Involvement of dual serotypes during a severe dengue outbreak in Wadi area, Nagpur district, Maharashtra 2017.

BACKGROUND & OBJECTIVES: An outbreak of dengue-like illness was reported from Wadi area within the Nagpur Municipal Corporation during September-October 2017 with five deaths. Major symptoms reported were high fever (103-106 oF), acute joint pains, myalgia, drowsiness, breathlessness, etc. An investigation was conducted to confirm the etiological agent, its characterization and the vectors involved in the outbreak. METHODS: Serological analysis was conducted to detect dengue (DEN)/chikungunya IgM antibodies in 158 sera samples. Nested-PCR was carried out to serotype eight ELISA positive samples. Adult and larval mosquito collections were conducted in the affected areas to determine species composition and mosquito density. RESULTS: Dengue IgM antibodies were detected in 44 sera samples. Molecular typing revealed involvement of DEN-2 and DEN-3 serotypes. Dengue hemorrhagic fever symptoms were observed in two patients. Aedes aegypti breeding was found rampant with Breteu index and house index ranging from 23 to 70 and 17 to 56, respectively. Major breeding habitats encountered were, used tyres, cement tanks and refrigerator trays. INTERPRETATION & CONCLUSION: Clinical symptoms, detection of anti-DEN IgM antibodies in high number of samples and heavy breeding of Ae. aegypti confirmed it was a dengue outbreak.

High occurrence of HBV among STD clinic attenders in Bombay, India.

The pattern of sexually transmitted disease (STD) is the basis for designing surveillance of specific STD, their trends and syndromic management protocols. Two hundred and fifteen consecutive first-time STD clinic attenders at a teaching hospital in Bombay were recruited for the study in October 1995. Thorough clinical examination and the following investigations were done: wet mount, Gram stain, Giemsa stain, modified Thayer-Martin (MTM) medium culture, Fontana stain, Venereal Disease Research Laboratory (VDRL), Treponema pallidium haemagglutination test (TPHA), HBsAg and HIV. Ulcerative STD constituted 73.5% of total STD while 15.8% were discharges and 10.2% were genital growths. Ulcers in decreasing order of frequency were chancroid (51.9%), genital herpes (29.1%) and syphilis (14.5). 76.5% of genital discharges were due to gonococcal infection. The high rate of ulcerative STD is possibly an important co-factor for the high HIV prevalence of 31.2% in Bombay. Of 182 patients tested for HBV, 16 (8.8%) were reactive for HBsAg, revealing a high prevalence among STD attenders. A high co-relation of HBsAg positive with either HIV or VDRL requires urgent attention for HBV intervention strategies in this population.

PIP: Analysis of the pattern of various sexually transmitted diseases (STDs) in a given region is essential to the design of surveillance programs and syndromic management protocols since the pattern varies from area to area. Enrolled in the present study were 215 consecutive, first-time STD clinic attenders at a teaching hospital in Bombay, India, in October 1995. Patients were grouped into 5 categories--genital ulcer disease, genital discharges, buboes, genital growths, and others--and tested accordingly. The mean age of the 193 male STD patients was 26.6 years, while that of the 22 female patients was 22.9 years. Genital ulcer disease constituted 73.5% of all STDs in this series, while 15.8% were discharges and 10.2% were genital growths. Ulcers were chancroid (51.9%), genital herpes (29.1%), and syphilis (14.5%). 76.5% of genital discharges were due to gonococcal infection. HIV was detected in 60 men (31.1%) and 7 women (31.8%), for an overall prevalence of 31.2%. 70.1% were infected with HIV-1, 8.9% with HIV-2, and 21% were positive for both HIV-1 and HIV-2. The high rate of ulcerative STD in this sample is a likely co-factor in the high HIV prevalence. Hepatitis B surface antigen prevalence was 8.8%, and one-quarter of these patients were also HIV-infected. This finding indicates a need for more widespread hepatitis B vaccination in India.

Effects of diltiazem on calcium ion translocation: a study on isolated frog rectus abdominis muscle.

Diltiazem, a calcium channel blocker was studied to observe its effects on the acetylcholine contractile responses of isolated frog rectus abdominis muscle. This response was modified in a dual manner i.e., initial potentiation, followed by inhibition. Diltiazem may not have anticholinesterase like mechanism, as it potentiated the responses to both acetylcholine and succinylcholine. Rectus muscle preparation, incubated in calcium free frog Ringer, showed dose dependent inhibition of acetylcholine contractile responses by diltiazem. The study suggests that diltiazem inhibits calcium ion influx across receptor operated calcium channels and may also inhibit calcium ion release from intracellular structures.

Estimation of complement C3 in oral submucous fibrosis.

Oral submucous fibrosis is a chronic disease of obscure aetiology. Considering the significant immunological findings in oral submucous fibrosis, the serum C3 levels were estimated by RID method and were found to be unaltered.

Histamine receptors in guinea-pig isolated urinary bladder.

Spasmogenic action of histamine, 2-(2-aminoethyl) pyridine (H1 receptor agonist) and 4 methyl-histamine (H2 receptor agonist), have been studied in guinea pig isolated urinary bladder in the presence of mepyramine (H1 antagonist) and metiamide (H2 antagonist) to identify the presence of H1 and H2 receptors. The study suggested the presence of H1 as well as H2 receptors in this preparation.