Introduction: The Coronavirus Disease 2019 (COVID-19) is associated with damage of cells of both innate and adaptive immunity, which results in immune system’s impairment leading to secondary ...infections. Microbiological evaluation helps in diagnostic as well as antimicrobial stewardship leading to accurate treatment of COVID-19 infected patients. Aim: To evaluate superadded bacterial and fungal infections in COVID-19 infected patients and to evaluate bacterial and fungal infections in COVID-19 non infected patients admitted with Acute Respiratory Illness (ARI). Materials and Methods: This retrospective study was carried out in a tertiary care hospital in Delhi, India, over a period of eight months (May to December, 2020). Respiratory samples, received from indoor patients with history of ARI, were processed for COVID-19 (TrueNat Real Time Polymerase chain reaction) as well as for bacterial and fungal cultures following Standard Operating Procedures (SOP). Identification and susceptibility pattern was evaluated by Vitek2 compact system (bioMérieux, Inc. Durham, North Carolina/USA). Quality control strains used were American Type Culture Collection (ATCC) Staphylococcus aureus 29213, Escherichia coli 25922 and Candida parapsilosis ATCC 22019. Minimum Inhibitory Concentration (MIC) levels were standardised as per Clinical and Laboratory Standards Institute (CLSI) guideline, 2020. All statistical analysis was done by Chi-square test using Software Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Total patients admitted with the history of ARI were 542; COVID-19 Positive Group (CPG) included 115 (21.22%) while COVID-19 Negative Group (CNG) included 427 (78.78%). Growth in bacterial and fungal cultures in CPG was 59.13% (68/115) while in CNG; it was 47.78% (204/427). Among the bacterial isolates, most common isolate was Klebsiella pneumoniae {CPG: 41.93% (26/62); CNG: 36.72% (76/207)}, followed by Pseudomonas aeruginosa {CPG: 33.87% (21/62); CNG: 31.88% (66/207)}. Fungal isolates in CPG was 19.48% (15/77) (p-value 0.0445). On comparing Antimicrobial Susceptibility (AST) pattern of Enterobacterales in both CPG (n=36) and CNG (n=102), no statistically significant difference was observed. Co-morbid conditions were found mostly in CNG 89% (140/158) with ARI while only 11% (18/158) was found in CPG. Conclusion: Secondary respiratory infections are quite common amongst COVID-19 positive patients. However, growth in culture, type of isolates, Antimicrobial Resistance (AMR) was almost similar with COVID-19 non infected patients admitted with ARI. Co-morbidity had the similar impact as COVID-19 infection with respect to co-infections.
In December 2019, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) appeared and spread worldwide, triggering a pandemic of respiratory illness. So, there was an urgent need for vaccines ...worldwide. The mRNA-based vaccines are undergoing an accelerated phase of development during this pandemic. WHO has issued interim guidelines for administering the Moderna mRNA-1273 vaccine against COVID-19 based on advice given by the Strategic Advisory Group of Experts on Immunization (SAGE). The significant future directions for study would be comparing and elucidating the immune processes triggered by mRNA vaccine platforms, developing existing methods focused on these mechanisms, and introducing new clinical trials of these vaccines against additional disease targets.
This study aims to reveal the important role and contribution of the Moderna mRNA-1273 vaccine to COVID-19 vaccinology.
Moderna mRNA-1273 vaccine could be the keystone of modern vaccinology in the context of the COVID-19 pandemic.
Stroke is a complex multifactorial disease influenced by several genetic and environmental factors. Vitamin B12 deficiency is a major public health problem in Indian population due to adherence to ...strict vegetarian diet. Transcobalamin II is a key protein involved in intracellular transport of vitamin B12. So, genetic variation in transcobalamin II gene may lower concentration of intracellular vitamin B12 and may increase the susceptibility of stroke. The objective of the present study was to explore the effect of transcobalamin II gene polymorphism upon susceptibility to stroke in Indian population. A case-control study was conducted in Department of Biochemistry and Medicine, VMMC and SJH, New Delhi, which included 32diagnosed cases of stroke and 32 age and sex matched healthy control subjects. Genomic DNA isolation was done by DNA extraction Kit. The genotyping for transcobalamin II SNP (rs4820889 (A right arrow G)) was done by Allele Specific Polymerase chain reaction. Among cases, genotype frequency of AA is 75%, AG is 18.8%, GG is 6.3% and allelic frequency of A is 84.4% and G is 15.6%. Among controls, genotype frequency of AA is 93.8%, AG and GG is 3.1% and allelic frequency of A is 95.3% and G is 4.7%. Pearson Chi-Square p-value = 0.0389, OR = 5.0;95% = 0.96-25.78. In our study we have found that transcobalamin II gene SNP rs4820889 is significantly (p-value <0.05) associated with the risk of stroke.
: The Novel Corona Virus pandemic caused significant morbidity and mortality worldwide. The biochemical parameters in affected individuals can differentiate between moderate and severe COVID-19 ...infection. Early identification will facilitate appropriate care and reduce the mortality.
: In the present study, we are exploring the possibility of association of the data of biochemical investigations done at the time of admission with COVID-19 severity in patients, as timely modulation in medical management could reduce the mortality and shorten hospital stay.
: A cross sectional study including 452RT-PCR positive, moderate to severe cases of COVID-19 patients admitted to a tertiary care centre, New Delhi were enrolled in the study, in the months of June to October 2020.Biochemical profile of moderate and severe COVID 19 patients was evaluated on admission and correlated with severity of the disease.
Out of 452 patients, 331 patients had moderate disease while 121 had severe disease. Total bilirubin in moderate disease was 0.6mg/dl(0.4-0.9) and 0.6mg/dl(0.4-0.8) in severe disease (p=0.780). AST was 46U/L(31-73.75) and 45 U/L(30-76) in moderate and severe disease respectively (p=0.544), while ALT was 42U/L(25-78.25) and 42U/L(26-72)(p=0.936) respectively in moderate and severe disease. The ALP was 111U/L(86.5-165.5) and 106U/L(77-157) in moderate and severe disease respectively (p=0.828). The serum urea in moderate COVID-19 patients was 32mg/dl(22-61) while 42mg/dl(22-94) in severe disease (p=0.016). The serum creatinine in moderate disease was 0.7mg/dl(0.6-1.1) while 0.8mg/dl(0.6-1.8)(p=0.143) in severe disease. The median (IQR) serum HsCRP in moderate disease was 103.2mg/L(9.7-202) and in severe disease it was 103.76mg/L(19.53-181.26)(p=0.132). The median (IQR) LDH level in moderate COVID-19 patients was 245U/L(137.25-372.25) while in severe disease it was 385U/L(278-598)(p<0.001).
: The serum biomarkers Urea and inflammatory marker LDH could serve as potential biomarkers to differentiate between moderate and severe COVID-19 patients.
•Vaccine proximate status epilepticus (VP-SE) most frequently occurred following receipt of dose-1 measles-containing vaccine.•Half of all SE were febrile SE and half had a laboratory confirmed ...infection.•There was no difference in seizure severity between VP-SE and NVP-SE cases.
Status epilepticus is associated with significant morbidity and mortality. While vaccine-proximate status epilepticus (VP-SE) has rarely been associated with cases of Dravet syndrome, it is not known whether VP-SE differs clinically from non-vaccine proximate status epilepticus (NVP-SE).
Medical records of children aged ≤24 months, presenting to one of five Australian tertiary pediatric hospitals with their first episode of status epilepticus from 2013 to 2017 were identified using ICD-coded discharge diagnoses. Vaccination history was obtained from the Australian Immunisation Register. Hospitalization details, subsequent epilepsy diagnosis, and vaccination uptake were compared between VP-SE and NVP-SE cases.
Of 245 first status epilepticus hospitalization with immunization records, 35 (14%) were VP-SE and 21 (60%) followed measles-containing vaccines. Vaccine-proximate status epilepticus cases had a median age of 12.5 months IQR 7.1–14.73, 23 (66%) were in males, 15 (43%) were febrile status epilepticus and 17 (49%) had an infection confirmed. There were no significant differences in hospitalization duration (P = 0.50) or intensive care unit admission (P = 0.42) between children with VP-SE compared to children with NVP-SE. Children with no history of seizures at their first VP-SE had longer hospitalizations, were more likely to require intensive care unit admission, but were less likely to have a subsequent diagnosis of epilepsy than children with previous seizures at their first VP-SE.
First VP-SE was predominantly associated with a measles-containing vaccine at 12-months of age. Seizure severity was no different between first VP-SE and first NVP-SE. In children with VP-SE, subsequent seizure admissions and epilepsy diagnosis were associated with having seizure prior to their first SE.
Recent global outbreaks of vaccine-preventable diseases, both before and since the coronavirus disease 2019 pandemic, have led to the introduction or strengthening of vaccine mandate policies to ...target vaccine refusal. Globally, there is wide variation in how governments and jurisdictions implement and enforce mandatory vaccination as well as the financial and educational consequences to those who fail to comply. We explored the impact of mandate vaccination policies on Australian Immunization Specialists who work in Specialist Immunization Clinics (SIC) for approving vaccine exemptions outside of the mandated criteria. In particular, their interactions with patients and families.
A national, prospective, mixed methods, survey-based study conducted with members of the Australian Adverse Event Following Immunisation Clinical Assessment Network between February 2020 and June 2020.
Sixteen Immunization physicians and nurse practitioner specialists working in a SIC completed the survey. All sixteen respondents had been requested by parents to provide a Medical Exemptions at least once. 88% of respondents felt pressure to provide an exemption that was not medically justified according to legislation. Seventy-five percent of SIC consultants felt that the "No Jab" policies created a moderate or extreme amount of stress to both themselves and parents. All respondents reported experiencing hostility from parents with three respondents having received threats of violence.
Mandatory vaccination policies are associated with increased vaccination coverage but can result in widened financial and social inequity, and may harm families' relationships with health care providers. Countries considering the implementation of vaccination mandates should use the least restrictive health policies to ensure a balance between the public health and individual benefit whilst minimizing burdens on health care professionals, children and their parents.
Background & objectives: India has been reporting the cases of coronavirus disease 2019 (COVID-19) since January 30, 2020. The Indian Council of Medical Research (ICMR) formulated and established ...laboratory surveillance for COVID-19. In this study, an analysis of the surveillance data was done to describe the testing performance and descriptive epidemiology of COVID-19 cases by time, place and person.
Methods: The data were extracted from January 22 to April 30, 2020. The frequencies of testing performance were described over time and by place. We described cases by time (epidemic curve by date of specimen collection; seven-day moving average), place (area map) and person (attack rate by age, sex and contact status), and trends were represented along with public health measures and events.
Results: Between January 22 and April 30, 2020, a total of 1,021,518 individuals were tested for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Testing increased from about 250 individuals per day in the beginning of March to 50,000 specimens per day by the end of April 2020. Overall, 40,184 (3.9%) tests were reported positive. The proportion of positive cases was highest among symptomatic and asymptomatic contacts, 2-3-fold higher than among those with severe acute respiratory infection, or those with an international travel history or healthcare workers. The attack rate (per million) by age was highest among those aged 50-69 yr (63.3) and was lowest among those under 10 yr (6.1). The attack rate was higher among males (41.6) than females (24.3). The secondary attack rate was 6.0 per cent. Overall, 99.0 per cent of 736 districts reported testing and 71.1 per cent reported COVID-19 cases.
Interpretation & conclusions: The coverage and frequency of ICMR's laboratory surveillance for SARS-CoV-2 improved over time. COVID-19 was reported from most parts of India, and the attack rate was more among men and the elderly and common among close contacts. Analysis of the data indicates that for further insight, additional surveillance tools and strategies at the national and sub-national levels are needed.
Seed coat permeability and electrolyte leaching are the important traits that have been negatively associated with seed longevity in soybean. The objective of this study was to use SSR markers to ...identify genomic regions significantly associated with QTLs controlling seed coat permeability and electrolyte leaching in a segregating F
2
population derived from a cross of Birsa soya-1 x JS 71-05. Parental polymorphism survey using 145 SSR markers identified 21 polymorphic ones, which were used to genotype 153 F
2
individuals. Four independent markers (Satt434, Satt538, Satt281 and Satt598) were significantly (P=0.05) associated with seed coat permeability. One of these markers (Satt 281) also showed significant association with electrolyte leaching that partly supported the observed positive correlation (r = 0.425) between the two traits. Markers for seed coat permeability individually explained 3.9% to 4.5% of the total phenotypic variation, while the marker linked with electrolyte leaching explained 5.6% of the total variation.
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