An atypical case of fatal chikungunya infection in pregnancy

Chikungunya viral infection is a mosquito borne illness which is known to have a limited course and complete recovery is seen in most of the patients. However the virus has been reported to have atypical manifestations and lethal complications have been reported in patients suffering from chikungunya infection. In the present outbreak of chikungunya virus in the national capital territory of Delhi we report a case of chikungunya fever in a pregnant female with no significant medical history. The patient developed thrombocytopenia, hepatic injury and disseminated intravascular coagulation and ultimately succumbed to the illness due to cardiovascular collapse

Spectrum of gynecological disorders in geriatric women: a tertiary care centre study

Background: Older women constitute the fastest growing segment of Indian population. Postmenopausal phase is important and primary care physicians should be aware of common gynaecologic concerns and the potential impact of these on the function and quality of life of older women.Methods: A Prospective cross-sectional study was conducted over a period of one year on 100 postmenopausal women aged 65 years or above, who attended OPD or were hospitalised between November 2015 and October 2016.Results: Literacy rate was 30%. Study population was drawn equally from rural and urban population. Genital tract malignancy was the major gynecological disorder (32%), the commonest being the carcinoma cervix. Next in order was carcinoma ovary and carcinoma endometrium. This was followed by pelvic organ prolapse (26%) and urogenital infections (17%). POP was grade 3 in 85% patients.Conclusions: Pelvic organ prolapse, genital tract malignancies and urogenital infections were the major gynecological problems faced by older women. Moreover, postmenopausal bleeding was a possible underlying cause of malignancy, of which carcinoma cervix tops the list, emphasizing the need for a screening programme in Indian women. There is urgent need to develop dedicated geriatric units and to encourage women to receive routine gynecological check-ups in the early post menopausal period that will enable early diagnosis and treatment

Bibliometric analysis on Hand Gesture Controlled Robot

This paper discusses about the survey and bibliometric analysis of hand gesture-controlled robot using Scopus database in analyzing the research by area, influential authors, countries, institutions, and funding agencies. The 293 documents are extracted from the year 2016 till 6th March 2021 from the database. Bibliometric analysis is the statistical analysis of the research published as articles, conference papers, and reviews, which helps in understanding the impact of publication in the research domain globally. The visualization analysis is done with open-source tools namely GPS Visualizer, Gephi, VOS viewer, and ScienceScape. The visualization aids in a quick and clear understanding of the different perspective as mentioned above in a particular research domain search

Serum Proteomic Signature of Human Chagasic Patients for the Identification of Novel Potential Protein Biomarkers of Disease

Chagas disease is initiated upon infection by Trypanosoma cruzi. Among the health consequences is a decline in heart function, and the pathophysiological mechanisms underlying this manifestation are not well understood. To explore the possible mechanisms, we employed IgY LC10 affinity chromatography in conjunction with ProteomeLab PF2D and two-dimensional gel electrophoresis (2D-GE) to resolve the proteome signature of high-abundance and low-abundance serum proteins in chagasic patients. MALDI-TOF MS/MS analysis yielded 80 and 14 differentially expressed proteins associated with cardiomyopathy of chagasic and other etiologies, respectively. The extent of oxidative stress-induced carbonyl modifications of the differentially expressed proteins (n=26) was increased and coupled with a depression of antioxidant proteins. Functional annotation of the top networks developed by Ingenuity Pathway Analysis of proteome database identified dysregulation of inflammation/acute phase response signaling and lipid metabolism relevant to production of prostaglandins and arachidonic acid in chagasic patients. Overlay of the major networks identified prothrombin and plasminogen at a nodal position with connectivity to proteome signature indicative of heart disease (i.e. thrombosis, angiogenesis, vasodilatation of blood vessels or the aorta, increased permeability of blood vessel and endothelial tubes), and inflammatory responses (e.g., platelet aggregation, complement activation, phagocytes activation and migration). The detection of cardiac proteins (myosin light chain 2, myosin heavy chain 11) and increased levels of vinculin and plasminogen provided a comprehensive set of biomarkers of cardiac muscle injury and development of clinical Chagas disease in human patients. These results provide an impetus for biomarker validation in large cohorts of clinically characterized chagasic patientsFil: Wen, Jian Jun. University of Texas Medical Branch; Estados UnidosFil: Zago, María Paola. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Patología Experimental. Universidad Nacional de Salta. Facultad de Ciencias de la Salud. Instituto de Patología Experimental; ArgentinaFil: Nuñez, Sonia. Provincia de Salta. Hospital San Bernardo; ArgentinaFil: Gupta, Shivali. University of Texas Medical Branch; Estados UnidosFil: Nuñez Burgos, Federico. Provincia de Salta. Hospital San Bernardo; ArgentinaFil: Garg, Nisha Jain. University of Texas Medical Branch; Estados Unido

Defects of mtDNA replication impaired mitochondrial biogenesis during Trypanosoma cruzi infection in human cardiomyocytes and Chagasic patients: The role of Nrf1/2 and antioxidant response

Mitochondrial dysfunction is a key determinant in chagasic cardiomyopathy development in mice; however, its relevance in human Chagas disease is not known. We determined if defects in mitochondrial biogenesis and dysregulation of peroxisome proliferator-activated receptor gamma (PPARγ) coactivator-1 (PGC-1)-regulated transcriptional pathways constitute a mechanism or mechanisms underlying mitochondrial oxidative-phosphorylation (OXPHOS) deficiency in human Chagas disease. We utilized human cardiomyocytes and left-ventricular tissue from chagasic and other cardiomyopathy patients and healthy donors (n>6/group). We noted no change in citrate synthase activity, yet mRNA and/or protein levels of subunits of the respiratory complexes were significantly decreased in Trypanosoma cruzi-infected cardiomyocytes (0 to 24 hours) and chagasic hearts. We observed increased mRNA and decreased nuclear localization of PGC-1-coactivated transcription factors, yet the expression of genes for PPARγ-regulated fatty acid oxidation and nuclear respiratory factor (NRF1/2)-regulated mtDNA replication and transcription machinery was enhanced in infected cardiomyocytes and chagasic hearts. The D-loop formation was normal or higher, but mtDNA replication and mtDNA content were decreased by 83% and 40% to 65%, respectively. Subsequently, we noted that reactive oxygen species (ROS), oxidative stress, and mtDNA oxidation were significantly increased, yet NRF1/2-regulated antioxidant gene expression remained compromised in infected cardiomyocytes and chagasic hearts. The replication of mtDNA was severely compromised, resulting in a significant loss of mtDNA and expression of OXPHOS genes in T cruzi-infected cardiomyocytes and chagasic hearts. Our data suggest increased ROS generation and selective functional incapacity of NRF2-mediated antioxidant gene expression played a role in the defects in mtDNA replication and unfitness of mtDNA for replication and gene expression in Chagas disease.Fil: Wan, Xianxiu. University of Texas Medical Branch; Estados UnidosFil: Gupta, Shivali. University of Texas Medical Branch; Estados UnidosFil: Zago, María Paola. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Patología Experimental. Universidad Nacional de Salta. Facultad de Ciencias de la Salud. Instituto de Patología Experimental; ArgentinaFil: Davidson, Mercy M.. Columbia University; Estados UnidosFil: Dousset, Pierre. Hospital San Bernardo; ArgentinaFil: Amoroso, Alejandro. Hospital San Bernardo; ArgentinaFil: Garg, Nisha Jain. University of Texas Medical Branch; Estados Unido

Antigenicity and diagnostic potential of vaccine candidates in human Chagas disease

Chagas disease is the most common cause of congestive heart failure related deaths among young adults in the endemic areas of South and Central America and Mexico. Diagnosis and treatment of T. cruzi infection has remained difficult and challenging after 100 years of its identification. In >95% of human cases, T. cruzi infection remains undiagnosed until several years later when chronic evolution of progressive disease results in clinical symptoms associated with cardiac damage. Diagnosis generally depends on the measurement of T. cruzi'specific antibodies that can result in false positives. A conclusive diagnosis of T. cruzi infection thus often requires multiple serological tests, in combination with epidemiological data and clinical symptoms. In this study, we investigated the antibody response to TcG1, TcG2, and TcG4 in clinically characterized chagasic patients. These antigens were identified as vaccine candidates and shown to elicit protective immunity to T. cruzi and Chagas disease in experimental animals. Our data show the serology test developed using the TcGmix (multiplex ELISA) is a significantly better alternative to epimastigote extracts currently used in T. cruzi serodiagnosis or the trypomastigote lysate used in this study for comparison purposes.Fil: Gupta, Shivali. University Of Texas Medical Branch. Department Of Pathology; Estados UnidosFil: Wan, Xianxu. University Of Texas Medical Branch. Department Of Pathology; Estados UnidosFil: Zago, María Paola. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Salta. Instituto de Patología Experimental; ArgentinaFil: Martinez Sellers, Valena C.. University Of Texas Medical Branch. Department of Pathology; Estados UnidosFil: Silva, Trevor S.. University Of Texas Medical Branch. Department of Pathology; Estados UnidosFil: Assiah, Dadjah. University Of Texas Medical Branch. Department of Pathology; Estados UnidosFil: Dhiman, Monisha. University Of Texas Medical Branch. Department of Pathology; Estados UnidosFil: Nuñez, Sonia. Provincia de Salta. Hospital Público de Gestion Descentralizada San Bernardo; ArgentinaFil: Petersen, John R.. University Of Texas Medical Branch. Department of Pathology; Estados UnidosFil: Vazquez Chagoyán, Juan C.. Universidad Autónoma de Estado de México ; MéxicoFil: Estrada Franco, Jose G.. Universidad Autónoma de Estado de México; MéxicoFil: Garg, Nisha Jain. University Of Texas Medical Branch. Department of Pathology; Estados Unido

Immune protection against Trypanosoma cruzi induced by TcVac4 in a canine model

Chagas disease, caused by Trypanosoma cruzi, is endemic in southern parts of the American continent. Herein, we have tested the protective efficacy of a DNA-prime/T. rangeli-boost (TcVac4) vaccine in a dog (Canis familiaris) model. Dogs were immunized with two-doses of DNA vaccine (pcDNA3.1 encoding TcG1, TcG2, and TcG4 antigens plus IL-12- and GMCSF- encoding plasmids) followed by two doses of glutaraldehyde-inactivated T. rangeli epimastigotes (TrIE); and challenged with highly pathogenic T. cruzi (SylvioX10/4) isolate. Dogs given TrIE or empty pcDNA3.1 were used as controls. We monitored post-vaccination and post-challenge infection antibody response by an ELISA, parasitemia by blood analysis and xenodiagnosis, and heart function by electrocardiography. Post-mortem anatomic and pathologic evaluation of the heart was conducted. TcVac4 induced a strong IgG response (IgG2>IgG1) that was significantly expanded post-infection, and moved to a nearly balanced IgG2/IgG1 response in chronic phase. In comparison, dogs given TrIE or empty plasmid DNA only developed high IgG titers with IgG2 predominance in response to T. cruzi infection. Blood parasitemia, tissue parasite foci, parasite transmission to triatomines, electrocardiographic abnormalities were significantly lower in TcVac4-vaccinated dogs than was observed in dogs given TrIE or empty plasmid DNA only. Macroscopic and microscopic alterations, the hallmarks of chronic Chagas disease, were significantly decreased in the myocardium of TcVac4-vaccinated dogs.We conclude that TcVac4 induced immunity was beneficial in providing resistance to T. cruzi infection, evidenced by control of chronic pathology of the heart and preservation of cardiac function in dogs. Additionally, TcVac4 vaccination decreased the transmission of parasites from vaccinated/infected animals to triatomines.CONACYT PROY No. 156701 UAEM PROY No. 2381/2006U National Institutes of Health/National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/Pages/ default.aspx GRANT NUMBER (AI072538) NJG; American Heart Association http://www.heart.org/ HEARTORG/ GRANT NUMBER (0855059F) to NJG