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Mehta N, Sharma A, Sindhuja T, Dudani P, Sahni K, Khanna N, Gupta S. Procedural dermatology and its unmet need. Indian J Dermatol Venereol Leprol 2023; 89:807-818. [PMID: 36688880 DOI: 10.25259/ijdvl_322_2022] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/01/2022] [Indexed: 12/16/2022]
Abstract
Procedural dermatology includes invasive conventional dermatologic surgeries which involve significant use of knife and suture, minimally invasive procedures and device-based procedures. Device-based procedures are the easiest to learn and are less prone to human errors due to automation but can lead to monotony, while conventional surgeries require significant skill, craftsmanship and interest. There has been a recent shift in the approach to procedural dermatology as a therapeutic option with complementary and combination models replacing the conventional hierarchical model in which procedures were last in the step-ladder approach. The demand for both conventional dermatologic surgeries and minimally invasive cosmetic procedures is increasing. Unfortunately, this demand has not been met with adequate supply. Consequently, the number of trained professionals with expertise in these procedures is very limited; they are far outnumbered by unqualified practitioners. A limited number of dermatologic surgeons practicing conventional surgeries has resulted in huge waiting lists for vitiligo surgeries, inappropriate excisions for skin cancers and poor cosmetic outcomes of excisions without proper knowledge of flaps and grafts. Increasingly procedures are being performed by inadequately trained personnel, resulting in complications. There is also an absence of good quality research on the subject of procedural dermatology, which has resulted in a lack of standardisation of various procedures and knowledge about the efficacy of various drug-procedure and procedure-procedure combinations. An increasing variety of gimmicky but costly procedures are being offered to the public without much evidence of efficacy. Individual institutional and broad policy directives are needed to address these issues. Special emphasis is required on formal hands-on procedural dermatology training during residency and beyond it.
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Affiliation(s)
- Nikhil Mehta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Ananya Sharma
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Tekumalla Sindhuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Pankhuri Dudani
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Kanika Sahni
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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2
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Mehta N, Thanneru S, Sikka K, Tyagi M, Khanna N. Acute ecchymotic facial swelling in a child. Int J Dermatol 2023; 62:1425-1427. [PMID: 37424106 DOI: 10.1111/ijd.16789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/24/2023] [Accepted: 06/26/2023] [Indexed: 07/11/2023]
Affiliation(s)
- Nikhil Mehta
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | | | - Kapil Sikka
- Department of Otorhinolaryngology, AIIMS, New Delhi, India
| | - Mehul Tyagi
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
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3
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Swarnkar B, Sharma A, Gupta V, Ramam M, Khanna N. Traditional versus e-learning during COVID-19 pandemic: An online survey on dermatology postgraduate teaching. Indian J Dermatol Venereol Leprol 2023; 0:1-3. [PMID: 38031676 DOI: 10.25259/ijdvl_1172_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 07/10/2023] [Indexed: 12/01/2023]
Affiliation(s)
| | | | - Vishal Gupta
- Department of Dermatology, AIIMS, New Delhi, India
| | - M Ramam
- Department of Dermatology, AIIMS, New Delhi, India
| | - Neena Khanna
- Department of Dermatology, Amrita Hospital, Faridabad, Haryana, India
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Rawre J, Khullar S, Gupta S, Khanna N, Dhawan B. Oropharyngeal Chlamydia in MSM attending STI clinic of India. Indian J Dermatol Venereol Leprol 2023; 0:1-2. [PMID: 37317741 DOI: 10.25259/ijdvl_1136_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/15/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Jyoti Rawre
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Swati Khullar
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Benu Dhawan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
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5
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Gupta S, Sharma V, Bhat B, Khanna G, Khanna N. Exploring the Unusual: A Case of Vulvar Crohn's Disease with Concomitant Leukocytoclastic Vasculitis. Indian J Dermatol Venereol Leprol 2023; 0:1-3. [PMID: 37317761 DOI: 10.25259/ijdvl_167_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/25/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Sachin Gupta
- Department of Dermatology, Amrita Institute of Medical Sciences and Research Centre, Faridabad, Haryana, India
| | - Vichitra Sharma
- Department of Dermatology, Amrita Institute of Medical Sciences and Research Centre, Faridabad, Haryana, India
| | - Bela Bhat
- Department of Dermatology, Amrita Institute of Medical Sciences and Research Centre, Faridabad, Haryana, India
| | - Gaurav Khanna
- Department of Pathology, Amrita Institute of Medical Sciences and Research Centre, Faridabad, Haryana, India
| | - Neena Khanna
- Department of Dermatology, Amrita Institute of Medical Sciences and Research Centre, Faridabad, Haryana, India
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Kumar R, Kumar Saini K, Rani R, . M, Khanna N, Mehta B. An Overview of Recent Advances in Hantzsch’s Multicomponent Synthesis of 1,4-
Dihydropyridines: A Class of Prominent Calcium Channel Blockers. CURR ORG CHEM 2023. [DOI: 10.2174/1385272827666230403112419] [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: 04/08/2023]
Abstract
Abstract:
Among all the heterocyclic scaffolds, 1,4-dihydropyridine (1,4-DHPs) is an important class of nitrogen-containing heterocyclic compounds possessing prominent therapeutic
effects, which play an essential role in pharmaceutical chemistry. Multicomponent reactions
(MCRs) have proven to be an invaluable tool for swiftly synthesizing large and structurally diverse molecules from simple starting materials. The chemists have discovered a large number
of new MCRs for the synthesis of 1,4-dihydropyridine. The synthesis of 1,4-Dihydropyridine
via multicomponent reaction is an efficient procedure in terms of delivering adequate structural
diversity, which is essential for the process of discovering new 1,4-DHPs compounds and their
therapeutics.1,4-dihydropyridines are well-known L-type calcium channel blockers. This review aims to study and summarize the recent developments in the multicomponent synthesis of
1,4-dihydropyridines and their fused analogs that act as potent antihypertensive drugs. The findings of this study
will prove to be an invaluable resource for researchers in the areas of heterocyclic chemistry, medicinal chemistry,
and drug design.
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Affiliation(s)
- Rakesh Kumar
- Department of Chemistry, University of Delhi, Delhi-110007, India
| | - Keshav Kumar Saini
- Department of Chemistry, University of Delhi, Delhi-110007, India
- Dyal Singh College, University of Delhi, Delhi-110003, India
| | - Rupal Rani
- Department of Chemistry, University of Delhi, Delhi-110007, India
| | - Muskan .
- Department of Chemistry, University of Delhi, Delhi-110007, India
| | - Neena Khanna
- Shivaji College, University of Delhi, Delhi-110027, India
| | - Bhupinder Mehta
- Swami Shraddhanand College, University of Delhi, Delhi-110036, India
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Tarique M, Naz H, Suhail M, Turan A, Saini C, Muhammad N, Shankar H, Zughaibi TA, Khan TH, Khanna N, Sharma A. Differential expression of programmed death 1 (PD-1) on various immune cells and its role in human leprosy. Front Immunol 2023; 14:1138145. [PMID: 37153623 PMCID: PMC10161389 DOI: 10.3389/fimmu.2023.1138145] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 01/05/2023] [Accepted: 03/14/2023] [Indexed: 05/10/2023] Open
Abstract
Leprosy is a chronic bacterial disease caused by Mycobacterium leprae. Leprosy patients have been found to have defects in T cells activation, which is critical to the clearance of the bacilli. Treg cell suppression is mediated by inhibitory cytokines such as IL10, IL-35 and TGF-β and its frequency is higher in leprosy patients. Activation and overexpression of programmed death 1 (PD-1) receptor is considered to one of the pathways to inhibit T-cell response in human leprosy. In the current study we address the effect of PD-1 on Tregs function and its immuno-suppressive function in leprosy patients. Flow cytometry was used to evaluate the expression of PD-1 and its ligands on various immune cells T cells, B cells, Tregs and monocytes. We observed higher expression of PD-1 on Tregs is associated with lower production of IL-10 in leprosy patients. PD-1 ligands on T cells, B cells, Tregs and monocytes found to be higher in the leprosy patients as compared to healthy controls. Furthermore, in vitro blocking of PD-1 restores the Tregs mediated suppression of Teff and increase secretion of immunosuppressive cytokine IL-10. Moreover, overexpression of PD-1 positively correlates with disease severity as well as Bacteriological Index (BI) among leprosy patients. Collectively, our data suggested that PD-1 overexpression on various immune cells is associated with disease severity in human leprosy. Manipulation and inhibition of PD-1 signaling pathway on Tregs alter and restore the Treg cell suppression activity in leprosy patients.
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Affiliation(s)
- Mohammad Tarique
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Huma Naz
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi, India
| | - Mohd Suhail
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ali Turan
- Department of Molecular Microbiology and Immunology, University of Missouri, Columbia, MO, United States
| | - Chaman Saini
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Naoshad Muhammad
- Department of Radiation Oncology, Washington University in Saint Louis, Saint Louis, MO, United States
| | - Hari Shankar
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Torki A. Zughaibi
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Tabish H. Khan
- Department of Pathology and Immunology, Washington University in Saint Louis, Saint Louis, MO, United States
| | - Neena Khanna
- Department of Dermatology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Alpana Sharma
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
- *Correspondence: Alpana Sharma,
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8
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Dhawan B, Khullar S, Rawre J, Gupta S, Khanna N. Prevalence of genital Chlamydia trachomatis at a Tertiary Care Hospital in North India: A 10-year observational study. Indian J Sex Transm Dis AIDS 2023; 44:104-105. [PMID: 37457530 PMCID: PMC10343125 DOI: 10.4103/ijstd.ijstd_111_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/11/2023] [Accepted: 03/01/2023] [Indexed: 07/18/2023] Open
Affiliation(s)
- Benu Dhawan
- Department of Microbiology All India Institute of Medical Sciences, New Delhi, India
| | - Swati Khullar
- Department of Microbiology All India Institute of Medical Sciences, New Delhi, India
| | - Jyoti Rawre
- Department of Microbiology All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Mehta N, Tyagi M, Khan I, Khanna N. Persistent Exaggerated Granulomatous Hypersensitivity Reaction to Mycobacterium indicus pranii Immunomodulatory Therapy for COVID-19 Sepsis. Indian J Dermatol 2023; 68:95-96. [PMID: 37151265 PMCID: PMC10162732 DOI: 10.4103/ijd.ijd_981_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Affiliation(s)
- Nikhil Mehta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India E-mail:
| | - Mehul Tyagi
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India E-mail:
| | - Iftekhar Khan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India E-mail:
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, Delhi, India E-mail:
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Bajpai J, Simha V, Anne S, Bhargava P, Srinivas S, Khanna N, Rekhi B, Noronha V, Patil V, Laskar S, Prabhash K, Gupta S, Banavali S. 431P Alveolar soft part sarcomas: A tertiary care Indian centre experience. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.462] [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: 12/05/2022] Open
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11
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Gulia A, Puri A, Kamath N, Thakur R, Laskar S, Bajpai J, Khanna N, Chinnaswamy G, Rekhi B. 436P Oncologic outcomes in patients with extraskeletal Ewing’s sarcoma (EES): A tertiary care centre experience. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.467] [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: 12/05/2022] Open
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12
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Bagal B, Goda Shastri J, Nayak L, Chatterjee A, Dasgupta A, Jain H, Thorat J, Sahay A, Epari S, Khanna N, Laskar S, Gupta T, Sengar M. 216P Lenalidomide maintenance after whole brain radiotherapy in relapsed/refractory primary CNS lymphoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.251] [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: 12/07/2022] Open
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13
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Criscuolo M, Salmanton-García J, Fracchiolla N, Dragonetti G, Khanna N, Weinbergerová B, Schönlein M, Machado M, Labrador J, Kolditz M, Itri F, Gomes da Silva M, Bonuomo V, Sciumè M, Nunes Rodrigues R, Gräfe S, Marchesi F, Cornely OA, Pagano L. SARS-CoV-2 Infection among Patients with Mastocytosis: An EPICOVIDEHA Report. J Investig Allergol Clin Immunol 2022:0. [PMID: 35894666 DOI: 10.18176/jiaci.0845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M Criscuolo
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - J Salmanton-García
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany University of Cologne, Faculty of Medicine and University Hospital Cologne, Colo
| | - N Fracchiolla
- Hematology Unit, Fondazione IRCCS Ca´ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Dragonetti
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - N Khanna
- Division of Infectious Diseases and Hospital Epidemiology, and Department of Clinical Research, University and University Hospital of Basel, Basel, Switzerland
| | - B Weinbergerová
- University Hospital Brno - Department of Internal Medicine, Hematology and Oncology, Brno, Czech Republic
| | - M Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Machado
- Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J Labrador
- Department of Hematology, Hospital Universitario de Burgos, Burgos, Spain
| | - M Kolditz
- University Hospital Dresden, Dresden, Germany
| | - F Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | | | - V Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - M Sciumè
- Hematology Unit, Fondazione IRCCS Ca´ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - S Gräfe
- Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany; University of Cologne
| | - F Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - O A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Cha
| | - L Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy; Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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Thangaraju S, Relan J, Sinha A, Arava SK, Khanna N, Raju SN. Vascular neoplasia masquerading as cellulitis and persistent hemorrhagic pericardial effusion. Ann Pediatr Cardiol 2022; 15:304-307. [PMID: 36589655 PMCID: PMC9802615 DOI: 10.4103/apc.apc_140_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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/18/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022] Open
Abstract
Tufted angioma and kaposiform hemangioendothelioma are considered to represent two ends of the spectrum of benign vascular neoplasms that predominantly present during infancy or early childhood. We report a rare case of a 5-month-old infant with complicated vascular neoplasm involving the pericardial cavity and skin over cervical region, masquerading as infective pericarditis with cellulitis. The patient responded dramatically to therapy with oral prednisolone and sirolimus, with a significant reduction of size of skin lesions and complete resolution of pericardial effusion over 8 weeks. The report also highlights the importance of a multidisciplinary team in managing such complicated cases.
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Affiliation(s)
- Sharan Thangaraju
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Jay Relan
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Aditi Sinha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sudheer Kumar Arava
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Sreenivasa Narayana Raju
- Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India
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Yadav D, Bhatia S, Ramam M, Singh V, Khanna N, Khandpur S, Gupta V. Patient perception and satisfaction with a smartphone-based teledermatology service initiated during the COVID-19 pandemic at a tertiary care hospital in North India. Indian J Dermatol Venereol Leprol 2022; 88:623-632. [PMID: 35389031 DOI: 10.25259/ijdvl_608_2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 06/01/2021] [Accepted: 11/01/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Telemedicine is being increasingly used to provide healthcare to patients, particularly during the COVID-19 pandemic. AIMS The study aimed to study patient perception and satisfaction with a smartphone-based hybrid teledermatology service initiated during the COVID-19 pandemic. METHODS This was a cross-sectional telephonic survey including patients ≥18 years of age who had received a teledermatology consultation. After noting the demographic, clinical and teleconsultation details, patients were administered the Telemedicine Satisfaction Questionnaire and an additional 6-item questionnaire. Patients were also asked to give qualitative feedback and suggestions for improvement using a semi-structured interview guide. RESULTS We interviewed 201 subjects. The most common diagnoses were pemphigus (27, 13.4%), superficial fungal infections (24, 11.8%), psoriasis (22, 10.9%) and dermatitis (21, 10.4%). The overall mean Telemedicine Satisfaction Questionnaire score was 4.20± 0.71. One hundred seventy-one (85.1%) patients responded that they would use teledermatology services again, while 168 (83.6%) reported satisfaction with the quality of services. A majority of the patients were largely satisfied with the various components involved, though some concerns were raised about the care perceived as not at par with physical consultations, difficulty in procuring medicines, lack of confidence in photographic diagnoses and the lack of a personal touch. Patients with urticaria (P=0.020), those who were advised a change in treatment (P=0.029) and those with improvement in their skin disease (P=0.026) were more likely to be satisfied. LIMITATIONS Our study was conducted during the COVID-19 pandemic when patient acceptability was likely to be higher. Only follow-up patients were included in the study. CONCLUSION Patient satisfaction levels were generally high with teledermatology. Addressing lacunae that negatively impact patient perception and satisfaction will help in greater acceptance of teledermatology services.
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Affiliation(s)
- Deepika Yadav
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Bhatia
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - M Ramam
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishwajeet Singh
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Sujay Khandpur
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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16
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Dhawan B, Raj JS, Rawre J, Dhawan N, Khanna N. Mycoplasma genitalium: A new superbug. Indian J Sex Transm Dis AIDS 2022; 43:1-12. [PMID: 35846530 PMCID: PMC9282694 DOI: 10.4103/ijstd.ijstd_103_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022] Open
Abstract
Mycoplasma genitalium (MG) is an emerging sexually transmitted pathogen. It is an important cause of nongonococcal urethritis in men and is associated with cervicitis and pelvic inflammatory disease in women, putting them at risk of infertility. Multiple factors that aid pathogenesis of MG include its ability of adhesion, gliding motility, and intracellular invasion by means of the tip organelle. Through intracellular localization and antigenic variation, MG could result in treatment-resistant chronic infection. There are limited data on the prevalence of MG in Indian patients with urogenital syndromes. Recently, a high prevalence of extra genital infection with MG has been reported. Molecular assays are the major diagnostic techniques of MG infection. Antimicrobial agents such as macrolides, along with fluoroquinolones, are the treatment of choice for MG infections. The issue of drug resistance to azithromycin and fluoroquinolones in MG is rising globally. As molecular tests are becoming available for MG, both for the diagnosis and the detection of antimicrobial resistance, any patient with MG infection should then be tested for antimicrobial resistance. Consideration of MG as a cause of sexually transmitted disease in the Indian population is crucial in diagnostic algorithms and treatment strategies. The purpose of this review is to understand the prevalence of MG in different clinical scenarios, molecular mechanisms of pathogenesis, current status of antimicrobial resistance, and its impact on MG treatment.
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Sangwan SK, Khanna N, Sharma N, Agarwal T, Sharma A, Vajpayee RB. Clinical, Biochemical, Genetic, and Therapeutic Profile of Patients with Epidermal Necrolysis: A Descriptive Study. Indian J Dermatol 2022; 67:479. [PMID: 36578727 PMCID: PMC9792050 DOI: 10.4103/ijd.ijd_1089_20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Epidermal necrolysis (SJS/TEN) is a rare but acute severe drug reaction associated with high morbidity and mortality rates. Aims To describe the clinical, molecular, biochemical, and therapeutic profile of these patients. Methods A total of 24 acute SJS/TEN patients were recruited during their hospital stay and detailed clinical history and treatment course recorded. Blood samples collected were subjected to DNA and serum separation for molecular and biochemical analysis. Results Of 24 patients, 18 (75%) were females and six (25%) were males with six SJS, six SJS-TEN overlap, and 12 TEN cases. The inciting drugs were non-steroidal anti-inflammatory (87.50%; n = 21) followed by antibiotics (66.67%; n = 16), antiepileptics (37.50%; n = 9), and others (37.50%; n = 9). Seventeen patients (77.2%) showed skin eruptions within 7 days after drug intake. Different co-morbidities were observed in 22 (91.6%) and 20 (83.3%) patients showed ocular manifestations. Length of hospital stay ranged from 8 to 55 days, 20 (83.3%) patients were treated with corticosteroids, and four (16.6%) received antimicrobial therapy. Interleukin polymorphisms revealed significantly low frequency of IL-4 in the patients, HLA-A locus typing revealed higher frequency of HLA-A*3301 (20.8%), HLA-A*02 (25%), HLA-A*2402 (14.6%), and sera showed raised levels of granulysin and sFas L in the patients compared to controls. Conclusions The preliminary study illustrates the clinical, molecular, and biochemical features of acute SJS/TEN and provides a better understanding that helps to improve patient care at an earlier stage. It also highlights the use of corticosteroids and antimicrobial therapy for effective treatment of patients.
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Affiliation(s)
- Sushil K. Sangwan
- From the Department of Anatomy, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermat ology and Venereology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tushar Agarwal
- Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Arundhati Sharma
- From the Department of Anatomy, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India,Address for correspondence: Prof. Arundhati Sharma, Laboratory of Cyto-Molecular Genetics, Department of Anatomy, All India Institute of Medical Sciences, New Delhi - 110 029, India. E-mail:
| | - Rasik B. Vajpayee
- Royal Victorian Eye and Ear Hospital, Melbourne, University of Melbourne, Vision Eye Institute, Melbourne, Australia
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Dhawan B, Ahmed J, Rawre J, Dhawan N, Dudani P, Khanna N. Genital ulcer disease: A review. J Family Med Prim Care 2022; 11:4255-4262. [PMID: 36352984 PMCID: PMC9638565 DOI: 10.4103/jfmpc.jfmpc_2111_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 02/11/2022] [Accepted: 02/17/2022] [Indexed: 11/04/2022] Open
Abstract
Genital ulcer disease (GUD) continues to be an important cause of morbidity and mortality worldwide. It is an important risk factor for the acquisition of HIV. GUD is mainly caused by five sexually transmitted infections. Three pathogens most frequently associated with GUD are herpes simplex virus 2 (HSV-2), Treponema pallidum, and Haemophilus ducreyi. Although their prevalence varies among different geographical regions, HSV-2 is the leading cause of this syndrome globally. In recent years, there has been an epidemiological transition of HSV-1 with a growing role of this virus as a causative agent of GUD. GUD may present with unique features depending on the etiological agent that can help clinicians identify the etiology and start treatment. However, owing to atypical presentations and co-infections, an accurate clinical diagnosis is often a challenge without confirmatory laboratory tests. Standard methods used to detect the causative pathogens of GUD have limitations. Molecular methods can provide a more sensitive and rapid microbiological diagnosis, with detection of the pathogen from the clinical sample directly. In situations where no laboratory support is available, the syndromic approach for management should be followed. The current scenario, clinical presentation (typical and atypical), laboratory diagnosis, and management of GUD will be discussed in this review. We searched PubMed literature and Google search engine using the terms "genital ulcer disease," "epidemiology of genital ulcer disease," and "clinical features of genital ulcer disease and atypical presentations" and relevant literature was selected to provide current perspectives of GUD.
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19
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Sangwan SK, Sharma N, Agarwal T, Khanna N, Pandey RM, Sharma A, Vajpayee RB. Chronic ocular sequelae in Stevens-Johnson syndrome: a genetic association study. Mol Vis 2022; 28:526-535. [PMID: 37089698 PMCID: PMC10115362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 12/29/2022] [Indexed: 04/25/2023] Open
Abstract
Purpose This study sought to investigate the association of molecular markers with chronic ocular sequelae in Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Methods One hundred SJS/TEN patients (200 eyes) with confirmed diagnosis were enrolled between July 2011 and July 2015 from a tertiary eye-care hospital, and their clinical histories were noted. Each eye was scored for severity of manifestation on a scale of 0-5. Peripheral blood samples were collected for DNA followed by screening for interleukin (IL-4, IL-13, IL-4R) polymorphisms, HLA-A locus allele typing, and sera to detect levels of the apoptotic markers granulysin and sFas L. Results Of the 100 enrolled patients (53 males/47 females; age range: 6-58 years), the incriminating drugs were non-steroidal anti-inflammatory (52%), antibiotics (10%), sulphonamides (8%), anti-epileptics (6%), and unknown (24%). Significant differences in the frequencies of IL-4R polymorphism, HLA-A*3301, HLA-A*02, and HLA-A*2402 alleles, and elevated levels of granulysin and sFas L were observed in patients compared to controls. The ocular complications of conjunctival keratinization (p=0.004) showed an association with IL-13 promoter region (IL-13a) genotypes. Conclusions The study highlights the possible association of interleukin-13 with severity-graded chronic sequelae and the role of HLA-A alleles- HLA-A*3301, HLA-A*02, and HLA-A*2402 in SJS/TEN causation and manifestation. Screening of these alleles may help caregivers to identify markers associated with severe and lifelong ocular complications, and help in appropriate treatment and management of the condition.
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Affiliation(s)
- Sushil K. Sangwan
- Laboratory of Cyto-Molecular Genetics, Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Cornea, Cataract & Refractive Surgery Services, Dr. R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tushar Agarwal
- Cornea, Cataract & Refractive Surgery Services, Dr. R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra M. Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Arundhati Sharma
- Laboratory of Cyto-Molecular Genetics, Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
| | - Rasik B. Vajpayee
- Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- University of Melbourne, Australia
- Vision Eye Institute, Melbourne, Australia
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20
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Shivakumar J, Parambil B, Prasad M, Gollamudi V, Ramadwar M, Qureshi S, Laskar S, Khanna N, Baheti A, Patil V, Shah S, Chinnasamy G. Clinical profile and outcome of adrenocortical in children: A single center retrospective study from India. Pediatric Hematology Oncology Journal 2022. [DOI: 10.1016/j.phoj.2022.10.121] [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: 11/27/2022] Open
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21
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Aggarwal A, Das CJ, Khanna N, Sharma R, Srivastava DN, Goyal V, Netaji A. Role of diffusion tensor imaging in the evaluation of ulnar nerve involvement in leprosy. Br J Radiol 2022; 95:20210290. [PMID: 34558292 PMCID: PMC8722232 DOI: 10.1259/bjr.20210290] [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: 01/03/2023] Open
Abstract
OBJECTIVE Early detection of peripheral neuropathy is extremely important as leprosy is one of the treatable causes of peripheral neuropathy. The study was undertaken to assess the role of diffusion tensor imaging (DTI) in ulnar neuropathy in leprosy patients. METHODS This was a case-control study including 38 patients (72 nerves) and 5 controls (10 nerves) done between January 2017 and June 2019. Skin biopsy proven cases of leprosy, having symptoms of ulnar neuropathy (proven on nerve conduction study) were included. MRI was performed on a 3 T MR system. Mean cross-sectional area, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of ulnar nerve at cubital tunnel were calculated. Additional ancillary findings and appearance of base sequences were evaluated. RESULTS Ulnar nerve showed thickening with altered T2W signal in all the affected nerves, having an average cross-sectional area of 0.26 cm2. Low FA with mean of 0.397 ± 0.19 and high ADC with mean of 1.28 ± 0.427 x 10 -3 mm2/s of ulnar nerve in retrocondylar groove was obtained. In the control group, mean cross-sectional area was 0.71cm2 with mean FA and ADC of 0.53 ± 0.088 and 1.03 ± 0.24 x 10 -3 mm2/s respectively. Statistically no significant difference was seen in diseased and control group. Cut-off to detect neuropathy for FA and ADC is 0.4835 and 1.1020 × 10 -3 mm2/s respectively. CONCLUSION DTI though is challenging in peripheral nerves, however, is proving to be a powerful complementary tool for assessment of peripheral neuropathy. Our study validates its utility in infective neuropathies. ADVANCES IN KNOWLEDGE 1. DTI is a potential complementary tool for detection of peripheral neuropathies and can be incorporated in standard MR neurography protocol.2. In leprosy-related ulnar neuropathy, altered signal intensity with thickening or abscess of the nerve is appreciated along with locoregional nodes and secondary denervation changes along with reduction of FA and rise in ADC value.3. Best cut-offs obtained in our study for FA and ADC are 0.4835 and 1.1020 × 10 -3 mm2/s respectively.
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Affiliation(s)
| | | | - Neena Khanna
- Department of Dermatology, AIIMS, New Delhi, India
| | - Raju Sharma
- Department of Radiology, AIIMS, New Delhi, India
| | | | - Vinay Goyal
- Department of Neurology, AIIMS, New Delhi, India
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22
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Sindhuja T, Ramam M, Khanna N, Bhari N. Assessment of Dermatology Residents During the Covid-19 Pandemic: A Single Institute Experience. Indian Dermatol Online J 2021; 12:933-935. [PMID: 34934741 PMCID: PMC8653715 DOI: 10.4103/idoj.idoj_79_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/06/2021] [Accepted: 02/14/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Tekumalla Sindhuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - M Ramam
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neetu Bhari
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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23
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Khullar S, Rawre J, Yadav D, Khanna N, Dhawan B. Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, and Ureaplasma spp. Coinfection in an HIV-Positive Homosexual Man. J Lab Physicians 2021; 13:380-383. [PMID: 34975260 PMCID: PMC8714406 DOI: 10.1055/s-0041-1731119] [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] [Indexed: 12/01/2022] Open
Abstract
A 21-year-old human immunodeficiency virus-positive male patient presented with complaints of multiple hyperpigmented verrucous papules over his perianal area. He reported having unprotected anal and oral sex with multiple male partners. On examination, superficial ill-defined perianal erosions were present. A first void urine sample and clinician-collected rectal and oropharyngeal swabs were sent for the detection of
Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis
, and
Ureaplasma
spp. Rectal swab tested positive for all the four pathogens. Oropharyngeal swab and urine samples tested positive for
C. trachomatis
. The patient was treated with doxycycline and moxifloxacin. This case underscores the importance of screening of men who have sex with men for possible coinfections with multiple sexually transmitted pathogens.
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Affiliation(s)
- Swati Khullar
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Jyoti Rawre
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepika Yadav
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Benu Dhawan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
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24
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McCall N, Eng T, Shelton J, Hanasoge S, Patel P, Patel A, McCook A, Switchenko J, Cole T, Khanna N, Han C, Gordon A, Starbuck K, Remick J. Severe Toxicity and Provider-Reported Subjective Symptoms in Patients With Vulvar Cancer Receiving Curative-Intent Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1686] [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: 10/20/2022]
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25
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Averbuch D, De Greef J, Duréault A, Wendel L, Tridello G, Lebeaux D, Mikulska M, Gil L, Knelange N, Zuckerman T, Roussel X, Robin C, Xhaard A, Aljurf M, Beguin Y, Le Bourgeois A, Botella-Garcia C, Khanna N, Van Praet J, Kröger N, Blijlevens N, Ducastelle Leprêtre S, Ho A, Roos-Weil D, Yeshurun M, Lortholary O, Fontanet A, de la Camara R, Coussement J, Maertens J, Styczynski J. Nocardia infections in hematopoietic cell transplant recipients: a multicenter international retrospective study of the Infectious Diseases Working Party (IDWP) of the European Society for Blood and Marrow Transplantation (EBMT). Clin Infect Dis 2021; 75:88-97. [PMID: 34596213 DOI: 10.1093/cid/ciab866] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 07/21/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nocardiosis is rare after hematopoietic cell transplantation (HCT). Little is known regarding its presentation, management, and outcome in this population. METHODS In this retrospective international study, we reviewed nocardiosis episodes in HCT recipients (01.01.2000-31.12.2018; 135 transplant centers; 33 countries) and described their clinical, microbiological, radiological, and outcome characteristics. RESULTS We identified 81 nocardiosis episodes in 74 allo- and 7 auto-HCT recipients. Nocardiosis occurred at a median of 8 (IQR 4-18) months post-HCT. The most frequently involved organs were lungs (70/81; 86%) and brain (30/81; 37%); 29 (36%) patients were afebrile; 46/81 (57%) had disseminated infections. The most common lung imaging findings were consolidations (33/68; 49%) or nodules (32/68; 47%); and brain imaging findings were multiple brain abscesses (19/30; 63%). 10/30 (33%) patients with brain involvement lacked neurological symptoms. 14/48 (29%) patients were bacteremic. N. farcinica was the most common among molecularly identified species (27%, 12/44). Highest susceptibility rates were reported to linezolid 45/45 (100%), amikacin 56/57 (98%), trimethoprim-sulfamethoxazole 57/63 (90%), and imipenem 49/57 (86%).One-year and last follow-up (IQR: 4-42.5 months) all-cause mortality were 40% (32/81) and 52% (42/81), respectively. In the multivariable analysis, underlying disease not in complete remission (HR 2.81, 95%CI 1.32-5.95), and prior bacterial infection (HR 3.42, 95%CI 1.62-7.22) were associated with higher one-year all-cause mortality. CONCLUSIONS Nocardiosis is a late post-HCT infection usually manifesting as a pulmonary disease with frequent dissemination, brain infection and bacteremia. Brain imaging should be performed in HCT recipients with nocardiosis regardless of neurological symptoms. Overall mortality is high.
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Affiliation(s)
- D Averbuch
- Pediatric Infectious Diseases Faculty of Medicine, Hebrew University of Jerusalem; Hadassah Medical Center, Jerusalem, Israel
| | - J De Greef
- Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Duréault
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Paris, France
| | - L Wendel
- EBMT Data Office, Leiden, Netherlands
| | - G Tridello
- Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - D Lebeaux
- Université de Paris, F-75006 Paris, France.,Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, Paris, France
| | - M Mikulska
- Division of Infectious Diseases, University of Genoa and Ospedale Policlinico San Martino, Genova, Italy
| | - L Gil
- University of Medical Sciences, Poznan, Poland
| | | | | | - X Roussel
- University hospital of Besançon, hematology department, Besançon, France
| | - C Robin
- Henri Mondor University Hospital, Creteil, France
| | - A Xhaard
- Hematology-transplantation, Hospital St-Louis, Paris Diderot University, Paris, France
| | - M Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Y Beguin
- CHU of Liège and University of Liège, Liège, Belgium
| | | | | | - N Khanna
- Division of Infectious Diseases and Hospital Epidemiology. University and University Hospital of Basel, Basel, Switzerland
| | - J Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - N Kröger
- Department of Stem Cell Transplantation, University Medical Center, Hamburg, Germany
| | - N Blijlevens
- Radboud university medical center, Nijmegen, The Netherlands
| | | | - A Ho
- Singapore General Hospital, Singapore, Singapore
| | - D Roos-Weil
- Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - M Yeshurun
- Institution of Hematology, Rabin medical Center, Petah Tikva, Israel and Sacker School of Medicine, Tel Aviv University, Israel
| | - O Lortholary
- Paris University, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, Necker Enfants malades University Hospital, Paris, France.,National Reference Center for Invasive Mycoses and Antifungals, Molecular Mycology Unit, CNRS UMR 2000, Institut Pasteur, Paris, France
| | - A Fontanet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Global Health Department, Paris, France.,PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| | | | - J Coussement
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.,National Centre for Infection in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Maertens
- Department of Haematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - J Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
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26
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Gupta V, Mohta P, Sharma VK, Khanna N. A retrospective case series of 12 patients with chronic reactive arthritis with emphasis on treatment outcome with biologics. Indian J Dermatol Venereol Leprol 2021; 87:227-234. [DOI: 10.4103/ijdvl.ijdvl_519_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 11/01/2018] [Indexed: 01/31/2023]
Abstract
Background:
Patients with reactive arthritis frequently present to dermatologists. However, there is paucity of information regarding its clinical aspects and management in dermatological literature.
Objective:
To review the clinical features and management of patients with chronic reactive arthritis admitted to the dermatology department of a teaching hospital.
Methods:
This was a retrospective analysis of patients with reactive arthritis admitted to the Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India from January 2016 to February 2018.
Results:
There were 12 males (disease duration 9–180 months). Biologics were used in 9 (75%) patients on 16 different occasions, the most frequent being infliximab (n = 10 times), followed by adalimumab (n = 3), etanercept, secukinumab and itolizumab (n = 1 each), in combination with other systemic agents. Response rate with treatment regimens including biologics (69% responders, 31% partial responders) was statistically significantly better than those without biologics (27% responders, 46% partial responders, 27% nonresponders; P = 0.036), using a composite measure assessing improvement in skin and joint symptoms. Biologics were discontinued on 50% of the occasions, after a median of 3.5 months (range 1.5–7.5 months) because of satisfactory response (n = 4), therapeutic fatigue (n = 3) or adverse event (n = 1). After biologic discontinuation, the response was sustained for a median of 5 months (range 3–6 months) before disease exacerbation. The number of treatment switches increased with the follow-up duration (median three switches per patient, range 1–8). The median follow-up duration was 10.5 months (range 4–76 months).
Conclusion:
Biologics produce rapid improvement in skin and joint symptoms in chronic reactive arthritis, but the response is not long-lasting. Patients with chronic reactive arthritis have a waxing and waning course despite regular treatment.
Limitations:
The limitations are retrospective design, small sample size and lack of a validated outcome measure.
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Miller RP, Farrugia L, Leask J, Khalsa K, Khanna N, Melia L. Successful treatment of Rhizopus arrhizus rhino-orbital-cerebral mucormycosis with isavuconazole salvage therapy following extensive debridement. Med Mycol Case Rep 2021; 32:39-42. [PMID: 33816097 PMCID: PMC8010354 DOI: 10.1016/j.mmcr.2021.03.005] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/02/2021] [Accepted: 03/06/2021] [Indexed: 12/29/2022] Open
Abstract
A 61-year old lady with poorly-controlled type 2 diabetes mellitus was diagnosed with rhino-orbital-cerebral mucormycosis following presentation with sinusitis, ophthalmoplegia, proptosis and facial numbness. She was treated successfully with aggressive surgical intervention including orbital exenteration, accompanied by anti-fungal therapy with liposomal amphotericin B and posaconazole, followed by isavuconazole as salvage therapy. We discuss the challenges around optimising antifungal therapy of this lethal infection in the context of hepatic and renal toxicity.
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Affiliation(s)
- R P Miller
- Department of Ear, Nose & Throat (ENT) Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - L Farrugia
- Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK
| | - J Leask
- Depatment of Urology, Queen Elizabeth University Hospital, Glasgow, UK
| | - K Khalsa
- Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK
| | - N Khanna
- Department of Microbiology, Queen Elizabeth University Hospital, Glasgow, UK
| | - L Melia
- Department of Ear, Nose & Throat (ENT) Surgery, Queen Elizabeth University Hospital, Glasgow, UK
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28
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Sey M, Siddiqi O, McDonald C, cocco S, Hindi Z, Rahman H, Chakraborti D, French K, Alsager M, Blier M, makandey B, Al-obaid S, Wong A, Siebring V, Brahmania M, Gregor JC, Khanna N, Teriaky A, Wilson A, Guizzetti L, Yan B, Jairath V. A113 ANNUAL COLONOSCOPY VOLUME IS NOT PREDICTIVE OF COLONOSCOPY QUALITY - FINDINGS FROM THE SOUTHWEST ONTARIO COLONOSCOPY COHORT. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.111] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Performing a minimum number of colonoscopies annually has been proposed by some jurisdictions as a requirement for maintaining privileges. However, this practice is supported by limited evidence.
Aims
The objective of this study was to determine if annual colonoscopy volume was associated with colonoscopy quality metrics.
Methods
A population-based study was performed using the Southwest Ontario Colonoscopy cohort, which consists of all adult patients who underwent colonoscopy between April 2017 and Oct 2018 at 21 academic and community hospitals within the health region. Data were collected through a mandatory quality assurance form completed after each procedure and pathology reports were manually reviewed. Physician annualized colonoscopy volumes were compared by correlation analysis to each quality-related outcome, by means of the area under the receiver operating characteristics curve (AUROC), and logistic regression. The prognostic value of colonoscopy volume was also adjusted for case-mix and potential confounders in separate regression analyses for each outcome. The primary outcome was ADR. Secondary outcomes were polyp detection rate (PDR), sessile serrated polyp detection rate (SSPDR), and cecal intubation.
Results
A total of 47,195 colonoscopies were performed by 75 physicians (37.5% by gastroenterologists, 60% by general surgeons, 2.5% others). There were no clear relationships between annual colonoscopy volumes and study outcomes. Colonoscopy volume was not associated with ADR (OR 1.03, 95% CI 0.96–1.10, p=0.48) and corresponded to an AUROC not significantly different from the null (AUROC 0.52, 95% CI 0.43–0.61, p=0.65). Multi-variable regression adjusting for case-mix also demonstrated no predictive value of annual colonoscopy volume for the primary outcome (OR 1.03, 95% CI 0.94–1.12, p=0.55). Similarly, analyses of secondary outcomes failed to find an association between colonoscopy volume and PDR, SSPDR, or cecal intubation (Table 1).
Conclusions
Annual colonoscopy volumes do not predict ADR, PDR, SSPDR, or cecal intubation rate.
Results of unconditional and conditional approaches for examining the predictive value of annual colonoscopy volume for quality related outcomes.
Funding Agencies
None
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Affiliation(s)
- M Sey
- Western University, London, ON, Canada
| | - O Siddiqi
- SOM, Royal College of Surgeons in Ireland and Medical University of Bahrain, London, ON, Canada
| | - C McDonald
- Lawson Health Research Institute, London, ON, Canada
| | - S cocco
- Western University, London, ON, Canada
| | - Z Hindi
- Western University, London, ON, Canada
| | - H Rahman
- Western University, London, ON, Canada
| | | | - K French
- Western University, London, ON, Canada
| | - M Alsager
- Western University, London, ON, Canada
| | - M Blier
- Western University, London, ON, Canada
| | - b makandey
- Queen’s University, Kingston, ON, Canada
| | | | - A Wong
- Western University, London, ON, Canada
| | | | | | | | - N Khanna
- Western University, London, ON, Canada
| | - A Teriaky
- Western University, London, ON, Canada
| | - A Wilson
- Western University, London, ON, Canada
| | | | - B Yan
- Medicine, Gastroenterology, Western University, London, ON, Canada
| | - V Jairath
- Medicine, Western University, London, ON, Canada
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Sey M, Yan B, Hindi Z, Brahmania M, Gregor JC, Jairath V, Wilson A, Khanna N, McDonald C, cocco S, Chakraborti D, French K, ALasseger M, Siddiqi O, Blier M, makandey B, Al-obaid S, wong A, Siebring V, Brackstone M, Teriaky A, Vinden C, Guizzetti L. A117 PROPOFOL SEDATION DOES NOT IMPROVE MEASURES OF COLONOSCOPY QUALITY – FINDINGS FROM THE SOUTHWEST ONTARIO COLONOSCOPY COHORT. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.115] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The use of propofol during colonoscopy has gained increased popularity due to deeper anesthesia compared to conscious sedation. Prior studies examining the use of propofol sedation during colonoscopy have primarily focused on anesthesia outcomes. Whether propofol sedation is associated with improvements in colonoscopy outcomes is uncertain.
Aims
The primary outcome was adenoma detection rate (ADR). Secondary outcomes were the detection of any adenoma (conventional adenoma, sessile serrated polyp, and traditional serrated adenoma), sessile serrated polyp detection rate, polyp detection rate, cecal intubation rate, and perforation rate.
Methods
The Southwest Ontario Colonoscopy cohort consists of all patients who underwent colonoscopy between April 2017 and Oct 2018 at 21 hospitals serving a large geographic area in Southwest Ontario. Procedures performed in patients less than 18 years of age or by endoscopist who perform <50 colonoscopies/year were excluded. Data were collected through a mandatory quality assurance form that was completed by the endoscopist after each procedure. Pathology reports were manually reviewed.
Results
A total of 46,634 colonoscopies were performed by 75 physicians (37.5% by gastroenterologists, 60% by general surgeons, 2.5% others) of which 16,408 (35.2%) received propofol and 30,226 (64.8%) received conscious sedation (e.g. combination of a benzodiazepine and a narcotic). Patients who received propofol were likely to have a screening indication (49.2% vs 45.5%, p<0.0001), not have a trainee endoscopist present and be performed at a non-academic centre (32.2% vs 44.6%, p<0.0001). Compared to conscious sedation, use of propofol was associated with a lower ADR (24.6% vs. 27.0%, p<0.0001) and detection of any adenoma (27.7% vs. 29.8%, p<0.0001); no difference was observed in the detection ofsessile serrated polyps (5.0% vs. 4.7%, p=0.26), polyp detection rate (41.2% vs 41.2%, p=0.978), cecal intubation rate (97.1% vs. 96.8%, p=0.15) or perforation rate (0.04% vs. 0.06%,p=0.45). On multi-variable analysis, the use of propofol was not significantly associated with any improvement in ADR (RR=0.90, 95% CI 0.74–1.10, p=0.30), detection of any adenoma (RR=0.93, 95% CI 0.75–1.14, p=0.47), sessile serrated polyp detection rate (RR=1.20, 95%CI 0.90–1.60, p=0.22), polyp detection rate (RR=1.00, 95% CI 0.90–1.11, p=0.99), or cecal intubation rate (RR=1.00, 95%CI 0.80–1.26, p=0.99).
Conclusions
The use of propofol sedation does not improve colonoscopy quality metrics.
Funding Agencies
None
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Affiliation(s)
- M Sey
- Western University, London, ON, Canada
| | - B Yan
- Medicine, Gastroenterology, Western University, London, ON, Canada
| | - Z Hindi
- Department of Medicine, University of Western Ontario, London, ON, Canada
| | - M Brahmania
- Gastroenterology, University of Toronto, Toronto, ON, Canada
| | - J C Gregor
- Medicine, Los Alamos National Laboratory, London, ON, Canada
| | - V Jairath
- Medicine, Western University, London, ON, Canada
| | - A Wilson
- Gastroenterology, University of Western Ontario, London, ON, Canada
| | - N Khanna
- Western University, London, ON, Canada
| | - C McDonald
- Medicine, Gastroenterology, Western University, London, ON, Canada
| | - S cocco
- Western University, London, ON, Canada
| | | | - K French
- Western University, London, ON, Canada
| | | | - O Siddiqi
- Western University, London, ON, Canada
| | - M Blier
- Western University, London, ON, Canada
| | | | | | - A wong
- Western University, London, ON, Canada
| | | | | | - A Teriaky
- Western University, London, ON, Canada
| | - C Vinden
- Western University, London, ON, Canada
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30
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Crowe K, White B, Khanna N, Cooke B, Kingsmore DB, Jackson A, Stevenson KS, Kasthuri R, Thomson PC. Epidemiology of bloodstream infections in a Scottish haemodialysis population with focus on vascular access method. J Hosp Infect 2021; 110:37-44. [PMID: 33484781 DOI: 10.1016/j.jhin.2021.01.008] [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: 08/29/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Infection is the second highest cause of mortality in end-stage renal disease, with a significant proportion relating to haemodialysis (HD) vascular access-related infection (VARI). AIM To report the rate and antimicrobial resistance (AMR) of all-source bloodstream infections (BSIs) by vascular access type in a Scottish HD cohort. METHODS Retrospective analysis was undertaken of data on adult patients attending seven HD units during 2017. Total HD days for each vascular access type were calculated. BSIs were analysed with rates expressed per 1000 HD days. AMR was verified using health board microbiology databases. FINDINGS Excluding contaminant organisms, there was an overall BSI rate of 0.57 per 1000 HD days. The highest all-source and vascular access-related infection (VARI) BSI rates per 1000 HD days were in the non-tunnelled central venous catheter (CVC) group (3.11 and 2.07 respectively), followed by tunnelled CVC (1.10 and 0.67), arteriovenous graft (0.51 and 0.31), and finally arteriovenous fistula (0.29 and 0.02). The non-VARI BSI rates were lowest in the arteriovenous graft group. Staphylococci comprised the majority of events, with Staphylococcus aureus implicated in 29%. Gram-negative BSIs were prevalent, particularly in CVC groups, and associated with higher mortality. Multidrug-resistant (MDR) S. aureus and carbapenem resistance were relatively low. MDR Gram-negatives were high compared with the Scottish population. CONCLUSION Arteriovenous fistula access is confirmed as having lowest all-source and VARI BSI rates, and arteriovenous graft access the lowest non-VARI BSI rates. Staphylococci remain the prevailing genus; however, the contributions of Gram-negative BSIs, the higher mortality, and proportion of MDR organisms in this group are notable.
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Affiliation(s)
- K Crowe
- Queen Elizabeth University Hospital, Glasgow, UK.
| | - B White
- Queen Elizabeth University Hospital, Glasgow, UK
| | - N Khanna
- Queen Elizabeth University Hospital, Glasgow, UK
| | - B Cooke
- Forth Valley Royal Hospital, Larbert, UK
| | | | - A Jackson
- Queen Elizabeth University Hospital, Glasgow, UK
| | | | - R Kasthuri
- Queen Elizabeth University Hospital, Glasgow, UK
| | - P C Thomson
- Queen Elizabeth University Hospital, Glasgow, UK
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31
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Gupta V, Parihar AS, Sharma VK, Jain S, Singh V, Khanna N. Evaluation of platelet-rich plasma on hair regrowth and lesional T-cell cytokine expression in alopecia areata: A randomized observer-blinded, placebo-controlled, split-head pilot study. J Am Acad Dermatol 2020; 84:1321-1328. [PMID: 33359595 DOI: 10.1016/j.jaad.2020.12.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/11/2020] [Accepted: 12/16/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Platelet-rich plasma has shown some promise in the treatment of alopecia areata. OBJECTIVE To evaluate the effect of platelet-rich plasma on hair regrowth and lesional T-cell cytokine expression in alopecia areata. METHODS This was a randomized, placebo-controlled, split-head study involving 27 patients with alopecia areata (Severity of Alopecia Tool score ≥25%). Alopecia patches on either side of the scalp were randomized to receive 3 intradermal injections of platelet-rich plasma or normal saline at monthly intervals and evaluated 3 months after the last session. Lesional T-cell cytokine messenger RNA expression was compared pre- and posttreatment in the platelet-rich plasma-treated sites. RESULTS The mean Severity of Alopecia Tool score did not change significantly compared with baseline with either platelet-rich plasma or placebo injections at any visit; however, the mean percentage reduction in the score in the platelet-rich plasma arm was more than in the placebo arm (9.05% ± 36.48% vs 4.99% ± 33.88%; P = .049) at final assessment. The mean interferon gamma (P = .001) and interleukin 17 cytokine (P = .009) messenger RNA expression decreased, whereas the mean interleukin 10 (P = .049) and FOXP3 (P = .011) messenger RNA expression increased significantly after platelet-rich plasma treatment. LIMITATIONS Small sample size and a relatively short follow-up. CONCLUSION Platelet-rich plasma was found to have limited efficacy in alopecia areata. However, it may play a role in restoring immune balance in the alopecic patches.
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Affiliation(s)
- Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
| | - Anita Singh Parihar
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vinod Kumar Sharma
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Suman Jain
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishwajeet Singh
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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32
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Hinić V, Seth-Smith HMB, Damm S, Amico P, Khanna N, Egli A, Bättig V. Unexpected Mycoplasma hominis infection in two renal transplant recipients traced back to the same donor by whole-genome sequencing. Eur J Clin Microbiol Infect Dis 2020; 40:1097-1102. [PMID: 33367958 PMCID: PMC8084823 DOI: 10.1007/s10096-020-04116-y] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/25/2020] [Indexed: 11/10/2022]
Abstract
Mycoplasma hominis is a common colonizer of the lower genitourinary tract. Although its clinical relevance for causing urogenital infections in immunocompetent individuals is controversial, this bacterium has been involved in severe invasive infections in allograft recipients. In this report, we describe two cases of M. hominis infection in two young renal transplant recipients within the first month post-transplant. Although at first no epidemiological link between the two cases had been suspected, whole-genome sequencing (WGS) analysis showed that both isolates were identical, highly suggestive of an origin with the common organ donor.
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Affiliation(s)
- V Hinić
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland.
| | - H M B Seth-Smith
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland.,Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - S Damm
- Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
| | - P Amico
- Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland
| | - N Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - A Egli
- Division of Clinical Bacteriology and Mycology, University Hospital Basel, Basel, Switzerland.,Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - V Bättig
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
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Abstract
Mycoplasma hominis, a commensal of the genital tract, is a potential underestimated pathogen causing both genitourinary and extragenital infections including neonatal infections. Septic arthritis, prosthetic joint infection, central nervous system (CNS) infections, infective endocarditis and abscess formation are common extragenital infections associated mainly with immunocompromised patients. Mycoplasma hominis lipoproteins play an important role in pathogenicity and directly interact with the host immune system. Polymerase chain reaction (PCR) is the mainstay of diagnosis. Increasing resistance to tetracyclines and quinolones which are used for treatment, is a matter of global concern. We reviewed PubMed literature and Google search engine on the recent developments of association of Mycoplasma hominis with various diseases, pathogenesis, diagnosis and treatment.
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Affiliation(s)
- Jaweed Ahmed
- Department of Microbiology, AIIMS, New Delhi, India
| | - Jyoti Rawre
- Department of Microbiology, AIIMS, New Delhi, India
| | - Neha Dhawan
- Department of Dermatology and Venereology, Gandhi Medical College, Secunderabad, India
| | - Neena Khanna
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | - Benu Dhawan
- Department of Microbiology, AIIMS, New Delhi, India.
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Saini C, Srivastava R, Khanna N, Ramesh V, Sharma A. IL-6 promotes pathogenic Th17 in T1R leprosy reactions by stimulating Il17 producing by IL-6R pathway. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1212] [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: 11/28/2022] Open
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35
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Dhawan B, Rawre J, Brijwal M, Sreenivas V, Dar L, Khanna N. Etiology of genital ulcer disease in patients attending the sexually transmitted disease clinic of a tertiary care hospital: Evaluation of multiplex PCR assay for diagnosis. Indian J Med Microbiol 2020; 39:118-121. [PMID: 33610242 DOI: 10.1016/j.ijmmb.2020.10.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
| | | | | | | | | | - Neena Khanna
- Dept. of Dermatology and Venereology, AIIMS, India
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36
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Bhatia R, Rawre J, Dhawan B, Khanna N. Not eliminated (yet!): chancroid in an HIV-infected man. Int J Dermatol 2020; 60:e21-e22. [PMID: 33017055 DOI: 10.1111/ijd.15216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/25/2020] [Accepted: 09/02/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Riti Bhatia
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Jyoti Rawre
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Benu Dhawan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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37
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Kohut A, Booher M, Naumova A, Kuhn T, Southern G, Flowers L, Conrad L, Gordon A, Khanna N. Citation classics in gynecologic oncology: A bibliometric analysis. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.546] [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: 10/23/2022]
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38
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Kohut A, Kuhn T, Booher M, Naumova A, Southern G, Flowers L, Conrad L, Gordon A, Rodriguez L, Khanna N. Evaluating risk factors for surgical site infection following minimally invasive surgery for endometrial cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.545] [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: 11/26/2022]
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39
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Saini C, Srivastava RK, Tarique M, Kurra S, Khanna N, Ramesh V, Sharma A. Elevated IL-6R on CD4 + T cells promotes IL-6 driven Th17 cell responses in patients with T1R leprosy reactions. Sci Rep 2020; 10:15143. [PMID: 32934336 PMCID: PMC7493991 DOI: 10.1038/s41598-020-72148-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 06/09/2020] [Accepted: 08/24/2020] [Indexed: 12/12/2022] Open
Abstract
Th17 cells play vital role during pathogenesis of leprosy reactions. Previously, we have reported that IL-23 is involved in Th17 cells differentiation. Subsequently, our group also showed that IL-6 induces Th17 cell differentiation along with TGF-β in leprosy reactions. Here, we next asked the question that whether IL-6 or IL-23 induced Th17 cells are different in nature? In this study, Type 1 Reactions (T1R) showed significantly (p < 0.001) higher percentage of IL-17A producing CD4+IL6R+ T cells as compared to non-reaction (NR) patients. Furthermore, recombinant IL-6, IL-23 and TGF-β promoted IL-17A secretion by CD4+IL6R+ T cells. Subsequently, IL-6R and IL-23R blocking experiments showed significantly (p < 0.002) down regulated IL-17A in T1R reaction as compared to NR leprosy patients. The present study for the first time establishes that pathogenic Th17 cells produce IL-17 in an IL-6 dependent manner in leprosy T1R reactions. Thus, present approaches that specifically target Th17 cells and/or the cytokines that promote their development, such as IL-6, TGF-β and IL-23A may provide more focused treatment strategies for the management of Mycobacterium leprae and its reactions.
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Affiliation(s)
- Chaman Saini
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, India. .,Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
| | - Rupesh K Srivastava
- Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, India
| | - Mohd Tarique
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Santosh Kurra
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India
| | - V Ramesh
- Department of Dermatology, Safdarjung Hospital, New Delhi, India
| | - Alpana Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
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Tarique M, Naz H, Saini C, Suhail M, Shankar H, Khanna N, Sharma A. Association of IL-10 Gene Polymorphism With IL-10 Secretion by CD4 and T Regulatory Cells in Human Leprosy. Front Immunol 2020; 11:1974. [PMID: 32849660 PMCID: PMC7424005 DOI: 10.3389/fimmu.2020.01974] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 07/21/2020] [Indexed: 01/02/2023] Open
Abstract
Leprosy is a chronic bacterial disease caused by Mycobacterium leprae. Cytokines are known to play vital role as a peacekeeper during inflammatory and other immunocompromised conditions such as leprosy. This study has tried to bridge the gap of information on cytokine gene polymorphisms and its potential role in the pathogenesis of leprosy. Interleukin-10 (IL-10) is an immunosuppressive cytokine, found to be elevated in leprosy that accounted for the suppression of host’s immune system by regulating the functions of other immune cells. T helper cells and T regulatory (Tregs) cells are the major source of IL-10 in lepromatous leprosy patients. In this study, we have documented the association of IL-10 cytokine gene polymorphism with the disease progression. A total of 132 lepromatous leprosy patients and 120 healthy controls were analyzed for IL-10 cytokine gene polymorphisms using PCR-SSP assay and flow cytometry was used to analyze IL-10 secretion by CD4 and Tregs in various genotype of leprosy patients. The frequencies of IL-10 (-819) TT and IL-10 (-1082) GG genotypes were significantly higher in leprosy patients as compared to healthy controls. This observation advocates that these genotypes were associated with the susceptibility and development of the disease. In addition, flow cytometry analysis demonstrated an increased number of IL-10 producing CD4 and Treg cells in IL-10 (819) TT genotype compared to CT and CC genotypes. These observations were further supported by immunohistochemical studies. Therefore, we can conclude that IL-10 cytokine gene polymorphisms by affecting its production can determine the predilection and progression of leprosy in the study population.
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Affiliation(s)
- Mohammad Tarique
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Huma Naz
- Centre for Interdisciplinary Research in Basic Sciences, Jamia Millia Islamia, New Delhi, India
| | - Chaman Saini
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Mohd Suhail
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hari Shankar
- Parasite-Host Biology Group, ICMR - National Institute of Malaria Research, New Delhi, India
| | - Neena Khanna
- Department of Dermatovenerology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Alpana Sharma
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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41
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Coste AT, Kritikos A, Li J, Khanna N, Goldenberger D, Garzoni C, Zehnder C, Boggian K, Neofytos D, Riat A, Bachmann D, Sanglard D, Lamoth F. Emerging echinocandin-resistant Candida albicans and glabrata in Switzerland. Infection 2020; 48:761-766. [PMID: 32661647 PMCID: PMC7518979 DOI: 10.1007/s15010-020-01475-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/28/2020] [Indexed: 01/14/2023]
Abstract
Echinocandins represent the first-line therapy of candidemia. Echinocandin resistance among Candida spp. is mainly due to acquired FKS mutations. In this study, we report the emergence of FKS-mutant Candida albicans/glabrata in Switzerland and provide the microbiological and clinical characteristics of 9 candidemic episodes. All patients were previously exposed to echinocandins (median 26 days; range 15–77). Five patients received initial echinocandin therapy with persistent candidemia in 4 of them. Overall mortality was 33%.
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Affiliation(s)
- A T Coste
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - A Kritikos
- Service of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - J Li
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Service of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - N Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
| | - D Goldenberger
- Division of Clinical Bacteriology and Mycology, University and University Hospital of Basel, Basel, Switzerland
| | - C Garzoni
- Clinica Luganese Moncucco, Lugano, Switzerland
| | - C Zehnder
- SYNLAB Suisse SA, Bioggio, Switzerland
| | - K Boggian
- Division of Infectious Diseases and Hospital Epidemiology, Kantonsspital St.Gallen, St.Gallen, Switzerland
| | - D Neofytos
- Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - A Riat
- Service of Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - D Bachmann
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - D Sanglard
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - F Lamoth
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Service of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
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42
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Gupta V, Sharma A, Khanna N, Mahajan S, Mridha AR. Nonhealing ulcer on the fingertip. Indian J Dermatol Venereol Leprol 2020; 88:207-209. [PMID: 32541126 DOI: 10.4103/ijdvl.ijdvl_448_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 01/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Ananya Sharma
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Swati Mahajan
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Asit Ranjan Mridha
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Wu P, Sisniega A, Stayman JW, Zbijewski W, Foos D, Wang X, Khanna N, Aygun N, Stevens RD, Siewerdsen JH. Cone-beam CT for imaging of the head/brain: Development and assessment of scanner prototype and reconstruction algorithms. Med Phys 2020; 47:2392-2407. [PMID: 32145076 PMCID: PMC7343627 DOI: 10.1002/mp.14124] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/06/2020] [Accepted: 02/21/2020] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Our aim was to develop a high-quality, mobile cone-beam computed tomography (CBCT) scanner for point-of-care detection and monitoring of low-contrast, soft-tissue abnormalities in the head/brain, such as acute intracranial hemorrhage (ICH). This work presents an integrated framework of hardware and algorithmic advances for improving soft-tissue contrast resolution and evaluation of its technical performance with human subjects. METHODS Four configurations of a CBCT scanner prototype were designed and implemented to investigate key aspects of hardware (including system geometry, antiscatter grid, bowtie filter) and technique protocols. An integrated software pipeline (c.f., a serial cascade of algorithms) was developed for artifact correction (image lag, glare, beam hardening and x-ray scatter), motion compensation, and three-dimensional image (3D) reconstruction [penalized weighted least squares (PWLS), with a hardware-specific statistical noise model]. The PWLS method was extended in this work to accommodate multiple, independently moving regions with different resolution (to address both motion compensation and image truncation). Imaging performance was evaluated quantitatively and qualitatively with 41 human subjects in the neurosciences critical care unit (NCCU) at our institution. RESULTS The progression of four scanner configurations exhibited systematic improvement in the quality of raw data by variations in system geometry (source-detector distance), antiscatter grid, and bowtie filter. Quantitative assessment of CBCT images in 41 subjects demonstrated: ~70% reduction in image nonuniformity with artifact correction methods (lag, glare, beam hardening, and scatter); ~40% reduction in motion-induced streak artifacts via the multi-motion compensation method; and ~15% improvement in soft-tissue contrast-to-noise ratio (CNR) for PWLS compared to filtered backprojection (FBP) at matched resolution. Each of these components was important to improve contrast resolution for point-of-care cranial imaging. CONCLUSIONS This work presents the first application of a high-quality, point-of-care CBCT system for imaging of the head/ brain in a neurological critical care setting. Hardware configuration iterations and an integrated software pipeline for artifacts correction and PWLS reconstruction mitigated artifacts and noise to achieve image quality that could be valuable for point-of-care detection and monitoring of a variety of intracranial abnormalities, including ICH and hydrocephalus.
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Affiliation(s)
- P Wu
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - A Sisniega
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - J W Stayman
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - W Zbijewski
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - D Foos
- Carestream Health, Rochester, NY, 14608, USA
| | - X Wang
- Carestream Health, Rochester, NY, 14608, USA
| | - N Khanna
- Department of Radiology, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - N Aygun
- Department of Radiology, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - R D Stevens
- Department of Radiology, Johns Hopkins University, Baltimore, MD, 21205, USA
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
- Department of Neurology, Johns Hopkins University, Baltimore, MD, 21205, USA
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - J H Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA
- Department of Radiology, Johns Hopkins University, Baltimore, MD, 21205, USA
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, 21205, USA
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Sinno A, Pinkerton J, Febbraro T, Jones N, Khanna N, Temkin S, Iglesias D, Pothuri B. Hormone therapy (HT) in women with gynecologic cancers and in women at high risk for developing a gynecologic cancer: A Society of Gynecologic Oncology (SGO) clinical practice statement. Gynecol Oncol 2020; 157:303-306. [DOI: 10.1016/j.ygyno.2020.01.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
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Khullar S, Rawre J, Khanna N, Sreenivas V, Dhawan B. Utility of polymerase chain reaction assays for confirmation of liquid culture test results for Ureaplasma spp. Indian J Med Microbiol 2020; 38:235-236. [PMID: 32883942 DOI: 10.4103/ijmm.ijmm_20_224] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Swati Khullar
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Jyoti Rawre
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Benu Dhawan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
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Balubaid I, Khanna N. A109 CELIAC DISEASE IS A RARE CAUSE OF BENIGN DUODENAL STRICTURE. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.108] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Benign duodenal stricture is an uncommon problem encountered by gastroenterologists. The most common cause is peptic ulcer disease (PUD). With the diagnosis and eradication of H. Pylori, early diagnosis of PUD and the use of PPIs to treat upper gastrointestinal inflammation, the incidence of benign duodenal stricture has dramatically decreased. Patients with duodenal stricture may present with early satiety, nausea, vomiting and weight loss. We present the case of a man with a refractory web-like stricture in the second part of the duodenum (D2) caused by Celiac disease.
Aims
To describe a rare endoscopic finding in a patient with Celiac disease
Methods
Case report with literature review
Results
We present a case of a 64 year old male was referred for consideration of duodenal stenting of a refractory stricture in the second part of the duodenum D2. The patient had a 1 year history of abdominal pain, early satiety and weight loss (10 lbs). He also reported intermittent episodes of diarrhea. Investigations included a CT scan of the abdomen which showed a stricture at the level of proximal D2 described as a “duodenal band”. Previous attempts at balloon dilation had not resulted in prolonged symptomatic or endoscopic improvement. Testing for H. Pylori was negative and he did not use NSAIDs.
Upper endoscopy was performed to assess the stricture prior to consideration of stenting. This showed a tight web-like stricture in proximal D2. The stricture was balloon dilated up to 16.5 mm, enabling the endoscope to pass beyond it. The mucosa in D2 was atrophic with flattening of the folds and scalloping. There was no inflammation seen. Biopsies from D2 revealed moderate villous blunting and intraepithelial lymphocytosis. Celiac serology testing was abnormal, with an anti-tTG Ab level of 32 RU/ml which confirmed the diagnosis of Celiac disease. The balloon dilation and gluten-free diet resulted in resolution of his symptoms. Follow up endoscopy revealed normalization of his duodenal folds and biopsies. In addition, anti-tTG Ab level was normalized. Although stricture improved with prolonged patency, he still has mild recurrence of his stricture requiring balloon dilation on an annual basis.
Conclusions
This case describes a very uncommon complication of Celiac disease. The likely pathophysiology involves inflammation and potentially ulceration from Celiac disease, resulting in a benign stricture. There have been a few case reports describing duodenal strictures as a complication of Celiac disease. Treatment involves a gluten-free diet and endoscopic therapy. More severe cases of obstruction would likely require surgical intervention. In our case, the gluten-free diet and balloon dilation were successful and duodenal stenting was not necessary. Given the possibility of Celiac disease as a cause of duodenal stricture, it would be reasonable to biopsy D2 and check anti-tTG Ab in cases of duodenal stricture.
Funding Agencies
None
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Affiliation(s)
- I Balubaid
- Gastroenterology, University of Western Ontario, London, ON, Canada
| | - N Khanna
- Gastroenterology, University of Western Ontario, London, ON, Canada
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Dhawan B, Rawre J, Dhawan N, Bhatia R, Gupta V, Khanna N. High prevalence of Mycoplasma genitalium in men who have sex with men: A cross-sectional study. Indian J Dermatol Venereol Leprol 2020; 86:195-196. [PMID: 32068192 DOI: 10.4103/ijdvl.ijdvl_494_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Benu Dhawan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Jyoti Rawre
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Neha Dhawan
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Riti Bhatia
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Rawre J, Dhawan B, Khanna N, Sreenivas V, Broor S, Chaudhry R. Distribution of Chlamydia trachomatis omp A genotypes in patients attending a sexually transmitted disease outpatient clinic in New Delhi, India. Indian J Med Res 2020; 149:662-670. [PMID: 31417035 PMCID: PMC6702700 DOI: 10.4103/ijmr.ijmr_1171_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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] [Indexed: 11/30/2022] Open
Abstract
Background & objectives: Limited data are available on the typing of Chlamydia trachomatis in India. Serovars D to K of C. trachomatis are chiefly responsible for urogenital infections. Thus, this study was conducted to determine the distribution of C. trachomatis serovars in patients with urogenital infections and to characterize ompA gene of the detected C. trachomatis isolates by sequence analysis. Presence of other co-infections was also evaluated. Methods: Endocervical swabs were collected from 324 women and urethral swabs/urine were collected from 193 men attending the sexually transmitted diseases outpatient clinic. The samples were screened for C. trachomatis by cryptic plasmid PCR and ompA gene PCR. Genotyping was performed by PCR-restriction fragment length polymorphism (RFLP) and sequencing of the ompA gene. Samples were screened for genital mycoplasmas, Neisseria gonorrhoeae, Treponema pallidum and human immunodeficiency virus (HIV). Results: C. trachomatis was found in 15.0 per cent men and 10.8 per cent women. Serovar D was the most prevalent followed by serovars E, F, I and G. Twenty two C. trachomatis isolates were selected for ompA gene sequencing. No mixed infection was found. Variability in ompA sequences was seen in
31.8 per cent cases. Both PCR-RFLP and ompA gene sequencing showed concordant results. The presence of Ureaplasma spp. and Mycoplasma hominis was observed in 18.7 and 9.5 per cent patients, respectively. Co-infection of C. trachomatis was significantly associated with Ureaplasma urealyticum and HIV. Interpretation & conclusions: The high occurence of C. trachomatis infections warrants its screening in addition to other sexually transmitted infections namely U. urealyticum and HIV. Genotyping of the ompA gene may provide additional information for vaccine development.
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Affiliation(s)
- Jyoti Rawre
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Benu Dhawan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Shobha Broor
- Department of Microbiology, SGT Medical College, Gurugram, India
| | - Rama Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
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Brijwal M, Rawre J, Dhawan B, Khanna N, Choudhary A, Dar L. Herpes Simplex Virus Type 1 Genital Ulcer Disease at a Tertiary Care Hospital in North India. Clin Infect Dis 2020; 68:1783-1784. [PMID: 30388201 DOI: 10.1093/cid/ciy943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Megha Brijwal
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi
| | - Jyoti Rawre
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi
| | - Benu Dhawan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi
| | - Aashish Choudhary
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi
| | - Lalit Dar
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi
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Gupta V, Mehta N, Singh G, Xess I, Khanna N. Mystifying brown, pear-shaped multiseptate structures in the potassium hydroxide mounts of patients with suspected dermatophytosis. Int J Dermatol 2019; 59:e68-e70. [PMID: 31721170 DOI: 10.1111/ijd.14704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/07/2019] [Accepted: 10/08/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Nikhil Mehta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Gagandeep Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Immaculata Xess
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Neena Khanna
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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