SEROPREVALENCE AND GENOTYPING OF HEPATITIS C VIRUS AMONG HOSPITAL BASED GENERAL POPULATION IN VIJAYPUR, INDIA

Objective: Hepatitis C virus (HCV) has emerged as a leading cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. According to World Health Organization (WHO) there are 180 million people affected with HCV worldwide and about 12.5 million carriers in India. Genotypes of HCV can vary in pathogenecity and can impact on treatment outcome. Hence this study was undertaken to know the seroprevalence and different genotypes of HCV among hospital based general population in Vijaypur, Karnataka.Methods: Study subjects were those attending various Out-Patient Department (OPD) and In-Patient Department (IPD) of Shri B. M. Patil Medical College, Hospital and Research Centre, Vijaypur, Karnataka. 5 ml of blood sample was aseptically collected in plain vial from the study subjects. Serum was separated and aliquoted in different vials. All the 1,200 serum samples were tested for HCV antibodies by third generation Enzyme Linked Immunosorbent Assay (ELISA). The serum samples positive by ELISA were tested for HCV RNA by Reverse Transcription Polymerase Chain Reaction (RT-PCR). Serum samples positive for HCV RNA were subjected to geno typing by RFLP (Restriction Fragment Length Polymorphism) and direct sequencing.Results: Of the 1,200 samples tested, 32 (2.6%) were positive for anti-HCV antibody and 25 (2.1%) were positive for HCV RNA. HCV genotype 1 (68%) was found to be the most predominant type followed by genotype 3 (32%). The subtypes of genotype 1 were 1a and 1b, whereas subtypes of genotype 3 were 3a and 3b.Conclusion: The seroprevalence of HCV in this study was 2.6% and HCV genotype 1 and genotype 3 were found to be the predominant genotypes respectively. For physicians, knowing the genotype of hepatitis C virus is helpful in deciding type and duration of therapy. In addition, knowledge of circulating genotypes could impact on future vaccine formulations.Â

DRUG RESISTANCE PATTERNS OF CLINICAL ISOLATES OF STAPHYLOCOCCUS AUREUS IN TERTIARY CARE CENTER OF SOUTH INDIA

Objectives: Staphylococcus aureus were initially described in 1961 and emerged in the last decade as one of the most important nosocomial pathogens. The current study was undertaken to provide data for empirical selection of appropriate antibiotics for the treatment of diseases caused by S. aureus. Methods: Various clinical samples like pus, urine, stool, sputum, blood and other body fluids of patients were selected for study from June 2012 to June 2013. Staphylococcus aureus were identified by various biochemical tests and antimicrobial susceptibility testing of the isolates were performed by Kirby Bauer disc diffusion method. Detection of the MRSA was done by Oxacillin disc diffusion method.Results: A total of 137 isolates of S. aureus were obtained over duration of 12 months. These included isolates from the sample of pus, urine, sputum, body fluids. Out of 137 S. aureus strains isolated, 62 (45.3%) were identified as MRSA and 75 (54.7%) were identified as MSSA based on oxacillin disk diffusion method. Anti-biograms revealed the high level of resistance among MRSA isolates when compared to MSSA isolates The most effective agent against MRSA isolates was linezolid (96.8%sensitive), followed by tetracycline (90.9%) and piperacillin/tazobactam (80.6%).Conclusion: The prevalence of MRSA in our hospital was high. Therefore to reduce the incidence of infections due to MRSA, we suggest implementation of the strict antibiotic policy guidelines and continuous monitoring of antibiotic susceptibility patterns of such pathogens.Â

RAPIDIRON Trial Follow-Up Study - the RAPIDIRON-KIDS Study: Protocol of a Prospective Observational Follow-Up Study

BACKGROUND: Anemia is a worldwide problem with iron deficiency being the most common cause. When anemia occurs in pregnancy, it increases the risk of adverse maternal, fetal, and postnatal outcomes. It induces preterm births and low birth weight (LBW) deliveries, long-term neurodevelopmental sequelae, and an increased risk of earlier onset of postnatal iron deficiency. Anemia rates are among the highest in South Asia, and India\u27s National Family Health Survey (NFHS-5) for 2019-2021 indicated that over half of pregnant women, and more than 65% of children, in the country are classified as anemic (Sciences IIfP, National Family Health Survey-5, 2019-21, India Fact Sheet). In 2021, the parent RAPIDIRON Trial (Derman et al., Trials 22:649, 2021) was initiated in two states in India, with the goal of assessing whether a dose of intravenous (IV) iron given to anemic women during early pregnancy results in a greater proportion of participants with normal hemoglobin concentrations in the third trimester and a lower proportion of participants with LBW deliveries compared to oral iron. As a follow-up to the RAPIDIRON Trial, the RAPIDIRON-KIDS Study will follow the offspring of previously randomized mothers to assess, neurobehavioral, hematological, and health outcomes. METHODS: This prospective observational cohort study will follow a subset of participants previously randomized as part of the RAPIDIRON Trial and their newborns. Study visits occur at birth, 6 weeks, 4 months, 12 months, 24 months, and 36 months and include blood sample collection with both maternal and infant participants and specific neurobehavioral assessments conducted with the infants (depending on the study visit). The primary outcomes of interest are (1) infant iron status as indicated by both hemoglobin and ferritin (a) at birth and (b) at 4 months of age and (2) the developmental quotient (DQ) for the cognitive domain of the Bayley Scales of Infant Development Version IV (BSID-IV) at 24 months of age. DISCUSSION: This RAPIDIRON-KIDS Study builds upon its parent RAPIDIRON Trial by following a subset of the previously randomized participants and their offspring through the first 3 years of life to assess neurodevelopmental and neurobehavioral (infants, children), hematological, and health outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT05504863 , Registered on 17 August 2022. Clinical Trials Registry - India CTRI/2022/05/042933 . Registered on 31 May 2022

CASE REPORT: Primary Cutaneous Nocardiosis of Axillary Region: A Case Report

Background: Nocardiosis is an uncommon but world-wide infection caused by several species of soil-borne aerobic bacteria belonging to the genus Nocardia. Primary cutaneous nocardiosis (PCN) is an uncommon entity. It usually occurs among immunocompetent but occupationally predisposed individuals. Clinically, it can present as acute infection (abscess or cellulitis), mycetoma, or sporotrichoid infection [1]. Here we are reporting a case of PCN presented as mycetoma in axilla which is a rare site. Case History: The patient had extensive lesions in and around the axilla, which could be attributed to the fact that the patient, being an agriculturist, had been exposed to recurrent trauma while carrying firewood and soiled sacks. Single lesion initiated four years ago, progressed to multiple lesions with few healed scars. Despite the treatment in several hospitals, lesions recurred. The present patient was diagnosed as PCN caused by Nocardia brasiliensis and appropriately treated. Conclusion: Nocardia infection should be considered in the differential diagnosis of a supportive and granulomatous dermatitis that presents clinically as multiple discharging sinuses with papules and nodules in and around axilla apart from tuberculosis

Sequence of oral manifestations in rhino-maxillary mucormycosis

Mucormycosis, caused by saprophytic fungi of the order Mucorales of the class Zygomycetes, is a rare opportunistic fungal infection, which has a rapidly progressive and fulminant course with fatal outcome. These fungi are ubiquitous, found in soil, bread molds, decaying fruits and vegetables. The most common form of mucormycosis is rhinocerebral and is usually seen in uncontrolled diabetes mellitus or in immunocompromised patients. This fungus invades the arteries, leading to thrombosis that subsequently causes necrosis of hard and soft tissues. We report a case of palatal perforation by rhino-maxillary mucormycosis in an immunocompromised patient. The aim of this article is to draw attention to the clinical presentation and pathogenesis of mucormycosis and to emphasize the need for high degree of suspicion in its diagnosis and management

Attention for and awareness of anemia in adolescents in Karnataka, India : A qualitative study

Between 1990 and 2016 the number of adolescents with anemia world-wide increased by 20% to almost one in four. Iron deficiency in adolescence results in compromised growth, decreased cognitive function, and depressed immune function, and can increase the risk of negative outcomes in pregnancy, especially in the case of young adolescents. In India, despite several decades of governmental investment in anemia prevention and treatment, more than half of women of reproductive age are anemic, with rates even higher in the adolescent population. Although awareness of adolescence as a nutrition-sensitive developmental stage is increasing, there is a lack of qualitative research on the perspectives of adolescents and families on anemia and related services. In this study, we explored the issues influencing adolescents’ awareness of anemia in three rural areas of Karnataka. Sixty-four in-depth interviews and six focus group discussions were conducted with adolescents (those who had never been pregnant, pregnant adolescents, and young mothers), community members, and nutrition-related service providers in the health and education sectors. An inductive analytical approach was used. We found that adolescent girls, particularly those who have not experienced pregnancy or motherhood, had very low awareness of anemia. State programs including school-based distribution of iron and folic acid supplements and nutrition talks were not seen to be resulting in knowledge and acceptance of the importance of preventing anemia. Pregnancy represents a turning point in which adolescents are systematically tested for anemia as part of routine antenatal care, increasing their awareness of, and access to, treatment for the condition. At the same time, pregnancy represents to family and community a period to insist on a nutritious diet. For progress in anemia reduction to be made, improved age-appropriate measures specific for adolescence are required. Improving school-based nutrition outreach is an important opportunity to reach adolescents

Attention for and awareness of anemia in adolescents in Karnataka, India: A qualitative study.

Between 1990 and 2016 the number of adolescents with anemia world-wide increased by 20% to almost one in four. Iron deficiency in adolescence results in compromised growth, decreased cognitive function, and depressed immune function, and can increase the risk of negative outcomes in pregnancy, especially in the case of young adolescents. In India, despite several decades of governmental investment in anemia prevention and treatment, more than half of women of reproductive age are anemic, with rates even higher in the adolescent population. Although awareness of adolescence as a nutrition-sensitive developmental stage is increasing, there is a lack of qualitative research on the perspectives of adolescents and families on anemia and related services. In this study, we explored the issues influencing adolescents' awareness of anemia in three rural areas of Karnataka. Sixty-four in-depth interviews and six focus group discussions were conducted with adolescents (those who had never been pregnant, pregnant adolescents, and young mothers), community members, and nutrition-related service providers in the health and education sectors. An inductive analytical approach was used. We found that adolescent girls, particularly those who have not experienced pregnancy or motherhood, had very low awareness of anemia. State programs including school-based distribution of iron and folic acid supplements and nutrition talks were not seen to be resulting in knowledge and acceptance of the importance of preventing anemia. Pregnancy represents a turning point in which adolescents are systematically tested for anemia as part of routine antenatal care, increasing their awareness of, and access to, treatment for the condition. At the same time, pregnancy represents to family and community a period to insist on a nutritious diet. For progress in anemia reduction to be made, improved age-appropriate measures specific for adolescence are required. Improving school-based nutrition outreach is an important opportunity to reach adolescents