COVID-19 disease and comorbidity: an outcome? A study on Indian population in a COVID care hospital

Background: The world has been severely affected by the novel coronavirus disease (Covid-19). Continuously rising number of cases has put a significant strain on healthcare resources of all countries of the world. Preliminary studies show that people suffering from comorbid conditions are at a relatively higher risk of severe disease and poor outcome.Methods: We studied the risk of ICU admission in 152 Covid-19 positive patients with comorbidity compared to those without comorbid conditions. We studied effect of old age (>65 years), male sex, presence of at least one comorbidity, presence of multiple comorbidities, diabetes mellitus, hypertension, CAD, respiratory disease, neurological disease, skin disease, and hypothyroidism on outcome of coronavirus disease with two tailed Student’s t-test, odds ratio, Chi-square test was used to test significance of results at 95% confidence interval 95% (95% CI). Fisher’s test was also used if one expected value (row total × column total/grand total) was less than 5.Results: In this study, 23 (15.13%) required ICU care. We found higher odds of ICU admission in Covid-19 patients in case of presence of comorbid condition (OR=7.3, 95% CI=2.674, 20.038), diabetes mellitus (OR=2.8, 95% CI=1.035, 8.028), hypertension (OR=1.3, 95% CI=0.396, 4.258), coronary artery disease (OR=2.3, 95% CI=0.430, 12.978) and malignancy (OR=6.5, 95% CI=1.516, 28.54). Case fatality rate (CFR) of those with comorbid conditions was higher (7.55) compared to those without comorbidity (3.03).Conclusions: This study shows that presence of comorbid conditions in Covid-19 positive patients results in significantly higher risk of ICU admission and poor outcome

Co-infection of human immunodeficiency virus and sexually transmitted infections in circumcised and uncircumcised cases in India

Background: Acquired Immunodeficiency Syndrome (AIDS), is now one of the greatest challenges facing the world. Sexual transmission is the primary route of human immunodeficiency virus infection worldwide. Male circumcision is being considered as strategy to reduce the burden of HIV/AIDS. Material and Methods: The present study was conducted on 200 HIV positive clients. They were screened for bacterial causes of STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Gardnerella vaginalis). Results: There were 138 males and 62 females. The males were examined and the circumcision status was observed. In the females, circumcision status of their male partners was observed. The coinfection of HIV and STIs in circumcised and uncircumcised cases was found out. Diagnosis was made using standard tests. A total of 23% cases were diagnosed to have HIV -STI coinfection. Most common diagnosed diseases were Chlamydia (10%), Gonorrhoea (9%), Bacterial Vaginosis (4.8%) and Syphilis (2.5%). The coinfection rate in uncircumcised cases was found to be higher (29.2% in males and 39.2% in females) as compared to the circumcised cases (14.2% in males and 13.6% in females). Conclusion: The present study suggests that circumcision is a protective factor for acquisition of STIs in HIV positive clients but other factors like sexual behaviours, use of barrier contraceptives, drug abuse etc also play a role

Evaluation of risk factors in patients attending STI clinic in a tertiary care hospital in North India

Background: In the past few years, the interest in STDs and their management has increased tremendously because of their proven role in facilitation of HIV infection, which, in turn, also increases the risk of acquiring STIs. Sexually transmitted diseases (STDs) are a major health problem affecting mostly young people, not only in developing, but also in developed countries Male circumcision is being considered as strategy to reduce the burden of HIV/AIDS. Aims: (i) To screen the new patients attending the STI clinic for bacterial causes of STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Gardnerella vaginalis) and (ii) to evaluate the role of various risk factors in the prevalence of STIs. Materials and Methods: The present study was conducted on 200 patients attending the STI clinic. They were evaluated for the prevalence of HIV and bacterial STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Gardnerella vaginalis) along with the role of risk factors particularly circumcision. Results: The prevalence of HIV was 7% and prevalence of other STI was 20%. The causative agents were Chlamydia 8%, Gonorrhea 7.5%, Bacterial Vaginosis 2.7% and Syphilis 2%. Conclusion: The factors found to be significantly associated with the prevalence of STI were circumcision, positive HIV status, education, religion, multiple sexual partners, contact with Commercial sex workers (CSW), non use of contraception, profession involving long stay away from home, and past history of STI. The present study suggests that circumcision is a protective factor for acquisition of STIs but other factors like sexual behavior, use of barrier contraceptives, drug abuse etc., also play a role

COVID-19 disease and comorbidity: an outcome? A study on Indian population in a COVID care hospital

Background: The world has been severely affected by the novel coronavirus disease (Covid-19). Continuously rising number of cases has put a significant strain on healthcare resources of all countries of the world. Preliminary studies show that people suffering from comorbid conditions are at a relatively higher risk of severe disease and poor outcome.Methods: We studied the risk of ICU admission in 152 Covid-19 positive patients with comorbidity compared to those without comorbid conditions. We studied effect of old age (&gt;65 years), male sex, presence of at least one comorbidity, presence of multiple comorbidities, diabetes mellitus, hypertension, CAD, respiratory disease, neurological disease, skin disease, and hypothyroidism on outcome of coronavirus disease with two tailed Student’s t-test, odds ratio, Chi-square test was used to test significance of results at 95% confidence interval 95% (95% CI). Fisher’s test was also used if one expected value (row total × column total/grand total) was less than 5.Results: In this study, 23 (15.13%) required ICU care. We found higher odds of ICU admission in Covid-19 patients in case of presence of comorbid condition (OR=7.3, 95% CI=2.674, 20.038), diabetes mellitus (OR=2.8, 95% CI=1.035, 8.028), hypertension (OR=1.3, 95% CI=0.396, 4.258), coronary artery disease (OR=2.3, 95% CI=0.430, 12.978) and malignancy (OR=6.5, 95% CI=1.516, 28.54). Case fatality rate (CFR) of those with comorbid conditions was higher (7.55) compared to those without comorbidity (3.03).Conclusions: This study shows that presence of comorbid conditions in Covid-19 positive patients results in significantly higher risk of ICU admission and poor outcome.</jats:p

Biochemical markers of tubercular ascites

ABSTRACT The diagnosis of abdominal tuberculosis requires a high index of suspicion due to its vague symptomatology. Early diagnosis of tubercular ascitis is crucial to prevent progression of disease to its advanced stages, thereby preventing the fatal complication like intestinal obstruction, fistulas and peritonitis. The objective of our research work is to evaluate the role of biochemical parameters such as Adenosine Deaminase (ADA), IgG, Lactate, Total protein and albumin, Glucose, Cholesterol and pH in diagnosis of abdominal tuberculosis. Ascitic fluid samples were taken from patients admitted in medicine wards of SSK Hospital after informed consent. A total of 100 patients meeting the selection criteria were enrolled in the study. The biochemical investigations performed for the ascitic fluid samples were Adenosine Deaminase (ADA), IgG against 38 kDa mycobacterial antigen, Lactate, Total protein, albumin, Glucose, Cholesterol and pH. In the 79 patients that had been followed up, with ATT response as a reference, a highly significant association was observed with ascitic fluid assays ADA, IgG, Serum Ascitic Albumin Gradient(SAAG), Cholesterol, Lactate and pH. Adenosine Deaminase (ADA) and IgG against 38 kDa mycobacterial antigen can be used as corroborative markers for diagnosis of extra pulmonary paucibacillary tubercular ascitis where conventional methods like smear microscopy and culture frequently fail to establish the diagnosis

Emerging Trend of Mutation Profile of rpoB Gene in MDR Tuberculosis, North India

The present study was conducted on North Indian population to observe rpoB gene mutation profile in multidrug resistant Mycobacterium tuberculosis. This was an observational study. 30 cases of MDR-TB proven by culture and drug sensitivity were selected. DNA sequencing of 81 bp (codon 507–533) long RRDR of Mycobacterium tuberculosis was done to detect the sites of mutation. Out of 30 cases, 24 showed a single mutation in the RRDR region of rpoB gene in which 16 (53.33 %) showed mutation in codon 531(TCG→TTG), 5 cases (16.66 %) showed mutation in codon 526(CAC→TAC), mutation in codon 516(GAC→GTC, AAC) was present in 3 cases (10 %). It was also observed that mutation in more than one codon was present in 4 cases (13.33 %), which included deletion at codon 509(AGC→–GC), mutation at 513(CAA→CTA), 516, 526, 529(CGA→CTA) and 531. No mutation was detected in RRDR in 2 cases (6.66 %). Our finding of 13.33 % cases with multiple sites of mutation in RRDR region is in contrast to earlier studies done in North India which showed single mutation detected in RRDR of rpoB gene that highlights the emerging change in the trend of mutation profile of rpoB gene in rifampicin resistant Mycobacterium tuberculosis