Red Cell Distribution Width (RDW) Index as a Predictor of Severity of Acute Ischemic Stroke: A Correlation Study

Introduction: Globally, stroke is one of the leading causes of death and disability-adjusted life-years (DALYs).  The red cell distribution width (RDW) is a readily available and inexpensive test which is done routinely as a part of complete blood count in these patients. Objective: In this study, we tried to correlate the RDW with severity of acute ischemic stroke (AIS). Methods: Patients presenting to emergency department (ED) within 24 hours of the onset of clinical signs and symptoms suggestive of AIS were assessed for Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) score followed by non-contrast computed tomography (NCCT) scan. RDW value for all the patients who were included in the study were co-related with the severity of the stroke. Results: The median (IQR) RDW in the patients with minor stroke on the basis of GCS was 13.5 (13.3-13.5), moderate stroke was 13.8 (13.5-14.4) and with severe stroke was 15.4 (15.1- 15.6) (p < 0.001). The median (IQR) RDW in the patients with minor stroke on the basis of NIHSS score was 13.4 (13.2 – 13.6), moderate stroke was 13.8 (13.5-14.3), and moderate to severe stroke was 14.7 (14.5-15.3) and with severe stroke was 15.5 (15.1-15.7) (p < 0.001). The median RDW in patients who were alive was 13.8 (13.5 -15.1) and in patients who expired was 15.5 (14.5 -15.7) (p = 0.048). Conclusion: Based on the findings of this study, RDW index has statistically significant correlation with the severity of AIS. So it can potentially be an important parameter to predict the prognosis of AIS patients

Different Faces of HIV in a Single Patient

Opportunistic infections (OIs) are a major cause of morbidity and mortality in patients with human immunodeficiency virus (HIV) infection. The most common opportunistic infection is tuberculosis, followed by candidiasis, infections causing diarrhoea, and pneumocystis carinii pneumonia (PCP). We hereby report the case of a 34-year-old male with clinical stage-IV acquired immunodeficiency syndrome (AIDS) who had multiple OIs including visceral leishmaniasis (VLs) an uncommon co-infection in the Indian scenario. This patient also had features of multiple pulmonary infections-bacterial, mycobacterial and fungal, a rare clinical problem in HIV

Red Cell Distribution Width (RDW) Index as a Predictor of Severity of Acute Ischemic Stroke: A Correlation Study

Introduction: Globally, stroke is one of the leading causes of death and disability-adjusted life-years (DALYs).  The red cell distribution width (RDW) is a readily available and inexpensive test which is done routinely as a part of complete blood count in these patients. Objective: In this study, we tried to correlate the RDW with severity of acute ischemic stroke (AIS). Methods: Patients presenting to emergency department (ED) within 24 hours of the onset of clinical signs and symptoms suggestive of AIS were assessed for Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) score followed by non-contrast computed tomography (NCCT) scan. RDW value for all the patients who were included in the study were co-related with the severity of the stroke. Results: The median (IQR) RDW in the patients with minor stroke on the basis of GCS was 13.5 (13.3-13.5), moderate stroke was 13.8 (13.5-14.4) and with severe stroke was 15.4 (15.1- 15.6) (p < 0.001). The median (IQR) RDW in the patients with minor stroke on the basis of NIHSS score was 13.4 (13.2 – 13.6), moderate stroke was 13.8 (13.5-14.3), and moderate to severe stroke was 14.7 (14.5-15.3) and with severe stroke was 15.5 (15.1-15.7) (p < 0.001). The median RDW in patients who were alive was 13.8 (13.5 -15.1) and in patients who expired was 15.5 (14.5 -15.7) (p = 0.048). Conclusion: Based on the findings of this study, RDW index has statistically significant correlation with the severity of AIS. So it can potentially be an important parameter to predict the prognosis of AIS patients

Quantification of Parasite Load in Clinical Samples of Leishmaniasis Patients: IL-10 Level Correlates with Parasite Load in Visceral Leishmaniasis

A rapid and accurate method to detect and quantify Leishmania parasite is urgently needed to facilitate early diagnosis of Leishmaniasis and monitoring of antileishmania therapy. In this study, real-time assay was applied to estimate parasite load in clinical samples of visceral leishmaniasis (VL) and post kala-azar dermal leishmaniasis (PKDL) patients. The mean parasite load in blood of VL patients (n = 31) was 8,372 parasites/ml, while the mean parasite load in bone marrow aspirate (BMA) was 194,962 parasites/million nucleated cells (n = 12). Parasite load was undetectable after treatment with amphotericin B (n = 9) in VL, while a residual parasite burden was detected in 2 of 6 patients following treatment with sodium antimony gluconate. Further, circulating levels of IFN-γ, TNF-α, IL-10, IL-6, IL-4 and IL-2 were analysed in VL patients (n = 29) by Cytometric Bead Array to evaluate correlation with parasitic load. Interestingly, IL-10 levels correlated significantly with parasite load (r = 0.82, P<0.0001). The mean parasite load in dermal lesions of PKDL patients was 9,502 parasites/µg tissue DNA at pre-treatment stage (n = 25), with no detectable parasites after therapy (n = 5). Parasite burden was distinctly higher (P<0.0001) in nodular lesions (n = 12) (19,586 parasites/µg tissue DNA) compared to papular/macular lesions (n = 13, 193 parasites/µg tissue DNA). Further, chronic PKDL lesions showed significantly (P = 0.0166) higher parasite load in comparison with acute lesions. Results indicate that chronic, nodular cases constitute the major parasite reservoir for anthroponotic transmission. Our results establish that the high parasite load in VL is strongly correlated with a high level of IL-10, implicating IL-10 as a marker of disease severity. The assay is applicable for diagnosis as well as prognosis of both VL and PKDL, providing a simple molecular tool to monitor the efficacy of antileishmanial drugs or vaccines

Traditional knowledge for dairy animals in Una district of Himachal Pradesh

662-668Traditional knowledge (TK), also known as indigenous knowledge (IK) or local knowledge (LK) generally refers to the matured long-standing traditions and practices of certain regional, indigenous, or local communities. India stands at number 1 in milk production as dairy master across the world. However, due to large number of animal population, distant/remote location, shortage of veterinary staff, some time, veterinary aids are not available to the farmers. In such instances, it is the traditional knowledge of the people which guides them to mitigate the sufferings of the animals. In this article, some of the ITKs are described based on oral communication with the people

Traditional knowledge for dairy animals in Una district of Himachal Pradesh

Traditional knowledge (TK), also known as indigenous knowledge (IK) or local knowledge (LK) generally refers to the matured long-standing traditions and practices of certain regional, indigenous, or local communities. India stands at number 1 in milk production as dairy master across the world. However, due to large number of animal population, distant/remote location, shortage of veterinary staff, some time, veterinary aids are not available to the farmers. In such instances, it is the traditional knowledge of the people which guides them to mitigate the sufferings of the animals. In this article, some of the ITKs are described based on oral communication with the people

In Vitro Evaluation of a Soluble Leishmania Promastigote Surface Antigen as a Potential Vaccine Candidate against Human Leishmaniasis

International audiencePSA (Promastigote Surface Antigen) belongs to a family of membrane-bound and secreted proteins present in severalLeishmania (L.) species. PSA is recognized by human Th1 cells and provides a high degree of protection in vaccinated mice.We evaluated humoral and cellular immune responses induced by a L. amazonensis PSA protein (LaPSA-38S) produced in aL. tarentolae expression system. This was done in individuals cured of cutaneous leishmaniasis due to L. major (CCLm) or L.braziliensis (CCLb) or visceral leishmaniasis due to L. donovani (CVLd) and in healthy individuals. Healthy individuals weresubdivided into immune (HHR-Lm and HHR-Li: Healthy High Responders living in an endemic area for L. major or L. infantuminfection) or non immune/naive individuals (HLR: Healthy Low Responders), depending on whether they produce high orlow levels of IFN-c in response to Leishmania soluble antigen. Low levels of total IgG antibodies to LaPSA-38S were detectedin sera from the studied groups. Interestingly, LaPSA-38S induced specific and significant levels of IFN-c, granzyme B and IL-10 in CCLm, HHR-Lm and HHR-Li groups, with HHR-Li group producing TNF-a in more. No significant cytokine response wasobserved in individuals immune to L. braziliensis or L. donovani infection. Phenotypic analysis showed a significant increasein CD4+ T cells producing IFN-c after LaPSA-38S stimulation, in CCLm. A high positive correlation was observed between thepercentage of IFN-c-producing CD4+ T cells and the released IFN-c. We showed that the LaPSA-38S protein was able toinduce a mixed Th1 and Th2/Treg cytokine response in individuals with immunity to L. major or L. infantum infectionindicating that it may be exploited as a vaccine candidate. We also showed, to our knowledge for the first time, the capacityof Leishmania PSA protein to induce granzyme B production in humans with immunity to L. major and L. infantum infectio

Pancytopenia in Cytophagic Histiocytic Panniculitis - Case Report

Cytophagic histiocytic panniculitis (CHP) is a rare subtype of panniculitis that usually follows a fatal course, with a terminal hemophagocytic syndrome. We observed a case of pancytopenia, generalized lymphadenopathy and panniculitis, which on subsequent investigations (skin biopsy and bone marrow biopsy) revealed hemophagocytic and cytophagocytic picture