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Gwalior, India
Gwalior, India
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Neeraja M.,Nizam's Institute of Medical Sciences | lakshmi V.,Nizam's Institute of Medical Sciences | Teja V.D.,Nizam's Institute of Medical Sciences | Lavanya V.,Nizam's Institute of Medical Sciences | And 7 more authors.
Archives of Virology | Year: 2014

Dengue is the most rapidly spreading mosquito-borne viral disease in the world, and as a larger proportion of the population is being affected, more unusual manifestations are being reported. Very few studies have documented unusual manifestations of dengue in South India. This prospective study was undertaken from July 2011 to June 2013 to document rare manifestations of dengue fever in 175 hospitalized patients. The clinical diagnosis was confirmed by the detection of NS1Ag, dengue IgM, or IgG by ELISA and/or a RT-PCR and CDC real-time PCR for dengue virus (DENV) RNA. The daily profiles of the hematological and biochemical investigations were followed and recorded. Unusual and rare manifestations of dengue were documented for 115 patients (66%). Hepatitis was observed in 70% of the cases. Pleural effusion was seen in 11%, acute renal failure in10 %, neurological complications such as encephalitis in 7.4%, myocarditis in 9%, and bleeding gastric ulcers in 3.4% of the cases. DENV serotype 2 was more prevalent in patients with unusual manifestations of dengue in our study. The WHO classification system does not include unusual and rare manifestations; hence, it is essential to be aware of these manifestations and closely monitor them for better clinical management and outcome of patients. © 2014 Springer-Verlag Wien.


Verma P.,All India Institute of Medical Sciences | Bhatnagar S.,All India Institute of Medical Sciences | Kumar P.,All India Institute of Medical Sciences | Chattree V.,All India Institute of Medical Sciences | And 4 more authors.
Clinical Chemistry and Laboratory Medicine | Year: 2014

Background: Many epidemic outbreaks of Chikungunya fever (CHIKF) have been reported throughout the world including India after its reemergence in 2005. The immuno protective role of envelope proteins during Chikungunya virus (CHIKV) infection has been reported. With the aim of identifying the immunodominant epitopes within the envelope protein we investigated the detailed analysis of fine specificity of antibody response in different individuals during CHIKV infection. Methods: The peptides corresponding to the full length of E1, E2 and E3 proteins of S27 strain of CHIKV were synthesized and their seroreactivity with CHIKV positive patients' sera collected from different epidemic regions of India was determined using indirect ELISA. Results: The data analysis reveals many potent epitopes throughout the length of envelope E2 protein thus displaying it as the most promising antigen for diagnostic purpose. We found that the main IgG isotype response to envelope protein was predominantly of subclass IgG3. Interestingly, most of the epitopes were found to be conserved for detecting IgM, IgG and IgG3 antibody response. Conclusions: Peptides E2P3, E2P7, E2P16 and E2P17 were revealed as the most immunodominant peptides that together can form the basis for designing an accurate, economical and easy to synthesize a peptide-based immunodiagnostic for CHIKV. This study provides new and important insight into the humoral response generated by CHIKV S27 strain during the early phase of infection.


Jha M.K.,KPC Medical College | Pal R.,Sikkim Manipal Institute of Medical science | Bhattacharrya P.,DRDE | Oberoi S.S.,Government Medical College | Garg A.,Gian Sagar Medical College
Journal of Punjab Academy of Forensic Medicine and Toxicology | Year: 2012

The concept of euthanasia is based on the philosophy of humanism and compassion. It recognizes the autonomy of an individual, freedom of choice to live or die with dignity. It is a very sensitive issue that polarized the world. Euthanasia is one of the most perplexing issues which the world faces today. Few developed countries have given nod to active euthanasia. India too has joined the club of euthanasia and can jubilate on Supreme Court's Judgment on March 07 2011. Nod was given to passive euthanasia in Aruna Ramchandra Shanbaug Vs Union Of India & Ors, date of j udgment 7/3/11 writ petition (Criminal) No 115 of 2009. For enhanced understanding of the issue two cases as reported in leading newspaper is selected and discussed, not forgetting the dictum 'We cannot add life to this world, so we have no right to take away any life'. © 2012 JPAFMAT. All rights reserved.


Bhatt P.,Command Hospital Southern Command | Tandel K.,DRDE | Singh A.,Armed Forces Medical College | Mugunthan M.,Armed Forces Medical College | And 2 more authors.
Medical Journal Armed Forces India | Year: 2016

Background: Coagulase-negative Staphylococci (CoNS), previously dismissed at contaminants, have now emerged as an important cause of nosocomial infections especially in patients with implants and prosthetic devices. They are a well-known cause of bloodstream infections, urinary tract infections, wound infections, prosthetic valve endocarditis and eye infections. This study was conducted with an aim to identify CoNS at the species level from various clinical samples and determine the antimicrobial resistance pattern of these isolates. Methods: This cross sectional study was carried out from September 2011 to February 2014 in which 150 non-repetitive clinical isolates of CoNS were identified at the species level by conventional phenotypic methods. Complete antimicrobial susceptibility profile was also determined by Kirby Bauer disc diffusion method. Susceptibility testing to vancomycin was done by E-test method. Results: Only three species of CoNS were isolated, the most common being Staphylococcu- sepidermidis (60%) followed by Staphylococcussaprophyticus (27.3%) and Staphylococcushemolyticus (12.7%). Most S. epidermidis were isolated from blood and intravascular catheter tip samples, whereas all S. saprophyticus were isolated from urine samples of female patients. All isolates were found to be resistant to penicillin, but were susceptible to glycopeptides and linezolid and showed variable resistance to fluoroquinolones, aminoglycosides and macrolides. Conclusion: CoNS are emerging nosocomial pathogens and should not always be overlooked as contaminants. However, growth of CoNS from blood cultures and intravascular catheter tips should be clinically correlated and carefully interpreted. As many CoNS strains exhibit drug resistance, antimicrobial susceptibility profile should be determined prior to treatment of these infections. © 2015 Published by Elsevier B.V. on behalf of Director General, Armed Forces Medical Services.


Neeraja M.,Nizam's Institute of Medical Sciences | Lakshmi V.,Drde | Dash P.K.,Drde | Parida M.M.,Drde | Rao P.V.L.,Drde
Journal of Clinical and Diagnostic Research | Year: 2013

Introduction: Dengue is an acute viral infection which presents as uneventful pyrexia to a fatal complication. This infection is increasingly being recognized as the world's major emerging tropical disease and an important public health problem. This article highlights the clinical manifestations of Dengue virus infection and the various molecular tests that were used for its laboratory diagnosis. Methods: Serum samples from 713 suspected cases of Dengue were collected between August and December 2007. The clinical profiles of 123 hospitalized patients were analyzed. Serology, RT- PCR, virus isolation and sequencing were done. Results: The most common clinical symptoms were fever, thrombocytopenia, rash and elevated liver enzymes. The demonstration of the Dengue RNA in 5.16% samples, the detection of Dengue specific IgM antibodies in 18% samples and the isolation of the DENV-4 and the DENV-3 viruses from the clinical samples confirmed this Dengue outbreak. A co-infection with Chikungunya was observed in 2.06% of the cases. The phylogenetic analysis revealed that the Indian Dengue-4 isolates from this outbreak belonged to the genotype I. This study clearly indicated the sudden dominance of DENV-4 in an Indian Dengue outbreak. Conclusion: The surveillance of the Dengue viruses needs to be closely monitored for the emergence of newer serotype(s) in hitherto unknown areas.

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