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Elangovan D, Neeravi A, Sahni RD, Santhanam S, Beck MM, Adhiya R, Kwatra G, Solaimalai D, Veeraraghavan B. Serotype distribution and antimicrobial susceptibility profile of invasive group B streptococcal disease-in South Indian population. Indian J Med Microbiol 2023; 45:100392. [PMID: 37573061 DOI: 10.1016/j.ijmmb.2023.100392] [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: 03/03/2023] [Revised: 05/13/2023] [Accepted: 05/22/2023] [Indexed: 08/14/2023]
Abstract
PURPOSE Invasive group B Streptococcal disease (iGBS) is an important cause of morbidity and mortality in neonates for which the development of an efficacious vaccine remains a global health imperative. The knowledge about the serotype distribution of iGBS is important component for formulation of Capsular polysaccharide (CPS)-based vaccine. However, there were absolute lack of information on serotype distribution in invasive GBS isolates from Indian subcontinent. Methods This study has assessed the serotype distribution and antimicrobial susceptibility profile of invasive group B streptococcal isolates for a period of 13 years from 2009 to 2022 from a tertiary care Center in South India. A total of 155 iGBS isolates were subjected to serotyping by conventional multiplex PCR for identification of all ten GBS serotype. Antimicrobial susceptibility profile and demographic details were extracted from microbiological records. Results Overall, the most common serotype causing invasive GBS were Ia (29%), V (26%), III (15%), II (12%), VI (6%), VII (5%) and Ib (5%). Serotypes IV, VIII and XI were not detected. Among the early-onset iGBS, the common serotype were Ia (36%), V (27%), and III (8%). In late onset iGBS, Serotype III (44%) was predominant. The common serotype in adults were Serotype V (31%) and III (20%). All the invasive GBS isolates were susceptible for penicillin (100%), but the susceptibility for clindamycin and erythromycin were 72% and 80% respectively. Conclusion The serotype distribution of invasive Group B streptococcal isolates from India suggest that hexavalent group B CPS vaccine will cover only 90% of GBS isolates causing invasive disease among the infants in India. Continued surveillance monitoring for serotype distribution and antimicrobial resistance patterns for iGBS are warranted to make public health interventions.
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Affiliation(s)
- Divyaa Elangovan
- Department of Clinical Microbiology, Christian Medical College, Vellore, India.
| | - Ayyanraj Neeravi
- Department of Clinical Microbiology, Christian Medical College, Vellore, India.
| | - Rani Diana Sahni
- Department of Clinical Microbiology, Christian Medical College, Vellore, India.
| | - Sridhar Santhanam
- Department of Neonatology, Christian Medical College, Vellore, India.
| | - Manisha Madhai Beck
- Department of Obstetrics and Gynaecology, Christian Medical College, Vellore, India.
| | - Ranjan Adhiya
- Department of Clinical Microbiology, Christian Medical College, Vellore, India.
| | - Gaurav Kwatra
- Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa; MRC, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
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Bakthavatchalam YD, Elangovan D, Jaganathan SV, Subburaju N, Shankar A, Manokaran Y, J. S, Devi R, Baveja S, Devi S, S. J, Bhattacharya S, S. M. R, Yesudhason B, Shetty V, Mutreja A, Manesh A, Varghese GM, Marwick CA, Parcell BJ, Gilbert IH, Veeraraghavan B. In Vitro Activity of Two Cefepime-Based Novel Combinations, Cefepime/Taniborbactam and Cefepime/Zidebactam, against Carbapenemase-Expressing Enterobacterales Collected in India. Microbiol Spectr 2023; 11:e0492522. [PMID: 36847537 PMCID: PMC10100882 DOI: 10.1128/spectrum.04925-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/31/2023] [Indexed: 03/01/2023] Open
Abstract
In recent times, discovery efforts for novel antibiotics have mostly targeted carbapenemase-producing Gram-negative organisms. Two different combination approaches are pertinent: β-lactam-β-lactamase inhibitor (BL/BLI) or β-lactam-β-lactam enhancer (BL/BLE). Cefepime combined with a BLI, taniborbactam, or with a BLE, zidebactam, has been shown to be promising. In this study, we determined the in vitro activity of both these agents along with comparators against multicentric carbapenemase-producing Enterobacterales (CPE). Nonduplicate CPE isolates of Escherichia coli (n = 270) and Klebsiella pneumoniae (n = 300), collected from nine different tertiary-care hospitals across India during 2019 to 2021, were included in the study. Carbapenemases in these isolates were detected by PCR. E. coli isolates were also screened for the presence of the 4-amino-acid insert in penicillin binding protein 3 (PBP3). MICs were determined by reference broth microdilution. Higher MICs of cefepime/taniborbactam (>8 mg/L) were linked to NDM, both in K. pneumoniae and in E. coli. In particular, such higher MICs were observed in 88 to 90% of E. coli isolates producing NDM and OXA-48-like or NDM alone. On the other hand, OXA-48-like-producing E. coli or K. pneumoniae isolates were nearly 100% susceptible to cefepime/taniborbactam. Regardless of the carbapenemase types and the pathogens, cefepime/zidebactam showed potent activity (>99% inhibited at ≤8 mg/L). It seems that the 4-amino-acid insert in PBP3 (present universally in the study E. coli isolates) along with NDM adversely impact the activity of cefepime/taniborbactam. Thus, the limitations of the BL/BLI approach in tackling the complex interplay of enzymatic and nonenzymatic resistance mechanisms were better revealed in whole-cell studies where the activity observed was a net effect of β-lactamase inhibition, cellular uptake, and target affinity of the combination. IMPORTANCE The study revealed the differential ability of cefepime/taniborbactam and cefepime/zidebactam in tackling carbapenemase-producing Indian clinical isolates that also harbored additional mechanisms of resistance. NDM-expressing E. coli with 4-amino-acid insert in PBP3 are predominately resistant to cefepime/taniborbactam, while the β-lactam enhancer mechanism-based cefepime/zidebactam showed consistent activity against single- or dual-carbapenemase-producing isolates including E. coli with PBP3 inserts.
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Affiliation(s)
| | - Divyaa Elangovan
- Department of Microbiology, Panimalar Medical College Hospital and Research Institute, Chennai, India
| | | | - Nivedhana Subburaju
- Department of Microbiology, Rainbow Children’s Hospital and Perinatal Care, Hyderabad, India
| | - Abirami Shankar
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, India
| | - Yuvasri Manokaran
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, India
| | - Sudarsana J.
- Department of Microbiology, Baby Memorial Hospital, Kozhikode, India
| | - Rema Devi
- Department of Microbiology, Dr. Somervell Memorial CSI Medical College and Hospital, Thiruvananthapuram, India
| | - Sujata Baveja
- Department of Microbiology, Lokmanya Tilak Municipal General Hospital and Medical College (Sion Hospital), Mumbai, India
| | - Sheela Devi
- Department of Microbiology, Pondicherry Institute of Medical Sciences, Kalapet, India
| | - Jayakumar S.
- Department of Microbiology, Saveetha Medical College and Hospital, Chennai, India
| | | | - Rudresh S. M.
- Department of Microbiology, ESI Post Graduate Institute of Medical Science and Research, Bengaluru, India
| | - Bineshlal Yesudhason
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, India
| | - Vignesh Shetty
- Department of Medicine, Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), University of Cambridge, Cambridge, United Kingdom
| | - Ankur Mutreja
- Department of Medicine, Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), University of Cambridge, Cambridge, United Kingdom
| | - Abi Manesh
- Department of Infectious Disease, Christian Medical College and Hospital, Vellore, India
| | - George M. Varghese
- Department of Infectious Disease, Christian Medical College and Hospital, Vellore, India
| | - Charis A. Marwick
- Population Health and Genomics, University of Dundee, Dundee, United Kingdom
| | | | - Ian H. Gilbert
- Division of Biological Chemistry and Drug Discovery, University of Dundee, Dundee, United Kingdom
| | - Balaji Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, India
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Elangovan D, Hussain SMS, Virudhunagar Muthuprakash S, Devi Periadurai N, Viswanath Nalankilli A, Volvoikar H, Ramani P, Sivasubramaniam J, Mohanram K, Surapaneni KM. Impact of COVID-19 Vaccination on Seroprevalence of SARS-CoV-2 among the Health Care Workers in a Tertiary Care Centre, South India. Vaccines (Basel) 2022; 10:vaccines10111967. [PMID: 36423062 PMCID: PMC9697367 DOI: 10.3390/vaccines10111967] [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: 10/07/2022] [Revised: 11/09/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022] Open
Abstract
Global vaccine development efforts have been accelerated in response to the devastating COVID-19 pandemic. The study aims to determine the seroprevalence of SARS-CoV-2 IgG antibodies among vaccine-naïve healthcare workers and to describe the impact of vaccination roll-out on COVID-19 antibody prevalence among the health care centers in tertiary care centers in South India. Serum samples collected from vaccinated and unvaccinated health care workers between January 2021 and April 2021were subjected to COVID-19 IgG ELISA, and adverse effects after the first and second dose of receiving the Covishield vaccine were recorded. The vaccinated group was followed for a COVID-19 breakthrough infection for a period of 6 months. Among the recruited HCW, 156 and 157 participants were from the vaccinated and unvaccinated group, respectively. The seroprevalence (COVID-19 IgG ELISA) among the vaccinated and unvaccinated Health Care Workers (HCW) was 91.7% and 38.2%, respectively, which is statistically significant. Systemic and local side-effects after Covishield vaccination occur at lower frequencies than reported in phase 3 trials. Since the COVID-19 vaccine rollout has commenced in our tertiary care hospital, seropositivity for COVID-19 IgG has risen dramatically and clearly shows trends in vaccine-induced antibodies among the health care workers.
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Affiliation(s)
- Divyaa Elangovan
- Department of Microbiology, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
| | - Shifa Meharaj Shaik Hussain
- Department of Microbiology, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
| | | | - Nanthini Devi Periadurai
- Department of Microbiology, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
- Department of Molecular Virology, Panimalar Medical College Hospital Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
| | - Ashok Viswanath Nalankilli
- Department of Microbiology, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
| | - Harshada Volvoikar
- Department of Microbiology, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
| | - Preethy Ramani
- Department of Microbiology, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
| | - Jayanthi Sivasubramaniam
- Department of Microbiology, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
| | - Kalyani Mohanram
- Department of Microbiology, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
| | - Krishna Mohan Surapaneni
- Department of Molecular Virology, Panimalar Medical College Hospital Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
- SMAART Population Health Informatics Intervention Center, Foundation of Healthcare Technologies Society, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
- Departments of Biochemistry, Medical Education, Research, Clinical Skills & Simulation, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai 600123, India
- Correspondence: or
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Gunasekaran K, Elangovan D, Perumalla S, Abhilash KPP, Prakash JAJ. Purpura Fulminans and Spotted Fever: A Case Series from South India. J Glob Infect Dis 2022; 14:162-164. [PMID: 36636298 PMCID: PMC9831211 DOI: 10.4103/jgid.jgid_297_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/03/2022] [Accepted: 06/03/2022] [Indexed: 12/12/2022] Open
Abstract
Purpura fulminans (PF) is associated with acute infections such as meningococcal, staphylococcal, streptococcal, and rickettsial infections. However, there are only a few reports of association of PF with rickettsial fever from India. In this case series of seven adults with PF, four were definitive cases of spotted fever as the ompA real-time polymerase chain reaction was positive. The other three adults were probable cases of spotted fever, as they were positive by immunoglobulin M enzyme-linked immunosorbent assay, and their fever subsided within 72 h of rickettsia-specific therapy. Three of the seven patients had peripheral gangrene. These patients, despite presenting with severe spotted fever, had a favorable outcome. This is attributed to the high index of suspicion and early treatment supported by diagnostic assays.
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Affiliation(s)
- Karthik Gunasekaran
- Department of Internal Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Divyaa Elangovan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Susmitha Perumalla
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Kundavaram Paul Prabhakar Abhilash
- Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India,Address for correspondence: Dr. Kundavaram Paul Prabhakar Abhilash, Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India. E-mail:
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Saravanan S, Kumar VV, Sarveshwaran V, Indirajithu A, Elangovan D, Allayear SM. Computational and Mathematical Methods in Medicine Glioma Brain Tumor Detection and Classification Using Convolutional Neural Network. Comput Math Methods Med 2022; 2022:4380901. [PMID: 36277002 PMCID: PMC9586767 DOI: 10.1155/2022/4380901] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/14/2022] [Accepted: 09/22/2022] [Indexed: 09/29/2023]
Abstract
The classification of the brain tumor image is playing a vital role in the medical image domain, and it directly assists the clinicians to understand the severity and to take an appropriate solution. The magnetic resonance imaging tool is used to analyze the brain tissues and to examine the different portion of brain circumstance. We propose the convolutional neural network database learning along with neighboring network limitation (CDBLNL) technique for brain tumor image classification in medical image processing domain. The proposed system architecture is constructed with multilayer-based metadata learning, and they have integrated with CNN layer to deliver the accurate information. The metadata-based vector encoding is used, and the type of coding estimation for extra dimension is known as sparse. In order to maintain the supervised data in terms of geometric format, the atoms of neighboring limitation are built based on a well-structured k-neighbored network. The resultant of the proposed system is considerably strong and subjective for classification. The proposed system used two different datasets, such as BRATS and REMBRANDT, and the proposed brain MRI classification technique outcome is more efficient than the other existing techniques.
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Affiliation(s)
- S. Saravanan
- Department of Computer Science and Engineering, Vel Tech Rangarajan Dr. Sagunthala R&D Institute of Science and Technology, Avadi, Chennai, India
| | - V. Vinoth Kumar
- Department of Computer Science and Engineering, Jain (Deemed to Be University), Bangalore, India
| | - Velliangiri Sarveshwaran
- Department of Computational Intelligence, SRM Institute of Science and Technology, Kattankulathur Campus, Chennai, India
| | - Alagiri Indirajithu
- School of Information Technology and Engineering, Vellore Institute of Technology, Vellore, 632014 Tamil Nadu, India
| | - D. Elangovan
- Department of Computer Science and Engineering, Panimalar Engineering College, Chennai, Tamil Nadu, India
| | - Shaikh Muhammad Allayear
- Department of Multimedia and Creative Technology, Daffodil International University, Daffodil Smart City, Khagan, Ashulia, Dhaka, Bangladesh
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Varghese R, Yesudhason BL, Vimala LR, Neeravi A, Anandhan K, Baskar P, Elangovan D, Manesh A, James P, Gupta R, Veeraraghavan B. Pneumococcal serotypes causing non-invasive pneumonia in adults from a South Indian tertiary care hospital and the impact of the newer conjugate vaccines. Access Microbiol 2022; 3:000258. [PMID: 35024548 PMCID: PMC8749137 DOI: 10.1099/acmi.0.000258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/28/2021] [Indexed: 11/24/2022] Open
Abstract
Background Streptococcus pneumoniae is the leading cause of community-acquired pneumonia (CAP) in adults. Ageing, chronic conditions and comorbidities are important risk factors for pneumococcal pneumonia. Purpose There is lack of data on the pneumococcal serotypes causing non-invasive pneumonia in India. This study aims to determine the prevalent pneumococcal serotypes causing non-invasive pneumonia, the associated comorbidities, and the coverage of both the available pneumococcal vaccines in India and conjugate vaccines that are currently undergoing clinical trials. Methods A total of 280 subjects (aged >16 years) who had clinical symptoms correlating with radiological findings for non-invasive bacteremic pneumonia and microbiological evidence of S. pneumoniae between 2018 and 2020 were included. The clinical, demographic, radiological and microbiological findings were retrieved from the Hospital Information System (HIS). Result The common serotypes in order of prevalence were 19F, 9V, 23F, 6B, 11A, 13, 34, 10A, 19A and 6A. The predominant non-vaccine serotypes were 13, 34, 35B, 31 and 16F. The associated radiological findings were pneumonic consolidation and multi-lobar involvement. Other coinfected bacterial pathogens included H. influenzae, S. aureus, K. pneumoniae and P. aeruginosa. Conclusion The pneumococcal vaccines: PCV10/GSK, PCV10/SII, PCV13, PCV15, PCV20 and PPSV23 provide an overall serotype coverage of 36, 41, 47, 48, 61 and 69 %, respectively of S. pneumoniae causing non-invasive pneumonia in South India. Increasing catch-up vaccination using PCV10(SII) in pre-school children could have a more significant impact on reducing pneumococcal pneumonia in adults (>50 years) in terms of increased herd immunity at an affordable cost.
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Affiliation(s)
- Rosemol Varghese
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | | | | | - Ayyanraj Neeravi
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Kavipriya Anandhan
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Pavithra Baskar
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Divyaa Elangovan
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Abi Manesh
- Department of Infectious Diseases, Christian Medical College, Vellore, India
| | - Prince James
- Department of Respiratory Medicine, Christian Medical College, Vellore, India
| | - Richa Gupta
- Department of Respiratory Medicine, Christian Medical College, Vellore, India
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Schmidt WP, Devamani CS, Elangovan D, Alexander N, Rose W, Prakash JAJ. Clinical characteristics of and antibody response to spotted fever group rickettsial infections in South India: Case series and serological cohort study. Trop Med Int Health 2021; 26:1616-1623. [PMID: 34597443 DOI: 10.1111/tmi.13682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The clinical and serological characteristics of spotted fever group rickettsial (SFGR) infections in South Asia are poorly understood. We studied the clinical presentation and the IgM/IgG response in cases enrolled at two health care centres in South India. METHOD We enrolled 77 patients. Fifty-seven of these patients were recruited at a tertiary care centre, the remaining 20 at a community hospital (secondary care level). Diagnostic tests included IgM and IgG enzyme-linked immunosorbent assay and polymerase chain reaction. Over a period of 1 year, 41 cases were followed up for repeated sero-analysis. RESULTS Median age was 9 years (range 1-79). A rash was present in 74% of cases (57/77). In cases aged <15 years, rash was present in 94% (44/47) vs. 43% (13/30) in cases aged ≥15 years. An eschar was found in two cases (3%). Severe infection or complications occurred in 10 cases (13%). These included central nervous system infection (6/77, 8%), kidney injury (3/77, 4%), shock (3/77, 4%), lung involvement (2/77, 3%) and peripheral gangrene (2/77, 3%). IgM antibody levels increased faster after fever onset than IgG antibodies, peaking at 50 and 60 days, respectively. After the peak, IgM and IgG levels showed a slow decline over one year with less than 50% of cases showing persistent IgG antibody levels. CONCLUSION Spotted fever group rickettsial infections in South India may be under-diagnosed, as many cases may not develop a rash. The proportion of cases developing severe infection seems lower than for scrub typhus in this region. IgG seroprevalence may substantially underestimate the proportion in a population with past SFGR infection.
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Affiliation(s)
- Wolf-Peter Schmidt
- Department of Emergency Medicine, Christian Medical College, Vellore, India.,Department for Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Carol S Devamani
- Rural Unit for Health & Social Affairs, Christian Medical College, Vellore, India
| | - Divyaa Elangovan
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - Neal Alexander
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Winsley Rose
- Department of Pediatrics and Pediatric Infectious Diseases, Christian Medical College, Vellore, India
| | - John A J Prakash
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
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Maurya VP, Elangovan D, Mourougayan V, Ranjini M. Severe Spinal Infection after Vertebral Fracture Stabilization: A Narrow Escape. Indian Journal of Neurotrauma 2020. [DOI: 10.1055/s-0040-1713307] [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: 10/23/2022]
Abstract
AbstractSpinal cord injury is typical following fall from height. The thoracolumbar vertebra undergoes maximum fracture following trauma. A 26-year-old man was brought to the emergency department with a history of fall from height. Clinical examination showed weakness in lower limbs with the inability to pass urine. Magnetic resonance imaging (MRI) of spine done elsewhere was suggestive of loss of second lumbar (L2) vertebral body height with compression over the lower end of the cord. Computed tomography (CT) scan of the spine revealed a burst fracture of L2 vertebra with bone fragments protruding into the spinal canal. The patient was taken up for spinal decompression with stabilization. His hospital stay was uneventful, and two weeks after discharge he was readmitted with wound bulge over the operative site. We started him on intravenous antibiotics and did regular debridement of the wound. Later on, he underwent wound closure with flap rotation.At last follow-up, he was ambulant with bladder and bowel control. During treatment, the titanium implants were left in situ. The decision for implant removal in early wound infection is at the discretion of the operating surgeon, along with the timing and nature of the disease.
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Affiliation(s)
- Ved Prakash Maurya
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Uttar Pradesh, India
| | - D. Elangovan
- Department of Neurosurgery, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - V. Mourougayan
- Department of Plastic Surgery, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - M. Ranjini
- Department of Neurosurgery, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
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Pragasam AK, Jennifer SL, Solaimalai D, Muthuirulandi Sethuvel DP, Rachel T, Elangovan D, Vasudevan K, Gunasekaran K, Veeraraghavan B. Expected plazomicin susceptibility in India based on the prevailing aminoglycoside resistance mechanisms in Gram-negative organisms derived from whole-genome sequencing. Indian J Med Microbiol 2020; 38:313-318. [PMID: 33154241 DOI: 10.4103/ijmm.ijmm_20_384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/04/2022]
Abstract
Background Aminoglycoside resistance is a growing challenge, and it is commonly mediated by the aminoglycoside-modifying enzymes (AMEs), followed by 16S rRNA methyl transferase. Plazomicin, a novel aminoglycoside agent approved by the Food and Drug Administration for complicated urinary tract infections is proven to overcome resistance mediated by AMEs but not due to 16S rRNA methyl transferase (16SRMTases). We undertook this study to predict the efficacy of plazomicin in India based on the antimicrobial resistance profile derived from whole-genome sequencing (WGS). Methodology A total of 386 clinical isolates of Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii subjected to WGS were screened for aminoglycoside-resistance mechanisms such as AMEs and 16SRMTases and its association with carbapenemases. Results AMEs was present in all E. coli, A. baumannii and in 90% of K. pneumoniae. In addition, up to 47% of E. coli and 38% of K. pneumoniae co-carried 16SRMTases with AMEs genes. However, A. baumannii showed 87% of isolates co-harbouring 16SRMTase. bla NDM, bla Oxa-48-like and bla Oxa-23-like were the most predominant carbapenemases in E. coli, K. pneumoniae and A. baumannii, respectively. Notably, 48% of NDM-producing E. coli and 35% of Oxa-48-like producing K. pneumoniae were identified to co-harbour AMEs + RMTAses, where plazomicin may not be useful. Conclusion Overall, 53%, 62% and 14% of carbapenemase-producing E. coli, K. pneumoniae and A. baumannii harbours only AMEs, indicating the role of plazomicin use. Plazomicin can be used both for ESBLs as "carbapenem-sparing agent" and carbapenemase producers as "colistin-sparing agent." For optimal use, it is essential to know the molecular epidemiology of resistance in a given geographical region where plazomicin empirical therapy is considered.
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Affiliation(s)
- Agila Kumari Pragasam
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - S Lydia Jennifer
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | | | - Tanya Rachel
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Divyaa Elangovan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Karthick Vasudevan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Karthick Gunasekaran
- Department of General Medicine (Unit.V), Christian Medical College, Vellore, Tamil Nadu, India
| | - Balaji Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
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Elangovan D, Perumalla S, Rose W, Verghese VP, Mammen J, Gowri MS, Jude Prakash JA. Assessment of two immunoassays for detection of IgM antibodies to scrub typhus using a serum panel. Indian J Med Microbiol 2019; 37:584-586. [PMID: 32436884 DOI: 10.4103/ijmm.ijmm_20_130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/04/2022]
Abstract
Laboratory tests are necessary for diagnosis of scrub typhus (ST) especially in the absence of the distinctive eschar. Performance of an ELISA and ICT (immunochromatography) to detect IgM antibodies to scrub typhus was assessed using a panel of 346 sera chosen from healthy individuals, those with scrub typhus and scrub-typhus like illness. A sensitivity of 98.7% for ST IgM ICT and 97.4% for ST IgM ELISA was observed while specificity was 96.3% for ICT and 95.9% for ELISA. As excellent concordance (98.8%) was noted between the two assays, IgM ICT can be used for rapid diagnosis of scrub typhus. Abbreviations: ST IgM ELISA: Scrub typhus IgM ELISA; ST IgM ICT: Scrub Typhus IgM Immunochromatography, Rapid diagnostic test: RDT.
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Affiliation(s)
- Divyaa Elangovan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Susmitha Perumalla
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Winsley Rose
- Department of Child Health-III, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Joy Mammen
- Department of Clinical Pathology, Christian Medical College, Vellore, Tamil Nadu, India
| | - M S Gowri
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
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11
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George R, Hariharan TD, Arunshankar A, Elangovan D, Lal B, Chandy VJ, Oommen AT, Poonnoose PM. Is it safe to do a single-stage implant exit and primary hip replacement? clinical and microbiological profiling. Indian J Med Microbiol 2019; 37:531-535. [PMID: 32436876 DOI: 10.4103/ijmm.ijmm_20_40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/04/2022]
Abstract
Background A single-stage implant revision for failed fixation of proximal femoral fractures is performed only when there is no evidence of infection. Else, a two-staged revision is preferred - where the definitive revision surgery is done a few months after the implant exit. This study aims to audit the safety and incidence of culture positivity in single-stage revisions. Materials and Methods Forty one of 284 patients that presented over the last 12 years for implant exchange of the hip, had a single stage revision surgery for failed fixation of a fracture of the hip, as there was no obvious evidence of infection at the time of implant exit. Results Micro-organisms were grown in 51% of the 41 hips. 76% were gram positive, of which 63% were Coagulase negative staphylococci (CoNS). 50% of CoNS and 75% of S. aureus were resistant to oxacillin, but susceptible to Vancomycin. Of the gram negative organisms, 2 (Enterobacter sp) were resistant to carbapenam, while others were susceptible. Preoperative ESR and CRP, individually, had low specificity - 50% for ESR >30mm at 1 hour and 62% for CRP>10. The combined use of ESR > 30mm and CRP>10 increased the specificity to 90%. 12% of the patients had immediate postoperative complications that required a wash out in theatre. The long term clinical follow up of these patients is limited. Conclusion This study suggests that implant exit and simultaneous arthroplasty for failed fracture fixation should be done with caution due to the high possibility of infection. It may be prudent to opt for a 2 stage revision.
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Affiliation(s)
- Rahul George
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India
| | - T D Hariharan
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India
| | - A Arunshankar
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Divyaa Elangovan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Binesh Lal
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - V J Chandy
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India
| | - A T Oommen
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India
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12
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Arunshankar A, Chandy VJ, Elangovan D, Hariharan TD, Jude Prakash JA, George R, Oommen AT, Poonnoose PM. Microbiological profile of infections of the hip joint: An Indian perspective. Indian J Med Microbiol 2019; 37:509-513. [PMID: 32436872 DOI: 10.4103/ijmm.ijmm_20_31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/01/2023]
Abstract
Background Knowledge of the local microbiological epidemiology helps in formulating protocols for appropriate treatment of hip infections. The aim of this study was to profile the organisms cultured from infected hips. Methods The microbiological profile and sensitivity pattern of organisms in eighty infected hips were reviewed. Results Infection was secondary to arthroplasty in 35, fracture surgery in 34 and primary septic arthritis in 11. Twenty percent of the infections were polymicrobial, whereas the rest were monomicrobial. Fifty-five percent were Gram-positive, of which 45% were Staphylococcus species (36% methicillin-sensitive Staphylococcus aureus, 20% methicillin-resistant S. aureus, and 44% coagulase sensitive Staphylococcal species). All Staphylococcus species were sensitive to vancomycin, but 20% of Enterococcus species were resistant to vancomycin. One-third of the Enterococcus species and 2% of Staphylococcus species were resistant to teicoplanin. Escherichia coli (n = 10) and Pseudomonas sp. (n = 13) were the most common Gram-negative organism. Although 18% of the Gram-negative organisms were carbapenem resistant, all were sensitive to colistin. Conclusion Staphylococcus sp. was the most common pathogen found in hip infections. However, the high incidence of Gram-negative infection requires that prophylactic antibiotics cover these organisms as well. The high resistance to first-line antibiotics should be taken into consideration while making protocols. The knowledge of the microbial profile is especially important when considering arthroplasty for arthritis secondary to hip infections.
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Affiliation(s)
- A Arunshankar
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India
| | - V J Chandy
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Divyaa Elangovan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - T D Hariharan
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Rahul George
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anil T Oommen
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pradeep M Poonnoose
- Department of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India
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13
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Muthuirulandi Sethuvel DP, Devanga Ragupathi NK, Bakthavatchalam YD, Vijayakumar S, Varghese R, Shankar C, Jacob JJ, Vasudevan K, Elangovan D, Balaji V. Current strategy for local- to global-level molecular epidemiological characterisation of global antimicrobial resistance surveillance system pathogens. Indian J Med Microbiol 2019; 37:147-162. [PMID: 31745014 DOI: 10.4103/ijmm.ijmm_19_396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/05/2023]
Abstract
The prime goal of molecular epidemiology is to identify the origin and evolution of pathogens, which can potentially influence the public health worldwide. Traditional methods provide limited information which is not sufficient for outbreak investigation and studying transmission dynamics. The recent advancement of next-generation sequencing had a major impact on molecular epidemiological studies. Currently, whole-genome sequencing (WGS) has become the gold standard typing method, especially for clinically significant pathogens. Here, we aimed to describe the application of appropriate molecular typing methods for global antimicrobial resistance surveillance system pathogens based on the level of discrimination and epidemiological settings. This shows that sequence-based methods such as multi-locus sequence typing (MLST) are widely used due to cost-effectiveness and database accessibility. However, WGS is the only method of choice for studying Escherichia coli and Shigella spp. WGS is shown to have higher discrimination than other methods in typing Klebsiella pneumoniae, Acinetobacter baumannii and Salmonella spp. due to its changing accessory genome content. For Gram positives such as Streptococcus pneumoniae, WGS would be preferable to understand the evolution of the strains. Similarly, for Staphylococcus aureus, combination of MLST, staphylococcal protein A or SCCmec typing along with WGS could be the choice for epidemiological typing of hospital- and community-acquired strains. This review highlights that combinations of different typing methods should be used to get complete information since no one standalone method is sufficient to study the varying genome diversity.
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Affiliation(s)
| | | | | | - Saranya Vijayakumar
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rosemol Varghese
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Chaitra Shankar
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Jobin John Jacob
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Karthick Vasudevan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Divyaa Elangovan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Veeraraghavan Balaji
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
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Pragasam AK, Anandan S, John J, Neeravi A, Narasimman V, Muthuirulandi Sethuvel DP, Elangovan D, Veeraraghavan B. An emerging threat of ceftriaxone-resistant non-typhoidal salmonella in South India: Incidence and molecular profile. Indian J Med Microbiol 2019; 37:198-202. [PMID: 31745019 DOI: 10.4103/ijmm.ijmm_19_300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/04/2022]
Abstract
Background Non-typhoidal Salmonella (NTS) infection is a serious public health problem globally. Although NTS infections are self-limited, antimicrobial therapy is recommended for severe infections and immunocompromised patients. Antimicrobial resistance (AMR) in these pathogens further limits its therapeutic options. Here, we report an incidence of ceftriaxone resistance in NTS over the past 9 years in a southern Indian region. Materials and Methods Molecular mechanisms of resistance in ceftriaxone-resistant NTS have been tested by both phenotypic and molecular methods. Minimum inhibitory concentration was determined by the E-test and broth microdilution method. AMR gene markers of β-lactamases such as AmpCs (blaMOX, blaCMY, blaDHA, blaFOX, blaACC and blaACT) and extended-spectrum β-lactamases (ESBLs) (blaSHV, blaTEM, blaVEB, blaPER, blaCTXM-1like,blaCTXM-2like, blaCTXM-8like, blaCTXM-9like and blaCTXM-25like) were screened. The presence of IncH12 and IncI1 plasmid was also analysed. Results The study reports a 5% prevalence of ceftriaxone resistance in NTS. The most common serogroup was Salmonella Group B followed by Salmonella Group E and Salmonella group C1/C2. The occurrence of blaCTX-M-1, blaTEM, blaCMY and blaSHV genes was observed in 54%, 54%, 48% and 3% of the isolates, respectively. Interestingly, few isolates carried dual resistance genes (ESBLs and AmpCs). IncH12 and IncI1 plasmid was identified in isolates carrying ESBL and AmpC genes, respectively. Conclusion This study shows that ceftriaxone resistance is mainly mediated by β-lactamases such as ESBL and AmpC. As the incidence of ceftriaxone resistance is rising gradually over the years, it is imperative to monitor the AMR in this species.
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Affiliation(s)
- Agila Kumari Pragasam
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Shalini Anandan
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - James John
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Ayyanraj Neeravi
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Vignesh Narasimman
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | | | - Divyaa Elangovan
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Balaji Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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15
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Sabu P, Elangovan D, Pragasam AK, Bakthavatchalam YD, Rodrigues C, Chitnis DS, Chaudhuri BN, Veeraraghavan B. Efficacy ratio: A tool to enhance optimal antimicrobial use for intra-abdominal infections. Indian J Pharmacol 2019; 50:332-335. [PMID: 30783326 PMCID: PMC6364343 DOI: 10.4103/ijp.ijp_264_18] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Antimicrobial resistance and inappropriate antibiotic regimen hamper a favorable outcome in intra-abdominal infections. Clinicians rely on the minimum inhibitory concentration (MIC) value to choose from the susceptible antimicrobials. However, the MIC values cannot be directly compared between the different antibiotics because their breakpoints are different. For that reason, efficacy ratio (ER), a ratio of susceptible MIC breakpoint and MIC of isolate, can be used to choose the most appropriate antimicrobial. MATERIALS AND METHODS A prospective, observational study conducted during 2015 and 2016 included 356 Escherichia coli and 158 Klebsiella spp. isolates obtained from the intra-abdominal specimens. MIC was determined by microbroth dilution method, and ER of each antibiotic was calculated for all the isolates. RESULTS For both E. coli and Klebsiella spp., ertapenem, amikacin, and piperacillin/tazobactam had the best activities among their respective antibiotic classes. DISCUSSION This is the first study calculating ER for deciding empiric treatment choices. ER also has a potential additional value in choosing the use of susceptible drugs as monotherapy or combination therapy. A shift in ERs over a period of time tracks rising MIC values and predicts antimicrobial resistance development. CONCLUSION Estimation of ER could be a meaningful addition for the interpretation of an antimicrobial susceptibility report, thus helping the physician to choose the best among susceptible antimicrobials for patient management.
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Affiliation(s)
- Priyanka Sabu
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Divyaa Elangovan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Agila Kumari Pragasam
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Camilla Rodrigues
- Department of Microbiology, PD Hinduja Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - D S Chitnis
- Department of Microbiology and Immunology, Choithram Hospital, Indore, Madhya Pradesh, India
| | | | - Balaji Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
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16
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Hariharan T, Joseph CM, Samuel S, Elangovan D, Livingston A, Ramasamy B, Nithyananth M, Jepegnanam T. Early Outcome of Culture-Negative Infection in Open Fractures of the Lower Limb: A Prospective Study. Indian J Med Microbiol 2019; 37:19-23. [DOI: 10.4103/ijmm.ijmm_19_143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Ambeth Kumar VD, Elangovan D, Gokul G, Praveen Samuel J, Ashok Kumar VD. Wireless sensing system for the welfare of sewer labourers. Healthc Technol Lett 2018; 5:107-112. [PMID: 30155261 PMCID: PMC6103782 DOI: 10.1049/htl.2017.0017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 12/16/2017] [Accepted: 01/09/2018] [Indexed: 11/19/2022] Open
Abstract
There is a growing demand for the environmental pollution monitoring and control systems. In the view of ever increasing sources of toxic chemicals, these systems should have the facilities to detect and calibrate the source quickly. Toxic gases are the ones that cause health impact but humans are being exposed to it in various situations. These gases have to be monitored such that increase in the normal level of them could be known and proper precaution measures can be undertaken. So, an embedded system is designed using a microcontroller with internet of things, for the purpose of detecting and monitoring the hazardous gas leakage, which aids in the evasion of endangering of human lives. The hazardous gases can be sensed and displayed each and every second, in proximity to one more sensor for tracking heart beats which help to monitor the condition of the sewer labourers. If both the gases along with a pulse detector exceeds the normal level then an alarm is generated immediately and also an alert warning message can be sent to the authorised administrator and as well to the nearest health center to make the sewer labourers feel comfortable with necessary first aid and possibilities with the treatment in the case of emergency. Once the message is received by the health center, they enforce their team with necessary first aid to the current location to save the sewer labourer. Once this system is established for a particular user this will completely become fully automated and does not need any other additional people for monitoring and alerting purpose. It has an advantage over the manual method in offering quick response time and accurate detection of an emergency.
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Affiliation(s)
- V D Ambeth Kumar
- Computer Science and Engineering, Panimalar Engineering College, Chennai, 600123, India
| | - D Elangovan
- Computer Science and Engineering, Panimalar Engineering College, Chennai, 600123, India
| | - G Gokul
- Electronics and Communication Engineering, Panimalar Engineering College, Chennai, 600123, India
| | - J Praveen Samuel
- Computer Science and Engineering, Panimalar Engineering College, Chennai, 600123, India
| | - V D Ashok Kumar
- Computer Science and Engineering, St. Peter's University, Chennai, 600054, India
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Manigandan D, Bharanidharan G, Aruna P, Devan K, Elangovan D, Patil V, Tamilarasan R, Vasanthan S, Ganesan S. Dosimetric characteristics of a MOSFET dosimeter for clinical electron beams. Phys Med 2009; 25:141-7. [PMID: 19128995 DOI: 10.1016/j.ejmp.2008.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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: 01/08/2008] [Revised: 09/24/2008] [Accepted: 11/13/2008] [Indexed: 10/21/2022] Open
Abstract
The fundamental dosimetric characteristics of commercially available metal oxide semiconductor field effect transistor (MOSFET) detectors were studied for clinical electron beam irradiations. MOSFET showed excellent linearity against doses measured using an ion chamber in the dose range of 20-630cGy. MOSFET reproducibility is better at high doses compared to low doses. The output factors measured with the MOSFET were within +/-3% when compared with those measured with a parallel plate chamber. From 4 to 12MeV, MOSFETs showed a large angular dependence in the tilt directions and less in the axial directions. MOSFETs do not show any dose-rate dependence between 100 and 600MU/min. However, MOSFETs have shown under-response when the dose per pulse of the beam is decreased. No measurable effect in MOSFET response was observed in the temperature range of 23-40 degrees C. The energy dependence of a MOSFET dosimeter was within +/-3.0% for 6-18MeV electron beams and 5.5% for 4MeV ones. This study shows that MOSFET detectors are suitable for dosimetry of electron beams in the energy range of 4-18MeV.
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Affiliation(s)
- D Manigandan
- Department of Physics, Anna University, Tamil Nadu, India
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19
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Karuppuswamy P, Sundararaj G, Elangovan D. Application of computerised maintenance management system coupled with risk management techniques for performance improvement of manufacturing systems. IJBPM 2007. [DOI: 10.1504/ijbpm.2007.011493] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Murthy KVR, Pallavi SP, Rahul G, Patel YS, Sai Prasad AS, Elangovan D. Thermoluminescence dosimetric characteristics of beta irradiated salt. Radiat Prot Dosimetry 2006; 119:350-2. [PMID: 16820400 DOI: 10.1093/rpd/nci568] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The thermoluminescence (TL) characteristics of sodium chloride (NaCl), known as common salt, used for cooking purposes (iodised salt), have been studied in the present paper considering its usage as an 'accidental dosemeter' in the case of a nuclear fallout. TL characteristics of common salt have been examined under excitation with a beta dose of 20 Gy from a 90Sr beta source. The salt specimens are used in the form of discs. The average salt grain that sticks to the disc is measured to be approximately 1 mg. The TL of the beta irradiated salt is recorded in the conventional TL apparatus. Initially three peaks were observed at 133, 205 and 238 degrees C. All three peaks are well resolved, having maximum intensity at 238 degrees C. The material under investigation, i.e. 'common salt' possesses many good dosimetric properties and therefore this can be considered as an 'accidental dosemeter'.
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Affiliation(s)
- K V R Murthy
- Display Materials Laboratory, Applied Physics Department, Faculty of Technology and Engineering, MS University of Baroda, Baroda 390 001, India.
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21
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Elangovan D, Subramanian S, Vasanthan S, Kushwah R, Shende S, Bansal V. SU-FF-T-20: Accuracy of Non-Coplanar Reconstruction of Shielded Colpostats in Intracavitary Brachytherapy. Med Phys 2005. [DOI: 10.1118/1.1997691] [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: 11/07/2022] Open
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22
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Elangovan D, Govindaraja K. Spinal tumour syndrome of tuberculous origin. Clin Neurol Neurosurg 1997. [DOI: 10.1016/s0303-8467(97)82104-x] [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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23
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Kanojia A, Mittal S, Kasliwal R, Omar A, Hsu TL, Ho SJ, Elangovan D, Sugeng L, Delabays A, Trehan N, Pandian N. Three-dimensional echocardiography is useful in the detailed assessment of valvular, subvalvular and annular morphology in rheumatic mitral valve disease-clinical experience in 130 cases. J Am Coll Cardiol 1996. [DOI: 10.1016/s0735-1097(96)82077-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Thanikachalam S, Ravindran G, Jayaraman G, Viswanathan TR, Elangovan D, Ranjan S, Lakshmikanthan C, Rajaram PC. Right ventricular volume estimation by single plane method--in vitro-cast study. Indian Heart J 1983; 35:218-23. [PMID: 6629401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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25
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Lakshmikanthan C, Alagesan R, Thanikachalam S, Ramamurthi B, Elangovan D, Viswanathan TR, Kumar S. Long term effects of yoga on hypertension and/or coronary artery disease. J Assoc Physicians India 1979; 27:1055-8. [PMID: 398852] [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: 12/15/2022]
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26
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Thanikachalam S, Rajaram PC, Namachivayam A, Elangovan D, Viswanathan TR, Lakshmikanthan C. Lymphatic drainage of the heart muscle and pericardial sac in the dog. Indian Heart J 1978; 30:287-92. [PMID: 730209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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