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Kulkarni PS, Padmapriyadarsini C, Vekemans J, Bavdekar A, Gupta M, Kulkarni P, Garg B, Gogtay NJ, Tambe M, Lalwani S, Singh K, Munshi R, Meshram S, Selvavinayagam T, Pandey K, Bhimarasetty DM, Ramakrishnan S, Bhamare C, Dharmadhikari A, Budhawant C, Bonhomme CJ, Thakar M, Kurle SN, Kelly EJ, Gautam M, Gupta N, Panda S, Bhargava B, Poonawalla CS, Shaligram U, Kapse D, Gunale B. Seropersistence of SII-ChAdOx1 nCoV-19 (COVID-19 vaccine): 6-month follow-up of a randomized, controlled, observer-blind, phase 2/3 immuno-bridging study in Indian adults. Hum Vaccin Immunother 2024; 20:2304974. [PMID: 38512394 PMCID: PMC10962622 DOI: 10.1080/21645515.2024.2304974] [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: 08/24/2023] [Accepted: 01/10/2024] [Indexed: 03/23/2024] Open
Abstract
AZD1222 (ChAdOx1 nCoV-19) is a replication-deficient adenoviral vectored coronavirus disease-19 (COVID-19) vaccine that is manufactured as SII-ChAdOx1 nCoV-19 by the Serum Institute of India Pvt Ltd following technology transfer from Oxford University/AstraZeneca. The non-inferiority of SII-ChAdOx1 nCoV-19 with AZD1222 was previously demonstrated in an observer-blind, phase 2/3 immuno-bridging study (trial registration: CTRI/2020/08/027170). In this analysis of immunogenicity and safety data 6 months post first vaccination (Day 180), 1,601 participants were randomized 3:1 to SII-ChAdOx1 nCoV-19 or AZD1222 (immunogenicity/reactogenicity cohort n = 401) and 3:1 to SII-ChAdOx1 nCoV-19 or placebo (safety cohort n = 1,200). Immunogenicity was measured by anti-severe acute respiratory syndrome coronavirus 2 spike (anti-S) binding immunoglobulin G and neutralizing antibody (nAb) titers. A decline in anti-S titers was observed in both vaccine groups, albeit with a greater decline in SII-ChAdOx1 nCoV-19 vaccinees (geometric mean titer [GMT] ratio [95% confidence interval (CI) of SII-ChAdOx1 nCoV-19 to AZD1222]: 0.60 [0.41-0.87]). Consistent similar decreases in nAb titers were observed between vaccine groups (GMT ratio [95% CI]: 0.88 [0.44-1.73]). No cases of severe COVID-19 were reported following vaccination, while one case was observed in the placebo group. No causally related serious adverse events were reported through 180 days. No thromboembolic or autoimmune adverse events of special interest were reported. Collectively, these data illustrate that SII-ChAdOx1 nCoV-19 maintained a high level of immunogenicity 6 months post-vaccination. SII-ChAdOx1 nCoV-19 was safe and well tolerated.
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Affiliation(s)
| | | | - Johan Vekemans
- Formerly of: Clinical Development, Infection, Late-stage Development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | | | - Madhu Gupta
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Praveen Kulkarni
- Department of Community Medicine, JSS Academy of Higher Education and Research, Mysore, India
| | - B.S. Garg
- Department of Community Medicine and Dr Sushila Nayar School of Public Health, Mahatma Gandhi Institute of Medical Sciences, Wardha, India
| | - Nithya J. Gogtay
- Department of Clinical Pharmacology, Seth G S Medical College & KEM Hospital, Mumbai, India
| | - Muralidhar Tambe
- Department of Community Medicine, B J Government Medical College and Sassoon General Hospitals, Pune, India
| | - Sanjay Lalwani
- Department of Pediatrics, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India
| | - Kiranjit Singh
- Jehangir Clinical Development Centre Pvt Ltd, Pune, India
| | - Renuka Munshi
- Department of Clinical Pharmacology, TN Medical College & BYL Nair Hospital, Mumbai, India
| | - Sushant Meshram
- Department of Pulmonary Medicine, Government Medical College, Nagpur, India
| | | | - Krishna Pandey
- Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | | | - S.R. Ramakrishnan
- Department of Clinical Research, Sri Ramchandra Institute of Higher Education and Research, Chennai, India
| | | | | | | | - Cyrille J. Bonhomme
- Laboratory Services, Vaccines Sciences Lab, Clinical Research, PPD, Part of Thermo Fisher Scientific, Richmond, VA, USA
| | | | | | - Elizabeth J. Kelly
- Formerly of: Translational Medicine, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
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Sapkal G, Deshpande GR, Gupta N, Deshpande K, Sharma S, Tandale B, Srivastava R, Vidhate S, Khutwad K, Tilekar BN. Harmonization of Zika serological assays and comparative evaluation of two commercial ZIKA IgG ELISA kits. Diagn Microbiol Infect Dis 2024; 109:116238. [PMID: 38554539 DOI: 10.1016/j.diagmicrobio.2024.116238] [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: 11/08/2023] [Revised: 01/27/2024] [Accepted: 02/27/2024] [Indexed: 04/01/2024]
Abstract
The interpretation for Zika virus serology results is challenging due to high antibody cross reactivity with other flaviviruses. This limits availability of reliable and accurate methods for serosurveillance studies to understand the disease burden. Therefore, we conducted study to harmonize anti-Zika IgG antibody detection assays with 1st WHO International Standard (16/352) and working standard (16/320) for anti-Zika virus antibody.Additionally, evaluated NuGenTMZIKA-IgG and NovaLisa®ZIKA virus IgG-Capture ELISA using a panel of 278 seraFurther, 106 samples positive for other-flavi viruses were taken for assessing cross-reactivity of the assay, all serums were further tested by Zika-PRNT. The results of this study indicates satisfactory performance of both the assays. Serological and neutralization assays were calibrated according to the international standards. This will help in understanding antibody dynamics in serosurveillance and vaccine studies. However the performance of the kits with possibilities of cross-reactivity will have to be verified by coupling ZIKV and DENV specific ELISA.
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Affiliation(s)
- Gajanan Sapkal
- ICMR-National Institute of Virology, Pune 411021, Maharashtra, India.
| | | | - Nivedita Gupta
- Indian Council of Medical Research, New Delhi 110001,India
| | - Ketki Deshpande
- ICMR-National Institute of Virology, Pune 411021, Maharashtra, India
| | - Sharada Sharma
- ICMR-National Institute of Virology, Pune 411021, Maharashtra, India
| | - Babasaheb Tandale
- ICMR-National Institute of Virology, Pune 411021, Maharashtra, India
| | - Rashi Srivastava
- ICMR-National Institute of Virology, Pune 411021, Maharashtra, India
| | - Shankar Vidhate
- ICMR-National Institute of Virology, Pune 411021, Maharashtra, India
| | - Kirtee Khutwad
- ICMR-National Institute of Virology, Pune 411021, Maharashtra, India
| | - B N Tilekar
- ICMR-National Institute of Virology, Pune 411021, Maharashtra, India
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Wee T, Gupta N, Miller E, Pauranik A. Not Dandy Walker variant: a review of prominent retrocerebellar CSF space in children. Clin Radiol 2024; 79:330-337. [PMID: 38429135 DOI: 10.1016/j.crad.2024.01.025] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 03/03/2024]
Abstract
The prominent retrocerebellar cerebrospinal fluid (CSF) space can be frequently encountered on paediatric neuroimaging studies. In cases involving abnormal vermian development where imaging does not align with the established criteria of Dandy-Walker malformation (DWM), the term "Dandy-Walker variant or continuum" has been historically employed to describe the aberrant posterior fossa development. Instead, the emphasis is on a more elaborate description of the findings in the posterior fossa. Moreover, combining the findings in the supratentorial brain can occasionally predict certain neurogenetic disorders that mimic Dandy-Walker phenotype. The present review demonstrates and differentiates the imaging features of various entities that result in an enlarged retrocerebellar CSF space, such as inferior vermian hypoplasia (IVH) and several neurogenetic conditions.
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Affiliation(s)
- T Wee
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - N Gupta
- Department of Medical Imaging, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada
| | - E Miller
- Department of Diagnostic and Interventional Radiology, University of Toronto, Toronto, ON, Canada
| | - A Pauranik
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada; Department of Radiology, BC Children's Hospital, Vancouver, BC, Canada.
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Gupta N, Konsam BD, Walia R, Bhadada SK, Chhabra R, Dhandapani S, Singh A, Ahuja CK, Sachdeva N, Saikia UN. An objective way to predict remission and relapse in Cushing disease using Bayes' theorem of probability. J Endocrinol Invest 2024:10.1007/s40618-024-02336-z. [PMID: 38619729 DOI: 10.1007/s40618-024-02336-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 02/12/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE In this study on patients with Cushing disease, post-transsphenoidal surgery (TSS), we attempt to predict the probability of remaining in remission, at least for a year and relapse after that, using Bayes' theorem and the equation of conditional probability. The number of parameters, as well as the weightage of each, is incorporated in this equation. DESIGN AND METHODS The study design was a single-centre ambispective study. Ten clinical, biochemical, radiological and histopathological parameters capable of predicting Cushing disease remission were identified. The presence or absence of each parameter was entered as binary numbers. Bayes' theorem was applied, and each patient's probability of remission and relapse was calculated. RESULTS A total of 145 patients were included in the study. ROC plot showed a cut-off value of the probability of 0.68, with a sensitivity of 82% (range 73-89%) and a specificity of 94% (range 83-99%) to predict the probability of remission. Eighty-one patients who were in remission at 1 year were followed up for relapse and 23 patients developed relapse of the disease. The Bayes' equation was able to predict relapse in only 3 out of 23 patients. CONCLUSIONS Using various parameters, remission of Cushing disease can be predicted by applying Bayes' theorem of conditional probability with a sensitivity and a specificity of 82% and 94%, respectively. This study provided an objective way of predicting remission after TSS and relapse in patients with Cushing disease giving a weightage advantage to every parameter.
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Affiliation(s)
- N Gupta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - B D Konsam
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - R Walia
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India.
| | - S K Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - R Chhabra
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Dhandapani
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - A Singh
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - C K Ahuja
- Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - N Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), 1010, Nehru Extension Block, Chandigarh, 160012, India
| | - U N Saikia
- Department of Histopathology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Sudharson NA, Lister P, Gupta N, Sharma M. Promoting informed choices: navigating global dental care challenges. Br Dent J 2024; 236:582. [PMID: 38671093 DOI: 10.1038/s41415-024-7362-3] [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] [Received: 03/03/2024] [Accepted: 03/11/2024] [Indexed: 04/28/2024]
Affiliation(s)
- N A Sudharson
- Assistant Professor, Department of Prosthodontics, Christian Dental College, Ludhiana, India.
| | - P Lister
- Dentist, Emmanuel Hospital Association, Division of Dentistry, Unit of Christian Dental College, Ludhiana, India.
| | - N Gupta
- Senior Dental Consultant, Shri Rama Charitable Hospital, Prabhat Nagar, Dholewal, Ludhiana, India.
| | - M Sharma
- Sure Smiles Dental Clinics, Silgudi, West Bengal, India.
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Thangaraj JWV, Prosperi C, Kumar MS, Hasan AZ, Kumar VS, Winter AK, Bansal AK, Chauhan SL, Grover GS, Jain AK, Kulkarni RN, Sharma SK, Soman B, Chaaithanya IK, Kharwal S, Mishra SK, Salvi NR, Sarmah NP, Sharma S, Varghese A, Sabarinathan R, Duraiswamy A, Rani DS, Kanagasabai K, Lachyan A, Gawali P, Kapoor M, Chonker SK, Sangal L, Mehendale SM, Sapkal GN, Gupta N, Hayford K, Moss WJ, Murherkar MV. Post-campaign coverage evaluation of a measles and rubella supplementary immunization activity in five districts in India, 2019-2020. PLoS One 2024; 19:e0297385. [PMID: 38551928 PMCID: PMC10980234 DOI: 10.1371/journal.pone.0297385] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 01/04/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND In alignment with the Measles and Rubella (MR) Strategic Elimination plan, India conducted a mass measles and rubella vaccination campaign across the country between 2017 and 2020 to provide a dose of MR containing vaccine to all children aged 9 months to 15 years. We estimated campaign vaccination coverage in five districts in India and assessed campaign awareness and factors associated with vaccination during the campaign to better understand reasons for not receiving the dose. METHODS AND FINDINGS Community-based cross-sectional serosurveys were conducted in five districts of India among children aged 9 months to 15 years after the vaccination campaign. Campaign coverage was estimated based on home-based immunization record or caregiver recall. Campaign coverage was stratified by child- and household-level risk factors and descriptive analyses were performed to assess reasons for not receiving the campaign dose. Three thousand three hundred and fifty-seven children aged 9 months to 15 years at the time of the campaign were enrolled. Campaign coverage among children aged 9 months to 5 years documented or by recall ranged from 74.2% in Kanpur Nagar District to 90.4% in Dibrugarh District, Assam. Similar coverage was observed for older children. Caregiver awareness of the campaign varied from 88.3% in Hoshiarpur District, Punjab to 97.6% in Dibrugarh District, Assam, although 8% of children whose caregivers were aware of the campaign were not vaccinated during the campaign. Failure to receive the campaign dose was associated with urban settings, low maternal education, and lack of school attendance although the associations varied by district. CONCLUSION Awareness of the MR vaccination campaign was high; however, campaign coverage varied by district and did not reach the elimination target of 95% coverage in any of the districts studied. Areas with lower coverage among younger children must be prioritized by strengthening the routine immunization programme and implementing strategies to identify and reach under-vaccinated children.
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Affiliation(s)
| | - Christine Prosperi
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Muthusamy Santhosh Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - Alvira Z. Hasan
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - V. Saravana Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - Amy K. Winter
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Avi Kumar Bansal
- ICMR-National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | - Sanjay L. Chauhan
- ICMR- National Institute for Research in Reproductive and Child Health, Mumbai, India
| | | | | | - Ragini N. Kulkarni
- ICMR- National Institute for Research in Reproductive and Child Health, Mumbai, India
| | | | - Biju Soman
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Achutha Menon Centre for Health Science Studies, Trivandrum, Kerala, India
| | - Itta K. Chaaithanya
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Sanchit Kharwal
- Department of Health Research, Model Rural Health Research Unit-Hoshiarpur, Punjab, India
| | - Sunil K. Mishra
- Department of Health Research, Model Rural Health Research Unit-Hoshiarpur, Punjab, India
| | - Neha R. Salvi
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Nilanju P. Sarmah
- Department of Health Research, Model Rural Health Research Unit-Chabua, Assam, India
| | - Sandeep Sharma
- ICMR-National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | - Adarsh Varghese
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Achutha Menon Centre for Health Science Studies, Trivandrum, Kerala, India
| | - R. Sabarinathan
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - Augustine Duraiswamy
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - D. Sudha Rani
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - K. Kanagasabai
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
| | - Abhishek Lachyan
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Poonam Gawali
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Mitali Kapoor
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Saurabh Kumar Chonker
- Department of Health Research, Model Rural Health Research Unit-Kanpur, Uttar Pradesh, India
| | - Lucky Sangal
- World Health Organization, Southeast Asia Region Office, New Delhi, India
| | | | | | - Nivedita Gupta
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Kyla Hayford
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - William J. Moss
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Manoj V. Murherkar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Epidemiology Chennai, Chennai, India
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Manchanda V, Muralidharan J, Nischal N, Aggarwal K, Gupta S, Gupta N, Velayudhan A, Kaur H, Brijwal M, Chhabra M, Vishwanathan R, Dhodapkar R, Mahajan SK, Deol S, Sekhar JC, Mitra S, Saxena S, Kumar J, Garg A, Lodha R, Ravi V, Soneja M, Verghese VP, Rodrigues C. Approach towards surveillance-based diagnosis of acute respiratory illness in India: Expert recommendations. Indian J Med Microbiol 2024; 48:100548. [PMID: 38403268 DOI: 10.1016/j.ijmmb.2024.100548] [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: 12/22/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Emerging infectious diseases, often zoonotic, demand a collaborative "One-Health" surveillance approach due to human activities. The need for standardized diagnostic and surveillance algorithms is emphasized to address the difficulty in clinical differentiation and curb antimicrobial resistance. OBJECTIVE The present recommendations are comprehensive diagnostic and surveillance algorithm for ARIs, developed by the Indian Council of Medical Research (ICMR), which aims to enhance early detection and treatment with improved surveillance. This algorithm shall be serving as a blueprint for respiratory infections landscape in the country and early detection of surge of respiratory infections in the country. CONTENT The ICMR has risen up to the threat of emerging and re-emerging infections. Here, we seek to recommend a structured approach for diagnosing respiratory illnesses. The recommendations emphasize the significance of prioritizing respiratory pathogens based on factors such as the frequency of occurrence (seasonal or geographical), disease severity, ease of diagnosis and public health importance. The proposed surveillance-based diagnostic algorithm for ARI relies on a combination of gold-standard conventional methods, innovative serological and molecular techniques, as well as radiological approaches, which collectively contribute to the detection of various causative agents. The diagnostic part of the integrated algorithm can be dealt at the local microbiology laboratory of the healthcare facility with the few positive and negative specimens shipped to linked viral disease research laboratories (VRDLs) and other ICMR designated laboratories for genome characterisation, cluster identification and identification of novel agents.
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Affiliation(s)
- Vikas Manchanda
- Department of Microbiology, Maulana Azad Medical College, Delhi, India.
| | - Jayshree Muralidharan
- Department of Pediatric Medicine (Advanced Pediatric Centre), PGIMER, Chandigarh, India.
| | - Neeraj Nischal
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), Delhi, India
| | - Kshitij Aggarwal
- Department of Pulmonary and Critical Care Medicine, Institute of Heart and Lung Diseases, Bahadurgarh, Haryana, India
| | - Swati Gupta
- Department of Radiodiagnosis, Maulana Azad Medical College, Delhi, India
| | - Nivedita Gupta
- Division of Epidemiology & Communicable Diseases, ICMR Headquarters, New Delhi, India
| | - Anoop Velayudhan
- Division of Epidemiology & Communicable Diseases, ICMR Headquarters, New Delhi, India
| | - Harmanmeet Kaur
- Division of Epidemiology & Communicable Diseases, ICMR Headquarters, New Delhi, India
| | - Megha Brijwal
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Delhi, India
| | - Mala Chhabra
- Department of Microbiology, Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS) and Dr. Ram Manohar Lohia Hospital (RML), Delhi, India
| | | | | | - Sanjay K Mahajan
- Department of Medicine, Indira Gandhi Medical College & Hospital (IGMC), Shimla, India
| | - Saumya Deol
- Division of Epidemiology & Communicable Diseases, ICMR Headquarters, New Delhi, India
| | | | - Srestha Mitra
- Department of Microbiology, Maulana Azad Medical College, Delhi, India
| | - Sonal Saxena
- Department of Microbiology, Maulana Azad Medical College, Delhi, India
| | - Jyoti Kumar
- Department of Radiodiagnosis, Maulana Azad Medical College, Delhi, India
| | - Anju Garg
- Department of Radiodiagnosis, Maulana Azad Medical College, Delhi, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Delhi, India
| | - V Ravi
- Department of Neurovirology, NIMHANS, Bengaluru, India
| | - Manish Soneja
- Department of Medicine, All India Institute of Medical Sciences (AIIMS), Delhi, India
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8
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As AK, Sahay RR, Radhakrishnan C, P S, Kandath S, Patil DY, Shete AM, M S, Ramakrishnan G, Moorkoth AP, Gupta N, Yadav PD, Godbole S, Ramakrishnan LV, Vadekkandiyil S, Ekkalayil D, V N, Balakrishnan A, Pullor NK, Asokan N, Joseph RK, Nair PR, Purayil SM, Mathew T, Kizhakkekandiyil R, Poovullathil JK, Ps KS, Pt U, George K, Rahim A, Kumar S, S S, Mohandas S, Rajan LS, Ramachandran SP, Thampi SP, Ashadevi, Anish TS, Chandran P, Mohan A, Vadakkayil B, Koroth SC, Hafeez N, Sasi RR, Abraham M. Clinico-epidemiological presentations and management of Nipah virus infection during the outbreak in Kozhikode district, Kerala state, India 2023. J Med Virol 2024; 96:e29559. [PMID: 38529536 DOI: 10.1002/jmv.29559] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/09/2024] [Accepted: 03/13/2024] [Indexed: 03/27/2024]
Abstract
India experienced its sixth Nipah virus (NiV) outbreak in September 2023 in the Kozhikode district of Kerala state. The NiV is primarily transmitted by spillover events from infected bats followed by human-to-human transmission. The clinical specimens were screened using real-time RT-PCR, and positive specimens were further characterized using next-generation sequencing. We describe here an in-depth clinical presentation and management of NiV-confirmed cases and outbreak containment activities. The current outbreak reported a total of six cases with two deaths, with a case fatality ratio of 33.33%. The cases had a mixed presentation of acute respiratory distress syndrome and encephalitis syndrome. Fever was a persistent presentation in all the cases. The Nipah viral RNA was detected in clinical specimens until the post-onset day of illness (POD) 14, with viral load in the range of 1.7-3.3 × 104 viral RNA copies/mL. The genomic analysis showed that the sequences from the current outbreak clustered into the Indian clade similar to the 2018 and 2019 outbreaks. This study highlights the vigilance of the health system to detect and effectively manage the clustering of cases with clinical presentations similar to NiV, which led to early detection and containment activities.
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Affiliation(s)
| | - Rima R Sahay
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | | | - Shihabudheen P
- Iqraa International Hospital and Research Centre, Kozhikode, Kerala, India
| | | | - Deepak Y Patil
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Anita M Shete
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Shamsudheen M
- Iqraa International Hospital and Research Centre, Kozhikode, Kerala, India
| | | | | | | | - Pragya D Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Sheela Godbole
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | | | | | | | - Nithasha V
- Iqraa International Hospital and Research Centre, Kozhikode, Kerala, India
| | - Anukumar Balakrishnan
- Indian Council of Medical Research-National Institute of Virology, Kerala Unit, Alappuzha, Kerala, India
| | | | | | - Reena Kalathil Joseph
- Public Health Department of Kerala, Directorate of Health Services (IDSP), Thiruvananthapuram, Kerala, India
| | - Priyanka R Nair
- Iqraa International Hospital and Research Centre, Kozhikode, Kerala, India
| | | | - Thomas Mathew
- Director of Medical Education, Thiruvananthapuram, Kerala, India
| | - Rajaram Kizhakkekandiyil
- Public Health Department of Kerala, Directorate of Health Services (IDSP), Thiruvananthapuram, Kerala, India
| | | | - Kannan Sabarinath Ps
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Ullas Pt
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | | | - Asma Rahim
- Government Medical College, Kozhikode, Kerala, India
| | - Surendra Kumar
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Siba S
- Indian Council of Medical Research-National Institute of Virology, Kerala Unit, Alappuzha, Kerala, India
| | - Sreelekshmy Mohandas
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Lekshmi S Rajan
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Shamin Punnath Ramachandran
- Public Health Department of Kerala, Directorate of Health Services (IDSP), Thiruvananthapuram, Kerala, India
| | | | - Ashadevi
- Government Medical College, Kozhikode, Kerala, India
| | | | | | - Anuja Mohan
- Government Medical College, Kozhikode, Kerala, India
| | | | - Shaji Cheriya Koroth
- Public Health Department of Kerala, Directorate of Health Services (IDSP), Thiruvananthapuram, Kerala, India
| | - Nimin Hafeez
- Government Medical College, Kozhikode, Kerala, India
| | | | - Minu Abraham
- Public Health Department of Kerala, Directorate of Health Services (IDSP), Thiruvananthapuram, Kerala, India
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Jayaprakasam M, Pandey RM, Choudhary H, Shanmugam S, Sivaramakrishnan GN, Gupta N. Evaluation of molecular diagnostic test for detection of adult pulmonary tuberculosis: A generic protocol. Indian J Med Res 2024; 159:246-253. [PMID: 38511943 PMCID: PMC11050747 DOI: 10.4103/ijmr.ijmr_2316_23] [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: 12/08/2023] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND OBJECTIVES Tuberculosis (TB) continues to be the second most-leading cause of death due to a single infectious agent as of 2022 after COVID-19. Many affordable new molecular diagnostic tools are being developed for early and more accurate diagnosis, especially for low-resource settings in low- and middle-income countries. In this context, there is a need to develop a standardized protocol for validation of new diagnostic tools. Here, we describe a generic protocol for multi-centric clinical evaluation of molecular diagnostic tests for adult pulmonary TB. METHODS This protocol describes a cross-sectional study in TB reference laboratories in India. Adults (>18 yr) visitng the chest clinics or outpatient departments with symptoms of TB need to be enrolled consecutively till the required sample size of 150 culture positives and 470 culture negatives are met. Mycobacterium tuberculosis (Mtb) culture (mycobacteria growth indicator tube liquid culture) to be used under this protocol as the gold standard and Xpert MTB/RIF molecular test will be used as the comparator. The sputum samples will be tested by smear microscopy, Mtb culture, Xpert MTB/RIF and index molecular test as per the proposed algorithm. The specificity sensitivity, and positive/ negative predictive values are to be calculated for the index test with reference to the gold standard. DISCUSSION TB diagnosis poses many challenges as it differs with type of disease, age group, clinical settings and type of diagnostic tests/kits used. Globally, different protocols are used by several investigators. This protocol provides standard methods for the validation of molecular tests for diagnosis of adult pulmonary TB, which can be adopted by investigators.
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Affiliation(s)
| | | | | | - Sivakumar Shanmugam
- Department of Bacteriology, ICMR-National Institute for Research in Tuberculosis, Chennai, India
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10
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Yadav PD, Sardana V, Deshpande GR, Shinde PV, Thangaraj JWV, George LS, Sapkal GN, Patil DY, Sahay RR, Shete AM, Joshi M, Murhekar M, Godbole S, Gupta N, Prakash S, Rathore M, Ujjainiya R, Singh AP, Mishra A, Dash D, Chaudhary K, Sengupta S. Neutralizing antibody responses to SARS-CoV-2 Omicron variants: Post six months following two-dose & three-dose vaccination of ChAdOx1 nCoV-19 or BBV152. Indian J Med Res 2024; 159:223-231. [PMID: 38517215 PMCID: PMC11050759 DOI: 10.4103/ijmr.ijmr_948_23] [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: 05/18/2023] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND OBJECTIVES The Omicron sub-lineages are known to have higher infectivity, immune escape and lower virulence. During December 2022 - January 2023 and March - April 2023, India witnessed increased SARS-CoV-2 infections, mostly due to newer Omicron sub-lineages. With this unprecedented rise in cases, we assessed the neutralization potential of individuals vaccinated with ChAdOx1 nCoV (Covishield) and BBV152 (Covaxin) against emerging Omicron sub-lineages. METHODS Neutralizing antibody responses were measured in the sera collected from individuals six months post-two doses (n=88) of Covishield (n=44) or Covaxin (n=44) and post-three doses (n=102) of Covishield (n=46) or Covaxin (n=56) booster dose against prototype B.1 strain, lineages of Omicron; XBB.1, BQ.1, BA.5.2 and BF.7. RESULTS The sera of individuals collected six months after the two-dose and the three-dose demonstrated neutralizing activity against all variants. The neutralizing antibody (NAbs) level was highest against the prototype B.1 strain, followed by BA5.2 (5-6 fold lower), BF.7 (11-12 fold lower), BQ.1 (12 fold lower) and XBB.1 (18-22 fold lower). INTERPRETATION CONCLUSIONS Persistence of NAb responses was comparable in individuals with two- and three-dose groups post six months of vaccination. Among the Omicron sub-variants, XBB.1 showed marked neutralization escape, thus pointing towards an eventual immune escape, which may cause more infections. Further, the correlation of study data with complete clinical profile of the participants along with observations for cell-mediated immunity may provide a clear picture for the sustained protection due to three-dose vaccination as well as hybrid immunity against the newer variants.
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Affiliation(s)
| | - Viren Sardana
- Big Data and Informatics Unit, CSIR-Institute of Genomics & Integrative Biology, New Delhi, India
- Academy of Scientific & Innovative Research, Ghaziabad, Uttar Pradesh, India
| | | | | | | | - Leyanna S. George
- Division of Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | | | | | - Rima R. Sahay
- Maximum Containment Laboratory, Pune, Maharashtra, India
| | - Anita M. Shete
- Maximum Containment Laboratory, Pune, Maharashtra, India
| | - Madhavi Joshi
- Department of Science & Technology, Gujarat Biotechnology Research Centre, Gandhinagar, Gujarat, India
| | - Manoj Murhekar
- Department of Epidemiology & Biostatistics, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Sheela Godbole
- ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Nivedita Gupta
- Division of Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Satyartha Prakash
- Big Data and Informatics Unit, CSIR-Institute of Genomics & Integrative Biology, New Delhi, India
- Academy of Scientific & Innovative Research, Ghaziabad, Uttar Pradesh, India
| | - Mamta Rathore
- Cardiometabolic Disease Unit, CSIR-Institute of Genomics & Integrative Biology, New Delhi, India
- Academy of Scientific & Innovative Research, Ghaziabad, Uttar Pradesh, India
| | - Rajat Ujjainiya
- Cardiometabolic Disease Unit, CSIR-Institute of Genomics & Integrative Biology, New Delhi, India
- Academy of Scientific & Innovative Research, Ghaziabad, Uttar Pradesh, India
| | - Ajay Pratap Singh
- Cardiometabolic Disease Unit, CSIR-Institute of Genomics & Integrative Biology, New Delhi, India
- Academy of Scientific & Innovative Research, Ghaziabad, Uttar Pradesh, India
| | - Aastha Mishra
- Cardiometabolic Disease Unit, CSIR-Institute of Genomics & Integrative Biology, New Delhi, India
- Academy of Scientific & Innovative Research, Ghaziabad, Uttar Pradesh, India
| | - Debasis Dash
- Cardiometabolic Disease Unit, CSIR-Institute of Genomics & Integrative Biology, New Delhi, India
- Academy of Scientific & Innovative Research, Ghaziabad, Uttar Pradesh, India
| | - Kumardeep Chaudhary
- Big Data and Informatics Unit, CSIR-Institute of Genomics & Integrative Biology, New Delhi, India
- Academy of Scientific & Innovative Research, Ghaziabad, Uttar Pradesh, India
| | - Shantanu Sengupta
- Big Data and Informatics Unit, CSIR-Institute of Genomics & Integrative Biology, New Delhi, India
- Academy of Scientific & Innovative Research, Ghaziabad, Uttar Pradesh, India
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Aggarwal S, Agarwal P, Gupta N. A comprehensive narrative review of challenges and facilitators in the implementation of various HPV vaccination program worldwide. Cancer Med 2024; 13:e6862. [PMID: 38213086 PMCID: PMC10911072 DOI: 10.1002/cam4.6862] [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: 09/08/2023] [Revised: 11/08/2023] [Accepted: 11/25/2023] [Indexed: 01/13/2024] Open
Abstract
INTRODUCTION Cervical cancer has been considered as one of the most common cancers in women (15-44 years) globally, but the advent of the human papilloma virus (HPV) vaccine has raised the anticipation that eradication of cervical carcinoma might be achieved in the near future as several prophylactic cervical carcinoma vaccines have already been currently licensed in various countries. Countries should devise strategies, practices and policies to attain and sustain higher levels of HPV immunization coverage as still 68% countries have introduced HPV vaccine in their national immunization programs even after 17 years following the licensure of the first prophylactic HPV vaccine. METHODOLOGY A comprehensive literature analysis was conducted using various databases and search engines, to include the most relevant research articles and data available and critically discussed the operational gaps that need to be answered to achieve adequate coverage of HPV vaccination. RESULTS The present review highlights the existing HPV vaccination strategies, unmet needs and challenges needed to be addressed for proper implementation framework as well as the collaborations required to achieve decent vaccination coverage. Well-coordinated vaccination strategy with focus on adolescent girls and if possible, boys can lead to dramatic impact on disease reduction around the world.
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Affiliation(s)
- Sumit Aggarwal
- Division of ECD, Indian Council of Medical ResearchNew DelhiIndia
| | - Pragati Agarwal
- Division of ECD, Indian Council of Medical ResearchNew DelhiIndia
| | - Nivedita Gupta
- Division of ECD, Indian Council of Medical ResearchNew DelhiIndia
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12
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Godbole S, Diwan V, Das S, Reddy MM, Kalyanasundaram M, Rajendran D, Biswas D, Mamulwar M, Tiwari RR, Majumder J, Mishra A, Muthusamy SK, Memeenao M, Gupta N, Gupta S, George LS, Kadale P, Trushna T, Saha I, Alam U, Kathiresan J, Phukan SK, Sane S, Bhowmik K, Yadav GK, Krishnamurthy V, Gogoi P, Padhye K, Kant R, Ghosh P, Kharat M, Kulkarni A. Facilitators and barriers to the uptake of COVID-19 vaccine precaution dose among adult population: qualitative analysis across six different states of India. Front Public Health 2024; 11:1293600. [PMID: 38328539 PMCID: PMC10847555 DOI: 10.3389/fpubh.2023.1293600] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/22/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction India launched the COVID-19 vaccination drive on 16th January 2021 by vaccinating the adult population above 18 years of age. This was followed by the introduction of an additional precaution dose. As on 18th October 2022, 1,02,66,96,808 (1.02 Billion) first dose and 94, 95, 39,516 (949 Million) second doses of COVID-19 vaccine were administered. However, when compared to the uptake of the primary doses, the precaution dose uptake lagged behind with only 21,75, 12,721 (217 million) doses administered. Even though, the uptake of the primary doses remained optimal, irrespective of different interventions by the Government of India, the uptake of the precaution dose remained poor. In this context, the Ministry of Health & Family Welfare wanted to understand the facilitators and Barriers for precaution dose uptake among adults so that future immunization campaigns could address these issues. Methods An exploratory qualitative study was conducted to assess the facilitators and barriers for COVID-19 precaution dose uptake at community level across 6 different states in India. From each of the states, two districts with the highest and lowest rates of COVID-19 vaccine precaution dose uptake were selected. In each of these districts, 2 block Primary Healthcare Centres (PHCs), one with high and one with low uptake were identified. Within these block PHCs, a PHC field area with high and low precaution dose uptakes was identified. From the identified sites a minimum of four IDIs, four FGDs were conducted among the community members. KIIs of the State Immunization Officers, District Immunisation Officers, PHC Medical Officers, healthcare workers like Accredited Social Health Activist/Auxiliary Nurse Midwife were also conducted. The data was audio recorded and it was transcribed, translated and analysed using framework approach. Results It was observed that rise in COVID-19 cases prompted the community to take the precaution dose, this along with the cost of hospitalization and the number of productive days being lost as a result of being infected resulted in vaccine uptake. The fear of non-availability of COVID-19 vaccines latter on also prompted people for vaccine uptake. While the barriers were, poor accessibility to vaccination centers, long hours of travel, poor road connectivity and lack of transportation facilities. However, the most prominent barriers observed across all study sites was that a sense of pandemic fatigue and complacency had developed both among the providers as well as the beneficiaries. Other barriers include differences in vaccination schedules and longer duration between the primary doses of some vaccines. Media was identified to be both a barrier and facilitator for Covid-19 Precaution dose uptake. Even though media played an important role in disseminating information in the beginning of the campaign, it was soon followed by the circulation of both misinformation and disinformation. Discussion The study identified that dissemination of accurate information and community involvement at each stage of planning and implementation are crucial for the success of any campaign. Efforts should be constantly made to address and re-invent strategies that will be most suitable for the needs of the community. Therefore, in order to ensure successful vaccination campaigns, it is crucial that along with political will it is also important to have a decentralized approach with inter-sectoral coordination with different stakeholders such as healthcare workers, community members and the different departments such as the local self-governments, education department, law & order department etc. These lessons learnt from COVID-19 vaccination campaigns must not be forgotten and must be applied in future vaccination campaigns and while framing public health policies.
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Affiliation(s)
| | - Vishal Diwan
- ICMR-National Institute for Research in Environmental Health, Bhopal, India
| | - Saibal Das
- ICMR-Centre for Ageing and Mental Health, Kolkata, India
| | | | | | | | - Dipankar Biswas
- ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, India
| | | | | | | | - Ayush Mishra
- ICMR-Regional Medical Research Centre Gorakhpur, Gorakhpur, India
| | | | - M. Memeenao
- ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, India
| | - Nivedita Gupta
- Division of Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Swati Gupta
- Division of Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Leyanna Susan George
- Division of Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | | | - Tanwi Trushna
- ICMR-National Institute for Research in Environmental Health, Bhopal, India
| | - Indranil Saha
- ICMR-Centre for Ageing and Mental Health, Kolkata, India
| | - Umaer Alam
- ICMR-Regional Medical Research Centre Gorakhpur, Gorakhpur, India
| | | | | | - Suvarna Sane
- ICMR-National AIDS Research Institute, Pune, India
| | - Kalyan Bhowmik
- ICMR-Centre for Ageing and Mental Health, Kolkata, India
| | | | | | - Punananda Gogoi
- ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, India
| | - Kedar Padhye
- ICMR-National AIDS Research Institute, Pune, India
| | - Rajni Kant
- ICMR-Regional Medical Research Centre Gorakhpur, Gorakhpur, India
| | - Pramit Ghosh
- ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, India
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13
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Das A, Ariyakumar G, Gupta N, Kamdar S, Barugahare A, Deveson-Lucas D, Gee S, Costeloe K, Davey MS, Fleming P, Gibbons DL. Identifying immune signatures of sepsis to increase diagnostic accuracy in very preterm babies. Nat Commun 2024; 15:388. [PMID: 38195661 PMCID: PMC10776581 DOI: 10.1038/s41467-023-44387-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/12/2023] [Indexed: 01/11/2024] Open
Abstract
Bacterial infections are a major cause of mortality in preterm babies, yet our understanding of early-life disease-associated immune dysregulation remains limited. Here, we combine multi-parameter flow cytometry, single-cell RNA sequencing and plasma analysis to longitudinally profile blood from very preterm babies (<32 weeks gestation) across episodes of invasive bacterial infection (sepsis). We identify a dynamically changing blood immune signature of sepsis, including lymphopenia, reduced dendritic cell frequencies and myeloid cell HLA-DR expression, which characterizes sepsis even when the common clinical marker of inflammation, C-reactive protein, is not elevated. Furthermore, single-cell RNA sequencing identifies upregulation of amphiregulin in leukocyte populations during sepsis, which we validate as a plasma analyte that correlates with clinical signs of disease, even when C-reactive protein is normal. This study provides insights into immune pathways associated with early-life sepsis and identifies immune analytes as potential diagnostic adjuncts to standard tests to guide targeted antibiotic prescribing.
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Affiliation(s)
- A Das
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK.
- Division of Infection and Immunity, University College London, London, WC1E 6BT, UK.
| | - G Ariyakumar
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - N Gupta
- Department of Neonatology, Evelina London Neonatal Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - S Kamdar
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - A Barugahare
- Bioinformatics Platform and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
| | - D Deveson-Lucas
- Bioinformatics Platform and Department of Microbiology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
| | - S Gee
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK
| | - K Costeloe
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - M S Davey
- Infection and Immunity Program and Department of Biochemistry and Molecular Biology, Biomedicine Discovery Institute, Monash University, Clayton, VIC, 3800, Australia
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - P Fleming
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Neonatology, Homerton Healthcare NHS Foundation Trust, London, UK
| | - D L Gibbons
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, Guy's Hospital, London, UK.
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Aggarwal S, Agarwal P, Nigam K, Vijay N, Yadav P, Gupta N. Mapping the Landscape of Health Research Priorities for Effective Pandemic Preparedness in Human Mpox Virus Disease. Pathogens 2023; 12:1352. [PMID: 38003816 PMCID: PMC10674790 DOI: 10.3390/pathogens12111352] [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: 09/16/2023] [Revised: 10/13/2023] [Accepted: 10/19/2023] [Indexed: 11/26/2023] Open
Abstract
The global re-emergence of monkeypox (Mpox) in non-endemic regions in 2022 has highlighted the critical importance of timely virus detection and robust public health surveillance in assessing outbreaks and their impact. Despite significant Mpox research being conducted worldwide, there is an urgent need to identify knowledge gaps and prioritize key research areas in order to create a roadmap that maximizes the utilization of available resources. The present research article provides a comprehensive mapping of health research priorities aimed at advancing our understanding of Mpox and developing effective interventions for managing its outbreaks, and, as evidenced by the fact that achieving this objective requires close interdisciplinary collaboration. The key research priorities observed were identifying variants responsible for outbreaks; discovering novel biomarkers for diagnostics; establishing suitable animal models; investigating reservoirs and transmission routes; promoting the One Health approach; identifying targets for vaccination; gaining insight into the attitudes, experiences, and practices of key communities, including stigma; and ensuring equity during public health emergencies. The findings of this study hold significant implications for decision making by multilateral partners, including research funders, public health practitioners, policy makers, clinicians, and civil society, which will facilitate the development of a comprehensive plan not only for Mpox but also for other similar life-threatening viral infections.
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Affiliation(s)
- Sumit Aggarwal
- Indian Council of Medical Research, New Delhi 110029, India; (S.A.)
| | - Pragati Agarwal
- Indian Council of Medical Research, New Delhi 110029, India; (S.A.)
| | - Kuldeep Nigam
- Indian Council of Medical Research, New Delhi 110029, India; (S.A.)
| | - Neetu Vijay
- Indian Council of Medical Research, New Delhi 110029, India; (S.A.)
| | - Pragya Yadav
- ICMR-National Institute of Virology, Pune 411001, India
| | - Nivedita Gupta
- Indian Council of Medical Research, New Delhi 110029, India; (S.A.)
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15
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Potdar V, Vijay N, Vipat V, Jadhav S, Gupta N, Aggarwal N. External quality assessment for laboratories in pan-India ILI/SARI surveillance for simultaneous detection of influenza virus and SARS-CoV-2. Front Public Health 2023; 11:1274508. [PMID: 38026348 PMCID: PMC10679675 DOI: 10.3389/fpubh.2023.1274508] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The Indian Council of Medical Research has set up a nationwide network of 28 laboratories for simultaneous surveillance of influenza virus and SARS-CoV-2 in ILI/SARI patients, using an in-house developed and validated multiplex real-time RTPCR assay. The aim of this study was to ensure the quality of testing by these laboratories by implementing an external quality assessment program (EQAP). Methods For this EQAP, a proficiency test (PT) panel comprising tissue-culture or egg-grown influenza virus and SARS-CoV-2 was developed. The PT panel was distributed to all the participant laboratories, which tested the panel and submitted the qualitative results online to the EQAP provider. The performance of the laboratories was evaluated on qualitative criteria but cycle threshold (Ct) values were also gathered for each sample. Results On a qualitative basis, all the laboratories achieved the criteria of 90% concordance with the results of the PT panel provider. Ct values of different samples across the laboratories were within ≤ ±3 cycles of the corresponding mean values of the respective sample. The results of this EQAP affirmed the quality and reliability of testing being done for simultaneous surveillance of influenza virus and SARS-CoV-2 in India.
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Affiliation(s)
- Varsha Potdar
- Indian Council of Medical Research–National Institute of Virology, Pune, India
| | - Neetu Vijay
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Veena Vipat
- Indian Council of Medical Research–National Institute of Virology, Pune, India
| | - Sheetal Jadhav
- Indian Council of Medical Research–National Institute of Virology, Pune, India
| | - Nivedita Gupta
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Neeraj Aggarwal
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
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16
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Potdar V, Vijay N, Mukhopadhyay L, Aggarwal N, Bhardwaj SD, Choudhary ML, Gupta N, Kaur H, Narayan J, Kumar P, Singh H, Abdulkader RS, Murhekar M, Mishra M, Thangavel S, Nagamani K, Dhodapkar R, Fomda BA, Varshney U, Majumdar A, Dutta S, Vijayachari P, Turuk J, Majumdar T, Sahoo GC, Pandey K, Bhargava A, Negi SS, Khatri PK, Kalawat U, Biswas D, Khandelwal N, Borkakoty B, Manjushree S, Singh MP, Iravane J, Kaveri K, Shantala GB, Brijwal M, Choudhary A, Dar L, Malhotra B, Jain A. Pan-India influenza-like illness (ILI) and Severe acute respiratory infection (SARI) surveillance: epidemiological, clinical and genomic analysis. Front Public Health 2023; 11:1218292. [PMID: 37927860 PMCID: PMC10624221 DOI: 10.3389/fpubh.2023.1218292] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 09/18/2023] [Indexed: 11/07/2023] Open
Abstract
Background Over time, COVID-19 testing has significantly declined across the world. However, it is critical to monitor the virus through surveillance. In late 2020, WHO released interim guidance advising the use of the existing Global Influenza Surveillance and Response System (GISRS) for the integrated surveillance of influenza and SARS-CoV-2. Methods In July 2021, we initiated a pan-India integrated surveillance for influenza and SARS-CoV-2 through the geographically representative network of Virus Research and Diagnostic Laboratories (VRDLs) across 26 hospital and laboratory sites and 70 community sites. A total of 34,260 cases of influenza-like illness (ILI) and Severe acute respiratory infection (SARI) were enrolled from 4 July 2021 to 31 October 2022. Findings Influenza A(H3) and B/Victoria dominated during 2021 monsoon season while A(H1N1)pdm09 dominated during 2022 monsoon season. The SARS-CoV-2 "variants of concern" (VoC) Delta and Omicron predominated in 2021 and 2022, respectively. Increased proportion of SARI was seen in extremes of age: 90% cases in < 1 year; 68% in 1 to 5 years and 61% in ≥ 8 years age group. Approximately 40.7% of enrolled cases only partially fulfilled WHO ILI and SARI case definitions. Influenza- and SARS-CoV-2-infected comorbid patients had higher risks of hospitalization, ICU admission, and oxygen requirement. Interpretation The results depicted the varying strains and transmission dynamics of influenza and SARS-CoV-2 viruses over time, thus emphasizing the need to continue and expand surveillance across countries for improved decision making. The study also describes important information related to clinical outcomes of ILI and SARI patients and highlights the need to review existing WHO ILI and SARI case definitions.
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Affiliation(s)
| | - Neetu Vijay
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Labanya Mukhopadhyay
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Neeraj Aggarwal
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | | | | | - Nivedita Gupta
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Harmanmeet Kaur
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Jitendra Narayan
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Prabhat Kumar
- Biomedical Informatics (BMI) Division, Indian Council of Medical Research, New Delhi, India
| | - Harpreet Singh
- Biomedical Informatics (BMI) Division, Indian Council of Medical Research, New Delhi, India
| | | | | | - Meena Mishra
- VRDL, All India Institute of Medical Sciences, Nagpur, India
| | | | - K. Nagamani
- VRDL, Gandhi Medical College, Secunderabad, India
| | - Rahul Dhodapkar
- VRDL, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | | | - Agniva Majumdar
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shanta Dutta
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - P. Vijayachari
- ICMR-Regional Medical Research Centre, Port Blair, India
| | | | | | | | - Krishna Pandey
- ICMR-Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | | | | | | | - Usha Kalawat
- VRDL, Sri Venkateswara Institute of Medical Sciences, Tirupati, India
| | - Debasis Biswas
- VRDL, All India Institute of Medical Sciences, Bhopal, India
| | | | | | | | - Mini P. Singh
- VRDL, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - K. Kaveri
- VRDL, King Institute of Preventive Medicine and Research, Chennai, India
| | - G. B. Shantala
- VRDL, Bangalore Medical College and Research Institute, Bangalore, India
| | - Megha Brijwal
- VRDL, All India Institute of Medical Sciences, New Delhi, India
| | | | - Lalit Dar
- VRDL, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amita Jain
- VRDL, King George’s Medical University, Lucknow, India
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Whitcroft KL, Altundag A, Balungwe P, Boscolo-Rizzo P, Douglas R, Enecilla MLB, Fjaeldstad AW, Fornazieri MA, Frasnelli J, Gane S, Gudziol H, Gupta N, Haehner A, Hernandez AK, Holbrook EH, Hopkins C, Hsieh JW, Huart C, Husain S, Kamel R, Kim JK, Kobayashi M, Konstantinidis I, Landis BN, Lechner M, Macchi A, Mazal PP, Miri I, Miwa T, Mori E, Mullol J, Mueller CA, Ottaviano G, Patel ZM, Philpott C, Pinto JM, Ramakrishnan VR, Roth Y, Schlosser RJ, Stjärne P, Van Gerven L, Vodicka J, Welge-Luessen A, Wormald PJ, Hummel T. Position paper on olfactory dysfunction: 2023. Rhinology 2023; 61:1-108. [PMID: 37454287 DOI: 10.4193/rhin22.483] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/18/2023]
Abstract
BACKGROUND Since publication of the original Position Paper on Olfactory Dysfunction in 2017 (PPOD-17), the personal and societal burden of olfactory disorders has come sharply into focus through the lens of the COVID-19 pandemic. Clinicians, scientists and the public are now more aware of the importance of olfaction, and the impact of its dysfunction on quality of life, nutrition, social relationships and mental health. Accordingly, new basic, translational and clinical research has resulted in significant progress since the PPOD-17. In this updated document, we present and discuss currently available evidence for the diagnosis and management of olfactory dysfunction. Major updates to the current version include, amongst others: new recommendations on olfactory related terminology; new imaging recommendations; new sections on qualitative OD and COVID-19 OD; updated management section. Recommendations were agreed by all co-authors using a modified Delphi process. CONCLUSIONS We have provided an overview of current evidence and expert-agreed recommendations for the definition, investigation, and management of OD. As for our original Position Paper, we hope that this updated document will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency, and generalisability of work in this field.
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Affiliation(s)
- K L Whitcroft
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
- and The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
| | - A Altundag
- Department of Otorhinolaryngology, Istanbul Surgery Hospital, Istanbul, Turkey
| | - P Balungwe
- Faculté de Médecine, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
- and Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - P Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - R Douglas
- Department of Otorhinolaryngology, University of Auckland, New Zealand
| | - M L B Enecilla
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Luke's Medical Center, Global City, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otorhinolaryngology, Medical Center Taguig, Taguig, Philippines
| | - A W Fjaeldstad
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Department of Otorhinolaryngology, University Clinic for Flavour, Balance and Sleep, Regional Hospital Gødstrup, Herning, Denmark
- and Department of Clinical Medicine, Flavour Institute, Aarhus University, Aarhus, Denmark
- and Center for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
| | - M A Fornazieri
- Department of Clinical Surgery, Universidade Estadual de Londrina and Pontifícia Universidade Católica do Paraná, Londrina, Brazil
| | - J Frasnelli
- Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- and Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - S Gane
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Royal National Throat Nose and Ear Hospital, UCLH, London
| | - H Gudziol
- Department of Otorhinolaryngology, University of Jena, Jena, Germany
| | - N Gupta
- Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - A K Hernandez
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines
| | - E H Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - C Hopkins
- Guys and St Thomas NHS Trust, London, United Kingdom
| | - J W Hsieh
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - C Huart
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium
- and Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - S Husain
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - R Kamel
- Department of Otorhinolaryngology, Cairo University, Cairo, Egypt
| | - J K Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University, College of Medicine, Seoul, Republic of Korea
| | - M Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - I Konstantinidis
- Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - B N Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - M Lechner
- Division of Surgery and Interventional Science, University College London, London, UK
- and UCL Cancer Institute, University College London, London, UK
- and ENT Department, Homerton Healthcare NHS Foundation Trust, London, UK
| | - A Macchi
- ENT Clinic, University of Insubria, ASST Sette Laghi, Varese, Italy
| | - P P Mazal
- Servicio de Otorrinolaringología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - I Miri
- Service Médecine Physique Réadaptation fonctionnelle, Institut Mohamed Kassab d'Orthopédie, Mannouba, Tunisia
| | - T Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan
| | - E Mori
- Department of Otorhinolaryngology, Jikei University, School of Medicine, Tokyo, Japan
| | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona
- IDIBAPS
- CIBERES. Barcelona, Catalonia, Spain
| | - C A Mueller
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - G Ottaviano
- Department of Neurosciences DNS, Otolaryngology Section, University, Padua, Italy
| | - Z M Patel
- Department of Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
- and The Smell and Taste Clinic, James Paget University Hospital, Gorleston, UK
| | - J M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - V R Ramakrishnan
- Department of Otolaryngology-Head and Neck Surgery, Indiana University of School Medicine, Indianapolis, IN, USA
| | - Y Roth
- The Institute for Nose and Sinus Therapy and Clinical Investigations, Department of Otolaryngology - Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler Faculty of Medicine, Holon, Israel
| | - R J Schlosser
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - P Stjärne
- Section of Rhinology, Department of Otorhinolaryngology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - L Van Gerven
- Department of Otorhinolaryngology, UZ Leuven, Belgium
- and Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Belgium
- and Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Unit, KU Leuven, Belgium
| | - J Vodicka
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - A Welge-Luessen
- University Hospital Basel - Otorhinolaryngology, Basel, Switzerland
| | - P J Wormald
- Department of Surgery-Otorhinolaryngology Head and Neck Surgery, University of Adelaide, Adelaide, SA, Australia
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Jain S, Cetnar A, Woollard J, Gupta N, Blakaj D, Chakravarti A, Ayan AS. Pulse parameter optimizer: an efficient tool for achieving prescribed dose and dose rate with electron FLASH platforms. Phys Med Biol 2023; 68:19NT01. [PMID: 37735967 DOI: 10.1088/1361-6560/acf63e] [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: 04/24/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023]
Abstract
Purpose. Commercial electron FLASH platforms deliver ultra-high dose rate doses at discrete combinations of pulse parameters including pulse width (PW), pulse repetition frequency (PRF) and number of pulses (N), which dictate unique combinations of dose and dose rates. Additionally, collimation, source to surface distance, and airgaps also vary the dose per pulse (DPP). Currently, obtaining pulse parameters for the desired dose and dose rate is a cumbersome manual process involving creating, updating, and looking up values in large spreadsheets for every treatment configuration. This work presents a pulse parameter optimizer application to match intended dose and dose rate precisely and efficiently.Methods. Dose and dose rate calculation methods have been described for a commercial electron FLASH platform. A constrained optimization for the dose and dose rate cost function was modelled as a mixed integer problem in MATLAB (The MathWorks Inc., Version9.13.0 R2022b, Natick, Massachusetts). The beam and machine data required for the application were acquired using GafChromic film and alternating current current transformers (ACCTs). Variables for optimization included DPP for every collimator, PW and PRF measured using ACCT and airgap factors.Results. Using PW, PRF,Nand airgap factors as parameters, a software was created to optimize dose and dose rate, reaching the closest match if exact dose and dose rates are not achievable. Optimization took 20 s or less to converge to results. This software was validated for accuracy of dose calculation and precision in matching prescribed dose and dose rate.Conclusion. A pulse parameter optimization application was built for a commercial electron FLASH platform to increase efficiency in dose, dose rate, and pulse parameter prescription process. Automating this process reduces safety concerns associated with manual look up and calculation of these parameters, especially when many subjects at different doses and dose rates are to be safely managed.
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Affiliation(s)
- S Jain
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A Cetnar
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - J Woollard
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - N Gupta
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - D Blakaj
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A Chakravarti
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A S Ayan
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
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Abstract
Zika virus (ZIKV) is an arthropod-borne flavivirus that presents with acute febrile illness associated with rash, arthralgia and conjunctivitis. After years of sporadic reports in Africa, the three major outbreaks of this disease occurred in Yap Islands (2007), French Polynesia (2013-14) and South Americas (2015-16). Although, serological surveys suggested the presence of ZIKV in India in 1950s, cross-reactivity could not be ruled out. The first four proven cases of ZIKV from India were reported in 2017. This was followed by major outbreaks in the states of Rajasthan and Madhya Pradesh in 2018. Fortunately, the outbreaks in India were not associated with neurological complications. These outbreaks in India highlighted the spread of this disease beyond geographical barriers owing to the growing globalization, increased travel and ubiquitous presence of its vector, the Aedes mosquito. In this review, we discuss the epidemiology, clinical features and management of ZIKV in India.
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Affiliation(s)
- N Gupta
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
| | - P Kodan
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
| | - K Baruah
- National Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, Government of India, 22 Shyam Nath Marg, New Delhi 110054, India
| | - M Soneja
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
| | - A Biswas
- From the Department of Medicine, All India Institute of Medical Sciences, 3rd Floor, Teaching Block, New Delhi 110029
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20
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Abdulkader RS, Potdar V, Mohd G, Chadwick J, Raju MK, Devika S, Bharadwaj SD, Aggarwal N, Vijay N, Sugumari C, Sundararajan T, Vasuki V, Bharathi Santhose N, Mohammed Razik CA, Madhavan V, Krupa NC, Prabakaran N, Murhekar MV, Gupta N. Protocol for establishing a model for integrated influenza surveillance in Tamil Nadu, India. Front Public Health 2023; 11:1236690. [PMID: 37663861 PMCID: PMC10469860 DOI: 10.3389/fpubh.2023.1236690] [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: 06/08/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023] Open
Abstract
The potential for influenza viruses to cause public health emergencies is great. The World Health Organisation (WHO) in 2005 concluded that the world was unprepared to respond to an influenza pandemic. Available surveillance guidelines for pandemic influenza lack the specificity that would enable many countries to establish operational surveillance plans. A well-designed epidemiological and virological surveillance is required to strengthen a country's capacity for seasonal, novel, and pandemic influenza detection and prevention. Here, we describe the protocol to establish a novel mechanism for influenza and SARS-CoV-2 surveillance in the four identified districts of Tamil Nadu, India. This project will be carried out as an implementation research. Each district will identify one medical college and two primary health centres (PHCs) as sentinel sites for collecting severe acute respiratory infections (SARI) and influenza like illness (ILI) related information, respectively. For virological testing, 15 ILI and 10 SARI cases will be sampled and tested for influenza A, influenza B, and SARS-CoV-2 every week. Situation analysis using the WHO situation analysis tool will be done to identify the gaps and needs in the existing surveillance systems. Training for staff involved in disease surveillance will be given periodically. To enhance the reporting of ILI/SARI for sentinel surveillance, trained project staff will collect information from all ILI/SARI patients attending the sentinel sites using pre-tested tools. Using time, place, and person analysis, alerts for abnormal increases in cases will be generated and communicated to health authorities to initiate response activities. Advanced epidemiological analysis will be used to model influenza trends over time. Integrating virological and epidemiological surveillance data with advanced analysis and timely communication can enhance local preparedness for public health emergencies. Good quality surveillance data will facilitate an understanding outbreak severity and disease seasonality. Real-time data will help provide early warning signals for prevention and control of influenza and COVID-19 outbreaks. The implementation strategies found to be effective in this project can be scaled up to other parts of the country for replication and integration.
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Affiliation(s)
| | | | - Gulam Mohd
- National Institute of Epidemiology, Chennai, India
| | | | | | - S. Devika
- National Institute of Epidemiology, Chennai, India
| | | | | | - Neetu Vijay
- Indian Council of Medical Research, New Delhi, India
| | | | - T. Sundararajan
- Government Mohan Kumaramangalam Medical College, Salem, India
| | - V. Vasuki
- Tiruvarur Medical College Hospital, Tiruvarur, India
| | | | | | | | - N. C. Krupa
- National Institute of Epidemiology, Chennai, India
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21
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Panwar V, Gupta N, Bhoriwal SK. Left main bronchus completely occluded by tumour fragment following right pneumonectomy. Anaesth Rep 2023; 11:e12261. [PMID: 38028659 PMCID: PMC10680573 DOI: 10.1002/anr3.12261] [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] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- V. Panwar
- Department of Onco‐Anaesthesia and Palliative MedicineDr. B.R.A. Institute‐Rotary Cancer Hospital, All India Institute of Medical SciencesNew DelhiIndia
| | - N. Gupta
- Department of Onco‐Anaesthesia and Palliative MedicineDr. B.R.A. Institute‐Rotary Cancer Hospital, All India Institute of Medical SciencesNew DelhiIndia
| | - S. K. Bhoriwal
- Department of Surgical OncologyDr. B.R.A. Institute‐Rotary Cancer Hospital, All India Institute of Medical SciencesNew DelhiIndia
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22
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van Riel L, van Hulst RA, van Hest L, van Moorselaar RJA, Boerrigter BG, Franken SM, Wolthuis RMF, Dubbink HJ, Marciniak SJ, Gupta N, van de Beek I, Houweling AC. Recommendations on scuba diving in Birt-Hogg-Dubé syndrome. Expert Rev Respir Med 2023; 17:1003-1008. [PMID: 37991821 PMCID: PMC10763569 DOI: 10.1080/17476348.2023.2284375] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION Although very uncommon, severe injury and death can occur during scuba diving. One of the main causes of scuba diving fatalities is pulmonary barotrauma due to significant changes in ambient pressure. Pathology of the lung parenchyma, such as cystic lesions, might increase the risk of pulmonary barotrauma. AREAS COVERED Birt-Hogg-Dubé syndrome (BHD), caused by pathogenic variants in the FLCN gene, is characterized by skin fibrofolliculomas, an increased risk of renal cell carcinoma, multiple lung cysts and spontaneous pneumothorax. Given the pulmonary involvement, in some countries patients with BHD are generally recommended to avoid scuba diving, although evidence-based guidelines are lacking. We aim to provide recommendations on scuba diving for patients with BHD, based on a survey of literature on pulmonary cysts and pulmonary barotrauma in scuba diving. EXPERT OPINION In our opinion, although the absolute risks are likely to be low, caution is warranted. Given the relative paucity of literature and the potential fatal outcome, patients with BHD with a strong desire for scuba diving should be informed of the potential risks in a personal assessment. If available a diving physician should be consulted, and a low radiation dose chest computed tomography (CT)-scan to assess pulmonary lesions could be considered.
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Affiliation(s)
- L. van Riel
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - RA. van Hulst
- Department of Hyperbaric Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - L. van Hest
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - RJA. van Moorselaar
- Department of Urology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - BG. Boerrigter
- Department of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - SM. Franken
- Department of Dermatology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - RMF. Wolthuis
- Department of Human Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - HJ. Dubbink
- Department of Pathology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - SJ. Marciniak
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK
- Royal Papworth Hospital, Trumpington, Cambridge, UK
| | - N. Gupta
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - I. van de Beek
- Family Cancer Clinic, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - AC. Houweling
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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23
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George E, MacPherson C, Pruthi S, Bilaniuk L, Fletcher J, Houtrow A, Gupta N, Glenn OA. Long-Term Imaging Follow-up from the Management of Myelomeningocele Study. AJNR Am J Neuroradiol 2023:ajnr.A7926. [PMID: 37385677 PMCID: PMC10337608 DOI: 10.3174/ajnr.a7926] [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] [Received: 04/18/2023] [Accepted: 05/23/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND AND PURPOSE Short-term results demonstrate that prenatal repair of a myelomeningocele is associated with a reduction in hydrocephalus and an increased likelihood of the reversal of Chiari II malformations compared with postnatal repair. The purpose of this study was to identify the long-term imaging findings at school age among subjects who underwent pre- versus postnatal repair of a myelomeningocele. MATERIALS AND METHODS A subset of subjects enrolled in the Management of Myelomeningocele Study who underwent either prenatal (n = 66) or postnatal (n = 63) repair of a lumbosacral myelomeningocele and had follow-up brain MR imaging at school age were included. The prevalence of posterior fossa features of Chiari II malformation and supratentorial abnormalities and the change in these findings from fetal to school-age MR imaging were compared between the 2 groups. RESULTS Prenatal repair of a myelomeningocele was associated with higher rates of normal location of fourth ventricle and lower rates of hindbrain herniation, cerebellar herniation, tectal beaking, brainstem distortion, and kinking at school age compared with postnatal repair (all P < .01). Supratentorial abnormalities, including corpus callosal abnormalities, gyral abnormalities, heterotopia, and hemorrhage, were not significantly different between the 2 groups (all P > .05). The rates of resolution of brainstem kinking, tectal beaking, cerebellar and hindbrain herniation, and normalization of fourth ventricle size from fetal to school age MR imaging were higher among the prenatal compared with postnatal surgery group (all, P < .02). CONCLUSIONS Prenatal repair of a myelomeningocele is associated with persistent improvement in posterior fossa imaging findings of Chiari II malformation at school age compared with postnatal repair.
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Affiliation(s)
- E George
- From the Departments of Radiology and Biomedical Imaging (E.G., O.A.G.)
| | - C MacPherson
- Biostatistics Center (C.M.), Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - S Pruthi
- Department of Radiology (S.P.), Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - L Bilaniuk
- Department of Radiology (L.B.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - J Fletcher
- Department of Psychology (J.F.), University of Houston, Houston, Texas
| | - A Houtrow
- Department of Physical Medicine and Rehabilitation (A.H.), University of Pittsburgh, Pittsburgh, Pennsylvania
| | - N Gupta
- Neurological Surgery (N.G.)
- Pediatrics (N.G.), University of California, San Francisco, San Francisco, California
| | - O A Glenn
- From the Departments of Radiology and Biomedical Imaging (E.G., O.A.G.)
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Jain A, Jain P, Rebello SC, Todaria M, Kaur H, Gupta N, Aggarwal N, Vijay N, Narayan J. Determination of a cut-off value for the serological diagnosis of scrub typhus by detecting anti- Orientia tsutsugamushi immunoglobulin M. Indian J Med Res 2023; 157:519-523. [PMID: 37530306 PMCID: PMC10466483 DOI: 10.4103/ijmr.ijmr_4098_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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Indexed: 08/03/2023] Open
Abstract
Background & objectives The diagnosis of scrub typhus (ST) is usually done using enzyme-linked immunosorbent assay (ELISA) due to its ease of performance and reading objectivity. The cut-off value for ELISA needs to be calculated for each geographical location as it depends on zonal endemicity of the disease. This study was, therefore, undertaken to calculate the pan-India cut-off for anti-Orientia tsutsugamushi (OT) immunoglobulin M (IgM) by ELISA. Methods Samples from cases (cases of ST) and controls (voluntary, consenting, healthy adults) were collected by a network of 29 laboratories across India and tested for anti-OT IgM by immunofluorescence assay (IFA), the considered gold standard test. These samples were retested by ELISA for anti-OT IgM and their optical densities (ODs) were used for cut-off estimation by receiver operating characteristic (ROC) curve. Results Anti-OT IgM ELISA ODs from 273 controls and 136 cases were used for the cut-off estimation. The ODs of the anti-OT IgM ELISA on healthy individuals and those of confirmed ST cases ranged from 0.1 to 0.75 and 0.5 to 4.718, respectively. ROC curve-based cut-off for ELISA was calculated as 0.554 at a sensitivity of 95.2 per cent and specificity of 95.1 per cent. A value of >1 was noted to have a specificity of 100 per cent in diagnosing ST. Interpretation & conclusions The cut-off calculated for India was similar to the previous cut-off that was used until now.
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Affiliation(s)
- Amita Jain
- Department of Microbiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Parul Jain
- Department of Microbiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Sanjay C. Rebello
- Department of Microbiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Moulika Todaria
- Department of Microbiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Harmanmeet Kaur
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Nivedita Gupta
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Neeraj Aggarwal
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Neetu Vijay
- Department of Health Research, Government of India, New Delhi, India
| | - Jitendra Narayan
- Department of Health Research, Government of India, New Delhi, India
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Shanmugasundaram D, Verma S, Singh K, Dwibedi B, Awasthi S, Mahantesh S, Singh H, Santhanam S, Mondal N, S G, Sreenivasan P, Malik S, Jain M, Viswanathan R, Tripathi S, Patel B, Sapkal G, Sabarinathan R, Singh MP, Ratho R, Nag V, Gadepalli R, Som TK, Mishra B, Jain A, Ashok M, Madhuri DS, Rani VS, Abraham AM, John D, Dhodapkar R, Syed Ali A, Biswas D, Pratyeke D, Bavdekar A, Prakash J, Singh V, Prasad N, Ray J, Majumdar A, Dutta S, Gupta N, Murhekar M, Sharma A, Ghosh A, Alexander A, Baranwal A, Anantharaj A, Bethou A, Shekhawat DS, Kiruthika G, Ram J, Gupta M, Gowda M, Rohit MK, Dash N, Sankhyan N, Kaushal N, Shivanna NH, Kasturi N, Kumar PP, Gupta PC, Gunasekaran PK, Singh P, Kumar P, Munjal SK, Agarwal S, Manasa S, Shukla S, Nehra U, Verghese VP, Vyas V, Gupta V. Congenital rubella syndrome surveillance in India, 2016-21: Analysis of five years surveillance data. Heliyon 2023; 9:e15965. [PMID: 37251844 PMCID: PMC10209330 DOI: 10.1016/j.heliyon.2023.e15965] [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] [Received: 07/25/2022] [Revised: 04/19/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Background In India, facility-based surveillance for congenital rubella syndrome (CRS) was initiated in 2016 to estimate the burden and monitor the progress made in rubella control. We analyzed the surveillance data for 2016-2021 from 14 sentinel sites to describe the epidemiology of CRS. Method We analyzed the surveillance data to describe the distribution of suspected and laboratory confirmed CRS patients by time, place and person characteristics. We compared clinical signs of laboratory confirmed CRS and discarded case-patients to find independent predictors of CRS using logistic regression analysis and developed a risk prediction model. Results During 2016-21, surveillance sites enrolled 3940 suspected CRS case-patients (Age 3.5 months, SD: 3.5). About one-fifth (n = 813, 20.6%) were enrolled during newborn examination. Of the suspected CRS patients, 493 (12.5%) had laboratory evidence of rubella infection. The proportion of laboratory confirmed CRS cases declined from 26% in 2017 to 8.7% in 2021. Laboratory confirmed patients had higher odds of having hearing impairment (Odds ratio [OR] = 9.5, 95% confidence interval [CI]: 5.6-16.2), cataract (OR = 7.8, 95% CI: 5.4-11.2), pigmentary retinopathy (OR = 6.7, 95 CI: 3.3-13.6), structural heart defect with hearing impairment (OR = 3.8, 95% CI: 1.2-12.2) and glaucoma (OR = 3.1, 95% CI: 1.2-8.1). Nomogram, along with a web version, was developed. Conclusions Rubella continues to be a significant public health issue in India. The declining trend of test positivity among suspected CRS case-patients needs to be monitored through continued surveillance in these sentinel sites.
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Affiliation(s)
| | - Sanjay Verma
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kuldeep Singh
- All India Institute of Medical Sciences, Jodhpur, India
| | | | | | - S. Mahantesh
- Indira Gandhi Institute of Child Health, Bengaluru, India
| | | | | | - Nivedita Mondal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Geetha S
- Government Medical College, Trivandrum, India
| | | | - Shikha Malik
- All India Institute of Medical Sciences, Bhopal, India
| | - Manish Jain
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, India
| | | | | | | | | | | | - Mini P. Singh
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R.K. Ratho
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | | | - Amita Jain
- King George's Medical University, Lucknow, India
| | - M. Ashok
- ICMR-National Institute of Virology, Pune, India
| | | | | | | | - Deepa John
- Christian Medical College, Vellore, India
| | - Rahul Dhodapkar
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - A. Syed Ali
- Government Medical College, Trivandrum, India
| | | | | | | | - Jayant Prakash
- Indira Gandhi Institute of Medical Sciences, Patna, India
| | - Varsha Singh
- Indira Gandhi Institute of Medical Sciences, Patna, India
| | - Nidhi Prasad
- Indira Gandhi Institute of Medical Sciences, Patna, India
| | - Jaydeb Ray
- Institute of Child Health, Kolkata, India
| | - Agniva Majumdar
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shanta Dutta
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | | | | | - Akhil Sharma
- King George's Medical University, Lucknow, India
| | | | - Arun Alexander
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Arun Baranwal
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Avinash Anantharaj
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Adhisivam Bethou
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | | | - G. Kiruthika
- ICMR–National Institute of Epidemiology, Chennai, India
| | - Jagat Ram
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhu Gupta
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mamatha Gowda
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Manoj K Rohit
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nabaneeta Dash
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naveen Sankhyan
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nidhi Kaushal
- All India Institute of Medical Sciences, Jodhpur, India
| | | | - Nirupama Kasturi
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - P. Prem Kumar
- Indira Gandhi Institute of Child Health, Bengaluru, India
| | - Parul Chawla Gupta
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Praveen Kumar
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | - Suhani Manasa
- Indira Gandhi Institute of Child Health, Bengaluru, India
| | | | - Urvashi Nehra
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Varuna Vyas
- All India Institute of Medical Sciences, Jodhpur, India
| | - Vikas Gupta
- All India Institute of Medical Sciences, Bhopal, India
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Gupta S, Dhillon HS, Gupta N. The Comparative Accuracy of BISAP and PANC3 Scoring System for the Disease Severity and Outcome in Acute Pancreatitis in Tertiary Care Hospital from North India. Kathmandu Univ Med J (KUMJ) 2023; 21:138-143. [PMID: 38628005] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Background Acute pancreatitis has local and systemic manifestations, so it's important to assess the severity by various scoring system. Among them bed side index for severity of acute pancreatitis and pancreatitis three score have been considered to be more predictive and easier. Objective To determine the comparative prognostic value of bed side index for severity of acute pancreatitis and pancreatitis 3 score and its correlation with the outcome. Method A prospective observational study was conducted on 50 cases of acute pancreatitis. The patients were assessed clinically, radiologically and biochemically and were categorised into mild, moderate and severe category as per Atlanta Classification. Bed side index for severity of acute pancreatitis and pancreatitis 3 score was calculated at the time of admission and followed till the time of discharge or they had mortality. Result Receiver operating characteristic curve, showed bed side Index for severity of acute pancreatitis score had sensitivity (66.67%), specificity (84.09%), diagnostic accuracy (84%) while pancreatitis 3 score had sensitivity (50%), specificity (81.82%), diagnostic accuracy (80%) for the severity of acute pancreatitis. Bed side index for severity of acute pancreatitis had sensitivity (100%), specificity (66.67%) and Pancreatitis 3 score had sensitivity (66.67%), specificity (80.85%) for predicting the mortality in acute pancreatitis. Conclusion Bed side index for severity of acute pancreatitis and pancreatitis 3 score are both simple, bedside tool for assessing the severity and mortality but bed side index for severity of acute pancreatitis score had better sensitivity, specificity for assessing the severity and mortality as compared to pancreatitis three score.
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Affiliation(s)
- S Gupta
- Department of General Medicine, Maharishi Markandeshwar Institute of medical sciences and research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala (Haryana), India
| | - H S Dhillon
- Department of General Medicine, Maharishi Markandeshwar Institute of medical sciences and research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala (Haryana), India
| | - N Gupta
- Department of General Medicine, Maharishi Markandeshwar Institute of medical sciences and research, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala (Haryana), India
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Siddiki M, Han J, Belkin M, Plana A, Gupta N, Pinney S, Kalantari S, Grinstein J. Response in Kidney Function in Heart Failure after Milrinone Loading. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.441] [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: 04/05/2023] Open
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Deshpande GR, Deshpande K, Kaur M, Vishwanathan R, Saka S, Srivastava R, Vidhate S, Khutwad K, Salunke A, Bhatt V, Gunjikar R, Tilekar B, Patil R, Kaur H, Vijay N, Narayan J, Gupta N, Sapkal G. External quality assurance of serological diagnosis of dengue, chikungunya and Japanese encephalitis virus infection. IJID Reg 2023; 6:113-119. [PMID: 36846076 PMCID: PMC9945709 DOI: 10.1016/j.ijregi.2022.11.014] [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] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Dengue, chikungunya and Japanese encephalitis are the most common arthropod-borne viral diseases in India. Due to overlapping clinical symptoms, accurate, high-quality and timely laboratory-based differential diagnosis is essential for control and containment of outbreaks. This is most commonly done by detection of IgM antibodies in serum using enzyme-linked immunosorbent assays. The Resource Centre for Virus Research and Diagnostic Laboratories (VRDLs) in Pune, India organized an external quality assurance (EQA) study to check the accuracy of serological diagnostics in the VRDL network. METHODS Three panels, one each for anti-dengue virus, anti-chikungunya virus and anti-Japanese encephalitis virus IgM antibodies, comprising six human serum samples (two positive and four negative) were distributed to test the sensitivity, specificity and reproducibility of serological testing in 124 VRDLs across India in 2018-19 and 2019-20. RESULTS Among the 124 VRDLs, the average concordance for both 2018-19 and 2019-20 was 98%. In 2018-19, 78.33%, 13.33% and 6.66% of VRDLs reported 100% concordance, 91-99% concordance and 81-90% concordance with the reference results, respectively, and 1.66% of VRDLs had concordance <80%. In 2019-20, 79.68%, 14.06% and 4.68% of VRDLs reported 100% concordance, 91-99% concordance and 81-90% concordance with the reference results, respectively, and 1.56% of VRDLs had concordance <80%. CONCLUSION The EQA programme was beneficial for assessing and understanding the performance of the VRDLs. The study data indicate good proficiency in serological diagnosis of dengue, chikungunya and Japanese encephalitis in the VRDL network laboratories. Further expansion of the EQA programme to cover other viruses of public health importance will increase confidence among the VRDL network, and generate evidence of high-quality testing.
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Affiliation(s)
- Gururaj Rao Deshpande
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Ketki Deshpande
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Mandeep Kaur
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Rajlakshmi Vishwanathan
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Sanskriti Saka
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Rashi Srivastava
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Shankar Vidhate
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Kirtee Khutwad
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Asha Salunke
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Vaishali Bhatt
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Rashmi Gunjikar
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Bipin Tilekar
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Roshani Patil
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Harmanmeet Kaur
- Virology Unit, Indian Council of Medical Research, New Delhi, India
| | - Neetu Vijay
- Virology Unit, Indian Council of Medical Research, New Delhi, India
| | - Jitendra Narayan
- Virology Unit, Indian Council of Medical Research, New Delhi, India
| | - Nivedita Gupta
- Virology Unit, Indian Council of Medical Research, New Delhi, India
| | - Gajanan Sapkal
- Diagnostic Virology Group, Indian Council of Medical Research-National Institute of Virology, Pune, India
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Kulkarni PS, Kadam A, Godbole S, Bhatt V, Raut A, Kohli S, Tripathi S, Kulkarni P, Ludam R, Prabhu M, Bavdekar A, Gogtay NJ, Meshram S, Kadhiravan T, Kar S, Narayana DA, Samuel C, Kulkarni G, Gaidhane A, Sathyapalan D, Raut S, Hadda V, Bhalla HL, Bhamare C, Dharmadhikari A, Plested JS, Cloney-Clarke S, Zhu M, Pryor M, Hamilton S, Thakar M, Shete A, Gautam M, Gupta N, Panda S, Shaligram U, Poonawalla CS, Bhargava B, Gunale B, Kapse D, Kakrani AL, Tripathy SP, Tilak AV, Dhamne AA, Mirza SB, Athavale PV, Bhowmik M, Ratnakar PJ, Gupta S, Deotale V, Jain J, Kalantri A, Jain V, Goyal N, Arya A, Rongsen-Chandola T, Dasgupta S, Periera P, A V, Kawade A, Gondhali A, Kudyar P, Singh A, Yadav R, Alexander A, Gunasekaran V, Dineshbabu S, Samantaray P, Ravish H, Kamra D, Gaidhane S, Zahiruddin QS, Moni M, Kumar A, Dravid A, Mohan A, Suri T, Patel TK, Kishore S, Choche R, Ghatage D, Salvi S. Safety and immunogenicity of SII-NVX-CoV2373 (COVID-19 vaccine) in adults in a phase 2/3, observer-blind, randomised, controlled study. Lancet Reg Health Southeast Asia 2023; 10:100139. [PMID: 36647543 PMCID: PMC9833646 DOI: 10.1016/j.lansea.2022.100139] [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] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023]
Abstract
Background NVX-CoV2373, a Covid-19 vaccine was developed in the USA with ∼90% efficacy. The same vaccine is manufactured in India after technology transfer (called as SII-NVX-CoV2373), was evaluated in this phase 2/3 immuno-bridging study. Methods This was an observer-blind, randomised, phase 2/3 study in 1600 adults. In phase 2, 200 participants were randomized 3:1 to SII-NVX-CoV2373 or placebo. In phase 3, 1400 participants were randomized 3:1 to SII-NVX-CoV2373 or NVX-CoV2373 (940 safety cohort and 460 immunogenicity cohort). Two doses of study products (SII-NVX-CoV2373, NVX-CoV2373 or placebo) were given 3 weeks apart. Primary objectives were to demonstrate non-inferiority of SII-NVX-CoV2373 to NVX-CoV2373 in terms of geometric mean ELISA units (GMEU) ratio of anti-S IgG antibodies 14 days after the second dose (day 36) and to determine the incidence of causally related serious adverse events (SAEs) through 180 days after the first dose. Anti-S IgG response was assessed using an Enzyme-Linked Immunosorbent Assay (ELISA) and neutralizing antibodies (nAb) were assessed by a microneutralization assay using wild type SARS CoV-2 in participants from the immunogenicity cohort at baseline, day 22, day 36 and day 180. Cell mediated immune (CMI) response was assessed in a subset of 28 participants from immunogenicity cohort by ELISpot assay at baseline, day 36 and day 180. The total follow-up was for 6 months. Trial registration: CTRI/2021/02/031554. Findings Total 1596 participants (200 in Phase 2 and 1396 in Phase 3) received the first dose. SII-NVX-CoV2373 was found non-inferior to NVX-CoV2373 (anti-S IgG antibodies GMEU ratio 0.91; 95% CI: 0.79, 1.06). At day 36, there was more than 58-fold rise in anti-S IgG and nAb titers compared to baseline in both the groups. On day 180 visit, these antibody titers declined to levels slightly lower than those after the first dose (13-22 fold-rise above baseline). Incidence of unsolicited and solicited AEs was similar between the SII-NVX-CoV2373 and NVX-CoV2373 groups. No adverse event of special interest (AESI) was reported. No causally related SAE was reported. Interpretation SII-NVX-CoV2373 induced a non-inferior immune response compared to NVX-CoV2373 and has acceptable safety profile. Funding SIIPL, Indian Council of Medical Research, Novavax.
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Affiliation(s)
- Prasad S. Kulkarni
- Serum Institute of India Pvt Ltd, Pune, India,Corresponding author: Serum Institute of India Pvt Ltd, Poonawalla Biotechnology Park SEZ, Manjari (Bk), Pune, 412307, India
| | - Abhijit Kadam
- Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | - Sheela Godbole
- Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | - Varsha Bhatt
- Dr. D. Y. Patil Medical College Hospital and Research Centre, Pune, India
| | - Abhishek Raut
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India
| | - Sunil Kohli
- Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | | | | | - Rakhi Ludam
- Institution of Medical Science and SUM Hospital, Bhubaneswar, India
| | - Madhav Prabhu
- KLES Dr. Prabhakar Kore Hospital and Medical Research Center, Belgavi, India
| | | | | | | | - Tamilarasu Kadhiravan
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sonali Kar
- Kalinga Institute of Medical Sciences, Bhubaneswar, India
| | | | | | | | - Abhay Gaidhane
- Acharya Vinoba Bhave Rural Hospital and Datta Meghe Institute of Medical Sciences, Sawangi (M), Wardha, India
| | | | | | - Vijay Hadda
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | - Mingzhu Zhu
- Clinical Immunology Laboratory, Novavax, Gaithersburg, MD, USA
| | - Melinda Pryor
- 360biolabs, 85 Commercial Road, Melbourne, Victoria, Australia
| | | | - Madhuri Thakar
- Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | - Ashwini Shete
- Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | | | | | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
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Gupta N, Max O, Hoefert JA. A dental abscess leading to maxillary osteomyelitis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00401-9] [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: 01/28/2023]
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Yadav PD, Kumar S, Agarwal K, Jain M, Patil DR, Maithal K, Mathapati B, Giri S, Mohandas S, Shete A, Sapkal G, Patil DY, Dey A, Chandra H, Deshpande G, Gupta N, Abraham P, Kaushal H, Sahay RR, Tripathy A, Nyayanit D, Jain R, Kumar A, Sarkale P, Baradkar S, Rajanathan C, Raju HP, Patel S, Shah N, Dwivedi P, Singh D. Needle-free injection system delivery of ZyCoV-D DNA vaccine demonstrated improved immunogenicity and protective efficacy in rhesus macaques against SARS-CoV-2. J Med Virol 2023; 95:e28484. [PMID: 36625386 DOI: 10.1002/jmv.28484] [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: 07/04/2022] [Revised: 09/12/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
The apprehension of needles related to injection site pain, risk of transmitting bloodborne pathogens, and effective mass immunization have led to the development of a needle-free injection system (NFIS). Here, we evaluated the efficacy of the NFIS and needle injection system (NIS) for the delivery and immunogenicity of DNA vaccine candidate ZyCoV-D in rhesus macaques against SARS-CoV-2 infection. Briefly, 20 rhesus macaques were divided into 5 groups (4 animals each), that is, I (1 mg dose by NIS), II (2 mg dose by NIS), III (1 mg dose by NFIS), IV (2 mg dose by NFIS) and V (phosphate-buffer saline [PBS]). The macaques were immunized with the vaccine candidates/PBS intradermally on Days 0, 28, and 56. Subsequently, the animals were challenged with live SARS-CoV-2 after 15 weeks of the first immunization. Blood, nasal swab, throat swab, and bronchoalveolar lavage fluid specimens were collected on 0, 1, 3, 5, and 7 days post infection from each animal to determine immune response and viral clearance. Among all the five groups, 2 mg dose by NFIS elicited significant titers of IgG and neutralizing antibody after immunization with enhancement in their titers postvirus challenge. Besides this, it also induced increased lymphocyte proliferation and cytokine response. The minimal viral load post-SARS-CoV-2 challenge and significant immune response in the immunized animals demonstrated the efficiency of NFIS in delivering 2 mg ZyCoV-D vaccine candidate.
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Affiliation(s)
- Pragya D Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Sanjay Kumar
- Department of Neurosurgery, Command Hospital [Southern Command], Armed Forces Medical College [AFMC], Pune, India
| | - Kshitij Agarwal
- Department of Respiratory Medicine, University college of Medical Scieneces and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Mukul Jain
- Zydus Research Centre, Cadila Healthcare Limited, Ahmedabad, Gujarat, India
| | - Dilip R Patil
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Kapil Maithal
- Vaccine Technology Centre, Cadila Healthcare Limited, Ahmedabad, Gujarat, India
| | - Basavaraj Mathapati
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Suresh Giri
- Zydus Research Centre, Cadila Healthcare Limited, Ahmedabad, Gujarat, India
| | - Sreelekshmy Mohandas
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Anita Shete
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Gajanan Sapkal
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Deepak Y Patil
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Ayan Dey
- Vaccine Technology Centre, Cadila Healthcare Limited, Ahmedabad, Gujarat, India
| | - Harish Chandra
- Vaccine Technology Centre, Cadila Healthcare Limited, Ahmedabad, Gujarat, India
| | - Gururaj Deshpande
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | | | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Himanshu Kaushal
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Rima R Sahay
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Anuradha Tripathy
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Dimpal Nyayanit
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Rajlaxmi Jain
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Abhimanyu Kumar
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Prasad Sarkale
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | - Shreekant Baradkar
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
| | | | - Hari Prasad Raju
- Vaccine Technology Centre, Cadila Healthcare Limited, Ahmedabad, Gujarat, India
| | - Satish Patel
- Zydus Research Centre, Cadila Healthcare Limited, Ahmedabad, Gujarat, India
| | - Niraj Shah
- Zydus Research Centre, Cadila Healthcare Limited, Ahmedabad, Gujarat, India
| | - Pankaj Dwivedi
- Zydus Research Centre, Cadila Healthcare Limited, Ahmedabad, Gujarat, India
| | - Dharmendra Singh
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, India
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Prosperi C, Thangaraj J, Hasan A, Kumar M, Truelove S, Kumar V, Winter A, Bansal A, Chauhan S, Grover G, Jain A, Kulkarni R, Sharma S, Soman B, Chaaithanya I, Kharwal S, Mishra S, Salvi N, Sharma N, Sharma S, Varghese A, Sabarinathan R, Duraiswamy A, Rani D, Kanagasabai K, Lachyan A, Gawali P, Kapoor M, Chonker S, Cutts F, Sangal L, Mehendale S, Sapkal G, Gupta N, Hayford K, Moss W, Murhekar M. Added value of the measles-rubella supplementary immunization activity in reaching unvaccinated and under-vaccinated children, a cross-sectional study in five Indian districts, 2018-20. Vaccine 2023; 41:486-495. [PMID: 36481106 PMCID: PMC9831119 DOI: 10.1016/j.vaccine.2022.11.010] [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] [Received: 07/06/2022] [Revised: 10/29/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Supplementary immunization activities (SIAs) aim to interrupt measles transmission by reaching susceptible children, including children who have not received the recommended two routine doses of MCV before the SIA. However, both strategies may miss the same children if vaccine doses are highly correlated. How well SIAs reach children missed by routine immunization is a key metric in assessing the added value of SIAs. METHODS Children aged 9 months to younger than 5 years were enrolled in cross-sectional household serosurveys conducted in five districts in India following the 2017-2019 measles-rubella (MR) SIA. History of measles containing vaccine (MCV) through routine services or SIA was obtained from documents and verbal recall. Receipt of a first or second MCV dose during the SIA was categorized as "added value" of the SIA in reaching un- and under-vaccinated children. RESULTS A total of 1,675 children were enrolled in these post-SIA surveys. The percentage of children receiving a 1st or 2nd dose through the SIA ranged from 12.8% in Thiruvananthapuram District to 48.6% in Dibrugarh District. Although the number of zero-dose children prior to the SIA was small in most sites, the proportion reached by the SIA ranged from 45.8% in Thiruvananthapuram District to 94.9% in Dibrugarh District. Fewer than 7% of children remained measles zero-dose after the MR SIA (range: 1.1-6.4%) compared to up to 28% before the SIA (range: 7.3-28.1%). DISCUSSION We demonstrated the MR SIA provided considerable added value in terms of measles vaccination coverage, although there was variability across districts due to differences in routine and SIA coverage, and which children were reached by the SIA. Metrics evaluating the added value of an SIA can help to inform the design of vaccination strategies to better reach zero-dose or undervaccinated children.
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Affiliation(s)
- C. Prosperi
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - J.W.V. Thangaraj
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - A.Z. Hasan
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - M.S. Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - S. Truelove
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - V.S. Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - A.K. Winter
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A.K. Bansal
- ICMR-National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | - S.L. Chauhan
- ICMR- National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, India
| | - G.S. Grover
- Directorate of Health Services, Government of Punjab, Chandigarh, India
| | - A.K. Jain
- ICMR-National Institute of Pathology, New Delhi, India
| | - R.N. Kulkarni
- ICMR- National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, India
| | - S.K. Sharma
- ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, India
| | - B. Soman
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - I.K. Chaaithanya
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - S. Kharwal
- Department of Health Research, Model Rural Health Research Unit-Hoshiarpur, Punjab, India
| | - S.K. Mishra
- Department of Health Research, Model Rural Health Research Unit-Hoshiarpur, Punjab, India
| | - N.R. Salvi
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - N.P. Sharma
- Department of Health Research, Model Rural Health Research Unit-Chabua, Assam, India
| | - S. Sharma
- Department of Health Research, Model Rural Health Research Unit-Kanpur, Uttar Pradesh, India
| | - A. Varghese
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - R. Sabarinathan
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - A. Duraiswamy
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - D.S. Rani
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - K. Kanagasabai
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - A. Lachyan
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - P. Gawali
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - M. Kapoor
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - S.K. Chonker
- Department of Health Research, Model Rural Health Research Unit-Kanpur, Uttar Pradesh, India
| | - F.T. Cutts
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - L. Sangal
- World Health Organization, Southeast Asia Region Office, New Delhi, India
| | - S.M. Mehendale
- PD Hinduja Hospital and Medical Research Centre, Mumbai, India
| | - G.N. Sapkal
- ICMR-National Institute of Virology, Pune, India
| | - N. Gupta
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - K. Hayford
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - W.J. Moss
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Corresponding author at: International Vaccine Access Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - M.V. Murhekar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
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Theja RS, Gupta N, Panwar V, Kumar N. Erector spinae plane block for peri-operative analgesia in a patient undergoing surgery for Ewing's sarcoma of the clavicle. Anaesth Rep 2023; 11:e12228. [PMID: 37124664 PMCID: PMC10143598 DOI: 10.1002/anr3.12228] [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] [Accepted: 04/07/2023] [Indexed: 05/02/2023] Open
Abstract
The erector spinae plane block is a regional anaesthetic technique originally developed to manage thoracic neuropathic pain. It is popular because of its ease of learning and its applicability in various types of surgeries, providing both cutaneous and visceral analgesia. We report a case of a 30-year-old man who underwent excision of Ewing's sarcoma of the clavicle with brachiocephalic vein repair and pectoralis major myocutaneous flap reconstruction under general anaesthesia, with bilateral erector spinae plane block, with catheter insertion on the side of the lesion. The operation necessitated peri-operative anticoagulation, and so erector spinae blocks were performed to provide analgesia where epidural insertion was contraindicated. Adequate pain relief was achieved during the entire postoperative stay. The erector spinae plane block is thought to work due to the direct spread and diffusion of local anaesthetic into the posterior rami of spinal nerves located deep to the erector spinae muscles, and anterior spread into paravertebral space with additional effect potentially due to systemic absorption This case highlights the role of the erector spinae plane block in complex clavicular surgery requiring peri-operative anticoagulation, and potentially obviates the need for neuraxial analgesia.
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Affiliation(s)
- R. S. Theja
- Department of Surgical Oncology, Rotary Cancer HospitalAll India Institute of Medical SciencesDelhiIndia
| | - N. Gupta
- Department of Surgical Oncology, Rotary Cancer HospitalAll India Institute of Medical SciencesDelhiIndia
| | - V. Panwar
- Department of Surgical Oncology, Rotary Cancer HospitalAll India Institute of Medical SciencesDelhiIndia
| | - N. Kumar
- Department of Surgical Oncology, Rotary Cancer HospitalAll India Institute of Medical SciencesDelhiIndia
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Lokwani P, Gupta N, Choudhary SK, Singh AK. Noise survey of neonatal intensive care unit at a government tertiary-care centre. J Neonatal Perinatal Med 2023; 16:619-625. [PMID: 38043020 DOI: 10.3233/npm-230031] [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] [Indexed: 12/04/2023]
Abstract
BACKGROUND With technological advancement, Neonatal Intensive Care Units (NICU) have become noisier than ever. Studies have shown the detrimental effects of increasing noise in NICU on growing pre-term and sick neonates. The present study aimed to survey the amount of noise in one of the NICU blocks of a government tertiary care centre and explore ways to control it when dealing with these sick babies. METHODS A detailed noise survey was carried out, for February 2023, in one of the two blocks of NICU in a government tertiary-care centre. The noise measurements were performed using two "Sound Ear 3" noise meters. The analyses were done in Leq (equivalent continuous sound levels) A-weighted decibels (dBA). RESULTS The extracted data analysis revealed that the NICU block was exposed to a mean Leq of 67.78 dBA noise with a maximum of 89.0 dBA. There was a significant difference between the values noted in devices at different locations and across different periods. There were certain instances (57 and 42 for two devices) when there were sudden spikes in the noise levels beyond 80 dBA. It was also seen that noise was more than 65 dBA most of the time (72% and 66% for the two devices). CONCLUSION The noise survey carried out over one month revealed a considerable amount of noise in the NICU of a government tertiary-care centre. The study also explored ways such as environmental modification, human behavior modification, awareness programs, and neonatal-centered modifications to reduce the noise and lower its detrimental effects on the growth of neonates.
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Affiliation(s)
- P Lokwani
- Audiologist, Model Early Intervention Centre, Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
| | - N Gupta
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
| | - S K Choudhary
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
| | - A K Singh
- Department of Neonatology, All India Institute of Medical Sciences, Jodhpur, India
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Yadav KK, Chouhan N, Thubstan R, Norlha S, Hariharan J, Borwankar C, Chandra P, Dhar VK, Mankuzhyil N, Godambe S, Sharma M, Venugopal K, Singh KK, Bhatt N, Bhattacharyya S, Chanchalani K, Das MP, Ghosal B, Godiyal S, Khurana M, Kotwal SV, Koul MK, Kumar N, Kushwaha CP, Nand K, Pathania A, Sahayanathan S, Sarkar D, Tolamati A, Koul R, Rannot RC, Tickoo AK, Chitnis VR, Behere A, Padmini S, Manna A, Joy S, Nair PM, Jha KP, Moitra S, Neema S, Srivastava S, Punna M, Mohanan S, Sikder SS, Jain A, Banerjee S, . K, Deshpande J, Sanadhya V, Andrew G, Patil MB, Goyal VK, Gupta N, Balakrishna H, Agrawal A, Srivastava SP, Karn KN, Hadgali PI, Bhatt S, Mishra VK, Biswas PK, Gupta RK, Kumar A, Thul SG, Kalmady R, Sonvane DD, Kumar V, Gaur UK, Chattopadhyay J, Gupta SK, Kiran AR, Parulekar Y, Agrawal MK, Parmar RM, Reddy GR, Mayya YS, Pithawa CK. Commissioning of the MACE gamma-ray telescope at Hanle, Ladakh, India. CURR SCI INDIA 2022. [DOI: 10.18520/cs/v123/i12/1428-1435] [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: 01/25/2023]
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Gupta S, Kumar A, Gupta N, Bharti DR, Aggarwal N, Ravi V. A two-step process for in silico screening to assess the performance of qRTPCR kits against variant strains of SARS-CoV-2. BMC Genomics 2022; 23:755. [DOI: 10.1186/s12864-022-08999-3] [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] [Received: 06/24/2022] [Accepted: 11/10/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
Since inception of the COVID-19 pandemic, early detection and isolation of positive cases is one of the key strategies to restrict disease transmission. Real time reverse transcription polymerase chain reaction (qRTPCR) has been the mainstay of diagnosis. Most of the qRTPCR kits were designed against the target genes of original strain of SARS-CoV-2. However, with the emergence of variant strains of SARS-CoV-2, sensitivity of the qRTPCR assays has reportedly reduced. In view of this, it is critical to continuously monitor the performance of the qRTPCR kits in the backdrop of variant strains of SARS-CoV-2. Real world monitoring of assay performance is challenging. Therefore, we developed a two-step in-silico screening process for evaluating the performance of various qRTPCR kits used in India.
Results
We analysed 73 qRT-PCR kits marketed in India, against the two SARS-CoV-2 VoCs. Sequences of both Delta (B.1.617.2) and Omicron (B.1.1.529) VoCs submitted to GISAID within a specific timeframe were downloaded, clustered to identify unique sequences and aligned with primer and probe sequences. Results were analysed following a two-step screening process. Out of 73 kits analysed, seven were unsatisfactory for detection of both Delta and Omicron VoCs, 10 were unsatisfactory for Delta VoC whereas 2 were unsatisfactory for only Omicron VoC.
Conclusion
Overall, we have developed a useful screening process for evaluating the performance of qRTPCR assays against Delta and Omicron VoCs of SARS-CoV-2 which can be used for detecting SARS-CoV-2 VoCs that may emerge in future and can also be redeployed for other evolving pathogens of public health importance.
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Gupta N, Kumar R, Sharma A. 214P Versican G3 domain promotes myeloma cell proliferation, migration and invasion via activation of FAK/STAT3 signaling. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.249] [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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Sarin A, Agarwal A, Dodagoudar C, Baghmar S, Qureshi S, Raj A, Kailey N, Hasthavaram N, Kumar R, Potsangbam L, Bansal R, Bhardwaj S, Rajpurohit S, Vaibhav V, Handoo A, Dadu T, Mittal A, Gupta N, Aggarwal S. 285P Reticulocyte hemoglobin equivalent as an early predictor of iron deficiency anemia in cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.311] [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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Su W, Anstadt E, Gupta N, Forrester V, Krausz A, Schoenfeld J, Vidimos A, Heusinkveld L, Koyfman S, Margalit D, Murad F, Ruiz E, Lukens J. A Multi-Institutional Study of Definitive Radiotherapy for Locally Advanced Basal Cell Carcinoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1809] [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: 10/31/2022]
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Ali AB, Majoros M, Zhang X, Collings E, Gupta N, Sumption M, Lu L. Study the Impact of Magnetic Field on Dosimetry of Proton Therapy Using Monte Carlo Simulation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2150] [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: 10/31/2022]
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Chen K, Raleigh D, Sneed P, Fogh S, Nakamura J, Boreta L, Reddy A, Banerjee A, Mueller S, Auguste K, Gupta N, Braunstein S. Radiosurgery for Primary and Metastatic CNS Malignancies in the Pediatric Population. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1741] [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: 10/31/2022]
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Murhekar MV, Gupta N, Hasan AZ, Kumar MS, Kumar VS, Prosperi C, Sapkal GN, Thangaraj JWV, Kaduskar O, Bhatt V, Deshpande GR, Thankappan UP, Bansal AK, Chauhan SL, Grover GS, Jain AK, Kulkarni RN, Sharma SK, Chaaithanya IK, Kharwal S, Mishra SK, Salvi NR, Sharma S, Sarmah NP, Sabarinathan R, Duraiswamy A, Rani DS, Kanagasabai K, Lachyan A, Gawali P, Kapoor M, Shrivastava AK, Chonker SK, Tilekar B, Tandale BV, Ahmad M, Sangal L, Winter A, Mehendale SM, Moss WJ, Hayford K. Evaluating the effect of measles and rubella mass vaccination campaigns on seroprevalence in India: a before-and-after cross-sectional household serosurvey in four districts, 2018-2020. Lancet Glob Health 2022; 10:e1655-e1664. [PMID: 36240831 PMCID: PMC9579355 DOI: 10.1016/s2214-109x(22)00379-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/14/2022] [Accepted: 08/19/2022] [Indexed: 11/07/2022]
Abstract
Background India did phased measles–rubella supplementary immunisation activities (MR-SIAs; ie, mass-immunisation campaigns) targeting children aged 9 months to less than 15 years. We estimated measles–rubella seroprevalence before and after the MR-SIAs to quantify the effect on population immunity and identify remaining immunity gaps. Methods Between March 9, 2018 and March 19, 2020 we did community-based, cross-sectional serosurveys in four districts in India before and after MR-SIAs. 30 villages or wards were selected within each district, and one census enumeration block from each was selected as the survey cluster. Households were enumerated and 13 children in the younger age group (9 months to <5 years) and 13 children in the older ager group (5 to <15 years) were randomly selected by use of computer-generated random numbers. Serum samples were tested for IgG antibodies to measles and rubella viruses by enzyme immunoassay. Findings Specimens were collected from 2570 children before the MR-SIA and from 2619 children afterwards. The weighted MR-SIA coverage ranged from 73·7% to 90·5% in younger children and from 73·6% to 93·6% in older children. Before the MR-SIA, district-level measles seroprevalence was between 80·7% and 88·5% among younger children in all districts, and between 63·4% and 84·5% among older children. After the MR-SIA, measles seroprevalence among younger children increased to more than 90% (range 91·5 to 96·0) in all districts except Kanpur Nagar, in which it remained unchanged 80·4%. Among older children, measles seroprevalence increased to more than 90·0% (range 93·7% to 96·5%) in all districts except Hoshiarpur (88·7%). A significant increase in rubella seroprevalence was observed in all districts in both age groups, with the largest effect in Dibrugarh, where rubella seroprevalence increased from 10·6% to 96·5% among younger children. Interpretation Measles–rubella seroprevalence increased substantially after the MR-SIAs but the serosurvey also identified remaining gaps in population immunity. Funding The Bill & Melinda Gates Foundation and Indian Council of Medical Research.
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Affiliation(s)
- Manoj V Murhekar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India,Correspondence to: Dr Manoj V Murhekar, ICMR-National Institute of Epidemiology, Tamil Nadu Housing Board, Ayapakkam, Ambattur, Chennai 600 070, India
| | - Nivedita Gupta
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Alvira Z Hasan
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - V Saravana Kumar
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - Christine Prosperi
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | | | | | - Avi Kumar Bansal
- ICMR-National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | - Sanjay L Chauhan
- ICMR- National Institute for Research in Reproductive and Child Health, Mumbai, India
| | | | | | - Ragini N Kulkarni
- ICMR- National Institute for Research in Reproductive and Child Health, Mumbai, India
| | | | - Itta K Chaaithanya
- ICMR- National Institute for Research in Reproductive and Child Health, Mumbai, India,Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Sanchit Kharwal
- Department of Health Research, Model Rural Health Research Unit-Hoshiarpur, Punjab, India
| | - Sunil K Mishra
- Department of Health Research, Model Rural Health Research Unit-Hoshiarpur, Punjab, India
| | - Neha R Salvi
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Sandeep Sharma
- ICMR-National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | - Nilanju P Sarmah
- Department of Health Research, Model Rural Health Research Unit-Chabua, Assam, India
| | - R Sabarinathan
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - Augustine Duraiswamy
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - D Sudha Rani
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - K Kanagasabai
- Indian Council of Medical Research (ICMR)-National Institute of Epidemiology, Chennai, India
| | - Abhishek Lachyan
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Poonam Gawali
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | - Mitali Kapoor
- Department of Health Research, Model Rural Health Research Unit-Dahanu, Maharashtra, India
| | | | - Saurabh Kumar Chonker
- ICMR-National JALMA Institute for Leprosy & Other Mycobacterial Diseases, Agra, India
| | | | | | | | - Lucky Sangal
- WHO, Southeast Asia Region Office, New Delhi, India
| | - Amy Winter
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology and Statistics, University of Georgia, Athens, GA, USA
| | | | - William J Moss
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kyla Hayford
- International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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McCormick LF, Gupta N, Prakash O, Lian LY, Dart C, Helassa N. Long QT syndrome-associated calmodulin mutations and their interactions with the Kv7.1 voltage-gated potassium channel. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2983] [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: 11/13/2022] Open
Abstract
Abstract
Introduction
Calmodulin (CaM) is a highly conserved mediator of calcium (Ca2+) dependent signalling. Its flexible structure allows CaM to bind and modulate many targets, including cardiac ion channels. Genotyping has revealed several CaM mutations associated with congenital disorders of heart rhythm, known as long QT-syndrome (LQTS). LQTS patients suffer from prolonged ventricular recovery times (QT-interval) which increases their risk of significant cardiac events. Loss of function KV7.1 mutations are the largest cause of LQTS, accounting for >50% of cases. CaM facilitates Ca2+-sensitivity to KV7.1 in producing IKs, Kv7.1 mutations which reduce CaM binding promote LQTS pathology. However, the effects of LQTS-associated CaM mutations on Kv7.1 function remain unknown.
Purpose
To determine the biophysical consequences of congenital LQTS-associated CaM mutations and how they alter modulation of Kv7.1 in producing the ventricular repolarising IKs current.
Methods
WT and mutant CaM proteins were recombinantly expressed and purified for biophysical characterisation. Using circular dichroism, secondary structures and thermostability of proteins were quantified. Isothermal titration calorimetry was used to quantitatively measure interactions between CaM proteins and binding sites of KV7.1 (Helix B). NMR was employed to study the conformations of target-bound WT and mutant proteins. Whole cell currents were determined using voltage clamp electrophysiology in HEK cells.
Results
Mutations significantly changed the thermostability and secondary structure distributions of CaM, and also caused site-dependent increases in susceptibility to protease digestion. CaM interacted with Helix B (KV7.1) via both Ca2+-dependent and independent mechanisms. Ca2+ dependent binding to Helix B was much higher affinity than Ca2+-independent binding, with >2000-fold reduction in dissociation constant measured. LQTS-CaM variants reduced Helix B affinity with the largest reductions found in EF-hand IV mutants. These mutants also adopted most distinct conformations when Helix B-bound. Calmodulation of the KV7.1 channel produced larger (IKs) currents without altering channel activation kinetics. IKs exhibited Ca2+-sensitivity, in response to increased cytosolic Ca2+, larger currents were generated. Modulation by CaM mutants reduced current density at systolic Ca2+-concentrations (1000 nM), within physiological time periods (0.35 s), revealing a direct QT-prolonging modulatory effect.
Conclusions
Provided here are mechanistic insights as to how LQTS-associated CaM variants contribute to electrical disease of the heart. Mutations in the highly conserved structure of CaM disrupt protein conformation and perturb complex formation with KV7.1. This results in aberrant Ca2+-sensitivity of Kv7.1, reducing IKs generation. This ultimately decreases the repolarisation capacity of cells and would extend the QT interval of myocytes.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Intermediate Basic Science Research Fellowship
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Affiliation(s)
- L F McCormick
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
| | - N Gupta
- University of Liverpool, Department of Molecular Physiology and Cell Signalling , Liverpool , United Kingdom
| | - O Prakash
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
| | - L Y Lian
- University of Liverpool, Department of Biochemistry and Systems Biology , Liverpool , United Kingdom
| | - C Dart
- University of Liverpool, Department of Molecular Physiology and Cell Signalling , Liverpool , United Kingdom
| | - N Helassa
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
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Helassa N, Prakash O, Gupta N, McCormick LF, Antonyuk S, Dart C. Disease-associated calmodulin mutations disrupt L-type Ca2+ channel (Cav1.2) activity and CaMKIIdelta phosphorylation in long QT syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2982] [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
Introduction
Long QT Syndrome (LQTS) is a major inherited arrhythmia syndrome that can cause sudden cardiac death. Using genome sequencing in human patients, mutations in the ubiquitous calcium (Ca2+) sensor protein calmodulin (CaM) have been associated to LQTS. CaM is an ion channel regulator and can modulate the activity of the voltage-gated calcium channel (Cav1.2) and Ca2+/CaM-dependent protein kinase II (CaMKIIδ), involved in cardiac muscle contraction. However the molecular mechanism by which CaM mutations contribute to irregular heartbeats remains unclear.
Methods
Interaction of CaM proteins with Cav1.2 and CaMKIId synthetic peptides (Cav1.2-NSCaTE51–68, Cav1.2-IQ1665–1685, Cav1.2-C1627–1652, CaMKIIδ294–315,) was investigated using Isothermal Titration Calorimetry (ITC) and X-ray crystallography. Whole-cell patch clamp electrophysiology was used to determine the effect of CaM mutations on L-type Ca2+ currents and Ca2+-dependent inactivation (CDI). CaMKIIδ phosphorylation activity was determined by western blot and fluorescence kinase assay.
Results
Binding affinity of CaMKIId and Cav1.2 peptides to the LQTS-associated CaM variants was significantly reduced, up to 7-fold. Interestingly, the Cav1.2-IQ1665–1685 peptide showed a stronger binding, up to 2-fold, towards LQTS-CaM mutants. Crystal structures of Ca2+-CaM:CaMKIId294–315 showed structural alterations induced by LQTS associated mutations. In addition, we demonstrated that CaMKIIδ autophosphorylation and kinase activity can be significantly reduced by LQTS-associated CaM mutants. Electrophysiological examination of Cav1.2 function revealed that CaM mutations significantly impaired channel CDI, without affecting the voltage dependence of activation and inactivation.
Conclusions
These data demonstrate a strong correlation between LQTS-associated CaM mutations and Cav1.2 activity. We provide molecular insights into the diverse factors contributing to CaM-mediated arrhythmias.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Intermediate Basic Science Research Fellowship
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Affiliation(s)
- N Helassa
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
| | - O Prakash
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
| | - N Gupta
- University of Liverpool, Department of Molecular Physiology and Cell Signalling , Liverpool , United Kingdom
| | - L F McCormick
- University of Liverpool, Department of Cardiovascular and Metabolic Medicine , Liverpool , United Kingdom
| | - S Antonyuk
- University of Liverpool, Department of Biochemistry and Systems Biology , Liverpool , United Kingdom
| | - C Dart
- University of Liverpool, Department of Molecular Physiology and Cell Signalling , Liverpool , United Kingdom
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Sharma RP, Gautam S, Sharma P, Singh R, Sharma H, Parsoya D, Deeba F, Bhomia N, Pal N, Potdar V, Yadav PD, Gupta N, Bhandari S, Kumar A, Joshi Y, Pandit P, Malhotra B. Genomic profile of SARS-CoV-2 Omicron variant and its correlation with disease severity in Rajasthan. Front Med (Lausanne) 2022; 9:888408. [PMID: 36213661 PMCID: PMC9538571 DOI: 10.3389/fmed.2022.888408] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background Omicron, a new variant of Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2), was first detected in November 2021. This was believed to be highly transmissible and was reported to evade immunity. As a result, an urgent need was felt to screen all positive samples so as to rapidly identify Omicron cases and isolate them to prevent the spread of infection. Genomic surveillance of SARS-CoV-2 was planned to correlate disease severity with the genomic profile. Methods All the SARS-CoV-2 positive cases detected in the state of Rajasthan were sent to our Lab. Samples received from 24 November 2021 to 4 January 2022 were selected for Next-Generation Sequencing (NGS). Processing was done as per protocol on the Ion Torrent S5 System for 1,210 samples and bioinformatics analysis was done. Results Among the 1,210 samples tested, 762 (62.9%) were Delta/Delta-like and other lineages, 291 (24%) were Omicron, and 157 (12.9%) were invalid or repeat samples. Within a month, the proportion of Delta and other variants was reversed, 6% Omicron became 81%, and Delta and other variants became 19%, initially all Omicron cases were seen in international travelers and their contacts but soon community transmission was seen. The majority of patients with Omicron were asymptomatic (56.7%) or had mild disease (33%), 9.2% had moderate symptoms, and two (0.7%) had severe disease requiring hospitalization, of which one (0.3%) died and the rest were (99.7%) recovered. History of vaccination was seen in 81.1%, of the previous infection in 43.2% of cases. Among the Omicron cases, BA.1 (62.8%) was the predominant lineage followed by BA.2 (23.7%) and B.1.529 (13.4%), rising trends were seen initially for BA.1 and later for BA.2 also. Although 8.9% of patients with Delta lineage during that period were hospitalized, 7.2% required oxygen, and 0.9% died. To conclude, the community spread of Omicron occurred in a short time and became the predominant circulating variant; BA.1 was the predominant lineage detected. Most of the cases with Omicron were asymptomatic or had mild disease, and the mortality rate was very low as compared to Delta and other lineages.
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Affiliation(s)
| | - Swati Gautam
- Department of Microbiology, Sawai Man Singh Medical College, Jaipur, India
| | - Pratibha Sharma
- Department of Microbiology, Sawai Man Singh Medical College, Jaipur, India
| | | | - Himanshu Sharma
- Department of Microbiology, Sawai Man Singh Medical College, Jaipur, India
| | - Dinesh Parsoya
- Department of Microbiology, Sawai Man Singh Medical College, Jaipur, India
| | - Farah Deeba
- Department of Microbiology, Sawai Man Singh Medical College, Jaipur, India
| | - Neha Bhomia
- Department of Microbiology, Sawai Man Singh Medical College, Jaipur, India
| | - Nita Pal
- Department of Microbiology, Sawai Man Singh Medical College, Jaipur, India
| | - Varsha Potdar
- Virology Department, National Institute of Virology (ICMR), Pune, India
| | - Pragya D. Yadav
- Virology Department, National Institute of Virology (ICMR), Pune, India
| | - Nivedita Gupta
- Virology Department, Indian Council of Medical Research (ICMR), New Delhi, India
| | - Sudhir Bhandari
- Department of Microbiology, Sawai Man Singh Medical College, Jaipur, India
| | - Abhinendra Kumar
- Virology Department, National Institute of Virology (ICMR), Pune, India
| | - Yash Joshi
- Virology Department, National Institute of Virology (ICMR), Pune, India
| | - Priyanka Pandit
- Virology Department, National Institute of Virology (ICMR), Pune, India
| | - Bharti Malhotra
- Department of Microbiology, Sawai Man Singh Medical College, Jaipur, India
- *Correspondence: Bharti Malhotra
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Prasad N, Gupta N. POS-054 TRIAD OF "FEVER, LIVER AND KIDNEY INJURY(FLIKI)": ETIOLOGY AND OUTCOMES IN NORTHERN INDIAN SETTINGS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.07.071] [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: 10/14/2022] Open
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Shete AM, Jain R, Mohandas S, Pardeshi P, Yadav PD, Gupta N, Mourya D. Development of Nipah virus-specific IgM & IgG ELISA for screening human serum samples. Indian J Med Res 2022; 156:429-434. [PMID: 36510890 PMCID: PMC10101364 DOI: 10.4103/ijmr.ijmr_2737_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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background & objectives Nipah virus (NiV) is a zoonotic paramyxovirus that causes fatal encephalitis in humans. Enzyme Linked Immunosorbent Assay (ELISA) is a safe, sensitive, specific, and affordable diagnostic tool that can be used during screening of large-scale epidemiological investigations. Development and evaluation of IgM and IgG ELISA for screening serum samples of NiV suspected cases would also help in planning public health interventions. Methods An IgM capture (MAC) ELISA and an indirect IgG ELISA were developed using NiV antigen to detect IgM and IgG antibodies against NiV in human sera. The sensitivity, specificity, and cross-reactivity of the assays were evaluated using NiV IgM, IgG positive, negative human sera and measles, mumps, rubella, Crimean-Congo haemorrhagic fever, Kyasanur forest disease IgM, IgG positive sera, respectively. Results The developed anti-NiV IgM and IgG ELISAs have shown specificity of 99.28 per cent and sensitivity of 100 per cent compared to reference test from Centers for Disease Control and Prevention, USA. Assays demonstrated negative predictive value of 100 per cent and positive predictive value as 90 and 93.94 per cent for anti-Nipah IgM ELISA and IgG ELISA respectively with test accuracy of 99.33 per cent. Interpretation & conclusions Timely diagnosis of NiV is crucial for the management of cases, which could prevent further spread of infection in the community. IgM ELISA can be used as primary diagnostic tool followed by polymerase chain reaction. These assays have advantages of its applicability during outbreak investigations and surveillance activities at hospital or onsite laboratories with basic biosafety practices.
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Affiliation(s)
- Anita M Shete
- Maximum Containment Facility, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Rajlaxmi Jain
- Maximum Containment Facility, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Sreelekshmy Mohandas
- Maximum Containment Facility, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Prachi Pardeshi
- Maximum Containment Facility, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Pragya D Yadav
- Maximum Containment Facility, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Nivedita Gupta
- Virology Unit, Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Devendra Mourya
- Virology Unit, Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
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Hanley M, Zhang S, Pavlakis N, Soo R, van der Wekken A, Ganju V, Pina A, Dong Q, Gupta N. EP08.02-109 A Drug-Drug Interaction Study of Mobocertinib and Midazolam in Patients With Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.792] [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]
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Niyas VKM, Arjun R, Titus L, Hussain F, Sreelakshmi SL, Jomes J, Gupta N. Hybrid immunity versus vaccine immunity among Indian health care workers after ChAdOx-nCov-19 vaccine. QJM 2022; 115:565-566. [PMID: 35781827 DOI: 10.1093/qjmed/hcac155] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V K M Niyas
- Department of Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - R Arjun
- Department of Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - L Titus
- Laboratory Medicine, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - F Hussain
- Department of Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - S L Sreelakshmi
- Internal Medicine, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - J Jomes
- Department of Infectious Diseases, KIMSHEALTH, Thiruvananthapuram, Kerala 695029, India
| | - N Gupta
- Infectious Diseases, Kasturba Medical College, Manipal, Karnataka 576104, India
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Kanungo S, Chatterjee P, Bavdekar A, Murhekar M, Babji S, Garg R, Samanta S, Nandy RK, Kawade A, Boopathi K, Kanagasabai K, Kamal VK, Kumar VS, Gupta N, Dutta S. Safety and immunogenicity of the Rotavac and Rotasiil rotavirus vaccines administered in an interchangeable dosing schedule among healthy Indian infants: a multicentre, open-label, randomised, controlled, phase 4, non-inferiority trial. The Lancet Infectious Diseases 2022; 22:1191-1199. [PMID: 35588754 PMCID: PMC9464301 DOI: 10.1016/s1473-3099(22)00161-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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/12/2022] [Accepted: 02/24/2022] [Indexed: 10/25/2022]
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