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Ramanathan K.,Unit 1 and Infectious Diseases | Mathai D.,Apollo Institute of Medical science and Research | Baruah K.,National Vector Borne Diseases Control Program
Indian Journal of Medical Microbiology | Year: 2013

Incidence of dengue is reported to be influenced by climatic factors. The objective of this study is to assess the association of local climate with dengue incidence, in two geographically distinct districts in Tamil Nadu. The study uses climate data, rainfall and mean maximum and minimum temperature to assess its association if any, with dengue incidence in two districts of Tamil Nadu, South India. According to this study while precipitation levels have an effect on dengue incidence in Tamil Nadu, non-climatic factors such as presence of breeding sites, vector control and surveillance are important issues that need to be addressed.


PubMed | Medical Center, Prince Aly Khan Hospital, Kalsekar Hospital, New Life Hospital and 11 more.
Type: Journal Article | Journal: Journal of global infectious diseases | Year: 2016

Respiratory tract infections are prevalent among Hajj pilgrims with pneumonia being a leading cause of hospitalization.


Daley P.,Memorial University of Newfoundland | Jagannathan V.,Christian Medical College | John K.R.,SRM University | Sarojini J.,Christian Medical College | And 7 more authors.
The Lancet Infectious Diseases | Year: 2015

Background: Vitamin D has immunomodulatory effects that might aid clearance of mycobacterial infection. We aimed to assess whether vitamin D supplementation would reduce time to sputum culture conversion in patients with active tuberculosis. Methods: We did this randomised, double-blind, placebo-controlled, superiority trial at 13 sites in India. Treatment-naive patients who were sputum-smear positive, HIV negative, and had pulmonary tuberculosis were randomly assigned (1:1), with centrally labelled, serially numbered bottles, to receive standard active tuberculosis treatment with either supplemental high-dose oral vitamin D3 (four doses of 2·5 mg at weeks 0, 2, 4, and 6) or placebo. Neither the patients nor the clinical and laboratory investigators and personnel were aware of treatment assignment. The primary efficacy outcome was time to sputum culture conversion. Analysis was by modified intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00366470. Findings: Between Jan 20, 2010, and Aug 23, 2011, we randomly assigned 247 participants to the vitamin D group (n=121) or the placebo group (n=126), of whom 211 participants (n=101 and n=110, respectively) were included in the primary efficacy analysis. Median time to culture conversion in the vitamin D group was 43·0 days (95% CI 33·3-52·8) versus 42·0 days (33·9-50·1) in the placebo group (log-rank p=0·95). Three (2%) patients died in the vitamin D group and one (1%) patient died in the placebo group; no death was considered attributable to the study intervention. No patients had hypercalcaemia. Interpretation: Our findings show that vitamin D supplementation did not reduce time to sputum culture conversion. Further studies should investigate the role of vitamin D in prevention or reactivation of tuberculosis infection. Funding: Dalhousie University and Infectious Diseases Training and Research Centre. © 2015 Elsevier Ltd.


PubMed | Apollo Institute of Medical science and Research and Freelance Biochemist
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Surveillance of anaemia is an ongoing process for assessing iron status and anaemia prevalence among individuals and the communities they live in. Measuring blood haemoglobin levels is the commonest method espoused worldwide for screening individuals and populations for anaemia and iron deficiency. World Health Organization (WHO) proposed a classification of public health significance of anaemia in populations on the basis of prevalence estimated from blood levels of haemoglobin. India falls under Severe public health problem category. An attempt has been made to categorise Severe public health problem into grades of severity that will help in prioritising the states and districts for targeted action.To adapt the WHO Classification of anaemia as a problem of public health significance and to use the same to identify and map high risk population groups in the southern states of India.The category of Severe Public Health Problem has been graded based on prevalence of anaemia. Secondary data published in the District Level Household and Facility Survey - 4 is analysed for five states and 1 UT (Union Territory) of southern part of India. Choropleth Mapping was done to visually depict the intensity of anaemia problem across the geographic territories.Children from 6 months to 59 months were having highest prevalence of both, anaemia (68%) and severe anaemia (10%). This was followed by pregnant women aged 15 to 49 years and Girl Child 6 to 9 years. Four of the Southern states of India including Andhra Pradesh, Karnataka, Telangana and Tamil Nadu fall in the Grade 2 SPHP (Severe Public Health Problem).The sixteen districts fall under Grade 3 Severe Public Health Problem in the states of Andhra Pradesh, Karnataka and Telangana, require special focus for identifying and addressing the determinants of such high prevalence of Anaemia. These populations and territories require priority in the Government of Indias Rashtriya Bal Swasthya Karyakram (RBSK) in the National Health Mission to address iron deficiency anaemia. The problem needs to be addressed through dietary diversification and improved access to foods that have high levels of bioavailable iron, including animal products apart from iron supplementation.


Aleksandrowicz L.,University of Toronto | Malhotra V.,University of Toronto | Dikshit R.,Tata Memorial Hospital | Gupta P.C.,Healis Sekhsaria Institute for Public Health | And 10 more authors.
BMC Medicine | Year: 2014

Background: Verbal autopsy (VA) has been proposed to determine the cause of death (COD) distributions in settings where most deaths occur without medical attention or certification. We develop performance criteria for VA-based COD systems and apply these to the Registrar General of India's ongoing, nationally-representative Indian Million Death Study (MDS).Methods: Performance criteria include a low ill-defined proportion of deaths before old age; reproducibility, including consistency of COD distributions with independent resampling; differences in COD distribution of hospital, home, urban or rural deaths; age-, sex- and time-specific plausibility of specific diseases; stability and repeatability of dual physician coding; and the ability of the mortality classification system to capture a wide range of conditions.Results: The introduction of the MDS in India reduced the proportion of ill-defined deaths before age 70 years from 13% to 4%. The cause-specific mortality fractions (CSMFs) at ages 5 to 69 years for independently resampled deaths and the MDS were very similar across 19 disease categories. By contrast, CSMFs at these ages differed between hospital and home deaths and between urban and rural deaths. Thus, reliance mostly on urban or hospital data can distort national estimates of CODs. Age-, sex- and time-specific patterns for various diseases were plausible. Initial physician agreement on COD occurred about two-thirds of the time. The MDS COD classification system was able to capture more eligible records than alternative classification systems. By these metrics, the Indian MDS performs well for deaths prior to age 70 years. The key implication for low- and middle-income countries where medical certification of death remains uncommon is to implement COD surveys that randomly sample all deaths, use simple but high-quality field work with built-in resampling, and use electronic rather than paper systems to expedite field work and coding.Conclusions: Simple criteria can evaluate the performance of VA-based COD systems. Despite the misclassification of VA, the MDS demonstrates that national surveys of CODs using VA are an order of magnitude better than the limited COD data previously available. © 2014 Aleksandrowicz et al.; licensee BioMed Central Ltd.


PubMed | Win Vision Eye Hospitals, Vasan Eye Care, Apollo Institute of Medical science and Research, GHR Micro Diagnostics and Medivision Eye and Health Care Center
Type: | Journal: Mycoses | Year: 2016

Fungal keratitis due to Schizophyllum commune is very rare. In this study, we report the clinical and microbiological profile of five patients with fungal keratitis due to S. commune. Direct microscopic examination of corneal scrapings from all five patients showed septate branching hyaline fungal filaments. Similarly, in all five patients Sabouraud dextrose agar (SDA) plates inoculated with corneal scrapings showed white, cottony colonies on the second day of incubation. Lactophenol cotton blue stained wet preparation of 7-day-old colonies on SDA revealed clamp connections and no spores. The fungus was identified by its characteristic clamp connections, fan-shaped bracket fruiting body with pinkish-grey longitudinally split-radiating gills. The phenotypic identification of one of the five isolates further conformed by ITS sequencing. Treatment outcome was available for two of the five patients; in these two patients, the keratitis resolved with topical natamycin.


Anuradha M.,Apollo Institute of Medical science and Research
Journal of Clinical and Diagnostic Research | Year: 2014

Leclercia adecarboxylata is usually isolated as a part of polymicrobial cultures in immunocompetent patients, and as a pure culture in immunocompromised persons. Although generally sensitive to most antibiotics, there are reports of resistant strains. Two case reports of L. adecarboxylata isolation in the lab in pure culture in immunocompetent persons are presented here, L adecarboxylata being isolated from a vaginal swab in the first case and from a gluteal abscess in the second case. Both the isolates were sensitive to most of the antibiotics tested. © 2014, Journal of Clinical and Diagnostic Research. All ights reseved.


Krishna Veni D.V.,Apollo Institute of Medical science and Research
International Journal of Pharma and Bio Sciences | Year: 2013

The study was undertaken to observe the gender based variation in serum bilirubin levels in neonatal Hyperbilirubinemia. A total of seventy nine healthy full term infants (50 females and 29 males) in age group of 1-7 days, who presented with visible nonhemolytic hyperbilirubinemia were analyzed. There was no significant difference in maternal age, gestational age, birth weight and perinatal age in between male and female infants. Total bilirubin levels were high both in female and male infants and there was no significant difference between them. But the direct bilirubin levels were significantly high in female infants compared to male infants during the neonatal period.


Sen S.,Apollo Institute of Medical science and Research | Bathini P.,Apollo Institute of Medical science and Research
Journal of Clinical and Diagnostic Research | Year: 2015

Introduction: Managing postoperative pain efficiently is one important therapeutic challenge in the hospitals. Combination use of analgesics is in vogue, where in drugs from the opioid and non-opioid group are given synergistically. The aim of this study is to audit the use of different analgesics on the first postoperative day. Effort has been made to look into the drug or drug combinations used and other factors associated with their use. Materials and Methods: Retrospective, cross sectional observational study was conducted over a period of 11 months in a tertiary care teaching hospital at Hyderabad with approval from institutional ethics committee. Medical records of 649 patients on the first postoperative day were analysed for analgesics by various indicators.Results: Average number of drugs per encounter was 4.23. Percentage of patients prescribed drugs from national essential drug list/WHO was 81.94%. Most common analgesic (monotherapy) prescribed was tramadol followed by diclofenac and the most common combination drugs prescribed were tramadol+Paracetamol. The most common route of administration was intravenous. All the drugs except piroxicam, were in the lower limit of the recommended daily dose. Conclusion: The present study gives an idea of the overall pattern of analgesic drug use in postoperative patients. The drug combinations used, the most common single use drug can be made out. The health professionals can be encouraged to prescribe by generic name and from the National List of Essential Medicines NLEMs. © 2015, Journal of Clinical and Diagnostic Research. All Rights Reserved.


PubMed | Apollo Institute of Medical science and Research
Type: | Journal: Case reports in pediatrics | Year: 2016

Tuberculous dactylitis is an unusual form of osteoarticular tuberculosis involving the short tubular bones of hands and feet, which is uncommon beyond six years of age. We report the case of a fifteen-year-old adolescent boy who was diagnosed with tuberculous dactylitis, involving contralateral hand and foot. His diagnosis was delayed due to lack of suspicion of this rare entity. The report also examines the diagnostic difficulties faced by clinicians in arriving at an appropriate diagnosis.

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