Liver Function Status in COVID-19: An Indian Perspective.

INTRODUCTION: In SARS-CoV2 infection multi-organ involvement of heart, kidney pancreas and liver are reported. Most studies suggest that though mild derangements of liver function may be experienced by most COVID-19 patients but significant liver injury is not common. The aim of this study was to describe clinical characteristics of COVID-19 patients admitted to this level 4 COVID hospital and find out their relation to the liver parameters. MATERIALS AND METHODS: COVID-19 patients admitted in this level -4 COVID hospital during the study period were classified as mild (Group 1,n=42), moderate (Group 2,n=40) and severe (Group 3,n=35) cases as per national guidelines. Serum samples were analyzed using biochemistry autoanalyzer. Serum levels of total and direct bilirubin, Alanine Transaminase (ALT) and Aspartate Transaminase (AST), Alkaline Phosphatase (ALKP), total protein and albumin were assayed. RESULTS: Patients with higher BMI (Body mass index) had developed greater COVID-19 related complications and hence had to be admitted either in HDU (Group 2) or in ICU (Group 3) set up. Total and direct serum bilirubin levels were normal and almost similar in the various study groups. The primary liver enzymes ALT and AST were raised in the entire study population. However differences between the study groups were statistically insignificant. ALKP was within normal reference range for all the cases. Serum total Protein levels were within normal physiological limits in all the three groups. However serum albumin levels were reduced significantly in Groups 3 and 2 in comparison to Group 1. CONCLUSION: Derangements of LFT in COVID-19 Patients are common especially in patients with severe disease but its long term impact is unknown. Hence, further investigation and long term follow up of recovered COVID-19 cases is warranted to understand the pathophysiology and implication of liver injury that occurs both in overt and covert forms during infection.

Status of Health-care Workers in Relation to COVID-19 Infection: A Retrospective Study in a Level 4 COVID Hospital in Eastern India.

INTRODUCTION: Healthcare workers (HCWs) have a high risk of acquiring SARSCoV- 2 infection, due to repeated occupational exposure, long working hours, stress and fatigue. In India, there is lack of data regarding the prevalence of COVID-19 amongst HCWs due to absence of routine screening programme within the hospital premises. We have designed this study in order to improve our understanding of the incidence of SARS-CoV2 within the health care workers working in a level 4 COVID hospital in Kolkata. MATERIALS AND METHODS: A retrospective observational study was conducted at the Department of Microbiology, ID and BG Hospital, Kolkata upon health care workers who presented with symptoms suggestive of Covid 19 and their direct contacts. Oropharyngeal and nasopharyngeal swabs collected from the participants were subjected to Real time RT-PCR for detection of E, RDRP and ORF1B N gene for Covid 19 detection. RESULT: Out of the 274 HCW tested, 75 (27%) of total HCWs were found to be positive. Among them 33(44%) were frontline workers and rest of them 42 (56%) were non-frontline workers. Predominance of SARS- CoV2 infection was found in male HCWs (57%) than female HCWs (43%). HCWs younger than 45 years (68%) were more infected.52 (69%) HCWs presented with symptoms like fever, sore throat, bodyache, loss of sensation of smell, coughs etc. 23(31%) were asymptomatic with history of direct contact with Covid-19 positive cases. CONCLUSION: Heath care workers are at higher risk of being exposed to SARS-CoV2 and could potentially has a role in transmission in and out of the hospital. Hence, routine screening of both symptomatic as well as asymptomatic hospital staff is essential for early diagnosis to prevent transmission of COVID 19 infection.

Changing pattern of dengue virus serotypes circulating during 2008-2012 and reappearance of dengue serotype 3 may cause outbreak in Kolkata, India.

Dengue virus infection is a major cause of morbidity within the endemic tropical and subtropical regions of the world. Dengue virus has four distinct serotypes with specific clinical manifestations. In this study, we observed the changing pattern of dengue serotypes, age-wise dengue infection and useful sero-detection methods needed in a dengue endemic region. We identified dengue serotypes during a period of 5 years among patients with dengue symptoms visiting one of the largest tertiary care infectious disease hospitals of eastern India in Kolkata. A total of 433 dengue RNA positive samples were isolated from 712 acute dengue suspected cases. Age wise distribution highlighted the susceptible age group being >21 years (24.02%) followed by 11-15 years (21.71%) and 5-10 years (21.02%) of the total infected population. Higher numbers of infected cases were found within females as they are involved in more indoor works. The period of study experienced two dengue outbreaks one in 2008 and another in 2012. For early dengue detection, NS1 was found to be more confirmatory than IgM ELISA regarding sensitivity and specificity. DENV-1, 2, and 4 serotypes were the common circulating strains from 2008 until 2010, after which DENV-3 serotype infections rise and led to a massive dengue outbreak in Kolkata with increased numbers of DHF and DSS cases in 2012. The finding within our study emphasizes the public health importance of such prospective surveillance programs with respect to the changing dengue viral etiology and serotypes. J. Med. Virol. 88:1697-1702, 2016. © 2016 Wiley Periodicals, Inc.

Retinol Levels in Serum and Chronic Skin Lesions of Atopic Dermatitis.

BACKGROUND: Atopic dermatitis (AD) is a common childhood dermatosis and a distressing cause of morbidity. The pathogenesis of AD is known to be associated with disorders of immune response and defect in antioxidant defense, genetic predisposition, environmental triggers, psychosomatic factors, and other mechanisms. Retinol has immunomodulatory and antioxidant effects, thus may have a protective role in AD. OBJECTIVE: The objective of this study was to evaluate the correlation of retinol levels in skin lesions and serum, with AD. MATERIALS AND METHODS: The study was a hospital-based, case-control study. Punch biopsy from the skin and venous blood of 86 participants (including 43 cases and 43 controls) were assayed for retinol levels by a reversed-phase high-performance liquid chromatography method. Analysis of data was performed using appropriate statistical methods. RESULTS: Skin and serum retinol levels were highly significantly decreased in patients in respect to that of controls. CONCLUSION: Retinol levels were decreased in AD. Retinol estimation may be used as a promising parameter for the elaboration of treatment strategy and monitoring.

Correlation Study Between HCV Genotypes Distribution Pattern and Viral Load in a Tertiary Care Hospital in Kolkata, India.

BACKGROUND: Hepatitis C virus infection is a leading cause for chronic liver disease. It has wide population specific genotype variability. Genotype knowledge and viral load assessment are equally important for designing therapeutic strategies and as predictors of treatment outcome among hepatitis C (HCV) infected patients. MATERIALS AND METHODS: Between June 2012 and 2013 an observational study was conducted among 350 chronic hepatitis patients visiting Calcutta National Medical College, Kolkata, India. Among them, 110 anti-HCV antibody positive cases were diagnosed and subjected to viral RNA extraction, viral genotyping and viral load quantification using polymerase chain reaction (PCR) based techniques. STATISTICAL ANALYSIS: Statistical analysis was done with IBM SPSS Statistics software, version 20. p-value <0.05 was regarded as statically significant. RESULTS: Among 66 HCV RNA positive cases, genotypes 1a, 3a and 3b were observed among 18 (27%), 44(67%) and 4(6%) cases respectively. Genotype 3a had higher viral load than patients infected with genotypes 1and 3b. However, no statistical significance was observed for viral load among the various HCV RNA genotypes. CONCLUSION: Genotype 3a accounted for the highest number of cases with positive HCV RNA. However, no statistically significant difference existed for viral load among the various HCV RNA genotypes in this study.

Primary cutaneous actinomycosis:a case report.

Actinomycosis is a subacute or chronic suppurative bacterial infection caused by filamentous gram positive, anaerobic to microaerophilic non acid fast bacilli primarily of the genus Actinomyces that normally colonize the mouth, colon and vagina. Primary cutaneous actinomycosis is a rare entity and is generally associated with trauma. We report a case of primary cutaneous actinomycosis of the back and left axilla in a 32-year-old female patient with no suggestive history of trauma.The diagnosis was suggested by the characteristic lesions with multiple discharging sinuses draining sero-sanguinous fluid scattered all over the lesions. Gram positive bacilli with plenty of pus cells were demonstrated in the direct examination of the discharging pus. Diagnosis was confirmed by isolation of the organisms by anaerobic culture giving typical molar tooth colonies. Final confirmation was done by histopathological examination.