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1.
Sensors (Basel) ; 24(6)2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38544060

RESUMO

A transparent and adhesive film-based enclosing and sealing method is here presented for out-of-cleanroom-based open-form microfluidic devices. The commercially available polyester flexible film known as Microseal 'B' is presented in this paper as a cover seal for open-form microfluidic devices. This film is adaptable to high working temperatures and is biocompatible. The quality of the sealing film was investigated by leak tests, fluorescence tests, and contact angle measurements. The investigations revealed its sealing strength, fluorescence detection compatibility, and surface wettability. It was found that the proposed sealing polyester film on the 3D-printed device could sustain a gauge pressure of 2.7 atm at a flow rate of 4 mL/min without any leaks. It also provided fluorescence detection compatibility and an intensity-to-background ratio in the range of 2.3 to 4.5 for particle sizes of 5 µm and 15 µm, respectively, which is comparable with the performances of other sealing materials. The film's hydrophobicity is comparable to other polymers used in microfluidics. This paper concludes by showcasing some applications of such transparent tops in classical microfluidic devices used for droplet generation and fluid mixing, in order to demonstrate the prospects of this fabrication technique in lab-on-a-chip devices.

3.
NPJ Vaccines ; 9(1): 41, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38383584

RESUMO

A fully liquid hexavalent containing Diphtheria (D), Tetanus (T) toxoids, whole cell Pertussis (wP), Hepatitis B (Hep B), type 1, 2, 3 of inactivated poliovirus (IPV) and Haemophilus influenzae type b (Hib) conjugate vaccine (DTwP-HepB-IPV-Hib vaccine, HEXASIIL®) was tested for lot-to-lot consistency and non-inferiority against licensed DTwP-HepB-Hib + IPV in an open label, randomized Phase II/III study. In Phase III part, healthy infants received DTwP-HepB-IPV-Hib or DTwP-HepB-Hib + IPV vaccines at 6, 10 and 14 weeks of age. Blood samples were collected prior to the first dose and 28 days, post dose 3. Non inferiority versus DTwP-HepB-Hib + IPV was demonstrated with 95% CIs for the treatment difference for seroprotection/seroconversion rates. For DTwP-HepB-IPV-Hib lots, limits of 95% CI for post-vaccination geometric mean concentration ratios were within equivalence limits (0.5 and 2). Vaccine was well-tolerated and no safety concerns observed.Clinical Trial Registration - CTRI/2019/11/022052.

4.
J Clin Res Pediatr Endocrinol ; 16(2): 192-199, 2024 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-38347684

RESUMO

Objective: To estimate the proportion and risk factors of non-thyroidal illness (NTI) in children with congenital heart disease (CHD) with congestive heart failure (CHF). Methods: This study enrolled children (6 weeks to 60 months age) with CHD and CHF. The clinical profile and disease severity, derived from the Pediatric Early Warning Score (PEWS) was recorded. Baseline blood samples were taken within 24 hours of hospitalization and evaluated for free tri-iodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), N-terminal pro-brain natriuretic peptide (NT pro-BNP) and reverse T3. Results: A total of 80 (64 acyanotic CHD) children of median (interquartile range) age 5 (2.5, 8.0) months were enrolled. NTI was seen in 37 (46%) of whom 27 had low fT3 levels. The proportion of NTI was highest in children with severe disease (20/30), than moderate (4/9) or mild disease (13/41) (p=0.018). Ten (27%) patients with NTI died compared to 2 (4.7%) without NTI with unadjusted odds ratio (OR) [95% confidence interval (CI)] 7.593 (1.54, 37.38); p=0.006. After adjusting for NTI, shock and NT-pro-BNP levels, PEWS was the only significant predictor of mortality (OR: 1.41, 95% CI: 1.03, 1.92; p=0.032). Linear regression for fT3 identified a significant relationship with log NT-BNP [beta -3.541, (95% CI: -1.387, -0.388)] and with TSH [beta 2.652 (95% CI: 0.054, 0.383)]. The cutoff (area under the curve, 95% CI) that predicted mortality were fT4 <14.5 pmol/L (0.737, 0.60, 0.88), fT3/rT3 index <1.86 pg/ng (0.284, 0.129, 0.438) and NT pro-BNP >3725 pg/mL (0.702; 0.53, 0.88). Conclusion: NTI was present in a significant proportion of children with CHD and CHF. fT3 level was significantly associated with NTBNP levels and thus severity of CHF.


Assuntos
Insuficiência Cardíaca , Índice de Gravidade de Doença , Humanos , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/diagnóstico , Feminino , Masculino , Pré-Escolar , Lactente , Cardiopatias Congênitas/sangue , Cardiopatias Congênitas/complicações , Fatores de Risco , Peptídeo Natriurético Encefálico/sangue , Síndromes do Eutireóideo Doente/sangue , Síndromes do Eutireóideo Doente/epidemiologia , Síndromes do Eutireóideo Doente/diagnóstico , Fragmentos de Peptídeos/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Tireotropina/sangue , Biomarcadores/sangue , Prognóstico
5.
Indian J Tuberc ; 70 Suppl 1: S29-S34, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38110257

RESUMO

Tuberculosis (TB) remains a significant public health concern, especially in children. The World Health Organization now provides estimates on pediatric TB cases and deaths, underscoring the urgency of addressing this issue. In India, childhood TB contributes significantly to the global burden, with a notable gap between reported cases and estimated incidence. Diagnosing pulmonary TB in children presents challenges, primarily due to difficulties in obtaining suitable respiratory specimens. Rapid tests like Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) have shown promise in enhancing diagnostic sensitivity. Recent research suggests that stool samples offer a non-invasive alternative for diagnosing pulmonary TB in children, with good diagnostic accuracy observed for stool CBNAAT. Furthermore, stool CBNAAT results demonstrate high agreement with gastric aspirate CBNAAT in TB diagnosis. Various stool processing methods, such as centrifugation, filtration, and sedimentation, have shown improved results for CBNAAT testing. However, it is crucial to standardize these methods to ensure consistent and comparable outcomes. Integrating stool CBNAAT into existing diagnostic algorithms for pediatric TB can enhance accuracy and efficiency in diagnosis. When implementing these algorithms, local resources, epidemiological context, and healthcare settings should be taken into account. Stool CBNAAT holds promise for microbiological confirmation of pediatric pulmonary TB, especially in resource-limited settings where obtaining representative respiratory specimens is challenging. Further comparative studies and standardization of stool processing methods are necessary to determine the most suitable approach in different contexts. By doing so, we can make significant strides in improving TB diagnosis and management in children.


Assuntos
Mycobacterium tuberculosis , Tuberculose Pulmonar , Tuberculose , Humanos , Criança , Mycobacterium tuberculosis/genética , Tuberculose Pulmonar/diagnóstico , Tuberculose/diagnóstico , Fezes/microbiologia , Técnicas de Amplificação de Ácido Nucleico/métodos , Sensibilidade e Especificidade
6.
Indian J Tuberc ; 70 Suppl 1: S76-S81, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38110265

RESUMO

OBJECTIVES: Subsequent to introduction of daily fixed dose combination (FDC) regimen with increased dosages and inclusion of ethambutol in continuation phase of antitubercular therapy (ATT) in India, this study was done to evaluate adverse drug reactions (ADRs) in children and adolescents. METHODS: Longitudinal observational study conducted in tertiary teaching hospital. Children (1 month-18 year), with newly diagnosed drug sensitive tuberculosis, started on daily FDC regimen of ATT, were included. Participants were followed up at 2 weeks, 8 weeks and 6 months. Division of AIDS (DAIDS) severity grading and World Health Organization-Uppsala Monitoring Centre (WHO-UMC) causality assessment was done. RESULTS: In 99 participants, 29 experienced ADRs. Most commonly ADRs involved hepatobiliary (11.1%) and gastrointestinal (8.1%) systems. Grade 3 severity noted in 35.5% ADRs. Certain causality classified in 19.3%. Presence of ADRs was significantly higher in participants with vs without malnutrition [40.5% vs 21.1% (p = 0.036)]. Tendency for more severe ADRs noted in participants with vs without malnutrition [Grade 3 ADRs out of all ADRs: 64.7% vs 0% (p < 0.001)]. CONCLUSION: Incidence and severity of ADRs has increased after introduction of daily FDC of ATT. Most common ADR observed were hepatobiliary. Malnutrition and less weight for age were risk factors for occurrence and severity of ADRs.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Desnutrição , Criança , Humanos , Adolescente , Estudos Longitudinais , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/tratamento farmacológico , Antituberculosos/efeitos adversos , Fatores de Risco
7.
Indian Pediatr ; 60(12): 1008-1012, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-37822203

RESUMO

OBJECTIVE: To study the spirometry parameters of children six months after severe acute coronavirus 2 (SARS-CoV-2) infection. METHODS: This single center descriptive study enrolled children aged 7-18 years after 6 months of SARS-CoV-2 infection. A detailed interval history and clinical examination was recorded. Spirometry was performed and best of the three attempts was taken into consideration to measure forced vital capacity (FVC) and forced expiratory volume 1 second (FEV1). RESULTS: A convenience sample of 40 (21 boys) children was enrolled, median (IQR) age 13 (10.75, 17) years. Twelve (30%) children had abnormal spirometry with low FVC (<80%); 10/12 (83.3%) had FEV1<80%. Children who were underweight had higher odds of having abnormal spirometry [OR (95% CI) 5.13 (1.19, 22.11); P=0.028]. There was no significant association of abnormal spirometry with age, sex, severity of initial infection and oxygen requirement during the initial infection (P>0.05). CONCLUSION: Abnormal spirometry results were observed in one-third children post-SARS-CoV-2 infection at six months follow-up.


Assuntos
COVID-19 , Masculino , Criança , Humanos , COVID-19/diagnóstico , COVID-19/epidemiologia , SARS-CoV-2 , Espirometria/métodos , Testes de Função Respiratória/métodos , Capacidade Vital , Volume Expiratório Forçado , Pulmão
8.
Cureus ; 15(6): e40255, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37440815

RESUMO

Background Osteoporotic vertebral compression fracture (OVCF) is a common problem in old age, which causes incapacitating pain and leads to significant disability, morbidity, and mortality. Percutaneous vertebroplasty (PVP), a minimally invasive procedure, results in immediate pain relief with decreased morbidity. The primary aim of this study was to evaluate the quality of life (QOL), as denoted by the Roland-Morris Disability Questionnaire (RMDQ) score. In contrast, the secondary aims were determining pain relief using the 11-point Numeric Pain Rating Scale (NPRS) and vertebral height restoration and wedge angle measurements after PVP. Methodology This prospective, longitudinal, interventional study on the efficacy of PVP was conducted among patients with low back pain due to osteoporotic vertebral collapse in a tertiary care institute. Patients with OVCF were managed by PVP and followed at one week, one month, three months, and six months for improvement in QOL by the RMDQ score and pain relief using the NPRS. The pre and post-vertebroplasty wedge angle and vertebral height (anterior, middle, and posterior columns) at one week and six months were also compared by pre and post-vertebroplasty lateral view skiagrams. Results A total of 24 patients were included in this study based on the inclusion and exclusion criteria. The demographic data were comparable. The RMDQ score showed a statistically significant difference in post-PVP at one week (p = 0.044), one month (p = 0.031), three months (p = 0.022), and six months (p = 0.018). There was a statistically significant difference in the NPRS at six months compared to the pre-PVP status, showing drastic pain relief in patients after PVP. The mean wedge angle (20.5 ± 2.07) measurement was reduced with a statistically significant increase in anterior body height restoration from pre-PVP to six months. There was no significant change in height at the middle and posterior columns compared to the pre-PVP height. Conclusions PVP is an effective, safe, minimally invasive pain and spine intervention for OVCFs with improved QOL and restoration of vertebral height.

9.
Indian J Med Microbiol ; 44: 100378, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37356837

RESUMO

OBJECTIVE: To study the virological profile of URI among children under 5 years of age. Since, it is very difficult to distinguish between various viral etiologies solely on the basis of symptoms, this study was attempted to generate evidence that majority of URI are caused due to viral illness and no antibiotics should be prescribed in the management of the same. METHODS: This observational study was conducted over a period of one year (June 2021-May 2022) in a tertiary care teaching hospital in New Delhi. A total of 180 children between the age of 0-5 years with symptoms of URI were included. Nasopharyngeal swabs were taken and processed for detection of viruses using multiplex RT PCR. RESULTS: Presence of viruses were detected in 136 (75.6%) samples. A single virus was identified in 113 samples, whereas 21 were found to harbour two viruses and 2 were carrying three viruses. The most common virus isolated was Human Rhinovirus (HRV- 55.8%) followed by Respiratory Syncytial Virus (RSV- 23.5%). In samples showing coinfection with two viruses, most common was Human Corona Virus (HCoV)- NL63, 229E, OC43, HKU1. None of the patients were given antibiotics. None of the patients required any hospital admission for severe respiratory illness. CONCLUSIONS: Viruses are a major cause of URI in children under five years of age, with the most prevalent organisms being HRV and RSV. Antibiotic prescriptions in URI are not warranted.


Assuntos
Coinfecção , Vírus Sincicial Respiratório Humano , Infecções Respiratórias , Viroses , Vírus , Criança , Humanos , Lactente , Pré-Escolar , Recém-Nascido , Estudos Transversais , Centros de Atenção Terciária , Infecções Respiratórias/epidemiologia , Viroses/epidemiologia , Índia/epidemiologia
10.
Cureus ; 14(7): e27345, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36046290

RESUMO

Background COVID-19 has now lasted for more than two years as a pandemic and has had enduring effects on the health of people as the post-COVID syndrome. Recent literature has shown the long-term effects of COVID-19 on various organ systems, including but not limited to respiratory, cardiovascular, neurological, musculoskeletal, and gastrointestinal systems. Methods and objectives We aimed to estimate the prevalence of post-acute COVID symptoms in a tertiary care center in northern India; observe the effects of the demographic profile of age, BMI, gender, and presence of comorbidities on the persistence of post-COVID syndrome, and explore any correlation between the severity of COVID-19 disease and the persistence of post-COVID symptoms. We designed a survey containing structured questions evaluating post-COVID symptoms beyond three weeks (post-acute COVID phase), six weeks (post-COVID phase), and 12 weeks of acute illness. It was administered online.  Results Prevalence of post-COVID symptoms both after three and six weeks was reported to be 16.67% and 7.37%, respectively. The most common symptoms to persist were musculoskeletal symptoms (fatigue), followed by upper respiratory symptoms. Disease severity (p<0.05), BMI (p<0.05), and comorbidities were seen to affect post-COVID symptoms significantly, whereas gender and age of the patient had no significant effect. Disease severity significantly affected the persistence of post-COVID symptoms up to 12 weeks; however, this effect does not hold true in long COVID haulers. Also, the risk of developing persistent post-acute COVID symptoms was more in moderate to severe disease than in mild disease. Conclusion The pandemic might be close to over, but it is not out of our lives yet, and the persistence of post-COVID symptoms is exigent.

12.
Indian J Tuberc ; 69(2): 178-183, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35379399

RESUMO

BACKGROUND: India houses 27% of the tuberculosis cases worldwide. Pediatric tuberculosis accounts for 11% cases worldwide. Microbiological confirmation of diagnosis is difficult in children. We aimed to study the proportion of Stool CBNAAT (Cartridge Based Nucleic Acid Amplification Test) and GA CBNAAT positive cases among the presumptive cases of tuberculosis in children and assess diagnostic utility of the Stool CBNAAT in comparison to GA CBNAAT and culture. METHODS: Ours was a cross sectional study. 75 children, aged 6 months to 12 years who were presumptive cases of pulmonary tuberculosis and who were unable to expectorate, were enrolled. Gastric aspirate and stool samples were obtained and CBNAAT and culture was done. Results of stool CBNAAT were compared with GA CBNAAT and culture. RESULTS: Of the 75 children enrolled, 28 were started on antitubercular therapy, 12 of whom were microbiologically confirmed and 16 were started on clinical grounds. Overall, 10 (13.3%) and 11 (14.6%) were positive by Stool CBNAAT and GA CBNAAT respectively. GA CBNAAT and Stool CBNAAT were found to have near perfect agreement (Cohen's kappa 0.834). Stool CBNAAT had sensitivity and specificity of 73% and 97% as compared to culture. CONCLUSIONS: Stool CBNAAT may be used for bacteriological confirmation of pediatric pulmonary tuberculosis. It was found to have a high degree of concordance with the conventionally used GA CBNAAT. This test would be helpful in endemic countries where there is a dearth of trained staff, especially in the periphery, to obtain gastric aspirate. Discomfort associated with sampling would be avoided.


Assuntos
Mycobacterium tuberculosis , Tuberculose Pulmonar , Tuberculose , Criança , Estudos Transversais , Humanos , Mycobacterium tuberculosis/genética , Técnicas de Amplificação de Ácido Nucleico/métodos , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Tuberculose Pulmonar/microbiologia
14.
BMC Biol ; 20(1): 3, 2022 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-34996429

RESUMO

BACKGROUND: Rodent ultrasonic vocalizations (USVs) are crucial to their social communication and a widely used translational tool for linking gene mutations to behavior. To maximize the causal interpretation of experimental treatments, we need to understand how neural control affects USV production. However, both the aerodynamics of USV production and its neural control remain poorly understood. RESULTS: Here, we test three intralaryngeal whistle mechanisms-the wall and alar edge impingement, and shallow cavity tone-by combining in vitro larynx physiology and individual-based 3D airway reconstructions with fluid dynamics simulations. Our results show that in the mouse and rat larynx, USVs are produced by a glottal jet impinging on the thyroid inner wall. Furthermore, we implemented an empirically based motor control model that predicts motor gesture trajectories of USV call types. CONCLUSIONS: Our results identify wall impingement as the aerodynamic mechanism of USV production in rats and mice. Furthermore, our empirically based motor control model shows that both neural and anatomical components contribute to USV production, which suggests that changes in strain specific USVs or USV changes in disease models can result from both altered motor programs and laryngeal geometry. Our work provides a quantitative neuromechanical framework to evaluate the contributions of brain and body in shaping USVs and a first step in linking descending motor control to USV production.


Assuntos
Ultrassom , Vocalização Animal , Animais , Comunicação , Camundongos , Ratos , Vocalização Animal/fisiologia
16.
Anesth Essays Res ; 15(1): 14-19, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34667342

RESUMO

BACKGROUND: Idiopathic trigeminal neuralgia (TGN) is a chronic pain disorder causing unilateral, severe brief stabbing recurrent pain in the distribution of one or more branches of the trigeminal nerve. Conventional radiofrequency (CRF) and pulsed radiofrequency (PRF) are two types of minimally invasive treatment. CRF selectively ablates the part of ganglion to provide the relief, but it has been found to be associated with some side effects such as dysesthesia or sensory loss in 6%-28% and loss of corneal reflex in 3%-8% of patients. PRF is a comparatively newer modality which is a nondestructive and neuromodulatory method of delivering radiofrequency energy to the gasserian ganglion to produce a therapeutic effect. AIMS: We aimed to compare the efficacy of CRF with long-duration, fixed voltage PRF in the treatment of idiopathic TGN. SETTING: This study was conducted in a tertiary care center research institute. STUDY DESIGN: This was a prospective randomized trial. MATERIALS AND METHODS: Twenty-seven adult patients of TGN were included in the study and randomly allocated into two groups (CRF and PRF). All procedures were performed operation suite with C-arm fluoroscopic guidance. Both, pre- and postprocedure, the patients were assessed for pain on the Visual Analog Scale (VAS) and Barrow Neurological Institute (BNI) Pain Intensity Scale at 1 week and thereafter at 1, 2, 3, and 6 months. Patients with a BNI score ≥4 after 1 month were considered a failure and offered other modes of treatment. A reduction in VAS score ≥50% and a BNI score <4 were considered as effective. STATISTICAL ANALYSIS: Discreet variables were recorded as proportions, ordinal variables and continuous variables with non-Gaussian distribution as medians with interquartile range, and continuous variables with Gaussian distribution as mean ± standard deviation. Association between ordinal variables was tested by Fisher's exact test/Chi-square test whenever appropriate. Equality of means/median was tested by using paired/unpaired t-test or nonparametric tests depending upon the distribution of data. P ≤ 0.5 was considered statistically significant. Data analysis was performed using STATA version 13.04 windows. RESULTS: Efficacy in terms of decrease in VAS ≥50% at 1 month was 33.33% and 83.33% in the PRF and CRF groups, respectively, which was statistically significant(P = 0.036). Effective reduction in BNI scores at the 7th day, 1 month, and 2 months postprocedure was evaluated and found in 41.67% and 83.33% of patients in the PRF and CRF groups, respectively, which was statistically insignificant (P = 0.089). There was a statistically significant reduction in BNI scores in PRF and CRF group patients at 3 and 6 months (at 3 months, 33.33% and 83.33%, P = 0.036 and at 6 months, 25% and 83.33%, P = 0.012). In the CRF group, mild hypoesthesia was evident in three patients which improved by the end of 1 month while no side effects were seen in the PRF group. CONCLUSION: CRF is a more effective procedure to decrease pain in comparison to long-duration, fixed voltage PRF for the treatment of idiopathic TGN. Although the side effects are more with CRF, they are mild and self-limiting.

17.
J Family Med Prim Care ; 10(7): 2546-2551, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34568134

RESUMO

CONTEXT: Socio-demographic and environmental factors attribute to stress for auto-rickshaw driver leading to compromise of driver and passenger safety. AIMS: This study assesses the prevalence and socio-demographic factors associated with stress and identifies the stressors and coping mechanisms in auto-rickshaw drivers. SETTINGS AND DESIGN: A cross-sectional study was conducted amongst 140 randomly selected auto-rickshaw drivers in Bengaluru city, India. METHODS AND MATERIAL: Data was collected at a place and time convenient to the study participants using semi-structured pre-tested tool. Stress was assessed using Cohen's Perceived Stress Scale. STATISTICAL ANALYSIS: Data was entered and analyzed using Epi Info™ software. Two sample t/ANOVA tests were used to compare the difference in means and standard deviations (SD) between the sub-groups. P <0.05 was considered statistically significant. RESULTS: Mean age of the auto-rickshaw drivers was 32.8 ± 8.3 years, majority belonged to the 25-30 years age-group. About 55.7%, 40.7% and 28.7% were consuming tobacco products, alcohol and some both, respectively. While the prevalence of self-reported stress was 76.4% (n = 107), 78.6% (n = 110) had stress based on Perceived Stress Scale (PSS) assessment. Mean PSS for participants self-reporting stress was 20.51 ± 5.25 as against 12.36 ± 4.98 who did not (P < 0.001). The mean PSS was 17.55 ± 4.13, 20.65 ± 5.23 and 23 ± 5.12 among those who self-reported having mild-, moderate- and severe-degree stress, respectively (P < 0.001). There was no significant association of any socio-demographic factors with the PSS score. Financial problems (n = 51; 47.7%) was the leading stressor, followed by road traffic (n = 49; 45.8%). Conclusions: Appropriate strategies are needed to address the high level of stress among auto-rickshaw drivers.

18.
J Trop Pediatr ; 67(4)2021 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-34549787

RESUMO

INTRODUCTION: Post-exposure prophylaxis using rabies immunoglobulin (RIG) is universal recommendation for category III exposures. This study was conducted to determine quantity of RIG used to infiltrate animal bite wounds in relation to longest dimension and area of wound. METHODS: Children aged 2-18 years reporting within 7 days of category III animal bite were included. eRIG (300 IU/ml) was used in all subjects. A predesigned proforma was filled for clinical and epidemiological details of subjects. Maximum length and width of wounds was measured by using non-stretchable measuring tape. RIG was infiltrated in wounds as per WHO recommendations and volume infiltrated was noted. RESULTS AND CONCLUSION: A total of 100 subjects were enrolled. The mean (±SD) volume of RIG infiltrated in wounds per unit length was 0.75 (±0.21) ml/cm and per unit area was 3.18 (±1.75) ml/cm2. Regression equations were calculated. Proposed equations y = 0.6x + 0.3, where y is the volume of RIG (ml) and x is the length of the wound (cm) and y = 0.9x + 1.1, where y is the volume of RIG (ml) and x is the area of the wound (cm2) can prove to be a useful tool in RIG volume calculation for primary health care providers.


Assuntos
Mordeduras e Picadas , Raiva , Animais , Criança , Pessoal de Saúde , Cavalos , Humanos , Imunoglobulinas , Profilaxia Pós-Exposição , Raiva/prevenção & controle
19.
J Infect Dis ; 224(6): 989-994, 2021 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-34260717

RESUMO

The SARS-CoV-2 B.1.617 variant emerged in the Indian state of Maharashtra in late 2020. There have been fears that 2 key mutations seen in the receptor-binding domain, L452R and E484Q, would have additive effects on evasion of neutralizing antibodies. We report that spike bearing L452R and E484Q confers modestly reduced sensitivity to BNT162b2 mRNA vaccine-elicited antibodies following either first or second dose. The effect is similar in magnitude to the loss of sensitivity conferred by L452R or E484Q alone. These data demonstrate reduced sensitivity to vaccine-elicited neutralizing antibodies by L452R and E484Q but lack of synergistic loss of sensitivity.


Assuntos
COVID-19/imunologia , COVID-19/virologia , Evasão da Resposta Imune , Mutação , SARS-CoV-2/genética , Enzima de Conversão de Angiotensina 2 , Animais , Anticorpos Neutralizantes/imunologia , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Vacina BNT162 , Vacinas contra COVID-19/imunologia , Chlorocebus aethiops , Células HEK293 , Humanos , Índia , Ligação Proteica , SARS-CoV-2/imunologia , Serina Endopeptidases , Glicoproteína da Espícula de Coronavírus/química , Glicoproteína da Espícula de Coronavírus/genética , Glicoproteína da Espícula de Coronavírus/imunologia , Células Vero
20.
Cureus ; 13(4): e14609, 2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-34040909

RESUMO

Background On March 24, 2020, the Government of India declared a nationwide lockdown and a series of measures aimed at limiting the spread of the coronavirus disease 2019 (COVID-19) infection. This led to dynamic changes in patient inflow and management in the emergency department.This study aims to evaluate the impact of the pre-lockdown and lockdown periods on the demography of trauma in a tertiary care teaching hospitaland to compare it with the homologous period of 2019. Methods The trauma caseloads between March 25, 2020, and April 14, 2020, and that of the homologous period of 2019 were thoroughly analyzed and compared retrospectively. Results There was an overall decrease in trauma patients. Elderly male patients had an increased incidence of injury during the lockdown period with a significant p-value (0.0009). There was a significant increase in the number of minor orthopedic procedures while there was a significant decrease in the number of major orthopedic procedures. Fractures of the proximal femur were significantly increased during the lockdown period (p-value0.011) and fractures of the femur and tibia shaft were significantly decreased during the lockdown period (p-value0.002). Fractures of the distal radius were significantly increased during the lockdown period (p-value0.005) and fractures of the shaft of humerus, radius, and ulna were significantly decreased during the lockdown period (p-value0.028). Injuries following fall, trivial trauma, and animal-induced trauma were significantly increased (p-values <0.0001, <0.0001, 0.014, respectively), whereas injuries following sports and motor vehicle accidents were significantly decreased (p-value 0.006, <0.0001, respectively). The number of patients reaching within the golden hour (<1 hour) was significantly increased (p-value 0.0003). The total number of patients presenting under the influence of alcohol during the lockdown period was significantly decreased (p-value- <0.0001). The use of government-sponsored ambulances for transport to the hospital was significantly increased during the lockdown period (p <0.0001). Conclusion Strict administrative measures had a high impact on the number and epidemiology of trauma with remarkable changes. There was a decreased number of trauma cases but the mechanism, type, and management of these cases were significantly altered from the homologous period of the previous year.

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