Immunoglobulin profile in pulmonary tuberculosis in endemically prevalent Kashmiri population, Kashmir, India

Background: Kashmir valley is endemically prevalent destination for tuberculosis. The role of T cell mediated immunity is very well known in the pathogenesis of tuberculosis. However, the B cell immune response has been studied less often. Thus, it was very interesting to estimate the levels of serum immunoglobulins in pulmonary tuberculosis.Methods: Serum levels of the immunoglobulins IgG, IgA and IgM were evaluated in 100 adult patients of untreated sputum positive cases of pulmonary tuberculosis in the age group of 20-65 years (36.42±8.95) and 50 controls of the same age group (34.26±9.46). The Immunoglobulins were estimated using single radial immunodiffusion method of Mancini et al.Results: The mean IgG and IgA levels were observed to be significantly increased in the patient group when compared with the controls (P<0.001). However, no significant difference was observed in the IgM levels between the two groups. There was no significant difference in the immunoglobulin levels between the two sexes as also between the various defined age groups. The mean serum IgG levels showed significant correlation with the duration of illness (P<0.001-highly significant), while as the difference was insignificant in case of IgA and IgM. Further, the immunoglobulin levels did not show any significant correlation with the extent and the nature of lesion on chest radiography.Conclusions: Serum IgG and IgA levels were significantly increased in patients of pulmonary tuberculosis as compared to controls. However, no significant difference was observed in serum IgM levels

Bilateral anterior opercular syndrome

Opercular syndrome, also known as Foix-Chavany-Marie syndrome is a rare disorder due to bilateral lesions of opercular cortex surrounding the insula. It is characterized by paralysis of facial, lingual, pharyngeal, and masticatory voluntary muscles with preservation of autonomic, involuntary, and reflexive functions. In the present case, a 71-years old female presented with acute onset of anarthria with difficulties in chewing, speaking, and swallowing that was diagnosed with opercular syndrome.

Tropical diabetic hand syndrome- a case report with a short review

Tropical diabetic hand syndrome (TDHS) encompasses an acute symptom complex found in patients of diabetes mellitus primarily in the tropical regions. The syndrome usually follows a minor trauma to the hand, may rapidly progress to gangrene, fulminant sepsis and may even be life threatening. The syndrome is less recognized and thus reported less often. The authors present here a case of Tropical diabetic hand syndrome (TDHS) in a middle aged female with a poor glycemic control. The patient was managed meticulously both by surgical debridement and proper, culture evidenced antibiotic therapy apart from routine diabetic management

A study evaluating the awareness among general population towards common medical emergencies

Background: Basic life support has been found to be lifesaving in common medical emergencies. The level of awareness about emergency care in general population and the approach of the common people with regards to common medical emergencies is an important determinant of positive outcome.Methods: This study was conducted in 445 participants randomly selected from visitors of our outpatient department, to study the awareness in general public about the medical emergencies and basic life support skills.Results:  This study was conducted in 445 participants randomly selected from visitors of our outpatient department, to study the awareness in general public about the medical emergencies and basic life support skills.Conclusions: Awareness about common medical emergencies is low in general public and there is a need to devise strategies to improve this awareness

Immunoglobulin profile in pulmonary tuberculosis in endemically prevalent Kashmiri population, Kashmir, India

Background: Kashmir valley is endemically prevalent destination for tuberculosis. The role of T cell mediated immunity is very well known in the pathogenesis of tuberculosis. However, the B cell immune response has been studied less often. Thus, it was very interesting to estimate the levels of serum immunoglobulins in pulmonary tuberculosis.Methods: Serum levels of the immunoglobulins IgG, IgA and IgM were evaluated in 100 adult patients of untreated sputum positive cases of pulmonary tuberculosis in the age group of 20-65 years (36.42±8.95) and 50 controls of the same age group (34.26±9.46). The Immunoglobulins were estimated using single radial immunodiffusion method of Mancini et al.Results: The mean IgG and IgA levels were observed to be significantly increased in the patient group when compared with the controls (P&lt;0.001). However, no significant difference was observed in the IgM levels between the two groups. There was no significant difference in the immunoglobulin levels between the two sexes as also between the various defined age groups. The mean serum IgG levels showed significant correlation with the duration of illness (P&lt;0.001-highly significant), while as the difference was insignificant in case of IgA and IgM. Further, the immunoglobulin levels did not show any significant correlation with the extent and the nature of lesion on chest radiography.Conclusions: Serum IgG and IgA levels were significantly increased in patients of pulmonary tuberculosis as compared to controls. However, no significant difference was observed in serum IgM levels

Tropical diabetic hand syndrome- a case report with a short review

Tropical diabetic hand syndrome (TDHS) encompasses an acute symptom complex found in patients of diabetes mellitus primarily in the tropical regions. The syndrome usually follows a minor trauma to the hand, may rapidly progress to gangrene, fulminant sepsis and may even be life threatening. The syndrome is less recognized and thus reported less often. The authors present here a case of Tropical diabetic hand syndrome (TDHS) in a middle aged female with a poor glycemic control. The patient was managed meticulously both by surgical debridement and proper, culture evidenced antibiotic therapy apart from routine diabetic management

Seroprevalence of SARS-CoV-2 specific IgG antibodies in District Srinagar, northern India - A cross-sectional study.

BackgroundPrevalence of IgG antibodies against SARS-CoV-2 infection provides essential information for deciding disease prevention and mitigation measures. We estimate the seroprevalence of SARS-CoV-2 specific IgG antibodies in District Srinagar.Methods2906 persons >18 years of age selected from hospital visitors across District Srinagar participated in the study. We tested samples for the presence of SARS-CoV-2 specific IgG antibodies using a chemiluminescent microparticle immunoassay-based serologic test.ResultsAge- and gender-standardized seroprevalence was 3.6% (95% CI 2.9% to 4.3%). Age 30-69 years, a recent history of symptoms of an influenza-like-illness, and a history of being placed under quarantine were significantly related to higher odds of the presence of SARS-CoV-2 specific IgG antibodies. The estimated number of SARS-CoV-2 infections during the two weeks preceding the study, adjusted for test performance, was 32602 with an estimated (median) infection-to-known-case ratio of 46 (95% CI 36 to 57).ConclusionsThe seroprevalence of SARS-CoV-2 specific IgG antibodies is low in the District. A large proportion of the population is still susceptible to the infection. A sizeable number of infections remain undetected, and a substantial proportion of people with symptoms compatible with COVID-19 are not tested

Data_Sheet_1_Seroprevalence of SARS-CoV-2-specific anti-spike IgM, IgG, and anti-nucleocapsid IgG antibodies during the second wave of the pandemic: A population-based cross-sectional survey across Kashmir, India.docx

BackgroundWithin Kashmir, which is one of the topographically distinct areas in the Himalayan belt of India, a total of 2,236 cumulative deaths occurred by the end of the second wave. We aimed to conduct this population-based study in the age group of 7 years and above to estimate the seropositivity and its attributes in Kashmir valley.MethodsWe conducted a community-based household-level cross-sectional study, with a multistage, population-stratified, probability-proportionate-to-size, cluster sampling method to select 400 participants from each of the 10 districts of Kashmir. We also selected a quota of healthcare workers, police personnel, and antenatal women from each of the districts. Households were selected from each cluster and all family members with age 7 years or more were invited to participate. Information was collected through a standardized questionnaire and entered into Epicollect 5 software. Trained healthcare personnel were assigned for collecting venous blood samples from each of the participants which were transferred and processed for immunological testing. Testing was done for the presence of SARS-CoV-2-specific anti-spike IgM, IgG antibodies, and anti-nucleocapsid IgG antibodies. Weighted seropositivity was estimated along with the adjustment done for the sensitivity and specificity of the test used.FindingsThe data were collected from a total of 4,229 participants from the general population within the 10 districts of Kashmir. Our results showed that 84.84% (95% CI 84.51–85.18%) of the participants were seropositive in the weighted imputed data among the general population. In multiple logistic regression, the variables significantly affecting the seroprevalence were the age group 45–59 years (odds ratio of 0.73; 95% CI 0.67–0.78), self-reported history of comorbidity (odds ratio of 1.47; 95% CI 1.33–1.61), and positive vaccination history (odds ratio of 0.85; 95% CI 0.79–0.90) for anti-nucleocapsid IgG antibodies. The entire assessed variables showed a significant role during multiple logistic regression analysis for affecting IgM anti-spike antibodies with an odds ratio of 1.45 (95% CI 1.32–1.57) for age more than 60 years, 1.21 (95% CI 1.15–1.27) for the female gender, 0.87 (95% CI 0.82–0.92) for urban residents, 0.86 (95% CI 0.76–0.92) for self-reported comorbidity, and an odds ratio of 1.16 (95% CI 1.08–1.24) for a positive history of vaccination. The estimated infection fatality ratio was 0.033% (95% CI: 0.034–0.032%) between 22 May and 31 July 2021 against the seropositivity for IgM antibodies.InterpretationDuring the second wave of the SARS-CoV-2 pandemic, 84.84% (95% CI 84.51–85.18%) of participants from this population-based cross-sectional sample were seropositive against SARS-CoV-2. Despite a comparatively lower number of cases reported and lower vaccination coverage in the region, our study found such high seropositivity across all age groups, which indicates the higher number of subclinical and less severe unnoticed caseload in the community.</p