1
|
Bandyopadhyay K, Ray S, Shikha D, Bhalla GS, Khetan A. Risk factors of osteoporosis in soldiers of the Armed Forces: A cross-sectional study from Western India. Med J Armed Forces India 2023; 79:194-200. [PMID: 36969126 PMCID: PMC10037050 DOI: 10.1016/j.mjafi.2021.04.008] [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: 10/28/2020] [Accepted: 04/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background Osteoporosis may result from risk factors such as smoking, alcohol, low body mass index, less physical exercise, and dietary calcium deficiency. The risk of osteoporosis fractures can be reduced with lifestyle changes, which include diet, exercise, and preventing falls. The present study is an effort to measure the burden of risk factors of osteoporosis in adult male soldiers in the Armed Forces. Methods The present study was a cross-sectional study among serving soldiers in South-Western part of India, and 400 participants consented to be included in the study. After obtaining informed consent, the questionnaire was distributed. Venous blood samples were collected to measure serum calcium, phosphorus, vitamin D, and parathyroid hormone (PTH). Results The prevalence of vitamin D3 severe deficiency (<10 ng/mL) was 38.5%, and the prevalence of vitamin D3 deficiency (10-19 ng/mL) was 33%. Low serum calcium (<8.4 mg/dL) and serum phosphorus (<2.5 mg/dL) were found among 19.5% and 11.5%, respectively, whereas a raised serum PTH level (>66.5 pg/mL) was seen in 5.5% of the participants. A statistically significant association was found between consumption of milk and milk products and levels of calcium. With a cutoff value of 20 ng/mL for vitamin D3 deficiency, a statistically significant association was found for consumption of fish, physical activity, and sun exposure. Conclusion A remarkably large percentage of otherwise normal healthy soldiers have deficiency or insufficiency of vitamin D and might be prone to osteoporosis. Despite significant advances in our understanding and management options for male osteoporosis, there still remain important gaps in knowledge which needs to be looked into.
Collapse
Affiliation(s)
| | - Sougat Ray
- SSO (Health), HQ Western Naval Command, Mumbai, India
| | - Deep Shikha
- Graded Specialist (Surgery), Military Hospital Bhathinda, Punjab, India
| | | | | |
Collapse
|
2
|
Sharma T, Kumar R, Kalra JS, Singh S, Bhalla GS, Bhardwaj A. Galaxy ASIST: A web-based platform for mapping and assessment of global standards of antimicrobial susceptibility: A case study in Acinetobacter baumannii genomes. Front Microbiol 2023; 13:1041847. [PMID: 36817105 PMCID: PMC9933921 DOI: 10.3389/fmicb.2022.1041847] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 12/21/2022] [Indexed: 01/28/2023] Open
Abstract
Introduction Antimicrobial susceptibility testing (AST) is used to determine the susceptibility of an organism to antibiotics. The determination of susceptibility is based on MIC breakpoints and is provided by EUCAST and CLSI. Likewise, phenotypic classification criteria developed by CDC/ECDC are used for the classification of pathogens into susceptible, multidrug-resistant, extremely drug-resistant, or totally drug-resistant categories. Whole-genome sequencing (WGS)-based diagnosis is now supplementing existing gold-standard microbiology methods for rapid and more precise AST, and therefore, EUCAST recommended quality criteria to assess whole-genome sequence for reporting the same. In this study, these three global standards, MIC breakpoints, phenotypic classification, and genome quality, are applied to the largest publicly available data for Acinetobacter baumannii (AB), the most critical priority pathogen identified by WHO. Materials and Methods The drug sensitivity profile and genomes for isolates of AB were obtained from PATRIC and evaluated with respect to AST standards (CLSI and EUCAST). Whole genome quality assessment and antimicrobial resistance mapping is performed with QUAST and ABRicate, respectively. Four in-house methods are developed for mapping standards and are integrated into a Galaxy workflow based system, Galaxy-ASIST. Analysis of the extent of agreement between CLSI 2022 and EUCAST 2022 for antibiotics was carried out using Cohen's kappa statistics. Results and Discussion An automated pipeline, Galaxy-ASIST, is designed and developed for the characterization of clinical isolates based on these standards. Evaluation of over 6,500 AB strains using Galaxy-ASIST indicated that only 10% of the publicly available datasets have metadata to implement these standards. Furthermore, given that CLSI and EUCAST have different MIC breakpoints, discrepancies are observed in the classification of resistant and susceptible isolates following these standards. It is, therefore, imperative that platforms are developed that allow the evaluation of ever increasing phenotypic and genome sequence datasets for AST. Galaxy-ASIST offers a centralized repository and a structured metadata architecture to provide a single globally acceptable framework for AST profiling of clinical isolates based on global standards. The platform also offers subsequent fine mapping of antimicrobial-resistant determinants. Galaxy-ASIST is freely available at https://ab-openlab.csir.res.in/asist.
Collapse
Affiliation(s)
- Tina Sharma
- Bioinformatics Centre, CSIR-Institute of Microbial Technology, Chandigarh, India,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Rakesh Kumar
- Bioinformatics Centre, CSIR-Institute of Microbial Technology, Chandigarh, India,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | | | - Shreya Singh
- Bioinformatics Centre, CSIR-Institute of Microbial Technology, Chandigarh, India
| | | | - Anshu Bhardwaj
- Bioinformatics Centre, CSIR-Institute of Microbial Technology, Chandigarh, India,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India,*Correspondence: Anshu Bhardwaj, ✉
| |
Collapse
|
3
|
Moharir SC, Thota SC, Goel A, Thakur B, Tandel D, Reddy SM, Vodapalli A, Singh Bhalla G, Kumar D, Singh Naruka D, Kumar A, Tuli A, Suravaram S, Chander Bingi T, Srinivas M, Mesipogu R, Reddy K, Khosla S, Harshan KH, Bharadwaj Tallapaka K, Mishra RK. Detection of SARS-CoV-2 in the air in Indian hospitals and houses of COVID-19 patients. J Aerosol Sci 2022; 164:106002. [PMID: 35495416 PMCID: PMC9040488 DOI: 10.1016/j.jaerosci.2022.106002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/14/2022] [Accepted: 04/17/2022] [Indexed: 05/05/2023]
Abstract
To understand the transmission characteristics of severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) through air, samples from different locations occupied by coronavirus disease (COVID-19) patients were analyzed. Three sampling strategies were used to understand the presence of virus in the air in different environmental conditions. In the first strategy, which involved hospital settings, air samples were collected from several areas of hospitals like COVID-intensive-care units (ICUs), nurse-stations, COVID-wards, corridors, non-COVID-wards, personal protective equipment (PPE) doffing areas, COVID rooms, out-patient (OP) corridors, mortuary, COVID casualty areas, non-COVID ICUs and doctors' rooms. Out of the 80 air samples collected from 6 hospitals from two Indian cities- Hyderabad and Mohali, 30 samples showed the presence of SARS-CoV-2 nucleic acids. In the second sampling strategy, that involved indoor settings, one or more COVID-19 patients were asked to spend a short duration of time in a closed room. Out of 17 samples, 5 samples, including 4 samples collected after the departure of three symptomatic patients from the room, showed the presence of SARS-CoV-2 nucleic acids. In the third strategy, involving indoor settings, air samples were collected from rooms of houses of home-quarantined COVID-19 patients and it was observed that SARS-CoV-2 RNA could be detected in the air in the rooms occupied by COVID-19 patients but not in the other rooms of the houses. Taken together, we observed that the air around COVID-19 patients frequently showed the presence of SARS-CoV-2 RNA in both hospital and indoor residential settings and the positivity rate was higher when 2 or more COVID-19 patients occupied the room. In hospitals, SARS-CoV-2 RNA could be detected in ICUs as well as in non-ICUs, suggesting that the viral shedding happened irrespective of the severity of the infection. This study provides evidence for the viability of SARS-CoV-2 and its long-range transport through the air. Thus, airborne transmission could be a major mode of transmission for SARS-CoV-2 and appropriate precautions need to be followed to prevent the spread of infection through the air.
Collapse
Affiliation(s)
- Shivranjani C Moharir
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
- The Tata Institute for Genetics and Society, Bangalore, 560065, India
| | - Sharath Chandra Thota
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
| | - Arushi Goel
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | - Bhuwaneshwar Thakur
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | - Dixit Tandel
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
| | - S Mahesh Reddy
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
| | - Amareshwar Vodapalli
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
| | | | - Dinesh Kumar
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | | | - Ashwani Kumar
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | - Amit Tuli
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | | | | | - M Srinivas
- ESI Hospital and Medical College, Hyderabad, 500018, India
| | | | - Krishna Reddy
- Durgabai Deshmukh Hospital, Hyderabad, 500044, India
| | - Sanjeev Khosla
- CSIR- Institute of Microbial Technology (CSIR-IMTech), Chandigarh, 160036, India
| | - Krishnan H Harshan
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
| | | | - Rakesh K Mishra
- CSIR- Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad, 500007, India
- The Tata Institute for Genetics and Society, Bangalore, 560065, India
| |
Collapse
|
4
|
Singh Bhalla G, Grover N, Singh G, Kumar M, Bhatt P, Singh Sarao M, Mishra D. Prevalence of non tuberculous mycobacterial infection in surgical site infections and their antibiotic susceptibility profile. Med J Armed Forces India 2020; 77:343-348. [PMID: 34305289 DOI: 10.1016/j.mjafi.2020.01.012] [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: 11/27/2017] [Accepted: 01/23/2020] [Indexed: 10/24/2022] Open
Abstract
Background Surgical site infections (SSIs) are one of the leading causes of hospital-acquired infections contributing to about 20% of all cases, thereby causing an increase in morbidity and financial burden. Causative organisms associated with SSIs have not changed greatly over the last 10-15 years; however, the proportions of different types of causative organisms have changed with an increase in case reports of rare organisms such as non-tuberculous mycobacteria (NTM). Methods Samples received from patients with SSI were simultaneously cultured for the isolation of NTM along with routine bacteriological examination. On isolation of NTM, identification was carried out by biochemical tests, and further antibiotic susceptibility profile was determined by using RAPMYCO kit. Results SSI occurred in 3.95% of the 7675 surgeries performed during the study period of which 10.9% were caused owing to NTM. Only rapidly growing NTM were isolated of which, Mycobacterium fortuitum was the most common (51.51%) and had least resistance to drugs. Other isolates were Mycobacterium abscessus and Mycobacterium chelonae having high degree of antimicrobial resistance. Conclusion NTM are an important cause of SSI having delayed presentation, are difficult to diagnose and often not treated correctly. Identification and susceptibility testing is important as different species respond differently to antimicrobial agents.
Collapse
Affiliation(s)
| | - Naveen Grover
- Senior Advisor (Pathology & Microbiology), Army Hospital (R&R), New Delhi, India
| | - Gurpreet Singh
- PhD Scholar, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Mahadevan Kumar
- Professor (Microbiology), Bharati Vidyapeeth Medical College, Pune, 411043, India
| | - Puneet Bhatt
- PhD Scholar, Manipal Institute of Virology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Manbeer Singh Sarao
- Medical Officer, Medical Oncology, Fortis Hospital, Shalimar Bagh, New Delhi, India
| | - Deepshikha Mishra
- Graded Specialist (Surgery), Military Hospital (Bathinda), Punjab, India
| |
Collapse
|
5
|
Agarwal M, Bhalla GS, Sahai K. Pulmonary alveolar microlithiasis: Incidental finding - should we Ignore? Autops Case Rep 2019; 10:e2019133. [PMID: 32039063 PMCID: PMC6945305 DOI: 10.4322/acr.2019.133] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/15/2019] [Indexed: 12/29/2022] Open
Abstract
Pulmonary alveolar microlithiasis (PAM) is a rare entity, presenting mostly as an incidental finding. This disease has an autosomal recessive inheritance with inactivating mutations in the gene “solute carrier family 34 member 2”. The present study was conducted to bring attention to this rare though preventable disease. The study was a cross-sectional descriptive study, conducted at the Department of Pathology, of a tertiary care hospital in New Dehli-India. PAMs were incidentally seen in two patients diagnosed with micronodular hepatic cirrhosis leading to reanalysis of 212 autopsies, retrospectively. Statistical analysis was done using Stata 14.0. We observed three forms (Type A, B and C) of round hyaline bodies measuring in diameter with thin delicate, radiating fibrils. These bodies were PAS positive, showed black discolouration of the pigment with von Kossa stain and birefringence on polarized microscopy using Congo red stain, however the refringence was light green as compared to apple green birefringence seen with amyloid deposition. PAM has a slow progressive course leading to a high rate of incidental detection. Drugs known to inhibit the micro-crystal growth of hydroxyapatite may slow the disease progression. The family members of patients with PAM may also be kept on follow up with regular imaging. Key messages: It is important to bring out the incidental finding as, seemingly innocuous observations may provide valuable insight into incurable diseases, especially rare diseases.
Collapse
Affiliation(s)
- Manisha Agarwal
- Army hospital (R&R), Department of Laboratory Sciences. New Delhi. India
| | | | - Kavita Sahai
- Army hospital (R&R), Department of Laboratory Sciences. New Delhi. India
| |
Collapse
|
6
|
Bhalla GS, Bandyopadhyay K, Sahai K. Keeping in pace with the new Biomedical Waste Management Rules: What we need to know! Med J Armed Forces India 2019; 75:240-245. [PMID: 31388224 DOI: 10.1016/j.mjafi.2018.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 12/05/2018] [Indexed: 11/16/2022] Open
Abstract
Biomedical Waste Management Rules were first implemented in our country on 20th July 1998. Thereafter, the rules have undergone periodic updates and amendments in the years 2003 and 2011. Latest Biomedical Waste Management Rules, 2016, and (Amendment) Rules, 2018, were an update and simplification of BMW disposal as compared with the previous version, keeping in pace with the changes in the requirements of the health-care setup. Although exhaustive, numerous medical devices/products/kits did not find any mention even in the latest amendment of the rules. Thus, this article aims to bring out the key points to be known by all health-care workers and the gray areas which require clarification and inclusion in the rules for a completeness of the said rules.
Collapse
Affiliation(s)
- Gurpreet Singh Bhalla
- Graded Specialist (Microbiology), O I/C Biomedical Waste Management, Army Hospital (R&R), New Delhi, India
| | - Kuntal Bandyopadhyay
- Graded Specialist (Community Medicine) & Officer Commanding, SHO, Amritsar Cantt, India
| | - Kavita Sahai
- DDG (Pension), Office of DGAFMS, Ministry of Defence, New Delhi, India
| |
Collapse
|
7
|
Sommer RM, Bhalla GS, Jackson JM, Cohen MI. Hypoventilation caused by ventilator valve rupture. Anesth Analg 1988; 67:999-1001. [PMID: 3166605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- R M Sommer
- Department of Anesthesiology, New York University Medical Center, NY 10016
| | | | | | | |
Collapse
|