases from Kerala, India. Indian J Med Res 2021; 154:533-535. [PMID: 35142653 PMCID: PMC9131784 DOI: 10.4103/ijmr.ijmr_4388_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Kannampulakkal SM, Sudevan SS, Tharayil HM, Radhakrishnan C. Psychosocial Effects of Isolation on Nipah Virus Infection Suspects during an Outbreak. J Assoc Physicians India 2021; 69:41-45. [PMID: 34227775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND METHODOLOGY Nipah Virus (NiV) belonging to the genus Henipavirus is a biosafety level 4 pathogen with high human to human transmission. Nipah Virus outbreak of 2018 in Kozhikode, Kerala has evoked immense panic and fear in the system. Other viral infections with similar transmission pattern (Ebola, SARS, MERS or COVID 19) also identified with the negative impacts of isolation. This retrospective observational study was planned during November -December 2018 to understand the psychosocial effects among the subjects in Nipah isolation facility. The symptoms of Post-traumatic stress disorder (PTSD) were assessed using the Impact of Events Scale-Revised version (IES-R). RESULTS AND CONCLUSIONS Of the 81 subjects, 73 could be contacted with a response rate of 90.12%. The mean age was 38 years (SD = 15.43) and 13.7% were health care workers. 63% of the subjects experienced fear of death during isolation stay and 12.3% of the subjects had lost their relatives or friends to Nipah infection. The mean IES score obtained was 10.78 (SD: 9.679, range 0-49) and 5 subjects had above the cut off 22. Nipah outbreak had evoked significant psychological disturbances in subjects who remained in isolation with its negative impacts.
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Affiliation(s)
- Shyam Mohan Kannampulakkal
- Junior Resident, Department of Pulmonary Medicine, Vallabh Bhai Patel Chest Institute, Delhi University, Delhi
| | - Swathy Sheela Sudevan
- Junior Resident, Department of Psychiatry, Government Medical College Kozhikode, Kerala
| | - Harish M Tharayil
- Professor of Psychiatry, Government Medical College Kozhikode, Kerala
| | - Chandni Radhakrishnan
- Professor of Medicine and HOD of Emergency Medicine, Government Medical College Kozhikode, Kerala
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17
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Karat A, Radhakrishnan C, Thulaseedharan N, Kalam S. Prevalence of thyroid dysfunction and anti–thyroid peroxidase antibody in gestational diabetes mellitus. J Diabetol 2021. [DOI: 10.4103/jod.jod_34_21] [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: 03/19/2023] Open
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18
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Abstract
Insulin is a lifesaving drug for patients with type 1 diabetes mellitus. Many type 2 diabetes mellitus patients will eventually require insulin. The rapid-acting and long-acting insulin analogues (RAIAs and LAIAs) have a pharmacological profile that closely mimics normal human physiology when compared to Neutral Protamine Hagedorn (NPH) insulin and regular human insulin, respectively. Glucagon-like peptide 1 receptor agonists (GLP-1RAs) were found to have a proven cardiovascular safety. They are preferred over insulin in many recent guidelines. Fixed-ratio combinations of GLP-1RAs and insulin are also recommended when either of these molecules fail to achieve glycaemic control. Despite decades of experience in using insulin, there is a debate among the scientific community over the safety of exogenous insulin, especially regarding their cardiovascular safety and the risk of cancer. There is also an ongoing debate regarding the safety, even though two long-acting insulin analogues (glargine and degludec) have proven their cardiovascular non-inferiority. Drugs with proven safety are often preferred in patients with pre-existing cardiovascular disease or at high risk of cardiovascular disease. In this review we will critically analyse efficacy and safety issues related to insulin molecules to help in clinical decision making.
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Affiliation(s)
| | - Chandni Radhakrishnan
- Professor of Medicine and Head of Department of Emergency Medicine, Govternment Medical College Kozhikode, Kerala, India
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19
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Arunkumar G, Devadiga S, McElroy AK, Prabhu S, Sheik S, Abdulmajeed J, Robin S, Sushama A, Jayaram A, Nittur S, Shakir M, Kumar KGS, Radhakrishnan C, Sakeena K, Vasudevan J, Reena KJ, Sarita RL, Klena JD, Spiropoulou CF, Laserson KF, Nichol ST. Adaptive Immune Responses in Humans During Nipah Virus Acute and Convalescent Phases of Infection. Clin Infect Dis 2020; 69:1752-1756. [PMID: 30615097 DOI: 10.1093/cid/ciz010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 10/15/2018] [Accepted: 01/04/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Nipah virus (NiV) is 1 of 10 potential causes of imminent public health emergencies of international concern. We investigated the NiV outbreak that occurred in May 2018 in Kerala, India. Here we describe the longitudinal characteristics of cell-mediated and humoral immune responses to NiV infection during the acute and convalescent phases in 2 human survivors. METHODS Serial blood samples were obtained from the only 2 survivors of the NiV outbreak in Kerala. We used flow cytometry to determine the absolute T-lymphocyte and B-lymphocyte counts and the phenotypes of both T and B cells. We also detected and quantitated the humoral immune response to NiV by virus-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) enzyme-linked immunosorbent assay. RESULTS Absolute numbers of T lymphocytes remained within normal limits throughout the period of illness studied in both survivors. However, a marked elevation of activated CD8 T cells was observed in both cases. More than 30% of total CD8 T cells expressed Ki67, indicating active proliferation. Proliferating (Ki-67+) CD8 T cells expressed high levels of granzyme B and PD-1, consistent with the profile of acute effector cells. Total B-lymphocyte, activated B-cell, and plasmablast counts were also elevated in NiV survivors. These individuals developed detectable NiV-specific IgM and IgG antibodies within a week of disease onset. Clearance of NiV RNA from blood preceded the appearance of virus-specific IgG and coincided with the peak of activated CD8 T cells. CONCLUSIONS We describe for the first time longitudinal kinetic data on the activation status of human B- and T-cell populations during acute NiV infection. While marked CD8 T-cell activation was observed with effector characteristics, activated CD4 T cells were less prominent.
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Affiliation(s)
| | - Santhosha Devadiga
- Manipal Centre for Virus Research, Manipal Academy of Higher Education, Karnataka, India
| | - Anita K McElroy
- Centers for Disease Control and Prevention, Atlanta, Georgia.,Department of Pediatrics, University of Pittsburgh, Pennsylvania
| | - Suresh Prabhu
- Manipal Centre for Virus Research, Manipal Academy of Higher Education, Karnataka, India
| | - Shahin Sheik
- Manipal Centre for Virus Research, Manipal Academy of Higher Education, Karnataka, India
| | - Jazeel Abdulmajeed
- Manipal Centre for Virus Research, Manipal Academy of Higher Education, Karnataka, India
| | - Sudandiradas Robin
- Manipal Centre for Virus Research, Manipal Academy of Higher Education, Karnataka, India
| | - Aswathyraj Sushama
- Manipal Centre for Virus Research, Manipal Academy of Higher Education, Karnataka, India
| | - Anup Jayaram
- Manipal Centre for Virus Research, Manipal Academy of Higher Education, Karnataka, India
| | - Sudheesh Nittur
- Manipal Centre for Virus Research, Manipal Academy of Higher Education, Karnataka, India
| | - Mohammed Shakir
- Manipal Centre for Virus Research, Manipal Academy of Higher Education, Karnataka, India
| | | | | | - Karayil Sakeena
- Directorate of Health Services, Government of Kerala, Thiruvananthapuram, India
| | - Jayasree Vasudevan
- Directorate of Health Services, Government of Kerala, Thiruvananthapuram, India
| | | | | | - John D Klena
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Stuart T Nichol
- Centers for Disease Control and Prevention, Atlanta, Georgia
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20
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Radhakrishnan S, Mujeeb H, Radhakrishnan C. Central skull base osteomyelitis secondary to invasive aspergillus sphenoid sinusitis presenting with isolated 12th nerve palsy. IDCases 2020; 22:e00930. [PMID: 32923366 PMCID: PMC7475189 DOI: 10.1016/j.idcr.2020.e00930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 11/21/2022] Open
Abstract
Skull base osteomyelitis is a potentially life-threatening infection, usually seen in elderly immunocompromised patients secondary to malignant otitis externa (MOE) caused by Pseudomonas. Central or atypical skull base osteomyelitis often poses a diagnostic challenge as they present as head-ache with or without cranial nerve palsy often without any obvious source of infection. Although the incidence of fungal skull base osteomyelitis is increasing central skull base osteomyelitis due to invasive fungal sinusitis presenting with isolated hypoglossal nerve palsy has not been reported in the literature, to our knowledge. We report a case of a 59-year-old diabetic patient on regular treatment including steroid for acetylcholine receptor binding antibody positive myasthenia gravis with thymoma who presented with persistent head-ache and on evaluation, was found to have 12th cranial nerve palsy on the right side. She was diagnosed to have invasive fungal sphenoid sinusitis and central skull base osteomyelitis involving the clivus and was successfully treated with endoscopic transnasal transsphenoidal debridement followed by antifungal therapy.
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Affiliation(s)
| | - Hiba Mujeeb
- Govt. Medical College, Manjeri, Malappuram, Kerala, India
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21
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N MM, Radhakrishnan C, P I. COVID-19: Striking a Balance between Health Care Provider Safety and Patient Care in the Indian Hospital Settings. J Assoc Physicians India 2020; 68:41-47. [PMID: 32610878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND The COVID-19 pandemic has taken its toll on the health care systems all over the world. The global shortage of resources has adversely affected the safety of healthcare personnel as well patients. This has forced the health care facilities to adopt various measures and improvisation in infection control practices, in addition to those in personnel protective equipments (PPEs) adapting to their need and their resources. OBJECTIVES To review the literature on the infection control practices in health care facilities against COVID-19 and put forward practical solutions, in addition to personnel protective equipments that may be adopted for health care personnel and patient safety in the Indian setting. CONCLUSIONS We are now amidst of COVID-19 pandemic and we need to focus on 'Risk reduction as much as possible'. The facilities and resources should transform to meet the challenges within the shortest time frame. The concept of patient care needs to balance with the safety of the healthcare, patient and society. This is achievable only by a combination of engineering controls, administrative controls and PPEs. It involves a lot of committed team work while managing an outbreak like COVID - 19 attached with a lot of social stigma.
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Affiliation(s)
- Midhun Mohan N
- Assistant Professor, Government Medical College, Kozhikode, Kerala
| | - Chandni Radhakrishnan
- Professor of Medicine, Department of Emergency Medicine, Government Medical College, Kozhikode, Kerala
| | - Indira P
- Biomedical Engineer, Biomedical Wing, Government Medical College, Kozhikode, Kerala
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Madathil J, Salim H, Balan A, Radhakrishnan C, Kumar N. Prevalence of oral lesions in patients with type 2 diabetes in north Kerala population. J Diabetol 2020. [DOI: 10.4103/jod.jod_7_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Kumar CPG, Sugunan AP, Yadav P, Kurup KK, Aarathee R, Manickam P, Bhatnagar T, Radhakrishnan C, Thomas B, Kumar A, Jayasree J, Philomina B, Kumar KGS, Thulaseedharan NK, Gupta N, Rajendran R, Saritha RL, Mourya DT, Gangakhedkar RR, Murhekar MV. Infections among Contacts of Patients with Nipah Virus, India. Emerg Infect Dis 2019; 25:1007-1010. [PMID: 31002050 PMCID: PMC6478200 DOI: 10.3201/eid2505.181352] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We conducted a serosurvey of 155 healthcare workers and 124 household and community members who had close contact with 18 patients who had laboratory-confirmed Nipah virus infections in Kerala, India. We detected 3 subclinical infections; 2 persons had IgM and IgG and 1 only IgM against Nipah virus.
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24
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Yadav PD, Shete AM, Kumar GA, Sarkale P, Sahay RR, Radhakrishnan C, Lakra R, Pardeshi P, Gupta N, Gangakhedkar RR, Rajendran VR, Sadanandan R, Mourya DT. Nipah Virus Sequences from Humans and Bats during Nipah Outbreak, Kerala, India, 2018. Emerg Infect Dis 2019; 25:1003-1006. [PMID: 31002049 PMCID: PMC6478210 DOI: 10.3201/eid2505.181076] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We retrieved Nipah virus (NiV) sequences from 4 human and 3 fruit bat (Pteropus medius) samples from a 2018 outbreak in Kerala, India. Phylogenetic analysis demonstrated that NiV from humans was 96.15% similar to a Bangladesh strain but 99.7%–100% similar to virus from Pteropus spp. bats, indicating bats were the source of the outbreak.
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25
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Viswanathan V, Pendsey S, Radhakrishnan C, Rege TD, Ahdal J, Jain R. Methicillin-Resistant Staphylococcus aureus in Diabetic Foot Infection in India: A Growing Menace. INT J LOW EXTR WOUND 2019; 18:236-246. [DOI: 10.1177/1534734619853668] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Diabetic foot infection (DFI) is a serious and common complication of diabetes mellitus. These infections are potentially disastrous and rapidly progress to deeper spaces and tissues. If not treated promptly and appropriately, DFI can be incurable or even lead to septic gangrene, which may require foot amputation. Mostly, these infections are polymicrobial, where Gram-positive pathogens mainly Staphylococcus aureus play a dominant causative role. Methicillin-resistant Staphylococcus aureus (MRSA) is present in 10% to 32% of diabetic infections and is associated with a higher rate of treatment failure, morbidity, and hospitalization cost in patients with DFIs. The increasing resistance of bacteria and the adverse effects pertaining to the safety and tolerability towards currently available anti-MRSA agents have limited the available treatment options for patients with DFI. Infection control, antimicrobial stewardship, and rapid diagnostics based on the microbiological culture and the antimicrobial susceptibility testing results are important components in helping curb this disturbing trend. Emphasis to revisit a vigorous research effort in order to improve the therapeutic options for the increasingly resistant and highly adaptable MRSA is the need of hour. Through this review article, we have made an attempt to explore the ongoing therapeutic trends in the management of DFI and highlighted the challenges in treatment of DFI. We have also given a brief overview of a few novel drugs that are under development to treat MRSA infections.
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Affiliation(s)
| | | | | | | | | | - Rishi Jain
- Wockhardt Ltd, Bandra Kurla Complex, Mumbai, India
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26
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Arunkumar G, Abdulmajeed J, Santhosha D, Aswathyraj S, Robin S, Jayaram A, Radhakrishnan C, Sajeeth KKG, Sakeena K, Jayasree V, Reena J, Sarita L. Persistence of Nipah Virus RNA in Semen of Survivor. Clin Infect Dis 2018; 69:377-378. [DOI: 10.1093/cid/ciy1092] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 12/12/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Govindakarnavar Arunkumar
- Manipal Centre for Virus Research, Manipal Academy of Higher Education (deemed to be university), Manipal, Karnataka
| | - Jazeel Abdulmajeed
- Manipal Centre for Virus Research, Manipal Academy of Higher Education (deemed to be university), Manipal, Karnataka
| | - Devadiga Santhosha
- Manipal Centre for Virus Research, Manipal Academy of Higher Education (deemed to be university), Manipal, Karnataka
| | - Sushama Aswathyraj
- Manipal Centre for Virus Research, Manipal Academy of Higher Education (deemed to be university), Manipal, Karnataka
| | - Sudandiradas Robin
- Manipal Centre for Virus Research, Manipal Academy of Higher Education (deemed to be university), Manipal, Karnataka
| | - Anup Jayaram
- Manipal Centre for Virus Research, Manipal Academy of Higher Education (deemed to be university), Manipal, Karnataka
| | | | | | - Karayil Sakeena
- Directorate of Health Services, Government of Kerala, Thiruvananthapuram, India
| | - Vasudevan Jayasree
- Directorate of Health Services, Government of Kerala, Thiruvananthapuram, India
| | - Joseph K Reena
- Directorate of Health Services, Government of Kerala, Thiruvananthapuram, India
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Vinod PK, Radhakrishnan C, Pk S. Incidence and Spectrum of Opportunistic Infections Among HIV Infected Patients Attending Government Medical College, Kozhikode. J Assoc Physicians India 2018; 66:33-36. [PMID: 31325258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND People with advanced human immunodeficiency virus (HIV ) infections are vulnerable to opportunistic infections because of a weakened immune system. Early diagnosis of Opportunistic infections and prompt treatment definitely contributes to increased life expectancy among infected patients and delays the progression to AIDS. AIMS AND OBJECTIVES are to study the incidence, clinical spectrum and outcome of opportunistic infections and relation between opportunistic infections and CD4 count. MATERIAL AND METHODS The study was carried out in the Anti Retroviral Treatment (ART ) clinic and medical wards of Government Medical College, Kozhikode. The study period was from January 2012 to January 2013 till 100 opportunistic infections are identified in newly diagnosed retro positive patients. This was a clinical observational study. 424 newly diagnosed retro positive patients were screened to identify 100 patients having opportunistic infections and they were studied in detail. RESULTS Out of the 100 patients, 71 were males and 29 were females.67% were in the age group of 30-49 years. The most common symptom of presentation was weight loss (77%) followed by fever (67%) and mucocutaneous lesions (60%). The commonest opportunistic infection detected was candidiasis (52%) followed by tuberculosis (50%).Majority of the patients had a CD4 count between 50-200/ microL. Out of the 100 patients 19 patients expired. Among them 10 patients had disseminated tuberculosis. Incidence of opportunistic infection was 23.59/100 person years. CONCLUSIONS This study demonstrates that Oral candidiasis is the commonest opportunistic infection in HIV patients and Tuberculosis is the second most common. The incidence of opportunistic infection is higher in the older age groups, males and patients with lowCD4 count.
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Affiliation(s)
- P K Vinod
- Junior Resident, Government Medical College, Kozhikode,Kerala; Corresponding Author
| | | | - Sasidharan Pk
- Formerly Professor and Head of Medcine, Government Medical College, Kozhikode,Kerala
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Joseph R, Sasikumar M, Mammen J, Joseraj MG, Radhakrishnan C. Nonsurgical periodontal-therapy improves glycosylated hemoglobin levels in pre-diabetic patients with chronic periodontitis. World J Diabetes 2017; 8:213-221. [PMID: 28572882 PMCID: PMC5437619 DOI: 10.4239/wjd.v8.i5.213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/22/2017] [Accepted: 03/13/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the effect of nonsurgical periodontal therapy on glycosylated haemoglobin levels in pre-diabetic patients with chronic periodontitis (CHP).
METHODS Sixty pre-diabetic patients with CHP were selected and equally allocated to case and control group. All subjects were evaluated at base line for periodontal parameters (plaque index, oral hygiene index, modified gingival index, probing pocket depth, clinical attachment level) and systemic parameters [glycosylated hemoglobin (HbA1c), fasting lipid profile, and fasting blood glucose]. The case group received non-surgical periodontal therapy. Subjects were re-evaluated for periodontal and systemic parameters after three months.
RESULTS Both groups were comparable at baseline. Three months after non surgical periodontal therapy (NSPT), there was significant improvement in periodontal parameters in case group. The mean difference in systemic parameters like HbA1c and fasting plasma glucose from baseline to fourth month for case group was 0.22 ± 0.11 and 3.90 ± 8.48 respectively and control group was -0.056 ± 0.10 and -1.66 ± 6.04 respectively, which was significant between case and control group (P < 0.05). In the case group there was a significant decrease in HbA1c from baseline to three months following NSPT (P < 0.05).
CONCLUSION This study showed that periodontal inflammation could affect the glycemic control in otherwise systemically healthy individuals. Periodontal therapy improved periodontal health status and decreased glycosylated haemoglobin levels, thus reducing the probability of occurrence of inflammation induced prediabetes in patients with CHP.
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Narayanan S, Panarkandy G, Subramaniam G, Radhakrishnan C, Thulaseedharan NK, Manikath N, Ramaswamy S, Radhakrishnan S, Ekkalayil D. The "black evil" affecting patients with diabetes: a case of rhino orbito cerebral mucormycosis causing Garcin syndrome. Infect Drug Resist 2017; 10:103-108. [PMID: 28405168 PMCID: PMC5378458 DOI: 10.2147/idr.s130926] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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] [Indexed: 11/23/2022] Open
Abstract
Mucormycosis is a life-threatening infection affecting patients with diabetes. It is an angioinvasive disease often resistant to treatment with a debilitating course and high mortality. Here, we report a case of a 45 year old woman with type 2 diabetes mellitus who presented to us with history of right-sided ptosis and facial palsy, and subsequently developed loss of vision and palatal palsy. She was in diabetic ketoacidosis. Nervous system examination revealed involvement of right second, third, fourth, sixth, seventh, ninth, and tenth cranial nerves, suggestive of Garcin syndrome. The hard palate had been eroded with formation of black eschar. Computed tomography of paranasal sinuses revealed right maxillary and ethmoid sinusitis, with spread of inflammation to infratemporal fossa and parapharynygeal neck spaces. Debridement of sinus mucosa was done, and culture of the same yielded growth of rhizopus species. Histopathological examination of the tissue showed angioinvasion and fungal hyphae suggestive of mucormycosis. She was treated with amphotericin B, posaconazole, and periodic nasal sinus debridement, but her general condition worsened after 8 weeks due to secondary sepsis and she succumbed to death.
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Affiliation(s)
| | | | | | | | | | | | | | - Suma Radhakrishnan
- Department of Otorhinolaryngology, Government Medical College, Kozhikode, Kerala, India
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Abstract
A common misconception is that immune thrombocytopenic purpura (ITP) causes only bleeding diathesis. From this case vignette of a young male with ITP who had cerebral venous thrombosis, we highlight the importance of considering venous thrombosis in such patients when they present with focal cerebral signs.
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Affiliation(s)
- Joe James
- Department of Internal Medicine, Government Medical College, Kozhikode, Kerala, India
| | - P V Shiji
- Department of Internal Medicine, Government Medical College, Kozhikode, Kerala, India
| | - Chandni Radhakrishnan
- Department of Internal Medicine, Government Medical College, Kozhikode, Kerala, India
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Mammen J, Vadakkekuttical RJ, George JM, Kaziyarakath JA, Radhakrishnan C. Effect of non-surgical periodontal therapy on insulin resistance in patients with type II diabetes mellitus and chronic periodontitis, as assessed by C-peptide and the Homeostasis Assessment Index. ACTA ACUST UNITED AC 2016; 8. [PMID: 27282797 DOI: 10.1111/jicd.12221] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [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: 02/16/2016] [Accepted: 03/19/2016] [Indexed: 12/12/2022]
Abstract
AIM A bidirectional relationship exists between diabetes and periodontitis. In the present clinical trial, we evaluated the effects of non-surgical periodontal therapy (NSPT) on insulin resistance in patients with type II diabetes mellitus (DM) and chronic periodontitis. METHODS Forty chronic periodontitis patients with type II DM were selected and equally allocated to case and control groups. All patients were assessed for periodontal parameters and systemic parameters. The case group received NSPT, and both groups were re-evaluated after 3 months. RESULTS All periodontal parameters were found to be significantly improved in the case group compared to the control group 3 months after NSPT. The mean differences in systemic parameters, such as fasting serum C-peptide, Homeostasis Assessment (HOMA) Index-insulin resistance, and HOMA-insulin sensitivity, from baseline to 3 months for the case group were 0.544 ± 0.73, 0.54 ± 0.63, and -25.44 ± 36.81, respectively; for the control group, they were significant at -1.66 ± 1.89, -1.48 ± 1.86, and 31.42 ± 38.82 respectively (P < 0.05). There was a significant decrease in fasting blood glucose and glycosylated hemoglobin A1c from baseline to 3 months in the case group (P < 0.05). CONCLUSION The present study showed that periodontal inflammation could affect glycemic control and insulin resistance. Effective periodontal therapy reduced insulin resistance and improved periodontal health status and insulin sensitivity in patients with type II DM and chronic periodontitis.
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Affiliation(s)
- Jerry Mammen
- Department of Periodontics, Government Dental College, Calicut, Kerala, India
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Emiliyamma K, Palot MJ, Radhakrishnan C. Microgomphus souteri Fraser, a new addition to the Odonata (Insecta) fauna of Kerala, southern India. J Threat Taxa 2012. [DOI: 10.11609/jott.o2885.2667-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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33
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Bhatta G, Dinesh K, Prashanth P, Kulkarni NU, Radhakrishnan C. New site records of Gegeneophis goaensis and G. mhadeiensis (Gymnophiona: Caeciliidae) from the Western Ghats of Goa and Karnataka. J Threat Taxa 2010. [DOI: 10.11609/jott.o2364.1105-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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34
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Palot MJ, Radhakrishnan C. First record of Yellow-bellied Sea Snake Pelamis platurus (Linnaeus, 1766) (Reptilia: Hydrophiidae) from a riverine tract in northern Kerala, India. J Threat Taxa 2010. [DOI: 10.11609/jott.o2284.1175-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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35
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Dinesh K, Radhakrishnan C, Gururaja K, Zacariya A. New locality records of Rhacophorus lateralis Boulenger, 1883 (Amphibia: Anura: Rhacophoridae), in Western Ghats, India. J Threat Taxa 2010. [DOI: 10.11609/jott.o2209.986-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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36
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Sureshan P, Bastawade D, Radhakrishnan C. Taxonomic studies on a collection of scorpions (Scorpiones: Arachnida) from Western Ghats in Kerala, India with two new distribution records. ACTA ACUST UNITED AC 2007. [DOI: 10.11609/jott.zpj.1751.2903-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Affiliation(s)
- C Radhakrishnan
- Department of Clinics, Madras Veterinary College, Tamil Nadu Veterinary and Animal Sciences University, India
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Guharaj PV, Gopalan P, Radhakrishnan C. Endomyocardial fibrosis. J Indian Med Assoc 1976; 67:75-7. [PMID: 1018141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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