1
|
Sam R, Zhang L, Tuot DS, Chaudhry R. The Decrease in Serum Total Cholesterol and Low-Density Lipoprotein (LDL) Concentrations With the Initiation of Hemodialysis Despite a Concomitant Increase in Serum Albumin Concentrations. Cureus 2023; 15:e47272. [PMID: 38022186 PMCID: PMC10655933 DOI: 10.7759/cureus.47272] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 12/01/2023] Open
Abstract
Background and objective Hemodialysis patients often have lower serum low-density lipoprotein (LDL) and total cholesterol concentrations compared to the general population. It is unclear if this is due to a persistent decline in the values due to kidney disease or if the hemodialysis itself is contributing to the lower values. It is often assumed that malnutrition and anorexia are the main causes of the low lipid concentration in hemodialysis patients. In this study, we aimed to determine the association between hemodialysis initiation and serum lipid and albumin concentrations. Methodology The medical records of all patients initiating hemodialysis over an 11-year period at a single center were retrospectively reviewed. The data of 145 patients who had all the required lab values available were ultimately included in the study. Serum lipid levels at the initiation of hemodialysis were compared to values obtained mostly 6-18 months later. In order to determine if poor nutritional status is the reason for the decline in serum lipid levels, the serum albumin concentration at the initiation of hemodialysis was compared to that obtained during follow-up labs. Results We observed that serum cholesterol concentration declined from an average of 147 mg/dL to 137 mg/dL, while LDL decreased from an average of 78 mg/dL to 68 mg/dL, and serum albumin concentration increased from 3.4 g/dL to 3.8 g/dL after an average follow-up period of 10.8 months. Conclusions Based on our findings, the decline in serum LDL and total cholesterol concentrations with the initiation of hemodialysis may not be attributed to poor nutritional intake.
Collapse
Affiliation(s)
- Ramin Sam
- Nephrology, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, USA
| | - Li Zhang
- Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, USA
| | - Delphine S Tuot
- Medicine/Nephrology, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, USA
| | - Rafia Chaudhry
- Medicine/Nephrology, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, USA
| |
Collapse
|
2
|
Raza MS, Das BK, Goyal V, Lodha R, Chaudhry R, Sood S, Sreenivas V, Nair D, Mohapatra S, Gautam H, Kapil A. IMPACT OF MOLECULAR METHOD FOR THE DIAGNOSIS OF ACUTE BACTERIAL MENINGITIS IN A TERTIARY HEALTH CARE CENTRE IN NORTH INDIA. IJMMR 2020. [DOI: 10.11603/ijmmr.2413-6077.2020.1.11103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. Acute bacterial meningitis is one of the significant infectious diseases that add an immense burden to the health system. Proper management of meningitis is an invincible need to overcome the severe consequences. Objectives. The aim of the study is detection of the etiological agents of acute bacterial meningitis by PCR. Methods. Total 267 CSF samples collected from suspected bacterial meningitis cases were processed for the detection of S. pneumoniae, H. influenzae, N. meningitidis, E. coli and Group B streptococci by conventional and molecular diagnosis method. CSF was inoculated on Blood, chocolate and MacConkey agar plates and incubated at 37 °C for 24-48 hrs. Bacteria grown were identified by Matrix assisted laser desorption/ionization time of flight (MALDI-TOF). Multiplex PCR of the enlisted bacteria was performed using DNA extracted from CSF by DNA extraction kit (Qiagen, USA). Results. 5 (1.87%) out of the total 267 CSF samples were culture positive (3 S. pneumoniae and 2 E. coli) and 28 (10.49%) had detectable DNA by conventional PCR. Out of these 28 samples, 20 (71.43%) were S. pneumoniae and 8 (28.57%) were E. coli. 15 (53.57%) out of total S. pneumoniae were present in children below 5 years of age. Similarly, E. coli was predominant in neonates. Sensitivity and specificity of the PCR was 100% and 95-98% respectively. Conclusions. Streptococcus pneumoniae is the commonest cause of community acquired bacterial meningitis in children below five years of age. Hence, for the promising outcome, PCR should be implemented for the diagnosis of acute bacterial meningitis.
Collapse
|
3
|
Mathew RO, Rosenson RS, Lyubarova R, Chaudhry R, Costa SP, Bangalore S, Sidhu MS. Concepts and Controversies: Lipid Management in Patients with Chronic Kidney Disease. Cardiovasc Drugs Ther 2020; 35:479-489. [PMID: 32556851 DOI: 10.1007/s10557-020-07020-x] [Citation(s) in RCA: 10] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) remains an important contributor of morbidity and mortality in patients with chronic kidney disease (CKD). CKD is recognized as an important risk enhancer that identifies patients as candidates for more intensive low-density lipoprotein (LDL) cholesterol lowering. However, there is controversy regarding the efficacy of lipid-lowering therapy, especially in patients on dialysis. Among patients with CKD, not yet on dialysis, there is clinical trial evidence for the use of statins with or without ezetimibe to reduce ASCVD events. Newer cholesterol lowering agents have been introduced for the management of hyperlipidemia to reduce ASCVD, but these therapies have not been tested in the CKD population except in secondary analyses of patients with primarily CKD stage 3. This review summarizes the role of hyperlipidemia in ASCVD and treatment strategies for hyperlipidemia in the CKD population.
Collapse
Affiliation(s)
- Roy O Mathew
- Columbia V.A. Health Care System, 6439 Garners Ferry Road, Columbia, SC, 29209, USA. .,University of South Carolina School of Medicine, Columbia, SC, USA.
| | | | | | | | | | | | - Mandeep S Sidhu
- Albany Medical College and Albany Medical Center, Albany, NY, USA
| |
Collapse
|
4
|
Thakur CK, Chaudhry R, Gupta N, Vinayaraj EV, Singh V, Das BK, Jadon RS, Wig N, Lodha R, Kabra SK, Dey AB, Chhabra M. Scrub typhus in patients with acute febrile illness: a 5-year study from India. QJM 2020; 113:404-410. [PMID: 31790119 DOI: 10.1093/qjmed/hcz308] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/17/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Scrub typhus was once thought to be a disease of rural origin and was confined to specific pockets in South Asia. Early diagnosis and treatment is extremely important as it is associated with high mortality if left untreated. AIM To delineate the clinical and molecular epidemiology of scrub typhus in patients presenting with acute febrile illness from various parts of India. METHODS During the study period of 5 years (October 2013 to October 2018), a total of 1742 patients with acute febrile illness <15 days were enrolled after taking informed consent. Patients were diagnosed using IgM Enzyme-linked immunosorbent assay (ELISA) based on the pre-determined region specific cut offs. Patients with positive IgM ELISA were also subjected to IgM Immunofluorescence assay and nested polymerase chain reaction (PCR) assay. The demographic and relevant clinical details of the patients were documented and analyzed. RESULTS A total of 210 (12.1%) patients were diagnosed with scrub typhus. Of these, nested PCR was positive in only 85 patients. Sequencing and phylogenetic analysis showed that the predominant circulating genotypes were Gilliam and Karp. On multivariate analysis, acute respiratory distress syndrome, myocarditis, encephalitis/encephalopathy, jaundice and splenomegaly were significantly more common in those patients who were diagnosed with scrub typhus. A total of 14 patients diagnosed with scrub typhus succumbed to the illness. CONCLUSION Patients with fever, headache, pulmonary manifestations, CNS manifestations, myocarditis, transaminitis or thrombocytopenia presenting in the monsoon and post-monsoon season should be evaluated for scrub typhus irrespective of the geographical location in India.
Collapse
Affiliation(s)
| | | | - N Gupta
- Department of Microbiology
- Department of Medicine
| | | | | | | | | | | | | | | | - A B Dey
- Department of Geriatric Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - M Chhabra
- Department of Microbiology, Dr. Ram Manohar Lohia Hospital, Post Graduate Institute of Medical Education and Research, Baba Kharak Singh Marg, Connaught Place, New Delhi 110001, India
| |
Collapse
|
5
|
Puckett L, Saba S, Henry S, Rosen S, Rooney E, Eacobacci K, Kapyur A, Laxer A, Pappas K, Gilbo P, Robeny J, Filosa S, Musial S, Chaudhry A, Chaudhry R, Lesser M, Riegel A, Ramoutarpersaud S, Charlton J, Lee L. Screening for Late Effects of Radiation: Coronary Artery Calcification in a Cohort of Long-Term Breast Cancer Survivors in The CAROLE (CArdiac Related Oncologic Late Effects) Study. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.420] [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: 10/26/2022]
|
6
|
Valli-Pulaski H, Peters KA, Gassei K, Steimer SR, Sukhwani M, Hermann BP, Dwomor L, David S, Fayomi AP, Munyoki SK, Chu T, Chaudhry R, Cannon GM, Fox PJ, Jaffe TM, Sanfilippo JS, Menke MN, Lunenfeld E, Abofoul-Azab M, Sender LS, Messina J, Klimpel LM, Gosiengfiao Y, Rowell EE, Hsieh MH, Granberg CF, Reddy PP, Sandlow JI, Huleihel M, Orwig KE. Testicular tissue cryopreservation: 8 years of experience from a coordinated network of academic centers. Hum Reprod 2019; 34:966-977. [PMID: 31111889 PMCID: PMC6554046 DOI: 10.1093/humrep/dez043] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 02/28/2019] [Indexed: 12/31/2022] Open
Abstract
STUDY QUESTION Is it feasible to disseminate testicular tissue cryopreservation with a standardized protocol through a coordinated network of centers and provide centralized processing/freezing for centers that do not have those capabilities? SUMMARY ANSWER Centralized processing and freezing of testicular tissue from multiple sites is feasible and accelerates recruitment, providing the statistical power to make inferences that may inform fertility preservation practice. WHAT IS KNOWN ALREADY Several centers in the USA and abroad are preserving testicular biopsies for patients who cannot preserve sperm in anticipation that cell- or tissue-based therapies can be used in the future to generate sperm and offspring. STUDY DESIGN, SIZE, DURATION Testicular tissue samples from 189 patients were cryopreserved between January 2011 and November 2018. Medical diagnosis, previous chemotherapy exposure, tissue weight, and presence of germ cells were recorded. PARTICIPANTS/MATERIALS, SETTING, METHODS Human testicular tissue samples were obtained from patients undergoing treatments likely to cause infertility. Twenty five percent of the patient's tissue was donated to research and 75% was stored for patient's future use. The tissue was weighed, and research tissue was fixed for histological analysis with Periodic acid-Schiff hematoxylin staining and/or immunofluorescence staining for DEAD-box helicase 4, and/or undifferentiated embryonic cell transcription factor 1. MAIN RESULTS AND THE ROLE OF CHANCE The average age of fertility preservation patients was 7.9 (SD = 5) years and ranged from 5 months to 34 years. The average amount of tissue collected was 411.3 (SD = 837.3) mg and ranged from 14.4 mg-6880.2 mg. Malignancies (n = 118) were the most common indication for testicular tissue freezing, followed by blood disorders (n = 45) and other conditions (n = 26). Thirty nine percent (n = 74) of patients had initiated their chemotherapy prior to undergoing testicular biopsy. Of the 189 patients recruited to date, 137 have been analyzed for the presence of germ cells and germ cells were confirmed in 132. LIMITATIONS, REASONS FOR CAUTION This is a descriptive study of testicular tissues obtained from patients who were at risk of infertility. The function of spermatogonia in those biopsies could not be tested by transplantation due limited sample size. WIDER IMPLICATIONS OF THE FINDINGS Patients and/or guardians are willing to pursue an experimental fertility preservation procedure when no alternatives are available. Our coordinated network of centers found that many patients request fertility preservation after initiating gonadotoxic therapies. This study demonstrates that undifferentiated stem and progenitor spermatogonia may be recovered from the testicular tissues of patients who are in the early stages of their treatment and have not yet received an ablative dose of therapy. The function of those spermatogonia was not tested. STUDY FUNDING/COMPETING INTEREST(S) Support for the research was from the Eunice Kennedy Shriver National Institute for Child Health and Human Development grants HD061289 and HD092084, the Scaife Foundation, the Richard King Mellon Foundation, the Departments of Ob/Gyn & Reproductive Sciences and Urology of the University of Pittsburgh Medical Center, United States-Israel Binational Science Foundation (BSF), and the Kahn Foundation. The authors declare that they do not have competing financial interests.
Collapse
Affiliation(s)
- H Valli-Pulaski
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - K A Peters
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - K Gassei
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - S R Steimer
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - M Sukhwani
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - B P Hermann
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - L Dwomor
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - S David
- Department of Molecular Genetics and Developmental Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - A P Fayomi
- Department of Molecular Genetics and Developmental Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - S K Munyoki
- Integrative Systems Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - T Chu
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - R Chaudhry
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - G M Cannon
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - P J Fox
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - T M Jaffe
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - J S Sanfilippo
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - M N Menke
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - E Lunenfeld
- The Center of Advanced Research and Education in Reproduction (CARER) , Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Depratment of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - M Abofoul-Azab
- Depratment of Obstetrics and Gynecology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - L S Sender
- Hyundai Cancer Institute, CHOC Children’s Hospital, Orange, CA, USA
| | - J Messina
- Hyundai Cancer Institute, CHOC Children’s Hospital, Orange, CA, USA
| | - L M Klimpel
- Hyundai Cancer Institute, CHOC Children’s Hospital, Orange, CA, USA
| | - Y Gosiengfiao
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - E E Rowell
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - M H Hsieh
- Sheik Zayed Institute for Pediatric Surgical Innovation at Children's National Health System, Washington, DC, USA
| | - C F Granberg
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - P P Reddy
- Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - J I Sandlow
- Department of Urology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Huleihel
- The Center of Advanced Research and Education in Reproduction (CARER) , Ben-Gurion University of the Negev, Beer-Sheva, Israel
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - K E Orwig
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Molecular Genetics and Developmental Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Integrative Systems Biology Graduate Program, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| |
Collapse
|
7
|
Raza M, Kapil A, Goyal V, Lodha R, Sood S, Gautam H, Chaudhry R, Das B. Impact of the real time PCR in the diagnosis of acute bacterial meningitis in infants in a tertiary health care center in India. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.217] [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: 10/27/2022] Open
|
8
|
Chaudhry R, Bilal A, Austin A, Mehta S, Salman L, Foulke L, Feustel P, Zuckerman R, Asif A. ANCA associated vasculitis: experience of a tertiary care referral center. ACTA ACUST UNITED AC 2018; 41:55-64. [PMID: 30095143 PMCID: PMC6534033 DOI: 10.1590/2175-8239-jbn-2018-0040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 02/05/2018] [Accepted: 05/03/2018] [Indexed: 11/22/2022]
Abstract
Background and objectives: Anti-neutrophil cytoplasmic autoantibodies (ANCA) associated vasculitis is a small vessel vasculitis with insufficient epidemiologic estimates in the United States. We aimed to determine demographic and clinical features of ANCA associated vasculitis patients presenting to a large tertiary care referral center in Upstate New York. Design, setting, participants, and measurements: A retrospective analysis of cases with pauci-immune GN on renal biopsy and clinical diagnosis of ANCA vasculitis presenting over 11 years was conducted. Outcomes of interest were: demographics, ANCA antibody positivity, patient and renal survival, and regional trends. Results: 986 biopsies were reviewed, 41 cases met the criteria for inclusion: 18 GPA, 19 MPA, and 4 double positive (anti-GBM disease plus ANCA vasculitis). Mean age at presentation was 52.4 years (SD 23.7), 23 (56%) were male and median creatinine was 2.6 mg/dL. The median patient follow up was 77 weeks (IQR 10 - 263 weeks), with a 3-month mortality rate of 5.7% and a 1-year estimated mortality rate of 12%. Thirteen patients required hemodialysis at the time of diagnosis; 7 patients came off dialysis, with median time to renal recovery of 4.86 weeks (IQR 1.57 - 23.85 weeks). C-ANCA positivity (p < 0.001) and C-ANCA plus PR3 antibody pairing (p = 0.005) was statistically significant in GPA versus MPA. P-ANCA positivity was observed in MPA versus GPA (p = 0.02) and double positive versus GPA (p = 0.002), with P-ANCA and MPO antibody pairing in MPA versus GPA (p = 0.044). Thirty-seven of the 41 cases were referred locally, 16 cases were from within a 15-mile radius of Albany, Schenectady, and Saratoga counties. Conclusions: ANCA vasculitis is associated with end stage renal disease and increased mortality. Our study suggests the possibility of higher regional incidence of pauci-immune GN in Upstate New York. Further studies should investigate the causes of clustering of cases to specific regions.
Collapse
Affiliation(s)
- Rafia Chaudhry
- Albany Medical College, Division of Nephrology and Hypertension, Albany, NY, USA
| | - Anum Bilal
- Albany Medical College, Division of Nephrology and Hypertension, Albany, NY, USA
| | - Adam Austin
- Albany Medical College, Division of Pulmonary Critical Care, Albany, NY, USA
| | - Swati Mehta
- Albany Medical College, Division of Nephrology and Hypertension, Albany, NY, USA
| | - Loay Salman
- Albany Medical College, Division of Nephrology and Hypertension, Albany, NY, USA
| | - Llewellyn Foulke
- Albany Medical College, Department of Pathology, Albany, NY, USA
| | - Paul Feustel
- Albany Medical College, Department of Neuroscience and Experimental Therapeutics, Albany, NY, USA
| | - Roman Zuckerman
- Jersey Shore University Medical Center, Seton Hall-Hackensack-Meridian School of Medicine, Neptune, NJ, USA
| | - Arif Asif
- Jersey Shore University Medical Center, Seton Hall-Hackensack-Meridian School of Medicine, Neptune, NJ, USA
| |
Collapse
|
9
|
Singla M, Jain NP, Chaudhry R. Correlation of type 2 diabetes mellitus with perceived stress and family functioning. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641815] [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] [Indexed: 10/28/2022]
Affiliation(s)
| | - NP Jain
- DMCH, Ludhiana, Punjab, India
| | | |
Collapse
|
10
|
Singh Y, Mirdha BR, Guleria R, Khalil S, Panda A, Chaudhry R, Mohan A, Kabra SK, Kumar L, Agarwal SK. Circulating genotypes of Pneumocystis jirovecii and its clinical correlation in patients from a single tertiary center in India. Eur J Clin Microbiol Infect Dis 2017; 36:1635-1641. [PMID: 28401321 DOI: 10.1007/s10096-017-2977-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 02/20/2017] [Accepted: 03/27/2017] [Indexed: 10/19/2022]
Abstract
The present study was carried out with the objectives of genotyping Pneumocystis jirovecii at three distinct loci, to identify the single nucleotide polymorphisms (SNPs), and to study its clinical implications in patients with Pneumocystis pneumonia (PCP). Analysis of genetic diversity in P. jirovecii from immunocompromised patients was carried out by genotyping at three distinct loci encoding mitochondrial large subunit rRNA (mtLSU rRNA), cytochrome b (CYB), and superoxide dismutase (SOD) using polymerase chain reaction (PCR) assays followed by direct DNA sequencing. Of the 300 patients enrolled in the present study, 31 (10.33%) were positive for PCP by a specific mtLSU rRNA nested PCR assay, whereas only 15 P. jirovecii could be amplified at the other two loci (SOD and CYB). These positives were further subjected to sequence typing. Important genotypic combinations between four SNPs (mt85, SOD110, SOD215, and CYB838) and clinical outcomes could be observed in the present study, and mt85A, mt85T, and SOD110C/SOD215T were frequently associated with "negative follow-up". These SNPs were also noted to be relatively more prevalent amongst circulating genotypes in our study population. The present study is the first of its kind from the Indian subcontinent and demonstrated that potential SNPs of P. jirovecii may possibly be attributed to the clinical outcome of PCP episodes in terms of severity or fatality in different susceptible populations likely to develop PCP during their course of illness.
Collapse
Affiliation(s)
- Y Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - B R Mirdha
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
| | - R Guleria
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - S Khalil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - A Panda
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - R Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - A Mohan
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - S K Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - L Kumar
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - S K Agarwal
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
11
|
Angrup A, Chaudhry R, Sharma S, Valavane A, Passi K, Padmaja K, Javed S, Dey AB, Dhawan B, Kabra SK. Application of real-time quantitative polymerase chain reaction assay to detect Legionella pneumophila in patients of community-acquired pneumonia in a tertiary care hospital. Indian J Med Microbiol 2017; 34:539-543. [PMID: 27934840 DOI: 10.4103/0255-0857.195353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Legionella pneumophila is one of the important pathogen responsible for community -acquired pneumonia attributing for 1-5% of cases. Since early and accurate therapy reduces mortality, rapid and reliable diagnostic methods are needed. A total of 134 samples of blood, urine and respiratory tract fluids were collected. Blood was tested for IgG, IgM and IgA antibodies using commercially available kits. A total of 8 (6%) samples were found to be positive for L. pneumophila by quantitative reverse transcription polymerase chain reaction (qRT-PCR), compared to conventional PCR where 6 (4.4%) samples were positive. Serology was positive in a total of 32 (23%) cases though only 3 (2.2%) of the PCR-positive cases were positive by serology as well. These results suggest that real-time PCR can detect Legionella infection early in the course of the disease before serological response develops.
Collapse
Affiliation(s)
- A Angrup
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - R Chaudhry
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - S Sharma
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - A Valavane
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - K Passi
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - K Padmaja
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - S Javed
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - A B Dey
- Department of Microbiology, All Institute of Medical Sciences, New Delhi, India
| | - B Dhawan
- Department of Medicine, All Institute of Medical Sciences, New Delhi, India
| | - S K Kabra
- Department of Pediatrics, All Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
12
|
Chaudhry R, Kokkayil P, Gosh A, Bahadur T, Kant K, Sagar T, Kabra S, Lodha R, Dey A, Menon V. Prevalence of Bartonella henselae infection and its diagnosis in diverse clinical conditions in a tertiary care hospital in North India. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.309] [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: 11/17/2022] Open
|
13
|
Abstract
Genus Mycoplasma, belonging to the class Mollicutes, encompasses unique lifeforms comprising of a small genome of 8,00,000 base pairs and the inability to produce a cell wall under any circumstances. Mycoplasma pneumoniae is the most common pathogenic species infecting humans. It is an atypical respiratory bacteria causing community acquired pneumonia (CAP) in children and adults of all ages. Although atypical pneumonia caused by M. pneumoniae can be managed in outpatient settings, complications affecting multiple organ systems can lead to hospitalization in vulnerable population. M. pneumoniae infection has also been associated with chronic lung disease and bronchial asthma. With the advent of molecular methods of diagnosis and genetic, immunological and ultrastructural assays that study infectious disease pathogenesis at subcellular level, newer virulence factors of M. pneumoniae have been recognized by researchers. Structure of the attachment organelle of the organism, that mediates the crucial initial step of cytadherence to respiratory tract epithelium through complex interaction between different adhesins and accessory adhesion proteins, has been decoded. Several subsequent virulence mechanisms like intracellular localization, direct cytotoxicity and activation of the inflammatory cascade through toll-like receptors (TLRs) leading to inflammatory cytokine mediated tissue injury, have also been demonstrated to play an essential role in pathogenesis. The most significant update in the knowledge of pathogenesis has been the discovery of Community-Acquired Respiratory Distress Syndrome toxin (CARDS toxin) of M. pneumoniae and its ability of adenosine diphosphate (ADP) ribosylation and inflammosome activation, thus initiating airway inflammation. Advances have also been made in terms of the different pathways behind the genesis of extrapulmonary complications. This article aims to comprehensively review the recent advances in the knowledge of pathogenesis of this organism, that had remained elusive during the era of serological diagnosis. Elucidation of virulence mechanisms of M. pneumoniae will help researchers to design effective vaccine candidates and newer therapeutic targets against this agent.
Collapse
Affiliation(s)
- R Chaudhry
- Department of Microbiology, AIIMS, New Delhi, India
| | | | | |
Collapse
|
14
|
Nowak KL, Chonchol M, Ikizler TA, Farmer-Bailey H, Salas N, Chaudhry R, Wang W, Smits G, Tengesdal I, Dinarello CA, Hung AM. IL-1 Inhibition and Vascular Function in CKD. J Am Soc Nephrol 2016; 28:971-980. [PMID: 27647856 DOI: 10.1681/asn.2016040453] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [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: 04/20/2016] [Accepted: 08/12/2016] [Indexed: 12/31/2022] Open
Abstract
Vascular endothelial dysfunction and increased arterial stiffness contribute to increased cardiovascular risk in patients with CKD who exhibit chronic systemic inflammation. Because chronic inflammation contributes to vascular dysfunction, blocking inflammation may reduce cardiovascular risk in patients with CKD. In a two-site, double-blind trial, we randomized 42 adult patients with stage 3-4 CKD who were already receiving optimal background therapy to receive either IL-1 trap rilonacept or placebo for 12 weeks. Coprimary end points included change in brachial artery flow-mediated dilation (FMDBA) and aortic pulse-wave velocity (aPWV) after 4, 8, and 12 weeks. Exploratory end points included change in high-sensitivity C-reactive protein (hsCRP), FMDBA after acute ascorbic acid infusion, and vascular endothelial cell protein expression of NADPH oxidase. Participants were 63±11 (mean±SD) years of age and 24% were women; mean eGFR was 38±13 ml/min per 1.73 m2 Compared with placebo, rilonacept improved FMDBA (baseline: 3.36%±2.06% [mean±SD], 12 weeks: 2.45%±2.29% with placebo and baseline: 3.75%±3.12%, 12 weeks: 4.86%±3.20% with rilonacept; P<0.01), without changing aPWV (P=0.56). Rilonacept also reduced hsCRP levels (median [interquartile range]) (baseline: 4.60 [1.90-8.22] mg/L, 12 weeks: 2.16 [0.92-7.38] mg/L; P<0.01) and endothelial cell NADPH oxidase expression (P<0.05). Acute infusion of ascorbic acid to inhibit superoxide production associated with a nonsignificant trend toward increased FMDBA in the placebo group (P=0.07) but not the rilonacept group (P=0.56). Rilonacept was well tolerated (five adverse events versus two with placebo). In conclusion, treatment with an IL-1 trap improved FMDBA without changing aPWV and reduced systemic inflammation in patients with CKD.
Collapse
Affiliation(s)
- Kristen L Nowak
- Department of Medicine, University of Colorado Denver, Aurora, Colorado;
| | - Michel Chonchol
- Department of Medicine, University of Colorado Denver, Aurora, Colorado
| | - Talat Alp Ikizler
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; and.,Department of Medicine, Veterans Administration Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee
| | | | - Natjalie Salas
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; and
| | - Rafia Chaudhry
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; and
| | - Wei Wang
- Department of Medicine, University of Colorado Denver, Aurora, Colorado
| | - Gerard Smits
- Department of Medicine, University of Colorado Denver, Aurora, Colorado
| | - Isak Tengesdal
- Department of Medicine, University of Colorado Denver, Aurora, Colorado
| | | | - Adriana M Hung
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; and .,Department of Medicine, Veterans Administration Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee
| |
Collapse
|
15
|
Pai R, Chaudhry R, Gupta N, Sryma PB, Biswas A, Dey AB. Tricky typhus ticks two: A report of two sisters from North India presenting with acute respiratory distress syndrome due to scrub typhus. Indian J Med Microbiol 2016; 34:244-6. [PMID: 27080784 DOI: 10.4103/0255-0857.176847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Scrub typhus is emerging as an important cause of acute febrile illness in Northern India. This is a report of two sisters presenting concurrently with acute respiratory distress syndrome. A diagnosis of scrub typhus was made in both the patients, and they were successfully treated with doxycycline.
Collapse
Affiliation(s)
| | - R Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | |
Collapse
|
16
|
Sebastian S, Dhawan B, Malhotra R, Kapil A, Chaudhry R, Sreenivas V, Kumar V. Microbial profile of prosthetic joint infections and effectiveness of cefuroxime prophylaxis: Experience from a tertiary care hospital. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.307] [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: 10/22/2022] Open
|
17
|
Latha MMP, Kaur IR, Avasthi R, Dey AB, Chaudhry R. Cytokine profile of patient’s sera of Leptospirosis to OMP of Leptospira interrogans serovar tarassovi. Asian J Med Sci 2015. [DOI: 10.3126/ajms.v7i1.12261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims and Objectives: In the past decade, Leptospirosis has emerged as a globally important emerging infectious disease. Leptospires have several chemical components such as Lipoproteins, glycolipoproteins which are toxic and participate in the pathogenesis of the disease. This study was focused to find out the immune response of outer membrane proteins (OMPs) of Leptospira interrogans serovar tarassovi by estimating the cytokine profile and antibody levels from cases of Leptospirosis.Materials and Methods: A total of 120 blood samples were collected from patients (90 male/30 female) presenting with acute febrile illness and fulfilling the criteria of clinical diagnosis of Leptospirosis. All the 120 samples & 40 healthy controls were subjected to ELISA (IgM serion), MAT and Leptospira interrogans serovar tarassovi IgM ELISA and also to detect TNF? and IL-6 levels using (BD Opt EIA Human IL-6 & TNF? ELISA kits).Results: Sera which were found to be reactive in L. interrogans serovar tarassovi OMP IgM ELISA had significant levels of TNF? and IL-6 and antibody titres in ELISA and MAT.Conclusions: Patients from Group I had significant levels of TNF? in the serum i.e., p = 0.02 which indicates the pro-inflammatory Th1 response as TNF? are macrophage derived cytokine mediators. The IL-6 level of Group I, II, III were significantly higher than the Group IV (p = 0.02) suggesting that Th2 anti-inflammatory response seen in majority of these cases which has a protective role in leptospirosis.Asian Journal of Medical Sciences Vol.7(1) 2015 93-95
Collapse
|
18
|
Dwivedi S, Das B, Kapil A, Sood S, Chaudhry R, Gupta S, Deb M, Nair D, Aneja S. Antigen sequence typing of outer membrane protein (fetA) gene of Neisseria meningitidis serogroup A from Delhi & adjoining areas. Indian J Med Res 2014; 140:766-9. [PMID: 25758575 PMCID: PMC4365350] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND & OBJECTIVES Meningitis caused by Neisseria meningitidis is a fatal disease. Meningococcal meningitis is an endemic disease in Delhi and irregular pattern of outbreaks has been reported in India. All these outbreaks were associated with serogroup A. Detailed molecular characterization of N. meningitidis is required for the management of this fatal disease. In this study, we characterized antigenic diversity of surface exposed outer membrane protein (OMP) FetA antigen of N. meningitidis serogroup A isolates obtained from cases of invasive meningococcal meningitis in Delhi, India. METHODS Eight isolates of N. meningitidis were collected from cerebrospinal fluid during October 2008 to May 2011 from occasional cases of meningococcal meningitis. Seven isolates were from outbreaks of meningococcal meningitis in 2005-2006 in Delhi and its adjoining areas. These were subjected to molecular typing of fetA gene, an outer membrane protein gene. RESULTS All 15 N. meningitides isolates studied were serogroup A. This surface exposed porin is putatively under immune pressure. Hence as a part of molecular characterization, genotyping was carried out to find out the diversity in outer membrane protein (FetA) gene among the circulating isolates of N. meningitidis. All 15 isolates proved to be of the same existing allele type of FetA variable region (VR) when matched with global database. The allele found was F3-1 for all the isolates. INTERPRETATION & CONCLUSIONS There was no diversity reported in the outer membrane protein FetA in the present study and hence this protein appeared to be a stable molecule. More studies on molecular characterization of FetA antigen are required from different serogroups circulating in different parts of the world.
Collapse
Affiliation(s)
- S. Dwivedi
- Department of Microbiology, All India Institute of Medical Science, New Delhi, India
| | - B.K. Das
- Department of Microbiology, All India Institute of Medical Science, New Delhi, India,Reprint requests: Dr Bimal Kumar Das, Department of Microbiology, All India Institute of Medical Sciences Ansari Nagar, New Delhi 110 029, India e-mail:
| | - A. Kapil
- Department of Microbiology, All India Institute of Medical Science, New Delhi, India
| | - S. Sood
- Department of Microbiology, All India Institute of Medical Science, New Delhi, India
| | - R. Chaudhry
- Department of Microbiology, All India Institute of Medical Science, New Delhi, India
| | - S. Gupta
- Department of Microbiology, National Center for Disease Control, New Delhi, India
| | - M. Deb
- Department of Microbiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - D. Nair
- Department of Microbiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - S. Aneja
- Department of Paediatrics, Lady Hardinge Medical College & Kalawati Saran Children's Hospital, New Delhi, India
| |
Collapse
|
19
|
Chaudhry R, Valavane A, Mohan A, Dey AB. Legionella pneumophila infection associated with renal failure causing fatality in a known case of sarcoidosis. Indian J Med Microbiol 2014; 32:324-7. [PMID: 25008831 DOI: 10.4103/0255-0857.136590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Legionella pneumophila infection may become fatal in immunocompromised state. We report here the first known fatal case from India due to Legionella pneumophila infection complicated by renal failure in a patient undergoing treatment for Sarcoidosis. Sarcoidosis is an idiopathic systemic inflammatory disease involving multiple organs. Urine antigen detection and polymerase chain reaction targeting 16S rRNA gene could help in rapid diagnosis of the infection and thereby start specific therapy. Clinical awareness along with availability of rapid diagnostic tests and institution of specific therapy may reduce morbidity and mortality associated with this infection especially in immunocompromised state.
Collapse
Affiliation(s)
- R Chaudhry
- Department of Microbiology), All India Institute of Medical Sciences, New Delhi, India
| | | | | | | |
Collapse
|
20
|
Kumar N, Ekka M, P R, Ranjan S, Sinha S, Sharma SK, Chaudhry R, Sharma N, Ahmad H, Samantaray JC, Sreenivas V. Clostridium difficile infections in HIV-positive patients with diarrhoea. Natl Med J India 2014; 27:138-140. [PMID: 25668083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Patients with HIV/AIDS are at a high risk of being infected with toxin-producing strains of Clostridium difficile (C. difficile) because of frequent hospitalization, exposure to antibiotics and antibiotic prophylaxis for opportunistic infections. There are little data from India on the prevalence of C. difficile infection in such patients. METHODS We assessed the occurrence of C. difficile infections in HIV-positive patients with diarrhoea by looking for the presence of its toxin as well as by culturing. Enzyme immunoassay (EIA, Premier toxins A and B; Meridian Diagnostic Inc.) was used to detect toxin from 237 fresh stool samples collected from HIV-positive patients with diarrhoea. Culture was done on cycloserine-cefoxitin-fructose agar and brain- heart infusion agar. RESULTS C. difficile was found in 12 of 237 (5.1%, 95% CI 2.64%-8.68%) HIV-positive patients with diarrhoea (9 patients were positive by EIA and 3 by culture). The presence of C. difficile in patients who had received antiretroviral therapy (7/66 [10.6%]) was significantly higher (p < 0.016) compared with those who had not (5/171 [3%]). Of the 12 patients positive for C. difficile, 7 were on antiretroviral therapy for a mean (SD) of 34.4 months with mean CD4+ count of 186 (98.81) cells/cmm and 5 patients were anti-retroviral-naïve with mean CD4+ count of 181 (68.7) cells/cmm. All the 12 patients were on antibiotics for previous 2 months and 4 of 12 had been hospitalized in the previous 30 days. CONCLUSION C. difficile infections occurred more frequently in patients who had received antiretroviral therapy. Our study population had a lower frequency of C. difficile infections compared to previous studies.
Collapse
Affiliation(s)
- N Kumar
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Department of Medicine
| | - M Ekka
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Department of Medicine
| | - Raghunandan P
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Department of Medicine
| | - S Ranjan
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Department of Medicine
| | - S Sinha
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Department of Medicine
| | - S K Sharma
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Department of Medicine
| | - R Chaudhry
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Department of Microbiology
| | - N Sharma
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Department of Microbiology
| | - H Ahmad
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Department of Microbiology
| | - J C Samantaray
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Department of Microbiology
| | - V Sreenivas
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, Department of Biostatistics
| |
Collapse
|
21
|
Chaudhry R, Das A, Premlatha M, Choudhary A, Chaurasia B, Chandel D, Dey A. Authors' response. Indian J Med Res 2013; 138:274. [PMID: 24187714 PMCID: PMC3788218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- R. Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India,For correspondence:
| | - A. Das
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - M.M. Premlatha
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - A. Choudhary
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - B.K. Chaurasia
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - D.S. Chandel
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - A.B. Dey
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| |
Collapse
|
22
|
Premlatha MM, Kaur IR, Avasthi R, Dey AB, Chaudhry R. A newer approach for the serodiagnosis of leptospirosis using outer membrane proteins of leptospira interrogans serovar tarassovi. Asian J Med Sci 2013. [DOI: 10.3126/ajms.v4i2.6693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: Leptospirosis in humans occurs throughout the world as an acute infection ranging imperceptible to severe, potentially fatal, renal and liver failure accompanied by haemorrhage and jaundice. In India, according to number of reports, Leptospirosis has been a significant health problem since 1980. This disease mimics influenza, hepatitis, dengue owing to which it often goes undiagnosed due to lack of awareness and diagnostic facilities in most of the laboratories in the country. This study was undertaken to diagnose suspected cases of Leptospirosis by IgM ELISA, DRIDOT and MAT, and also to standardize an in house IgM ELISA using OMP antigens of the L.tarassovi the predominant serovar in the study Materials & Methods: Blood samples were collected from a total of 287 patients (186 male and 101 female) presenting with acute febrile illness and fulfilling the criteria of clinical diagnosis of Leptospirosis. All the samples & healthy controls were subjected to ELISA (IgM serion), dridot, MAT, and Leptospira serovar Tarassovi OMP IgM ELISA, and for isolation of Leptospira. Results: IgM antibody could be detected by ELISA, Dridot and OMP ELISA of L. Tarassovi from Group I and Group II sera samples. It was observed by MAT that L.Tarassovi was the predominant serovar followed by L.australis, L.autumnalis, L.sejroe, L.pyrogenes, L.ballum, L.canicola, L.icterocopenhageni, L.cynopteri. A total of 5 isolates were recovered from Group I patients. Conclusion: IgM ELISA using sarcosyl extracted OMP antigens of serovar Tarassovi when compared with MAT the overall sensitivity and specificity was 72% and 81% respectively. The same sera reacted with serovar Australis, serovar Tarassovi, serovar Sejroe, serovar Pyrogenes, serovar Ballum and serovar Icterocopenhageni in MAT. DOI: http://dx.doi.org/10.3126/ajms.v4i2.6693 Asian Journal of Medical Sciences 4(2013) 41-46
Collapse
|
23
|
Chaudhry R, Das A, Premlatha M, Choudhary A, Chourasia B, Chandel D, Dey A. Serological & molecular approaches for diagnosis of leptospirosis in a tertiary care hospital in north India: a 10-year study. Indian J Med Res 2013; 137:785-90. [PMID: 23703348 PMCID: PMC3724261] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND & OBJECTIVES Leptospirosis, a spirochetal zoonosis, is underreported from the northern States of India. This study reports results of a 10-year retrospective sero-epidemiological survey of leptospirosis conducted in a tertiary care hospital in New Delhi, India. METHOD A total of 1453 patients clinically suspected for leptospirosis were included and investigated initially by IgM ELISA. A proportion of these were subjected to culture, microscopic agglutination test (MAT) and polymerase chain reaction (PCR). RESULTS Of the 1453 patients, 391 (26.90%) were positive serologically by IgM ELISA. Seropositive and seronegative patients revealed no significant difference in clinical features and laboratory parameters. Amongst the IgM seropositive cases, culture for leptospires was positive in 5 of 192 (2.6%), MAT in 50 of 138 (36.23%), PCR from blood and urine in 10 of 115 (8.7%) and 10 of 38 (26.31%) cases, respectively. In Leptospira spp. positive patients co-infections with viral hepatitis E, malaria and dengue fever were diagnosed in 27 cases. INTERPRETATION & CONCLUSIONS The overall seropositivity for leptospirosis was 26.9 per cent in our study. A decreasing trend in seropositivity was observed in recent years. Co-infections with malaria, dengue, hepatitis A and E were also seen. Since leptospirosis is a treatable disease, correct and rapid diagnosis may help in effective management of patients.
Collapse
Affiliation(s)
- R. Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India,Reprint requests: Dr Rama Chaudhry, Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India e-mail: ,
| | - A. Das
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - M.M. Premlatha
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - A. Choudhary
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - B.K. Chourasia
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - D.S. Chandel
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - A.B. Dey
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
24
|
Williams MR, Chaudhry R, Perera S, Pearce RKB, Hirsch SR, Ansorge O, Thom M, Maier M. Changes in cortical thickness in the frontal lobes in schizophrenia are a result of thinning of pyramidal cell layers. Eur Arch Psychiatry Clin Neurosci 2013; 263:25-39. [PMID: 22610045 DOI: 10.1007/s00406-012-0325-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [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] [Received: 11/08/2011] [Accepted: 04/30/2012] [Indexed: 12/23/2022]
Abstract
Decreased cortical thickness and reduced activity as measured by fMRI in the grey matter of the subgenual cingulate cortex have been reported in schizophrenia and bipolar disorder, and cortical grey matter loss has been reliably reported in the frontal and temporal lobes in schizophrenia. The aim of this study was to examine the thickness of each of the six cortical layers in the subgenual cingulate cortex, five frontal lobe and four temporal lobe gyri. We examined two separate cohorts. Cohort 1 examines the subgenual cingulate cortex (SCC) in schizophrenia (n = 10), bipolar disorder (n = 15) and major depressive disorder (n = 20) against control subjects (n = 19). Cohort two examines frontal and temporal gyri in schizophrenia (n = 16), major depressive disorder (n = 6) against matched controls (n = 32). The cohorts were selected with identical clinical criteria, but underwent different tissue processing to contrast the effect of chemical treatment on tissue shrinkage. Measurements of layer I-VI thickness were taken from cresyl-violet- and haematoxylin-stained sections in cohort one and from cresyl-violet- and H&E-stained sections in cohort two. SCC cortical thickness decreased in male subjects with bipolar disorder (p = 0.048), and male schizophrenia cases showed a specific decrease in the absolute thickness of layer V (p = 0.003). Compared to controls, the relative thickness of layer V in the crown of the SCC decreased in schizophrenia (p < 0.001). A significant decrease in total cortical thickness was observed across the frontal lobe in schizophrenia (p < 0.0001), with specific pyramidal layer thinning in layers III (p = 0.0001) and V (p = 0.005). There was no effect of lateralization. No changes were noted in temporal lobe cortical thickness. This study demonstrates diminished pyramidal layer thickness resulting in decreased frontal lobe thickness in schizophrenia.
Collapse
Affiliation(s)
- M R Williams
- Neuropathology Unit, Department of Experimental Medicine, Imperial College London, Charing Cross Hospital, UK.
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Bamola V, Sharma N, Chaudhry R. Assessment of the effects of beneficial microbes on immunoglobulin receptor concentration on viable colonocytes in the paediatric population. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.673] [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: 11/16/2022] Open
|
26
|
Chaudhry R, Galagali A, Narayanan RV. Focused Abdominal Sonography in Trauma (FAST). Med J Armed Forces India 2011; 63:62-3. [PMID: 27407941 DOI: 10.1016/s0377-1237(07)80113-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2006] [Accepted: 12/20/2006] [Indexed: 11/15/2022] Open
Affiliation(s)
- R Chaudhry
- Professor and Head, Department of Surgery, Armed Forces Medical College, Pune 411 040
| | - A Galagali
- Associate Professor, Department of Surgery, Armed Forces Medical College, Pune 411 040
| | - R V Narayanan
- Assistant Professor, Department of Surgery, Armed Forces Medical College, Pune 411 040
| |
Collapse
|
27
|
Abstract
BACKGROUND Laparoscopic surgery has changed the face of medical care forever. The benefits of laparoscopic open surgery have been demonstrated in virtually all major abdominal surgical procedures. Laparoscopy has introduced a new skill set that must be mastered and requires dedicated training. The teaching of laparoscopic operative skills in the clinical setting is constrained by the complexity of procedures, medicolegal and ethical concerns, fiscal and time limitations. This has created the need for formal training outside the operating room. Simulator-based training holds great promise in enhancing surgical education and providing a safe, cost-effective means for practicing techniques prior to their use in the operating room. METHODS The surgical residents of two batches were recruited for the study. The residents were randomized to either a group that received training on a simulator or a controlled group that did not receive the training or to a group that received training twice. RESULT The residents who received training on a simulator demonstrated better psychomotor skills in the operation theatre than those who did not. Training in simulator environment can contribute to the development of technical skills relevant to the performance of laparoscopic surgery in vivo. Training at regular intervals will benefit the residents in gaining significant improvement of their psychomotor skills. CONCLUSION Laparoscopic trainer is a promising tool for training in laparoscopic surgery.
Collapse
Affiliation(s)
- Pvr Mohan
- Associate Professor (Department of Surgery); Armed Forces Medical College, Pune
| | - R Chaudhry
- Dy DGAFMS (Plg), O/o DGAFMS, 'M' Block, Ministry of Defence, New Delhi
| |
Collapse
|
28
|
Nassaralla CL, Naessens JM, Hunt VL, Bhagra A, Chaudhry R, Hansen MA, Tulledge-Scheitel SM. Medication reconciliation in ambulatory care: attempts at improvement. Qual Saf Health Care 2011; 18:402-7. [PMID: 19812105 DOI: 10.1136/qshc.2007.024513] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To enhance overall accuracy of medication lists by providing performance feedback and training to the healthcare team and increasing patient participation in the medication reconciliation process. METHODS This prospective study involved patients seen in four academic, ambulatory primary care internal medicine clinics. Before the interventions, baseline data were analysed, assessing completeness, correctness and accuracy of medication documentation in the electronic medical record. Interventions to provide performance feedback and training to the healthcare team, increase patient awareness and participation in the medication reconciliation process were implemented. Immediately after each intervention, a data collection was undertaken to assess the effectiveness of the intervention on the accuracy of individual medications and medication lists. RESULTS Completeness of medication lists improved from 20.4% to 50.4% (p<0.001). The incomplete documentation of medication lists was mostly because of lack of frequency (15.4%) and route (8.9%) for individual medications within a medication list. Correctness of medication lists improved from 23.1% to 37.7% (p = 0.087). The incorrectness in a medication list was mostly because of incorrect medications dose. Patient participation in the medication reconciliation process increased from 13.9% to 33% (p<0.001). The medication list accuracy improved from 11.5% to 29% (p = 0.014). CONCLUSION In this setting, it was helpful to engage the active participation of all members of the healthcare team and most importantly the patient to improve the accuracy of medication lists.
Collapse
Affiliation(s)
- C L Nassaralla
- Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | | | | | | | | | | | | |
Collapse
|
29
|
Agarwal P, Nityanand S, Pandey P, Khetan D, Chaudhry R. 24 Effect of granulocyte-colony stimulating factor on hemostatic function in normal healthy allogenic donors undergoing large volume leukapheresis. Transfus Apher Sci 2010. [DOI: 10.1016/s1473-0502(10)70029-x] [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: 10/19/2022]
|
30
|
Chaudhry R, Chandel DS, Verma N, Singh N, Singh P, Dey AB. Rapid diagnosis of typhoid fever by an in-house flagellin PCR. J Med Microbiol 2010; 59:1391-1393. [PMID: 20671085 DOI: 10.1099/jmm.0.020982-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- R Chaudhry
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - D S Chandel
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - N Verma
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - N Singh
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - P Singh
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - A B Dey
- Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| |
Collapse
|
31
|
Kumar S, Saigal S, Sethi G, Chaudhry R. DNA amplification and sequence analysis of P1 adhesin gene fragments in M pneumoniae from pediatric respiratory infections. Int J Infect Dis 2010. [DOI: 10.1016/j.ijid.2010.02.542] [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: 11/30/2022] Open
|
32
|
Chaudhry R, Agrawal A. Natural Orifice Transluminal Endoscopic Surgery: Reality or Myth? Med J Armed Forces India 2009; 65:256-9. [PMID: 27408260 DOI: 10.1016/s0377-1237(09)80018-x] [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] [Received: 10/31/2008] [Accepted: 03/03/2009] [Indexed: 10/18/2022] Open
Affiliation(s)
- R Chaudhry
- Dy DGAFMS (Plg), O/oDGAFMS, Ministry of Defence, Pin-908713, C/o-56 APO
| | - A Agrawal
- Clinical Tutor (Department of Surgery) Armed Forces Medical College, Pune-40
| |
Collapse
|
33
|
Chaudhry R, Shah AK. Journal Scan. Med J Armed Forces India 2009. [DOI: 10.1016/s0377-1237(09)80153-6] [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: 11/15/2022] Open
|
34
|
Kumar S, Saigal S, Sethi G, Chaudhry R. PP-041 Diagnosis and DNA fragment analysis of Mycoplasma pneumoniae in pediatric community-acquired lower respiratory tract infections. Int J Infect Dis 2008. [DOI: 10.1016/s1201-9712(09)60192-2] [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: 10/21/2022] Open
|
35
|
Chaudhry R, Bharathi RS. Journal Scan. Med J Armed Forces India 2008. [DOI: 10.1016/s0377-1237(08)80131-1] [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
|
36
|
Singhal R, Chaudhry R, Dhawan B. Anaerobic bacteraemia in a tertiary care hospital of North India. Indian J Med Microbiol 2006; 24:235-6. [PMID: 16912451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
|
37
|
|
38
|
Rao P, Chaudhry R, Kumar S. Abdominal Compartment Pressure Monitoring - A Simple Technique. Med J Armed Forces India 2006; 62:269-70. [PMID: 27407906 DOI: 10.1016/s0377-1237(06)80017-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2006] [Accepted: 06/17/2006] [Indexed: 10/18/2022] Open
Affiliation(s)
- P Rao
- Classified Specialist (Surgery and GI Surgeon), Command Hospital (SC), Pune - 411040
| | - R Chaudhry
- Professor and Head (Department of Surgery), Armed Forces Medical College, Pune -411040
| | - S Kumar
- Classified Specialist (Surgery and Trauma Surgeon), Military Hospital Kirkee, Pune
| |
Collapse
|
39
|
Abstract
Damage control is not a modern concept, but the application of this approach represents a new paradigm in surgery, borne out of a need to save patients with severe exsanguinating injuries. Definitive control and repair may be accomplished in the immediate post injury setting but the physiological derangement due to massive shock state resulting from the severe injury and the resuscitation that follows, often leads to a fully repaired but dead patient. The vicious triad of death in trauma, namely hypothermia, acidosis and coagulopathy should be tackled by initial abbreviated laparotomy, correction of physiological derangements and finally definitive repair of all injuries at second laparotomy. The concept needs a dedicated team effort with careful patient selection for achieving the optimal results.
Collapse
Affiliation(s)
- R Chaudhry
- Prof & Head (Dept of Surgery), AFMC, Pune-40
| | | | - Y Singh
- DGMS (Navy), Integerated HQ, Ministry of Defence (Navy)
| |
Collapse
|
40
|
Joshy L, Chaudhry R, Dhawan B, Kumar L, Das BK. Incidence and characterization of Clostridium perfringens isolated from antibiotic-associated diarrhoeal patients: a prospective study in an Indian hospital. J Hosp Infect 2006; 63:323-9. [PMID: 16650503 DOI: 10.1016/j.jhin.2005.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2005] [Accepted: 12/30/2005] [Indexed: 11/25/2022]
Abstract
Clostridium perfringens has been reported as causing between 2-15% of all cases of antibiotic-associated diarrhoea (AAD), and may be diagnosed by detection of enterotoxin in faeces. A prospective study comprising 150 diarrhoeal patients and 100 non-diarrhoeal controls was undertaken to assess the incidence of C. perfringens-associated diarrhoea in an Indian hospital. Methods used included C. perfringens culture, reverse passive latex agglutination (RPLA) and enzyme-linked immunosorbent assay (ELISA) for detection of enterotoxin, and polymerase chain reaction (PCR) assay for the presence of enterotoxin gene. Attempts were made to type the isolates by multiplex PCR. Of the 150 diarrhoeal stool samples tested, 13 were culture positive. Of these, four were positive for C. perfringens enterotoxin by RPLA, two were positive by PCR and two were positive by RPLA and ELISA. Twenty-seven samples were positive for culture of C. perfringens in non-diarrhoeal controls but none were positive for enterotoxin either by RPLA or by PCR. The average incidence of C. perfringens AAD using these methods was 2.6%. Toxin typing showed that all the isolates belonged to type A. To conclude, the relatively low incidence of toxigenic C. perfringens suggests that enterotoxigenic C. perfringens is not a major cause of AAD in this population.
Collapse
Affiliation(s)
- L Joshy
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | |
Collapse
|
41
|
Do MT, Marrett LD, Demers PA, Payne J, Chaudhry R, Pichora E. 088-S: Asbestos and Pleural Cancer in Canada. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s22c] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
- M T Do
- Cancer Care Ontario, Toronto, ONT Canada
| | | | - P A Demers
- Cancer Care Ontario, Toronto, ONT Canada
| | - J Payne
- Cancer Care Ontario, Toronto, ONT Canada
| | - R Chaudhry
- Cancer Care Ontario, Toronto, ONT Canada
| | - E Pichora
- Cancer Care Ontario, Toronto, ONT Canada
| |
Collapse
|
42
|
Biju SS, Ahuja A, Khar RK, Chaudhry R. Formulation and evaluation of an effective pH balanced topical antimicrobial product containing tea tree oil. Pharmazie 2005; 60:208-11. [PMID: 15801675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The effect of pH on the antimicrobial activity of Melaleuca alternifolia essential oil formulations was studied. Microemulsions, liposomal dispersions, multiple emulsions and a colloidal bed of sterile clay were formulated using 5% w/w of tea tree oil. A number of formulations were prepared at various pH values (5.0, 5.5, 6.0, 6.5, and 7.0). Thermal stability studies showed that the formulations were stable for more than eight months. Agar dilution tests showed MICs of 1.0% v/v S. aureus and S. epidermidis. In the broth dilution test, MBC of the oil for P. acnes was 0.5% v/v. MIC and MBC values were comparable to those of non-formulated tea tree oil, indicating that tea tree oil retained its activity in the above-mentioned formulations. The microbiological evaluation showed that the formulations containing 5% w/w tea tree oil had a maximum effect at pH 5.5.
Collapse
Affiliation(s)
- S S Biju
- Department of Pharmaceutics, Faculty of Pharmacy, Hamdard University, New Delhi, India
| | | | | | | |
Collapse
|
43
|
Renuka K, Kapil A, Kabra SK, Wig N, Das BK, Prasad VVSP, Chaudhry R, Seth P. Reduced susceptibility to ciprofloxacin and gyra gene mutation in North Indian strains of Salmonella enterica serotype Typhi and serotype Paratyphi A. Microb Drug Resist 2004; 10:146-53. [PMID: 15256030 DOI: 10.1089/1076629041310028] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The emergence of reduced susceptibility to ciprofloxacin among Salmonella enterica serotype Typhi and serotype Paratyphi A leading to clinical failure of treatment poses a great therapeutic challenge. The mechanism of fluoroquinolone resistance in clinical isolates of S. Typhi and S. Paratyphi A is not very well documented. The present study was carried out with the objective of molecular characterization of reduced quinolone susceptibility amongst the strains of S. Typhi and S. Paratyphi A isolated from the patients with enteric fever during January, 2000, to April, 2003, in a North Indian hospital. A total of 422 culture-positive cases of enteric fever were reported to the hospital during the period of study, of which S. Typhi was isolated from 350 cases and S. Paratyphi A from 72 cases. The antimicrobial susceptibility of these strains was determined by disk diffusion and agar dilution method according to NCCLS guidelines, and E-test method. A total of 140 randomly selected strains, isolated during the years 1993-1999, that were available from the laboratory stocks were also studied to compare with the present strains. To study the quinolone susceptibility, the strains were divided into nalidixic acid sensitive (NAS), nalidixic acid intermediate resistant, (NAI) and nalidixic acid resistant (NAR) on the basis of susceptibility to nalidixic acid. Clinical history was available from 174 patients, of which 93 needed hospitalization due to severe disease. Of these, 82 patients were infected with NAR strains and 22 patients had a documented evidence of clinical failure to ciprofloxacin therapy. The patients infected with NAR strains were younger and had a significantly longer duration of fever (p value < 0.05) than those infected with NAS strains. It was observed that the proportion of NAR strains increased gradually over the years. These strains had a significantly higher range of MIC of ciprofloxacin (0.023-1.0 microg/ml) as compared to the NAS strains (0.002-0.125 microg/ml) (p value < 0.05). The sequencing of quinolone resistance determining region (QRDR) of the gyrA gene showed the presence of mutation at either Ser 83 or at Asp 87 in all the NAR and NAI strains. None of the NAS strains had a mutation, suggesting that the gyrA gene mutation is sufficient to confer resistance to nalidixic acid and reduced susceptibility to ciprofloxacin. This mutation, although phenotypically expressed as decreased susceptibility to ciprofloxacin, goes undetected by the disk diffusion method using the present NCCLS guidelines. Hence, it can increase morbidity and mortality due to delay in appropriate antibiotic treatment.
Collapse
Affiliation(s)
- K Renuka
- Department of Microbiology, India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Bansal M, Mohanti BK, Shah N, Chaudhry R, Bahadur S, Shukla NK. Radiation related morbidities and their impact on quality of life in head and neck cancer patients receiving radical radiotherapy. Qual Life Res 2004; 13:481-8. [PMID: 15085920 DOI: 10.1023/b:qure.0000018491.80646.bc] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Although 50-70% of head and neck cancer patients in India receive radiotherapy (RT), radiation-related acute and late morbidities and their impact on quality of life (QOL) are infrequently reported. Acute and late radiation morbidities and QOL were assessed in a prospective longitudinal study of 45 patients with head and neck cancers receiving radical RT to a dose of 7000 cGy in conventional fractionation. Grade II acute morbidities experienced by the largest percent of the sample during the course of RT pertained to the mucosa (66.4%), salivary gland (84%), and oesophagus (53%). These morbidities led to an increase in the symptom scores of appetite loss (76.46), fatigue (65.75) and pain (44.77). This increase in the symptom scores consequently led to a significant decline in physical, social and emotional functioning as well as global health status score during the course of RT (p < 0.001). Scores improved after 1 month of RT but did not reach the pre-RT value. Future studies may consider correlating QOL assessment to significant patient and disease related parameters such as performance status, weight loss, stage and site of disease.
Collapse
Affiliation(s)
- M Bansal
- Department of Radiation Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | |
Collapse
|
45
|
Ahuja A, Rahman S, Ali J, Chaudhry R. Effect of dental films containing amoxycillin and metronidazole on periodontal pathogens: microbiological response. Pharmazie 2003; 58:716-20. [PMID: 14609283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Biodegradable dental films containing a combination of amoxycillin and metronidazole were prepared by a dispersion method. The aim of the present study was to determine the antimicrobial activity of this formulation against the pathogens which are commonly implicated in periodontal infections. Films showed sustained release in vitro for a period of 16 days. In situ release studies carried out using fresh bovine buccal mucosa in a flow through cell, showed that drug concentrations were maintained above MIC values for the entire period of the release studies. Samples from these studies were capable of inhibiting the growth of most of the test strains. The combination of amoxycillin and metronidazole using carrier polymer poly-L (lactide co-glycolide) not only showed an extended spectrum of antimicrobial activity but also showed a synergistic effect against Eubacterium limosum, which had earlier been reported resistant to metronidazole.
Collapse
Affiliation(s)
- A Ahuja
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi, India.
| | | | | | | |
Collapse
|
46
|
Mathur P, Chaudhry R, Kumar L, Kapil A, Dhawan B. A study of bacteremia in febrile neutropenic patients at a tertiary-care hospital with special reference to anaerobes. Med Oncol 2003; 19:267-72. [PMID: 12512921 DOI: 10.1385/mo:19:4:267] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Patients with hematological malignancies who are receiving chemotherapy suffer prolonged periods of neutropenia, which leads to a greater risk of infection and mortality. A prospective study was conduced to determine the incidence of bacteremia in patients of hematological malignancies over a 2-yr period. A total of 119 episodes of febrile neutropenia occurred among 96 consecutive patients, of which 35 episodes were associated with bacteremia. Forty-four percent of the isolated bacteria were Gram-positive aerobes and 46% were Gram-negative aerobes. Staphylococcus aureus, Enterococcus spp., and Escherichia coli were the most common isolates. Gram-negative bacteremia was associated with a higher mortality. Anaerobes accounted for 4.4% of all isolates. The episodes of anaerobic bacteremia were polymicrobial and had a fatal outcome. A high incidence of antimicrobial resistance among aerobic and anaerobic bacteria was also recorded. Compared to previous years, a shift from a predominating Gram-negative to a Gram-positive etiology was noted. The initial empiric antibiotic regimens should be based on a local knowledge of the most common causative microorganisms, their sensitivity pattern, and the outcome of bacteremia.
Collapse
Affiliation(s)
- P Mathur
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi-10 029, India
| | | | | | | | | |
Collapse
|
47
|
Affiliation(s)
- Gurjit Singh
- Commandant, Artificial Limb Centre, Pune - 411 040
| | - Kpk Rao
- Graded Specialist (Surgery), 160 Military Hospital, C/o 99 APO
| | - S R Ghosh
- Classified Specialist (Surgery and GI Surgery), Command Hospital (Central Command), Lucknow
| | - R Chaudhry
- Senior Advisor (Surgery and GI Surgery), Command Hospital (Northern Command), C/o, 56 APO
| |
Collapse
|
48
|
Dhawan B, Lyngdoh V, Mehta VS, Chaudhry R. Brain abscess due to Streptococcus sanguis. Neurol India 2003; 51:131-2. [PMID: 12865554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
|
49
|
Goh YL, Puthucheary SD, Chaudhry R, Bhutta ZA, Lesmana M, Oyofo BA, Punjabi NH, Ahmed A, Thong KL. Genetic diversity of Salmonella enterica serovar Paratyphi A from different geographical regions in Asia. J Appl Microbiol 2002; 92:1167-71. [PMID: 12010557 DOI: 10.1046/j.1365-2672.2002.01655.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS Subtyping of Salmonella Paratyphi A isolates from India, Pakistan, Indonesia and Malaysia was carried out by pulsed-field gel electrophoresis (PFGE) to assess the extent of genetic diversity of these isolates from different endemic countries. METHODS AND RESULTS A total of 39 human isolates of Salmonella Paratyphi A from Pakistan, India, Indonesia and Malaysia were studied using PFGE analysis following digestion of chromosomal DNA with XbaI. Seven isolates from Pakistan were resistant to ampicillin, tetracycline and cotrimoxazole. It was noted that Salmonella Paratyphi A isolates obtained from outbreaks in India had limited genetic diversity and probably belonged to closely related clones. Significant genetic homogeneity was observed among antimicrobial-resistant isolates from Pakistan and antimicrobial-sensitive isolates from Pakistan and Indonesia, respectively. CONCLUSIONS PFGE was a useful subtyping technique to differentiate Salmonella Paratyphi A from different endemic countries. However, it fails to differentiate the antimicrobial-resistant and -sensitive strains. SIGNIFICANCE AND IMPACT OF THE STUDY The findings of the present study verify the usefulness of PFGE in characterizing and comparing strains of Salmonella Paratyphi A. Our study suggests that a limited number of clones are responsible for paratyphoid fever in these countries.
Collapse
Affiliation(s)
- Y-L Goh
- Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Baskaran V, Chaudhry R. Spontaneous cholecysto-cutaneous fistula mimicking postoperative scar sinus. Trop Gastroenterol 2002; 23:28-9. [PMID: 12170917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Although biliary fistulae are common, spontaneous biliary fistulae are very rare. Even more rare are spontaneous cholecysto-cutaneous fistulae. A case of spontaneous cholecysto-cutaneous fistula presenting through an abdominal scar mimicking a postoperative scar sinus is presented, the literature is reviewed and the reasons for occurrence of such a fistula are discussed.
Collapse
Affiliation(s)
- V Baskaran
- Department of Surgery, Command Hospital (EC), Alipore, Calcutta-700 027, India.
| | | |
Collapse
|