We retrieved Nipah virus (NiV) sequences from 4 human and 3 fruit bat (Pteropus medius) samples from a 2018 outbreak in Kerala, India. Phylogenetic analysis demonstrated that NiV from humans was ...96.15% similar to a Bangladesh strain but 99.7%-100% similar to virus from Pteropus spp. bats, indicating bats were the source of the outbreak.
Computer aided diagnosis using artificial intelligent techniques made tremendous improvement in medical applications especially for easy detection of tumor area, tumor type and grades. This paper ...presents automatic glioma tumor grade identification from magnetic resonant images using Wndchrm tool based classifier (Weighted Neighbour Distance using Compound Heirarchy of Algorithms Representing Morphology) and VGG-19 deep convolutional neural network (DNN). For experimentation, DICOM images are collected from reputed government hospital and the proposed intelligent system categorized the tumor into four grades such as low grade glioma, oligodendroglioma, anaplastic glioma and glioblastoma multiform. After preprocessing, features are extracted, optimized and then classified using Windchrm tool where the most significant features are selected on the basis of Fisher score. In the case of DNN classifier, data augmentation is also performed before applying the images into the deep learning network. The performance of the classifiers are analysed with various measures such as accuracy, precision, sensitivity, specificity and F1-score. The results showed reasonably good performance with a maximum classification accuracy of 92.86% for the Wndchrm classifier and 98.25% for VGG-19 DNN classifier. The results are also compared with similar recent works and the proposed system is found to have better performance.
A novel myxozoan parasite is identified and described from mudskipper,
Boleophthalmus dussumieri
, collected from a brackishwater ecosystem in Maharashtra, India.
Ellipsomyxa boleophthalmi
sp. nov. ...was found in the gallbladder of 58 of 60 fish examined (96.7%). The parasite formed disporous plasmodia that varied in size and shape, and the thin-walled, ellipsoidal and elongated myxospores measured 9.0–10.7 × 6.0–7.8 μm. The two, spherical polar capsules measured 2.7 μm in diameter and enclosed 3–4 coils of polar tubules. Histological observations of infected gallbladder revealed the attachment of disporous plasmodial stages of the parasite to the gallbladder wall with fine pseudopodia. Under the scanning electron microscope (SEM), the myxospores showed a distinct central sutural line and two distinct depressions on the opposite sides at the openings of polar capsules. SEM also revealed the engulfment of microvilli of gallbladder wall by pseudopodia of the plasmodial stages. Analysis of the partial fragment of the SSU rDNA region (1386 bp) showed less than 98% sequence similarity with the other reported
Ellipsomyxa
spp. In the phylogenetic tree, the present species formed as a distinct subclade within the major clade of
Ellipsomyxa
spp. The unique morphological and morphometric features of the myxospore, together with the molecular analysis, allowed us to conclude that the present myxozoan is a new species and is named
Ellipsomyxa boleophthalmi
sp. nov., after the generic name of the host. This is the first report on the occurrence of the genus
Ellipsomyxa
in
B
.
dussumieri.
Neurosyphilis, a chronic infection of the nervous system by Treponema pallidum can present in all stages of syphilis. Recently, it is found that neurosyphilis presents with novel manifestations. ...Here, we report a young patient who had neurosyphilis presenting as Normal Pressure Hydrocephalus (NPH) with bilateral optic atrophy. The patient showed improvement with treatment for neurosyphilis. Hence, it is evident that in young patients presenting with NPH and associated features, secondary etiologies should be investigated.
Abstract
Background
An outbreak of Nipah virus (NiV) disease occurred in the Kozhikode district of Kerala State in India in May 2018. Several cases were treated at the emergency medicine department ...(ED) of the Government Medical College, Kozhikode (GMCK). The clinical manifestations and outcome of these cases are described.
Methods
The study included 12 cases treated in the ED of GMCK. Detailed clinical examination, laboratory investigations, and molecular testing for etiological diagnosis were performed.
Results
The median age of the patients was 30 years and the male to female ratio was 1.4:1.0. All the cases except the index case contracted the infection from hospitals. The median incubation period was 10 days, and the case fatality ratio was 83.3%. Ten (83.3%) patients had encephalitis and 9 out of 11 patients whose chest X-rays were obtained had bilateral infiltrates. Three patients had bradycardia and intractable hypotension requiring inotropes. Encephalitis, acute respiratory distress syndrome, and myocarditis were the clinical prototypes, but there were large overlaps between these. Ribavirin therapy was given to a subset of the patients. Although there was a 20% reduction in NiV encephalitis cases treated with the drug, the difference was not statistically significant. The outbreak ended soon after the introduction of total isolation of patients and barrier nursing.
Conclusion
The outbreak of NiV disease in Kozhikode in May 2018 presented as encephalitis, acute respiratory distress and myocarditis or combinations of these. The CFR was high. Ribavirin therapy was tried but no evidence for its benefit could be obtained.
Twelve cases of Nipah virus disease were treated in the emergency department of a referral hospital in Kozhikode, India, in May 2018. The case fatality ratio was 83.3%. Ten cases each had encephalitis and acute respiratory distress syndrome and 3 had myocarditis. Transmission was mostly nosocomial.
Meningitis in patients with ventriculo-peritoneal shunt (VP shunt) caused by various species of Candida have been widely described in literature. However, reports describing Candida auris as a cause ...of meningitis is limited. In this case report we describe a case of multidrug resistant Candida auris meningitis secondary to VP shunt infection successfully treated with intrathecal amphotericin B deoxycholate and intravenous liposomal amphotericin B. This is the second case report of successful treatment of Candida auris meningitis from India. More literature regarding the use of intrathecal/intraventricular echinocandins including optimal dosing and duration of therapy is needed.
Nipah Virus (NiV) is a highly fatal emerging zoonotic virus and a potential threat to global health security. Here we describe the characteristics of the NiV outbreak that occurred in Kerala, India, ...during May-June 2018.
We used real-time reverse transcription polymerase chain reaction analysis of throat swab, blood, urine, and cerebrospinal fluid specimens to detect NiV. Further, the viral genome was sequenced and subjected to phylogenetic analysis. We conducted an epidemiologic investigation to describe the outbreak and elucidate the dynamics of NiV transmission.
During 2-29 May 2018, 23 cases were identified, including the index case; 18 were laboratory confirmed. The lineage of the NiV responsible for this outbreak was closer to the Bangladesh lineage. The median age of cases was 45 years; the sex of 15 (65%) was male. The median incubation period was 9.5 days (range, 6-14 days). Of the 23 cases, 20 (87%) had respiratory symptoms. The case-fatality rate was 91%; 2 cases survived. Risk factors for infection included close proximity (ie, touching, feeding, or nursing a NiV-infected person), enabling exposure to droplet infection. The public health response included isolation of cases, contact tracing, and enforcement of hospital infection control practices.
This is the first recorded NiV outbreak in South India. Early laboratory confirmation and an immediate public health response contained the outbreak.
The present study reports a case of hepatic microsporidiosis caused by
Microgemma
sp. in brackishwater fish,
Boleophthalmus dussumieri
(Valenciennes, 1837) (n = 60), from the west coast of India. An ...eight-month study from September 2017 to April 2018 revealed a prevalence of 11.7% for this parasite. The microsporidian showed tissue-specific infection and did not reveal any gross pathology in infected fish. Small whitish cysts containing microspores of size 0.3–0.5 mm were observed in the liver of fish. The range of pyriform microsporidian spore size varied from 2.9–3.77 × 1.85–2.67 µm
.
Scanning electron microscopy of the spores showed a distinct groove on the anterior end of the spore for polar tube extrusion. Polymerase chain reaction (PCR) amplification of the DNA extracted from the microsporidian-infected liver tissue using primers targeting small ribosomal subunit DNA (SSU rDNA) yielded ~ 1340 bp amplicon and the genetic distance analysis showed a 0.2% variation with the reported
M. tilanpasiri
. Accordingly, in the phylogenetic tree, the present species of
Microgemma
clustered with
M. tilanpasiri.
Even though, the morphomeristic characters of the present
Microgemma
sp. was marginally different from the reported
M. tilanpsasiri;
the SSU rDNA showed considerably higher similarity with
M. tilanpasiri.
Thus, we report the species of
Microgemma
as
Microgemma
aff.
tilanpasiri
from a new host. This is the first report of a microsporidian from
B. dussumieri
and the first record of the genus
Microgemma
from India.
We conducted a serosurvey of 155 healthcare workers and 124 household and community members who had close contact with 18 patients who had laboratory-confirmed Nipah virus infections in Kerala, ...India. We detected 3 subclinical infections; 2 persons had IgM and IgG and 1 only IgM against Nipah virus.
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