Training and Research Center

Delhi, India

Training and Research Center

Delhi, India
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Verma R.,AIIMS | Sood S.,AIIMS | Bala M.,Training and Research Center | Kapil A.,AIIMS | And 3 more authors.
Sexually Transmitted Infections | Year: 2010

Objectives: In the absence of a single nucleic acid amplification test (NAAT) that is both highly specific and sensitive for gonorrhoea, many have put forward the 16S-based assay as a confirmatory test for Neisseria gonorrhoeae. This study was undertaken to evaluate the performance of PCR based on 16S ribosomal gene in comparison with a porA pseudogene-based assay. Methods: The specificity of both the porA pseudogene-based PCR and 16S ribosomal gene PCR was checked against a panel of strains comprising of non N gonorrhoeae Neisseria sp (NgNS) and other gram-negative and gram-positive bacteria. The sensitivity studies were performed using different dilutions of N gonorrhoeae DNA. PCRs were also done on endocervical and urethral swab samples collected from a total of 100 female and 50 male patients presenting to sexually transmitted disease clinics, Dermatology OPD of AIIMS and Safdarjang Hospital, New Delhi, India, recruited as per inclusion criteria. Results: PCR assay based on 16S ribosomal gene showed cross-reactivity with three of six strains of N sicca. The porA pseudogene-based PCR was highly specific. Analytical sensitivity of 16S-based ribosomal assay was more than that of porA pseudogene-based assay. In clinical samples, for female patients, sensitivity, specificity, positive predictive value and negative predictive value of 16S ribosomal assay was 100% (95% CI 51.7% to 100%), 91.5% (95% CI 83.4% to 96%), 42.9% (95% CI 18.8% to 70.4%) and 100% (95% CI 94.7% to 100%), respectively, while for the male patients it was 100% (95% CI 85% to 100%), 95.5% (95% CI 75.1% to 99.8%), 96.6% (95% CI 80.4% to 99.8%) and 100% (95% CI 80.8% to 100%), respectively. Conclusions: The data presented in this report supports use of 16S ribosomal assay as a screening assay only. The porA pseudogene target is highly specific for N gonorrhoeae and may be used as a supplemental assay.


Verma R.,AIIMS | Sood S.,AIIMS | Bala M.,Training and Research Center | Mahajan N.,AIIMS | And 4 more authors.
Epidemiology and Infection | Year: 2012

Due to the poor positive predictive value of nucleic acid amplification tests (NAATs) for gonorrhoea when applied to a low-prevalence setting, current guidelines recommend the use of supplementary polymerase chain reaction (PCR) targeting a different gene for confirmation of true positives in urogenital specimens. This study sought to standardize and evaluate performance of an in-house opa gene-based PCR assay for gonorrhoea compared to assays targeting the porA pseudogene and 16S rRNA gene. Four hundred samples (300 endocervical, 100 urethral swabs) from patients attending STD clinics in New Delhi, India were used. The sensitivity, specificity, positive predictive value and negative predictive value of the opa-based PCR were 100%, 979%, 895% and 100%, respectively. In females, the use of NAATs provided enhanced diagnosis of gonorrhoea. © Copyright Cambridge University Press 2012.


Mukherjee A.,St James's Hospital | Sood S.,St James's Hospital | Bala M.,Training and Research Center | Satpathy G.,St James's Hospital | And 3 more authors.
Indian Journal of Medical Microbiology | Year: 2011

In the present pilot study, endocervical and urethral swabs collected from 100 patients attending sexually transmitted disease (STD) clinics and regional centre for STD in two referral hospitals in New Delhi were analyzed by enzyme immune assay (EIA), polymerase chain reaction (PCR) and direct fluorescent antibody (DFA) for detection of C. trachomatis. It was found that EIA could detect a very low number of cases (3/100) as against DFA (11/100) and PCR (9/100). Thus, in spite of the widespread availability, lower cost and ease of performance of the enzyme-linked-immunosorbent serologic assay, the present study highlights the need to employ sophisticated diagnostic tools like DFA and PCR for detection of Chlamydia trachomatis in STD patients.


Bala M.,Training and Research Center | Singh V.,Training and Research Center | Muralidhar S.,Training and Research Center | Ramesh V.,Training and Research Center
Indian Journal of Medical Microbiology | Year: 2013

In India, many state reference centres for sexually transmitted infections perform only a single screening assay for syphilis diagnosis. In this study, Treponema pallidum haemagglutination (TPHA) was performed on 1115 Venereal Disease Research Laboratory (VDRL)/rapid plasma regain (RPR) non-reactive and 107 reactive sera out of 10,489 tested by VDRL/RPR according to the National AIDS Control Organisation syphilis testing protocol. A total of 47 Specimens reactive in TPHA and non-reactive with VDRL test were subjected to fluorescent treponemal antibody absorption and enzyme-immunoassay. Seroprevalence considering both VDRL and TPHA positivity was highest (4.4%) in sexually transmitted diseases clinic attendees than in other subject groups. Positivity by two treponemal tests in 24 (2.2%) cases non-reactive by VDRL/RPR was representative of the fully treated patients or latent or late syphilis cases. The findings highlight that a suitable treponemal confirmatory test should be performed in all the diagnostic laboratories.


Singh S.,Banaras Hindu University | Singh S.,Training and Research Center | Sonkar G.K.,Banaras Hindu University | Singh U.,Banaras Hindu University | Singh U.,Training and Research Center
Journal of the Chinese Medical Association | Year: 2010

Coexistence of ankylosing spondylitis with connective tissue diseases is uncommon. We describe here the coexistence of ankylosing spondylitis and systemic lupus erythematosus in a 35-year-old man. He presented with a 4-year history of pain in the hip joint and lower spine, and he later developed a malar rash and discoid rash. Immunological tests revealed that antinuclear antibody and double stranded DNA antibody were positive. The human leukocyte antigen B27 antigen was also found to be positive. We propose that development of systemic lupus erythematosus in this case may have been due to low grade chronic inflammation. © 2010 Elsevier.


Verma R.,All India Institute of Medical Sciences | Sood S.,All India Institute of Medical Sciences | Singh R.,National Physical Laboratory India | Singh R.,Guru Gobind Singh Indraprastha University | And 7 more authors.
Diagnostic Microbiology and Infectious Disease | Year: 2014

Early diagnosis of gonococcal infections is important with regard to a patient's health and stage of infection. In this context, we report the development of an opa-gene-based electrochemical DNA biosensor for detection of Neisseria gonorrhoeae by monitoring redox peak of methylene blue indicator. The fabricated biosensor has been shown to be highly sensitive and specific when evaluated with complementary, non-complementary, and 1-base mismatch DNA sequences and polymerase chain reaction (PCR) amplified products (amplicons) of standard strain of N. gonorrhoeae (ATCC49226). The biosensor has been further evaluated using amplicons of known positive and negative clinical samples, and cut-off for positives has been determined using receiver operating characteristic curve. The sensitivity (SN), specificity (SP), positive predictive value, and negative predictive value of the biosensor have been found to be 96.2%, 88.2%, 92.6%, and 93.8%, respectively. We conclude that the combination of PCR amplification with electrochemical detection shows distinct advantage of high SN and increased SP for gonococcal detection. © 2014 Elsevier Inc.


Jahan S.,Research and Information Unit | Henary B.,Training and Research Center
Australian Journal of Primary Health | Year: 2013

Research in primary health care (PHC) is underdeveloped and scarce, especially in developing countries. It is important to understand the attitudes and aspirations of PHC physicians for the promotion of research. The aim of this study was to determine the attitudes of PHC physician managers toward research in Qassim province and to identify barriers that impede performing research in the PHC system. The study was based on social cognitive theory framework, and was pre-experimental with a 'one-group pre-test-post-test' design. The study participants were physician managers in PHC administration, Qassim. The participants' attitudes were measured by adapting statements from the Attitude Towards Research scale. The intervention was the 1-day training program 'Introduction to Research in Primary Health Care'. A total of 23 PHC physicians participated in the study. The mean age of the participants was 45.4 (±1.6) years, and the mean years of work experience was 16.2 (±2.2) years. Only one participant had an article published in a peer-reviewed journal. The results of the study showed that PHC physicians had a baseline positive attitude toward research that was further enhanced after participating in an introductory research-training program. During the pre-test, out of the total score of 63, the mean score on attitude toward research was 48.35 (±6.8) while the mean total attitude score in the post-test was 49.7 (±6.6). However, the difference was not statistically significant at P<0.05. The item with the highest score regarded the role of research in the improvement of health care services, while the lowest-scoring item was about support from administration to conduct research. The participants recognised lack of skills, lack of training and inadequate resources as major barriers in conducting research. Our study results suggest that the PHC physicians' positive attitudes toward research can be further improved through in-service training. To promote research in PHC in Qassim, regular research-training programs and incentives for conducting research should be provided to the PHC physicians. © La Trobe University 2013.


PubMed | Vardhman Mahavir Medical College and Safdarjang Hospital, University of Delhi and Training and Research Center
Type: Journal Article | Journal: Indian journal of sexually transmitted diseases | Year: 2014

Sexually experienced, unmarried adolescent women, usually commence sex, with marriage in mind. Initially, they resist sex but are unsuccessful due to lack of resilience to end an oppressive relationship, or convince their partners to postpone sex or use protection. To retain partners, they accept unprotected sex and suffer its consequences such as unwanted pregnancies, sexually transmitted diseases, HIV/AIDS and cervical cancer. Considerable numbers of adolescents face this emotional stress and suffer the consequences, while some manage to endure and emerge from the ordeal. This study attempts to determine this resilience and extrapolate it to others who might not be so successful without an intervention.The study compares sexual resilience in 100 unmarried adolescent abortion-seekers, in terms of time taken from meeting the partner, to sexual debut and correlates this with background factors such as age, education, family income, self-esteem, sexual knowledge, attitude toward pre-marital sex (PMS) and partner pressure.Mean debut age was 17.32 years. Partners took more initiative to form emotional (64%) and physical relationship (78%). Adolescent girls initiative reduced markedly from emotional (22%) to physical relation (5%). Correlation of sexual resilience with age, family income education and knowledge was not significant. It was significantly correlated with attitude toward PMS, self-esteem and partner pressure.It is desirable to improve self-esteem and attitude of young women to build negotiation skills in intimate relations. Counselors have to reorient the perspectives to improve attitude toward abstinence and increase self-esteem to resist pressure from partners.


PubMed | Training and Research Center, National Physical Laboratory India, All India Institute of Medical Sciences, Delhi Technological University and Guru Gobind Singh Indraprastha University
Type: Evaluation Studies | Journal: Diagnostic microbiology and infectious disease | Year: 2013

Early diagnosis of gonococcal infections is important with regard to a patients health and stage of infection. In this context, we report the development of an opa-gene-based electrochemical DNA biosensor for detection of Neisseria gonorrhoeae by monitoring redox peak of methylene blue indicator. The fabricated biosensor has been shown to be highly sensitive and specific when evaluated with complementary, non-complementary, and 1-base mismatch DNA sequences and polymerase chain reaction (PCR) amplified products (amplicons) of standard strain of N. gonorrhoeae (ATCC49226). The biosensor has been further evaluated using amplicons of known positive and negative clinical samples, and cut-off for positives has been determined using receiver operating characteristic curve. The sensitivity (SN), specificity (SP), positive predictive value, and negative predictive value of the biosensor have been found to be 96.2%, 88.2%, 92.6%, and 93.8%, respectively. We conclude that the combination of PCR amplification with electrochemical detection shows distinct advantage of high SN and increased SP for gonococcal detection.


PubMed | Training and Research Center
Type: | Journal: The Journal of the Association of Physicians of India | Year: 2013

Antiretroviral treatment (ART) programs from low-income countries utilizing standardized ART regimens, simplified approaches to clinical decision making and basic lab monitoring have reported high mortality rates. We determined the risk factors for mortality among HIV-infected adults following the initiation of ART from a single center in south India.ART-naive HIV-infected south Indian adults attending the Infectious Diseases clinic in a 2000-bed academic medical center in south India who were initiated on ART (generic, fixed-dose combinations) as per the national guidelines were followed up. Cases (32 patients who died) were compared with age and sex matched controls.Eight-hundred and twenty-two patients were started on ART from January 1, 2000 to December 31, 2008. The cumulative mortality was 6.8% (56/822). Among the cases mean age was 44 years, 18% were women and mean CD4 counts was 107 cells/microl. Among the controls mean age was 41 years, 18% were women and mean CD4 counts were 113 cells/microl. Stavudine based ART was predominant 62.5% in the cases vs 37.5% in the controls, followed by zidovudine based therapy in 31.2% of cases and 43.7% in the controls. Tenofovir based therapy was used in 6.2% of cases vs 18.7% in the controls. The commonest causes of death were drug toxicity 19%, advanced Acquired Immunodeficiency Syndrome (AIDS) in 37%, Immune Reconstitution Inflammatory Syndrome (IRIS) in 16%, non AIDS related deaths in 22% and malignancies 6%. In a univariate analysis, absolute lymphocyte count <1200 cells/cmm (p=0.03), development of immune reconstitution inflammatory syndrome (IRIS) (p=0.000) and mean CD4 cell count increase <75 cells/microl after 1 year of ART (p=0.001) were significantly associated with mortality.The mortality among our patients was comparable to that reported from other low-income countries. Earlier initiation of ART may reduce the high mortality rates observed.

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