International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Clinical Safety and Side Effects of Intra Dermal regimen of Tissue culture Anti-rabies Vaccine-Rabies is 100% fatal but preventable disease. WHO recommends Tissue culture Anti-rabies Vaccines for post exposure treatment but this prophylaxis becomes expensive. So for reducing the 1/6th cost of this prophylaxis intradermal ARV regime was also recommended. But again there is a question mark for balance between cost effectiveness and safty so this cross sectional study was carried out in year 2013 on 654 recipients of Purified Chick Embriyo Cell Vaccine (PCECV) anti-rabis vaccine (ARV) at Anti Rabies Clinic (ARC) of a tertiary-care teaching hospital (SMS) at Jaipur, Rajasthan. Side effects were observed during the follow up visits on days 3, 7 and 28. Though all the recipients complained of local side effects at site of inoculation but these symptoms were relieved by simple administration of paracetamol and ceterizine orally. The side effects (local symptoms) noted on First dose were local itch (4%), local pain (3.8%), low grade fever (2.1%) and the local signs noted are local induration (22.3%), local erythema (1.2%). Same pattern of sign and symptoms were observed in D3 and D7 dose of injection but in decreased frequency. None of the cases had anaphylaxis or regional lymphadenopathy. Thus, this cost effective way of treating the animal bite cases using PCECV in Intra Dermal Rabies Vaccination (IDRV) is recommended to deal with the burden of animal bite cases for the prevention of Rabies in India.
study of hematological paremeter in sepsis patients and its prognostic implic...RahulGupta1687
The current study was a cross-sectional study with a sample size of 117 patients with sepsis. Various hematological parameters of all the patients were obtained on day of admission (day 1) and seventh day (day 7) using hemogram reports and the difference of their statistical mean and standard deviation was estimated.
ABSTRACT- Aim: The present study was to know the seroprevalence of Hepatitis C virus among indoor and outdoor patients of a teaching ter-tiary care hospital in North India. Study design: Place and duration of study: Department of Microbiology, Pt. B. D. Sharma PGIMS Rohtak, Haryana, India, between August 2013 to July 2014. Methodology: This is a retrospective study performed on blood samples collected from patients of all ages and both sexes. Commercially available Erba Lisa Hepatitis C ELISA kits were used which detects anti-HCV IgG antibodies. Statistical analysis was performed when two or more variables were needed to compare. SPSS version 17 was used to calculate P value. Results: The prevalence of HCV was 3.74% in our study. 72.7% were from males and 27.3% were from females. Highest number of positive sam-ples was from 11-20 years age group (5.6%). The positivity for anti-HCV antibodies was higher in indoor samples (7.8%) as compared to outdoor samples (2.3%). Conclusion: Strict need to follow universal precautions for HCV control and education of public so that high risk activities should be controlled. KEYWORDS: Hepatitis C virus, Seroprevalence, anti-HCV antibodies, Indoor, HCV control
Clinical Safety and Side Effects of Intra Dermal regimen of Tissue culture Anti-rabies Vaccine-Rabies is 100% fatal but preventable disease. WHO recommends Tissue culture Anti-rabies Vaccines for post exposure treatment but this prophylaxis becomes expensive. So for reducing the 1/6th cost of this prophylaxis intradermal ARV regime was also recommended. But again there is a question mark for balance between cost effectiveness and safty so this cross sectional study was carried out in year 2013 on 654 recipients of Purified Chick Embriyo Cell Vaccine (PCECV) anti-rabis vaccine (ARV) at Anti Rabies Clinic (ARC) of a tertiary-care teaching hospital (SMS) at Jaipur, Rajasthan. Side effects were observed during the follow up visits on days 3, 7 and 28. Though all the recipients complained of local side effects at site of inoculation but these symptoms were relieved by simple administration of paracetamol and ceterizine orally. The side effects (local symptoms) noted on First dose were local itch (4%), local pain (3.8%), low grade fever (2.1%) and the local signs noted are local induration (22.3%), local erythema (1.2%). Same pattern of sign and symptoms were observed in D3 and D7 dose of injection but in decreased frequency. None of the cases had anaphylaxis or regional lymphadenopathy. Thus, this cost effective way of treating the animal bite cases using PCECV in Intra Dermal Rabies Vaccination (IDRV) is recommended to deal with the burden of animal bite cases for the prevention of Rabies in India.
study of hematological paremeter in sepsis patients and its prognostic implic...RahulGupta1687
The current study was a cross-sectional study with a sample size of 117 patients with sepsis. Various hematological parameters of all the patients were obtained on day of admission (day 1) and seventh day (day 7) using hemogram reports and the difference of their statistical mean and standard deviation was estimated.
ABSTRACT- Aim: The present study was to know the seroprevalence of Hepatitis C virus among indoor and outdoor patients of a teaching ter-tiary care hospital in North India. Study design: Place and duration of study: Department of Microbiology, Pt. B. D. Sharma PGIMS Rohtak, Haryana, India, between August 2013 to July 2014. Methodology: This is a retrospective study performed on blood samples collected from patients of all ages and both sexes. Commercially available Erba Lisa Hepatitis C ELISA kits were used which detects anti-HCV IgG antibodies. Statistical analysis was performed when two or more variables were needed to compare. SPSS version 17 was used to calculate P value. Results: The prevalence of HCV was 3.74% in our study. 72.7% were from males and 27.3% were from females. Highest number of positive sam-ples was from 11-20 years age group (5.6%). The positivity for anti-HCV antibodies was higher in indoor samples (7.8%) as compared to outdoor samples (2.3%). Conclusion: Strict need to follow universal precautions for HCV control and education of public so that high risk activities should be controlled. KEYWORDS: Hepatitis C virus, Seroprevalence, anti-HCV antibodies, Indoor, HCV control
Reseach on H9N2: evidence that link outbreaks in Eurasia, China, South Korea,...Harm Kiezebrink
In this study, scientists from the U.S. Geological Survey and U.S. Fish and Wildlife Service harnessed a new type of DNA technology to investigate avian influenza viruses in Alaska. Using a “next generation” sequencing approach, which identifies gene sequences of interest more rapidly and more completely than by traditional techniques, scientists identified low pathogenic avian influenza viruses in Alaska that are nearly identical to viruses found in China and South Korea.
The viruses were found in an area of western Alaska that is known to be a hot spot for both American and Eurasian forms of avian influenza.
“Our past research in western Alaska has shown that 70 percent of avian influenza viruses isolated in this area were found to contain genetic material from Eurasia, providing evidence for high levels of intercontinental viral exchange,” said Andy Ramey, a scientist with the USGS Alaska Science Center and lead author of the study. “This is because Asian and North American migratory flyways overlap in western Alaska.”
The new study, led by the USGS, found low pathogenic H9N2 viruses in an Emperor Goose and a Northern Pintail. Both of the H9N2 viruses were nearly identical genetically to viruses found in wild bird samples from Lake Dongting, China and Cheon-su Bay, South Korea.
“These H9N2 viruses are low pathogenic and not known to infect humans, but similar viruses have been implicated in disease outbreaks in domestic poultry in Asia,” said Ramey.
There is no commercial poultry production in western Alaska and highly similar H9N2 virus strains have not been reported in poultry in East Asia or North America, so it is unlikely that agricultural imports influenced this result.
The finding provides evidence for intercontinental movement of intact avian influenza viruses by migratory birds. The USGS recently released a publication about the detection of a novel highly pathogenic H5N8 virus in the U.S. that is highly similar to the Eurasian H5N8 viruses. This suggests that the novel re-assortment may be adapted to certain waterfowl species, enabling it to survive long migrations. That virus, and associated strains, have now spread from early detections in wild and domestic birds in Pacific states to poultry outbreaks in Minnesota, Missouri and Arkansas.
“The frequency of inter-hemispheric dispersal events of avian influenza viruses by migratory birds may be higher than previously recognized,” said Ramey.
While some of the samples for the project came from bird fecal samples collected from beaches at Izembek National Wildlife Refuge, most of the samples came from sport hunters.
“For the past several years, we’ve worked closely with sport hunters in the fall to obtain swab samples from birds and that has really informed our understanding of wildlife disease in this area,” said Bruce Casler, formerly a biologist with the USFWS Izembek National Wildlife Refuge and a co-author of the study. Non
Spatial, temporal and genetic dynamics of H5N1 in chinaHarm Kiezebrink
The spatial spread of H5N1 avian influenza, significant ongoing mutations, and long-term persistence of the virus in some geographic regions has had an enormous impact on the poultry industry and presents a serious threat to human health.
This study revealed two different transmission modes of H5N1 viruses in China, and indicated a significant role of poultry in virus dissemination. Furthermore, selective pressure posed by vaccination was found in virus evolution in the country.
Phylogenetic analysis, geospatial techniques, and time series models were applied to investigate the spatiotemporal pattern of H5N1 outbreaks in China and the effect of vaccination on virus evolution.
Results showed obvious spatial and temporal clusters of H5N1 outbreaks on different scales, which may have been associated with poultry and wild-bird transmission modes of H5N1 viruses. Lead–lag relationships were found among poultry and wild-bird outbreaks and human cases. Human cases were preceded by poultry outbreaks, and wild-bird outbreaks were led by human cases.
Each clade has gained its own unique spatiotemporal and genetic dominance. Genetic diversity of the H5N1 virus decreased significantly between 1996 and 2011; presumably under strong selective pressure of vaccination. Mean evolutionary rates of H5N1 virus increased after vaccination was adopted in China.
Dengue Virus Disease: Recent Updates on Vaccine DevelopmentRSIS International
This paper reviews the current experimental updates made in the development of a dengue vaccine particularly DNA and plant derived vaccine. Dengue is an endemic viral disease affecting human health particularly children. Till today there is no medication or treatment available for dengue. Vector control measures are not yet successful in controlling dengue transmission. Introduction of Wolbachia bacteria might be the new ray of hope for the effective dengue vector control measures. The development of an efficient dengue vaccine is difficult because vaccine must be tetravalent so that it includes all the serotypes. Therefore, a tetravalent formulation plays an important role in developing a dengue vaccine. Recently tetravalent French dengue vaccine, Dengvaxia (CYD-TDV) (Sanofi Pasteur’s, France) available (limited to a few countries) on the market since 2015. Sanofi branded, Dengavaxia (CYD-TDV) is the most promising one and has recently successfully completed the phase III clinical efficacy trials in Asia and Latin America. Dengavaxia (CYD-TDV) has been shown to be safe and has different levels of efficacy against the four serotypes. However, DNA vaccination has not yet successful mainly due to the insufficient immunogenicity. Botanical dengue vaccine production is also safe and have many advantages but there are still challenges that limit the rate of successful production of plant expressed vaccines. There are numerous dengue vaccine candidates in pipeline but none of them not yet promoting vaccination.
A Point Cross-sectional study of Swine Flu Cases admitted at a Tertiary Level Hospital, Jaipur (Rajasthan) India-Presently in India Swine Flu cases were reported maximum from Rajasthan in this year (2015). So this study was aimed to analyzed the swine flu cases on various grounds to know the reasons for this increase. 77 swine flu cases addimited on 10.3.15 in a tertiary level hospital were interrogated. Total 2603 swine flu cases and 101 deaths were confirmed upto 10.3.15 in this current year concluding CFR 3.88%. Mean age of identified 77 swine flu cases was 41.32 ± 16.19 years with age range 1.5 to 75 years and MF ratio 0.51. Significantly more females were affected with swine flu than males but no significant age wise difference was found in males and females. Out of total 77 cases, 32.47 % were in ICU. About one third (31%) were self motivated others were from government and private health institutes. They were correctly diagnosed symptomatically in 33.77% before referred and about half of cases were advised for investigation (44.16%) for swine flu and precautions (51.95%) regarding respiratory antiquates. And 63.64% were admitted within 24 hours shows good awareness. Co morbidity was found in 57.14% of admitted cases and maximum (84%) co morbidity was found in cases admitted in ICU.
Knowledgeon Snake Bitediagnosis &Management among Internees in a Government M...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Background & objectives: In Odisha, several cases of dengue virus infection were detected for the first time in 2010, the importance of dengue as a serious mosquito-borne viral infection was felt only in 2011 with the reporting of many more positive cases. This retrospective three year study was done to find out the seroprevalence of dengue Igm antibody and to know the predominant serotype of dengue virus among the patients suspected to have dengue virus infection in a tertiary care hospital in southern Odisha, India.
Methods: Blood samples from clinically suspected dengue cases admitted in the Medicine and Paediatrics departments of a tertiary care hospital were collected. These were processed for detection of dengue specific IgM antibody, carried out by the ELISA method. Dengue IgM antibody positive serum samples were tested for serotypic identification.
Results: of the 5102 samples tested, 1074 (21.05 %) were positive for dengue IgM. Maximum numbers of cases were found in 2012. Majority (47.86 %) of cases were detected in the month of September. The most common affected age group was 11 to 20 yr. DENV1 and DENV2 were the detected serotypes.
Interpretation & conclusions: Rapid increase in the dengue cases in 2012 became a public health concern as majority of cases were affecting the young adolescents. Most of the cases were reported in post-monsoon period indicating a need for acceleration of vector control programmes prior to arrival of monsoon.
Key words Dengue virus - IgM antibody - seroprevalence - serotype - vector control
Reseach on H9N2: evidence that link outbreaks in Eurasia, China, South Korea,...Harm Kiezebrink
In this study, scientists from the U.S. Geological Survey and U.S. Fish and Wildlife Service harnessed a new type of DNA technology to investigate avian influenza viruses in Alaska. Using a “next generation” sequencing approach, which identifies gene sequences of interest more rapidly and more completely than by traditional techniques, scientists identified low pathogenic avian influenza viruses in Alaska that are nearly identical to viruses found in China and South Korea.
The viruses were found in an area of western Alaska that is known to be a hot spot for both American and Eurasian forms of avian influenza.
“Our past research in western Alaska has shown that 70 percent of avian influenza viruses isolated in this area were found to contain genetic material from Eurasia, providing evidence for high levels of intercontinental viral exchange,” said Andy Ramey, a scientist with the USGS Alaska Science Center and lead author of the study. “This is because Asian and North American migratory flyways overlap in western Alaska.”
The new study, led by the USGS, found low pathogenic H9N2 viruses in an Emperor Goose and a Northern Pintail. Both of the H9N2 viruses were nearly identical genetically to viruses found in wild bird samples from Lake Dongting, China and Cheon-su Bay, South Korea.
“These H9N2 viruses are low pathogenic and not known to infect humans, but similar viruses have been implicated in disease outbreaks in domestic poultry in Asia,” said Ramey.
There is no commercial poultry production in western Alaska and highly similar H9N2 virus strains have not been reported in poultry in East Asia or North America, so it is unlikely that agricultural imports influenced this result.
The finding provides evidence for intercontinental movement of intact avian influenza viruses by migratory birds. The USGS recently released a publication about the detection of a novel highly pathogenic H5N8 virus in the U.S. that is highly similar to the Eurasian H5N8 viruses. This suggests that the novel re-assortment may be adapted to certain waterfowl species, enabling it to survive long migrations. That virus, and associated strains, have now spread from early detections in wild and domestic birds in Pacific states to poultry outbreaks in Minnesota, Missouri and Arkansas.
“The frequency of inter-hemispheric dispersal events of avian influenza viruses by migratory birds may be higher than previously recognized,” said Ramey.
While some of the samples for the project came from bird fecal samples collected from beaches at Izembek National Wildlife Refuge, most of the samples came from sport hunters.
“For the past several years, we’ve worked closely with sport hunters in the fall to obtain swab samples from birds and that has really informed our understanding of wildlife disease in this area,” said Bruce Casler, formerly a biologist with the USFWS Izembek National Wildlife Refuge and a co-author of the study. Non
Spatial, temporal and genetic dynamics of H5N1 in chinaHarm Kiezebrink
The spatial spread of H5N1 avian influenza, significant ongoing mutations, and long-term persistence of the virus in some geographic regions has had an enormous impact on the poultry industry and presents a serious threat to human health.
This study revealed two different transmission modes of H5N1 viruses in China, and indicated a significant role of poultry in virus dissemination. Furthermore, selective pressure posed by vaccination was found in virus evolution in the country.
Phylogenetic analysis, geospatial techniques, and time series models were applied to investigate the spatiotemporal pattern of H5N1 outbreaks in China and the effect of vaccination on virus evolution.
Results showed obvious spatial and temporal clusters of H5N1 outbreaks on different scales, which may have been associated with poultry and wild-bird transmission modes of H5N1 viruses. Lead–lag relationships were found among poultry and wild-bird outbreaks and human cases. Human cases were preceded by poultry outbreaks, and wild-bird outbreaks were led by human cases.
Each clade has gained its own unique spatiotemporal and genetic dominance. Genetic diversity of the H5N1 virus decreased significantly between 1996 and 2011; presumably under strong selective pressure of vaccination. Mean evolutionary rates of H5N1 virus increased after vaccination was adopted in China.
Dengue Virus Disease: Recent Updates on Vaccine DevelopmentRSIS International
This paper reviews the current experimental updates made in the development of a dengue vaccine particularly DNA and plant derived vaccine. Dengue is an endemic viral disease affecting human health particularly children. Till today there is no medication or treatment available for dengue. Vector control measures are not yet successful in controlling dengue transmission. Introduction of Wolbachia bacteria might be the new ray of hope for the effective dengue vector control measures. The development of an efficient dengue vaccine is difficult because vaccine must be tetravalent so that it includes all the serotypes. Therefore, a tetravalent formulation plays an important role in developing a dengue vaccine. Recently tetravalent French dengue vaccine, Dengvaxia (CYD-TDV) (Sanofi Pasteur’s, France) available (limited to a few countries) on the market since 2015. Sanofi branded, Dengavaxia (CYD-TDV) is the most promising one and has recently successfully completed the phase III clinical efficacy trials in Asia and Latin America. Dengavaxia (CYD-TDV) has been shown to be safe and has different levels of efficacy against the four serotypes. However, DNA vaccination has not yet successful mainly due to the insufficient immunogenicity. Botanical dengue vaccine production is also safe and have many advantages but there are still challenges that limit the rate of successful production of plant expressed vaccines. There are numerous dengue vaccine candidates in pipeline but none of them not yet promoting vaccination.
A Point Cross-sectional study of Swine Flu Cases admitted at a Tertiary Level Hospital, Jaipur (Rajasthan) India-Presently in India Swine Flu cases were reported maximum from Rajasthan in this year (2015). So this study was aimed to analyzed the swine flu cases on various grounds to know the reasons for this increase. 77 swine flu cases addimited on 10.3.15 in a tertiary level hospital were interrogated. Total 2603 swine flu cases and 101 deaths were confirmed upto 10.3.15 in this current year concluding CFR 3.88%. Mean age of identified 77 swine flu cases was 41.32 ± 16.19 years with age range 1.5 to 75 years and MF ratio 0.51. Significantly more females were affected with swine flu than males but no significant age wise difference was found in males and females. Out of total 77 cases, 32.47 % were in ICU. About one third (31%) were self motivated others were from government and private health institutes. They were correctly diagnosed symptomatically in 33.77% before referred and about half of cases were advised for investigation (44.16%) for swine flu and precautions (51.95%) regarding respiratory antiquates. And 63.64% were admitted within 24 hours shows good awareness. Co morbidity was found in 57.14% of admitted cases and maximum (84%) co morbidity was found in cases admitted in ICU.
Knowledgeon Snake Bitediagnosis &Management among Internees in a Government M...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Background & objectives: In Odisha, several cases of dengue virus infection were detected for the first time in 2010, the importance of dengue as a serious mosquito-borne viral infection was felt only in 2011 with the reporting of many more positive cases. This retrospective three year study was done to find out the seroprevalence of dengue Igm antibody and to know the predominant serotype of dengue virus among the patients suspected to have dengue virus infection in a tertiary care hospital in southern Odisha, India.
Methods: Blood samples from clinically suspected dengue cases admitted in the Medicine and Paediatrics departments of a tertiary care hospital were collected. These were processed for detection of dengue specific IgM antibody, carried out by the ELISA method. Dengue IgM antibody positive serum samples were tested for serotypic identification.
Results: of the 5102 samples tested, 1074 (21.05 %) were positive for dengue IgM. Maximum numbers of cases were found in 2012. Majority (47.86 %) of cases were detected in the month of September. The most common affected age group was 11 to 20 yr. DENV1 and DENV2 were the detected serotypes.
Interpretation & conclusions: Rapid increase in the dengue cases in 2012 became a public health concern as majority of cases were affecting the young adolescents. Most of the cases were reported in post-monsoon period indicating a need for acceleration of vector control programmes prior to arrival of monsoon.
Key words Dengue virus - IgM antibody - seroprevalence - serotype - vector control
Methods: Two groups were selected by non-probability random sampling technique including case group of 154 patients with
suspected dengue (fever>2days and <10days) and control group of 146 patients with febrile illness other than dengue. Clinical,hematological and serologic markers of cases and control groups were analyzed. The frequency distribution was used to compare categorical serologic markers and paired sample T test was applied for hematologic variables before and after treatment of dengue using SPSS version 21.
Upsurge of chikungunya cases in Uttar Pradesh, IndiaAhmad Ozair
Background & objectives: Chikungunya (CHIK) re-emerged in India in 2006 after a gap of three decades. In Uttar Pradesh (UP), <100 confirmed cases per million were reported during this outbreak. Based on an upsurge of CHIK cases at UP, this retrospective study was conducted to investigate clinical and serological profile of CHIK cases in UP. Methods: A retrospective study was done on all clinically suspected CHIK cases that had been tested by ELISA for anti-CHIK virus IgM antibodies from September 2012 to December 2017. Based on clinical features, a subset of patients had earlier been tested serologically for dengue and Japanese encephalitis (JE). Results: Of the 3240 cases enrolled, 771 (23.8%) were seropositive. Patients had a range of clinical manifestations with seropositivity highest in those exhibiting arthralgia with fever (40%), followed by fever of unknown origin (FUO) (22%), encephalitis (13%) and fever with rash (12%). Cases (total, seropositive) increased over 20-fold in 2016 (1389, 412) and 2017 (1619, 341), compared to 2012-2015. Nearly a third of dengue serology-positive cases and a fifth of JE serology-positive cases were co-positive for CHIKV. Interpretation & conclusions: Archival data from 2006-2011 and data from this study (2012-2017) indicated that UP experienced first CHIK outbreak in the decade in 2016, as part of a large-scale upsurge across northern India. CHIK should be considered as a differential diagnosis in patients presenting with fever of unknown origin or fever with rash or acute encephalitis, in addition to classical arthralgia.
—In the Indian sub-continent, first isolation of the chikungunya virus was done in Kolkata during 1963. During 2006 reports of large scale outbreaks in several parts of India have confirmed the re-emergence of this virus in the country. Since the incidence of this disease is increasing. So a retrospective analysis of laboratory confirmed chikungunya patients admitted to pediatric ward was done to study biochemical profile of chikungunya fever in children. Total 51 children were laboratory confirmed for chickungunya, 36 of them had isolated chikungunya infection. Male/female ratio of isolated chikungunya was 2.6:1. Fever was invariably present, associated constitutional symptoms consisted of skin rash, vomiting, diarrhea, pain abdomen, cough, corrhyza, myalgia and bleeding manifestations. The most characteristic feature of the infections in infants was skin manifestations in form of symmetrical superficial vesiculobullous lesions & maculopapular erythematous rash. Nine patients (25%) had neurological manifestations. Joint pain was present in only three patients but none had arthritis. Most common hematological abnormality revealed thrombocytopenia in 39% cases. There was mild to moderate elevation of liver enzymes in 13 patients (36%). Average length of hospital stay was 5.1 days. Thirty four patients recovered completely & two left against medical advise. It is concluded from this study that skin manifestations and neurological manifestations are common in younger age group apart from other constitutional symptoms. Arthralgia and chronic polyarthritis is rare in this age group as found in adults.
GeneXpert MTB/RIF: A Useful Tool for Rapid and Accurate Diagnosis of Tubercul...komalicarol
The primary objective of this study was to show the usefulness and
importance of GeneXpert MTB/RIF, a rapid test that simultaneously detects Mycobacterium tuberculosis complex (MTBC) and
resistance to rifampicin (RIF) in less than 2 hours.
NEUROLOGICAL MANIFESTATIONS OF HIV/AIDS: A CLINICAL PROSPECTIVE STUDYEarthjournal Publisher
&Objectives: To study the clinical profile of neurological manifestations of Human immunodeficiency
virus(HIV)/Acquired immunodeficiency syndrome(AIDS) and to correlate with the CD4+T lymphocyte
count.Material & Methods : 50 patients who were in the age goup18-55 years, had HIV infection and history
suggestive of Nervous system manifestations were included. The HIV patients with past/present history of
other immunocompromised conditions ( cytotoxic drugs for malignancies, Post organ transplant patients,
Patients using steroids for long term), previous history of epilepsy, focal neurological deficit and head injury
were excluded from the study. All the patients were examined in detail by history and clinical neurological
examination. For all the patients have done routine investigations, and specific investigations like CT/MRI
Brain, Nerve Conduction Studies, CSF Analysis,EEG and Specific antibodies for organisms or parasite done
only wherever it is required. All the patients were correlated with the CD4 T cell count.Results:: Among 50
patients, Commonest age group affected was 26-35 yrs with male predominance(62%). Most common symptom
was non specific headache(38%).Most common opportunistic infetction was Tuberculous meningitis(34%).
Toxoplasmsa encephalitis was the most common space occupying lesion(20%).More number of patients were
seen in the CD4 range in between 51-200 cells/mic.L(72%) with all the diseases had correlation with CD4 T cell
activityCONCLUSION: In the present study, Opportunistic infections were the leading cause in patients
infected with HIV having Neurological manifestastions, usually occurs when the patients had severe
immunosuppresion (CD4 count< 200 cells/μL).
Key words: HIV Positive patients, CD4 T cell count, Neurological manifestation
Objective: To generate preliminary information about of enteroviruses and Enterovirus 71 (EV71) in patients with aseptic meningitis in Khartoum State, Sudan.
Method: Cerebrospinal fluid specimens were collected from 89 aseptic meningitis patients from different Khartoum Hospitals
(Mohammed Alamin Hamid Hospital, Soba Teaching Hospital, Omdurman Military Hospital, Alban Gadeed Teaching Hospital and Police Hospital) within February to May 2015. Among these 89 patients, 43 (48%) were males and 46 (52%) were females. The patient’s age ranged between 1 day and 30 years old. The collected specimens were assayed to detect enteroviruses and EV71 RNA using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) technique
Evaluation of diagnostic accuracy of elisa method in the detection of anti-nuclear antibodies compared to immunofluorescence
Authors:N.Sudha, P.Balapriya, P.S. Arul Raja Murugan
Int J Biol Med Res. 2024; 15(1): 7746-7749
Abstract:
Autoimmune connective tissue diseases are group of disorders in which autoantibodies are formed against self-antigen present in the nucleus and other component of the cell. The most common methods to detect antinuclear antibodies are ELISA and indirect Immunofluorescence. This study aims to evaluate the validity of ANA ELISA method as compared to Indirect immunofluorescence (IF) assay which is considered as the gold standard test. This is a descriptive study conducted in the department of Immunology, Madras Medical College Chennai, during the period of October 2021 to December 2021 with 110 samples. ANA ELISA and Indirect Immunofluorescence were done as per the instructions provided by manufacturer of kit. Out of the 110 samples 75 cases were positive, in this 29 were positive by Immunofluorescence alone, 43 cases were positive by both and 3 cases were positive by ELISA alone. The Pearson Correlation coefficient value showed positive correlation between the grading of intensity of the positive immunofluorescence pattern and optical density of antinuclear antibodies by ELISA. So both the methods can be used but in centers with appropriate facilities Immunofluorescence proves to be the gold standard in the diagnosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
1. International Journal of Pharmaceutical Science Invention
ISSN (Online): 2319 – 6718, ISSN (Print): 2319 – 670X
www.ijpsi.org || Volume 3 Issue 12 || December 2014 || PP.11-16
www.ijpsi.org 11 | Page
Evaluation of Rapid ICT in comparison with MAC-ELISA in
diagnosis of dengue fever at a tertiary care hospital, South India.
Tabasum Begum M1
, Dr. Sumana MN2
, Dr. Basavana Gowdappa H.3
1
(Department of Microbiology, JSS Medical College/ JSS University, India)
2
(Department of Microbiology, JSS Medical College/ JSS University, India)
3
(Department of Medicine, JSS Medical College/ JSS University, India)
ABSTRACT : Dengue has emerged as a major public health concern throughout India. It is the most common
mosquito-borne viral disease of humans. This study aims to determine demographic, clinical and laboratory
investigations along with the disease outcome of all the suspected cases of dengue fever and comparison of two
commercial tests routinely useful in diagnosis of dengue fever.
MATERIALS AND METHODS: A total of 228 serum samples from patients with suspected dengue
infection were included and the study was undertaken at a tertiary care hospital from July 2013-October-2013.
All samples were subjected to rapid Immunochromatographic card test (ICT) and IgM-Capture ELISA (MAC-
ELISA). Result: The sensitivity and specificity of ICT was 66.24% and 90.14% while it was 93.69% and 54.70%
for MAC-ELISA. Platelet count, Aspartate Aminotransferase (AST) and Alanine transaminase (ALT) levels of
all the dengue positive cases and healthy controls were recorded and comparison showed that these parameters
are statistically significant with p-value <0.0001. Conclusion: Dengue NS1 antigen detection through
immunochromatographic rapid card test along with MAC-ELISA proves to be more sensitive in the early
diagnosis of dengue virus infection.
KEYWORDS : ALT, AST, Dengue Fever, ICT, MAC-ELISA.
I. INTRODUCTION
Dengue is the most rapidly spreading mosquito-borne viral disease in the world. It is commonly found
in tropical and subtropical countries. Dengue Fever (DF) is caused by an arbovirus and spread by Aedes
mosquitoes (Sumana MN et al; 2014). In last 50 years, incidence has increased 30-fold with increasing
geographic expansions to new countries and in the present decade, from urban to rural settings (WHO; 2009).
An estimated 50 million dengue infections occur annually and approximately 2.5 billion people live in dengue
endemic countries (Guzman M.G ; 2004). Dengue in India was first reported during 1956 from Vellore district
in Tamil Nadu. The first Dengue Hemorrhagic fever (DHF) outbreak occurred in Calcutta (West Bengal) in
1963 with 30% of cases showing hemorrhagic manifestation. All the four serotypes that is Dengue 1, 2, 3 and 4
have been isolated in India. Recurring outbreaks of DF/DHF have been from various states namely Andhra
Pradesh, Delhi, Goa, Haryana, Gujarat, Karnataka, Kerala, Maharashtra, Rajasthan, Uttar Pradesh, Pondicherry,
Tamil Nadu, West Bengal and Chandigarh (Guidelines for clinical management of Dengue fever, Dengue
Hemorrhagic fever and Dengue shock syndrome; 2008; Nivedita G et al; 2012). Dengue virus infection
continues to be the public health concern in Karnataka and neighboring states (Epidemiological investigations
on dengue virus infections in Karnataka and neighboring areas; Annual Report 2004-2005). Dengue is one of
the most important mosquito-borne diseases in the world but still remains very much under reported, especially
in developing countries where diagnostic facilities are inadequate. Most patients with dengue infections are
asymptomatic. The severe forms of dengue fever (DF) are dengue hemorrhagic fever (DHF) and dengue shock
syndrome (DSS). Early symptoms of dengue fever mimic other diseases often prevalent in areas where it is
endemic, such as malaria and leptospirosis (Satish N et al; 2003). Thus, a rapid differential diagnosis is crucial
for proper patient care.
The precise diagnosis of dengue infection can be achieved through viral isolation, viral RNA detection
through RT-PCR or by detecting dengue specific antigen or antibodies (Shrivastava A et al; 2011). As the first
two methods are time consuming, costly and not within the reach of even most of the tertiary care hospitals, its
diagnosis is based on the detection of dengue specific antibodies and/or NS1 antigen (Kumaraswamy V et al;
2011). According to the guidelines of National Vector Borne Disease Control Programme (NVBDCP), IgM
antibody capture ELISA should be considered as diagnostic test for dengue infections which will help in early
diagnosis of dengue (Directorate of National Vector Borne Disease Control Programme; 2008) . However, most
2. Evaluation of Rapid ICT in comparison…
www.ijpsi.org 12 | Page
of the private hospitals and several diagnostic laboratories are using various rapid immunochromatographic tests
(ICT) to detect the dengue specific antibodies and/or antigen (WHO; 1997). There was an outbreak of dengue
infection in and around Mysore district of Karnataka in the year 2013 (July 2013-October 2013) and hence, the
study was undertaken to prospectively analyze the demographic, clinical and laboratory features of suspicious
cases of dengue fever and evaluation of ICT and MAC-ELISA used for the diagnosis of dengue to establish an
accurate and early diagnosis of acute dengue infection at a tertiary care hospital in Mysore, Karnataka.
II. MATERIALS AND METHODS
A total of 228 serum samples obtained from clinically suspected cases of dengue infection were tested
in Microbiology Department of JSS Medical College and Hospital, Mysore from July 2013 to October 2013.
Since our laboratory works around the clock, the samples were tested immediately for NS1 antigen, IgG and
IgM antibodies by rapid visual immunochromatography-based test (ICT (EZDX Dengue Combo Ag-Ab) from
Advy chemicals Pvt.Ltd. Thane, Mumbai for dengue NS1, IgG and IgM as per manufacturer’s instructions. All
the samples were then subjected to Dengue IgM-capture ELISA by Inbios IgM antibody capture MAC-ELISA,
Seattle, USA. Clinical and laboratory manifestations of all the dengue seropositive cases and 50 dengue
seronegative cases which served as controls were recorded.
III. RESULTS AND DISCUSSION
Dengue specific antibodies were tested by IgM capture ELISA and ICT. Out of the 228 samples tested,
157 were positive by MAC-ELISA and 111 were found to be positive for dengue infection by rapid ICT. Of
these NS1 antigen alone was positive in 48, IgG was positive in 24, IgM was positive in 31 and both NS1, IgM
parameters were positive in 08.The samples tested with rapid ICT and IgM capture ELISA and comparison of
these tests showed that of the total 228 samples, 104 were positive and 64 were negative by both the tests. There
were 53 samples which were positive by ELISA and negative by ICT and were considered as false positive. 7
(NS1 antigen positive) samples were positive by ICT and negative by ELISA test and were considered as false
negative. The sensitivity, specificity, positive predictive values between the two tests are given in Table1.
TABLE 1: SENSITIVITY AND SPECIFICITY OF ICT AND MAC-ELISA
Sensitivity Specificity PPV NPV
ICT 66.24% 90.14% 93.69% 54.70%
MAC-
ELISA
93.69% 54.70% 66.24% 90.14%
Many Immunochromatographic test devices for detecting dengue NS1, IgM and IgG antibodies are
commercially available and many studies have evaluated their performances. In this study, the performance of
ICT (EZDX Dengue Combo Ag-Ab) from Advy chemicals Pvt Ltd. Thane, Mumbai for dengue NS1, IgG and
IgM) and MAC-ELISA (Inbios IgM antibody capture MAC-ELISA,Seattle,USA) was compared and the
sensitivity of ICT was 66.24% and sensitivity of MAC-ELISA was 90.14% where as specificity of ICT
obtained was 93.69% and specificity of MAC-ELISA was 54.70%.
Better sensitivity of IgM-capture ELISA in comparison to rapid ICT have been reported by Moorthy etal and
Jayasimha et al (Moorthy M et al; 2009; Jayasimha VL et al ; 2012). Several other studies showed differences
in sensitivity and specificity of ELISA and rapid tests and their difference might be due to the different
principles of these assays (Palmer CJ; 1999).
In a study by Pramiladevi et al., a total of 66 probable dengue cases were selected. 16 cases were found to be
positive for dengue rapid ICT, whereas 14 cases were found to be dengue positive by IgM capture ELISA. The
sensitivity and specificity of rapid test along with positive predictive value and negative predictive value were
deducted and compared with other studies. The study shows that the sensitivity of rapid card test is less but has a
good specificity. In situations of epidemic, the card test can be used for screening but with the support of IgM
capture ELISA. Highly suspicious cases should be subjected to investigations with higher sensitivity and
specificity, though the results take little more time (Dr. Pramiladevi et a ; 2013).
In our study, the demographic profile of patients with dengue fever was recorded. Out of 228 patients with
symptoms of dengue fever, 157 patients were found to be positive for dengue infection. Based on the degree of
clinical manifestations, the patients were classified as Dengue fever (134) and Dengue fever with
Thrombocytopenia where the platelet count is less than 1,00,000/ml (23) (National Rural Health Mission;
3. Evaluation of Rapid ICT in comparison…
www.ijpsi.org 13 | Page
2012). Of these 104 were males while 53 were females, giving a ratio of (2:1). The age distribution is shown in
Table 2. According to Age and sex wise distribution, there was more number of males in the age group of 15-35.
(Figure1&2). This is one of the most extensive studies to report dengue fever along with the clinical and
serological characteristics during the recent outbreak in and around Mysore district.
TABLE 2: AGE AND SEX WISE DISTRIBUTION
Figure 1: Age and Sex wise distribution of Dengue fever (n=134)
Figure 2: Age and Sex wise distribution of Dengue fever with Thrombocytopenia (n=23)
Clinical Manifestation observed in patients (DF, DFT) had fever along with myalgia (43.2%, 26.08%),
rash (20.89%, 8.69%), headache (14.17%, 21.73%), nausea (7.46%, 17.39%), arthralgia (5.97%, 0%),
Dengue Fever (DF)
N=134
Dengue Fever with
Thrombocytopenia (DFT)
N= 23
Age Group No. of Cases (%) No. of Cases (%)
Males Females Males Females
0-15 (<3yrs)
15-30
30-45
45-60
>60
14 (10.44%)
40 (29.85%)
21 (15.67%)
7 (5.22%)
6 (4.47%)
6 (4.47%)
18(13.43%)
13 (9.70%)
5 (3.73%)
4 (2.98%)
3 (13.04%)
9 (39.13%)
2 (8.69%)
2 (8.69%)
2 (8.69%)
3 (13.04%)
1 (4.34%)
1 (4.34%)
4. Evaluation of Rapid ICT in comparison…
www.ijpsi.org 14 | Page
body ache (5.22%, 17.39%) and itching (2.98%, 8.69 %). The clinical manifestation of patients is
shown in Table 3. Fever with myalgia, rash and arthralgia were more prevalent in DF patients whereas
headache, nausea, bodyache and itching were more prevalent in patients with DFT (Figure 3).
Table 3: Clinical Manifestation of Patients
Signs and Symptoms
No. of Cases
Dengue Fever (DF) Dengue Fever with
Thrombocytopenia (DFT)
Fever with Myalgia
Rash
Headache
Nausea
Arthralgia
Bodyache
Itching
54
45
33
16
12
5
3
8
6
4
3
4
2
1
Figure 3: Clinical Signs and Symptoms of Dengue fever and Dengue fever with
Thrombocytopenia.
Laboratory investigation showed that there was a 4 fold decrease in platelet count in DFT and 1 fold decrease in
platelet count in DF (Figure 4). AST levels (IU/L) for DFT, DF & HC were found to be 196+ 35.2; 69 +17.96;
28.18+ 3.2 respectively and ALT levels (IU/L) found were 171.29+38.18; 48.4+4.9; 28.39+3.32 respectively
as shown in Table 4. An 8 fold increase in DFT and 3 fold increase in DF of AST level was observed in both the
groups; 7 fold and 2 fold increase of ALT level was observed in both the groups respectively when compared to
the healthy controls (Figure 5& 6).
Table 4: Comparison of Platelet count, AST level, ALT level in DF, DFT and HC.
DF DFT HC p-value F-value
Group a: Comparison of
platelet count (X103
)
Normal Range :
150-400
119+4.5 56+15.18 150+3.2 0.0001 4572
Group b: Comparison of AST
level (IU/L)
Normal Range : 10-34 IU/L
196 + 35.2 69+17.96 28.18+3.2 0.0001 3319.06
Group c: Comparison of ALT
level (IU/L) Normal level :
10-40 IU/L
171.29+38.18 48.4+4.9 28.39+3.32 0.0001 2754.6
5. Evaluation of Rapid ICT in comparison…
www.ijpsi.org 15 | Page
Figure 4: Comparison of Platelet count of Dengue fever with Thrombocytopenia (DFT), Dengue fever
(DF) and Healthy Controls (HC).
Figure 5: Comparison of AST level of DFT, DF and HC subjects.
Figure 6: Comparison of ALT level of DFT, DF and HC subjects
Platelet count and AST and ALT level of all the dengue positive cases (DFT and DF) and Human
controls were recorded and comparison of counts between the following groups was studied.
6. Evaluation of Rapid ICT in comparison…
www.ijpsi.org 16 | Page
Group a: Comparison of platelet count of DFT, DF and HC subjects.
Group b: Comparison of AST level of DFT, DF and HC subjects.
Group c: Comparison of ALT level of DFT, DF and HC subjects as shown in Table 4.
Statistically the differences were found to be significant with p-value <. 0.0001 in group a,b,c
respectively. There was a statistical significant difference in mean Platelet count, AST and ALT
between DF, FT and HC groups. Mean Platelet count in DFT group was significantly less from DF and
HC. Mean AST level was significantly higher among DF group compared to DFT and HC. Mean ALT
level was also significantly higher in DF group compared to DFT and HC.
IV. CONCLUSION
The immunochromatographic test should not be used as a standalone device for diagnosing dengue
cases. NS1-antigen detection through ICT in combination with MAC-ELISA could help in early and accurate
diagnosis of dengue infection. Further population based studies are needed, as dengue has emerged as a
significant problem in Karnataka, to suggest an effective diagnostic technique for dengue virus detection.
V. ACKNOWLEDGEMENTS
We are gratefully acknowledging the HOD of Medicine Dr. Sudarshan Murthy and HOD of Pediatrics
Dr. Narayanappa for providing us the samples for this work. We are thankful to Assistant Professor of
Community Medicine Dr. Praveen Kulkarni for his kind help to carry out the statistical analysis which was
required for this study.
REFERENCES
[1] Sumana MN, Linda Rose Jose, Tabasum Begum M. Seroprevalence of Dengue and Leptospira co-infection in Mysore, Karnataka:
A study in children at a Tertiary care Hospital. International Journal of Inventions in Pharmaceutical Sciences, 2(3), 2014; 774-
778.
[2] World Health Organization, Dengue Hemorrhagic Fever: Diagnosis, treatment, prevention and control. New edition, Geneva,
Switzerland: WHO; 2009; 3-144.
[3] Guzman M.G, Kouri, G. Dengue diagnosis, advances and challenges. International Journal of Infectious Diseases, 8, 2004, 69-80.
[4] Guidelines for clinical management of Dengue fever, Dengue Hemorrhagic fever and Dengue shock syndrome, Directorate of
National Vector Borne Diseases Control Programme, Directorate General of Health Services, Ministry of Health and Family
Welfare, New Delhi, 2008; 1-33.
[5] Nivedita Gupta, Sakshi Srivastava, Amita Jain & Umesh C. Chaturvedi. Dengue in India. Indian Journal of Medical Research, 136,
2012; 373-390.
[6] Yergolkar P, Hanumayu K, Epidemiological investigations on dengue virus infections in Karnataka and neighboring areas. Annual
Report, 2004-2005; 51-67.
[7] Sathish N, Vijayakumar T.S, Abraham P and Sridharan G. Dengue Fever: Its Laboratory Diagnosis with special Emphasis on IgM
detection. Dengue Bulletin, 27, 2003; 116-125.
[8] Shrivastava A, Dash PK, Tripathi NK, Sahni AK, Gopalan N, Lakshmana Rao PV. Evaluation of a commercial dengue NS1
enzyme-linked immunosorbent assay for early diagnosis of dengue infection. Indian Journal of Medical Microbiology, 29, 2011;
51-55.
[9] Kumarasamy V, Wahab AH, Chua SK, Hassan Z, Chem YK, Mohamad M, Chua KB. Evaluation of a commercial dengue NS1
antigen-capture ELISA for laboratory diagnosis of acute dengue virus infection. Journal of Virological Methods, 140, 2007; 75-79.
[10] Guidelines for clinical management of dengue fever, dengue hemorrhagic fever and dengue shock syndrome. Directorate of
National Vector Borne Disease Control Programme. New Delhi, India: 2008; 11-12.
[11] World Health Organization. Dengue Hemorrhagic fever: Diagnosis, treatment, prevention and control. 2nd edition. Geneva,
Switzerland: WHO, 1997; 12-23.
[12] Moorthy M, Chandy S, Selvaraj K, Abraham AM. Evaluation of a rapid immunochromatographic device for the detection of IgM
and IgG antibodies to dengue viruses (DENV) in a tertiary care hospital in South India. Indian Journal of Medical Microbiology,
27, 2009; 254-256.
[13] Jayasimha VL, Thippeswamy MTR, Yogesh Babu KV, Vinodkumar CS, Niranjan HP, Raghkumar KG, et al. Dengue:
seroprevalence, comparison of rapid test with ELISA. National Journal of Basic Medical Sciences, 3, 2012; 57-60.
[14] Palmer CJ, King SD, Cuadrado RR, Perez E, Baum M, Ager AL. Evaluation of the MRL diagnostics dengue fever virus IgM
capture ELISA and the panbio rapid immunochromatographic test for diagnosis of dengue fever in Jamaica. Journal of Clinical
Microbiology, 37, 1999, 1600-1601.
[15] Pramiladev. R. Kaivalya, Shreeram Kora. Study of rapid serological tests for diagnosis of Dengue. Scholars Journal of Applied
Medical Sciences 1(5), 2003, 541-548.
[16] A pilot study on early diagnosis of dengue infection by NS1 Antigen detection and correlation of clinical and laboratory parameters
with disease outcome. The Study is Funded by: National Rural Health Mission. Department of Health & Family Welfare,
Government of West Bengal, 2012.