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11.
Sandeep K. Jha Imtiakum Jamir Kshitij Sisodia Niteen Kumar Gaurav Sood Nitin Shanker Sachin Anand Gaurav Dubey Vinod Choudhary Pankaj Lohia Amit Singhal Manav Wadhawan Ajay Kumar Abhideep Chaudhary 《Transplantation proceedings》2021,53(4):1118-1125
IntroductionLiving-donor liver transplantation (LDLT) has been mostly suspended and deceased-donor living transplantation activity has been considerably reduced because of coronavirus disease 2019 (COVID-19). We modified our protocols and procedures in line with COVID-19 guidelines. Since the restructuring, we have performed 20 LDLTs. Our study reports the outcomes of these cases and demonstrates the feasibility of LDLT during this pandemic.Materials and MethodsThe changes were influenced by experiences and communications from across the globe. A month-long self-imposed moratorium was spent in restructuring the program and implementing new protocols. Twenty LDLTs were performed between April 18 and September 15 using the new protocols. Our experience includes 2 simultaneous liver-kidney transplants, 1 ABO-incompatible LDLT, and 1 pediatric case (age 11 months).ResultsNineteen patients recovered and 1 patient died. We maintained our postoperative immunosuppression protocol without many changes. Major complications were observed in 30% of recipients but none of the donors. One recipient was infected with COVID-19 during the postoperative period. A donor-recipient couple contracted COVID-19 after discharge from the hospital. All patients recovered from COVID-19 and liver enzymes were unaffected.ConclusionThis study represents a microcosm of experience in LDLT during the COVID-19 era. Outcomes of LDLT are not affected by COVID-19 per se, provided that we make necessary changes. 相似文献
12.
Recombinant fusion proteins for haemagglutination-based rapid detection of antibodies to HIV in whole blood 总被引:2,自引:0,他引:2
Recombinant fusion proteins, consisting of a monovalent anti-human RBC monoclonal antibody B6, and conserved immunodominant peptide of HIV-1 envelope glycoprotein gp41 or HIV-2 envelope glycoprotein gp36, have been designed and purified after over-expression in E. coli. These fusion proteins are Fab-based and were obtained by assembling the light chain with Fd (variable domain and the first constant domain of the heavy chain) or Fd fusions containing HIV-derived peptide, and following a protocol of in vitro denaturation of inclusion bodies and subsequent renaturation to assemble functional Fab. Using a multistep column chromatographic procedure, monomeric Fab and Fab fusion proteins containing HIV-derived peptide were purified to high degree, free of aggregates. The yield of various proteins on the laboratory scale (1-2 l of shake flask culture) was in the range of tens of milligram. Purified anti-human RBC Fab fusion proteins containing sequences derived from HIV-1 gp41 and HIV-2 gp36 were highly specific for detection of antibodies to HIV-1 and HIV-2, respectively. The described design, expression and purification protocols will make it possible to produce specific recombinant reagents in large quantities for agglutination-based rapid detection of antibodies to HIV in whole blood. 相似文献
13.
Shyrar Tanussiya Ramu Madushika Dissanayake Chandima Jeewandara Farha Bary Michael Harvie Laksiri Gomes Ayesha Wijesinghe Dinuka Ariyaratne Graham S. Ogg Gathsaurie Neelika Malavige 《Immunology》2023,170(1):47-59
To further understand the role of NS1-specific antibodies (Abs) in disease pathogenesis, we compared neutralizing antibody levels (Nabs), NS1-Ab levels, IgG antibody subclass profiles and NS1-specific memory B-cell responses (Bmems) in individuals, with varying severity of past dengue. Nabs (Neut50 titres) were assessed using the Foci Reduction Neutralization Test (FRNT) and in-house ELISAs were used to assess NS1-Abs and NS1-Ab subclasses for all four DENV serotypes in individuals with past DF (n = 22), those with past DHF (n = 14) and seronegative (SN) individuals (n = 7). B-cell ELISpot assays were used to assess NS1-specific Bmem responses. 15/22 (68.18%) individuals with past DF and 9/14 (64.29%) individuals with past DHF had heterotypic infections. Neut50 titres were found to be significantly higher for DENV1 than DENV2 (p = 0.0006) and DENV4 (p = 0.0127), in those with past DHF, whereas there was no significant difference seen in titres for different DENV serotypes in those with past DF. Overall NS1-Ab to all serotypes and NS1-specific IgG1 responses for DENV1, 2 and 4 serotypes were significantly higher in those with past DHF than individuals with past DF. Those with past DHF also had higher IgG1 than IgG3 for DENV1 and DENV3, whereas no differences were seen in those with past DF. Over 50% of those with past DF or DHF had NS1-specific Bmem responses to >2 DENV serotypes. There was no difference in the frequency of Bmem responses to any of the DENV serotypes between individuals with past DF and DHF. Although the frequency of Bmem responses to DENV1 correlated with DENV1-specific NS1-Abs levels (Spearman r = 0.35, p = 0.02), there was no correlation with other DENV serotypes. We found that those with past DF had broadly cross-reactive Nabs, while those with past DHF had higher NS1-Ab responses possibly with a different functionality profile than those with past DF. Therefore, it would be important to further evaluate the functionality of NS1-specific antibody and Bmem responses to find out the type of antibody repertoire that is associated with protection against severe disease. 相似文献
14.
A rare case of splenic abscess occurring after blunt abdominal trauma in a previously healthy boy is reported. The diagnosis
was made by ultrasonography. The patient recovered after splenectomy and drainage of subphrenic and intraperitoneal pus. 相似文献
15.
Chaudhary S 《Indian journal of pediatrics》1996,63(4):433-436
Otitis media is a common pediatric problem. It is well established that over half of infants and children with acute otitis
media may have spontaneous recovery. Since it is difficult to predict the course (self-limited versus serious disease) all
the children with acute suppurative otitis media need to be treated with antibiotics. Amoxicillin is still the initial antibiotic
of choice. There are several alternate antibiotics available with activity against beta-lactamase positive bacteria. These
agents have no advantage over amoxicillin in infections due to penicillin resistant pneumococci. Recent use of beta-lactam
antibiotics and/or attendance in a day care where there is frequent use of antibiotics are predisposing factors for penicillin
resistant pneumococcal infection. In such cases after tympanocentesis, higher dose of amoxicillin, clindamycin or intramuscular
ceftriaxone should be considered. Secretory otitis media does not need to be treated with antibiotics unless the patient is
in high risk group. Prophylactic use of antibiotics should be actively discouraged. Influenza and pneumococcal vaccination
(2 years or older) should be encouraged in children with recurrent episodes of acute otitis media. Breast feeding should be
encouraged. 相似文献
16.
17.
The early institution of enteral nutrition is now accepted as the preferred route of feeding in critically ill patients with a functioning gastrointestinal tract. It is particularly important to establish early enteral nutrition in mechanically ventilated patients because of the metabolic demands associated with mechanical ventilation. The options for enteral access in mechanically ventilated patients are reviewed, with an emphasis on those techniques that may be performed at the bedside. The advantages, disadvantages, and complications of the different techniques will be considered. 相似文献
18.
Ayesha Anwar Kannika Na-Lampang Narin Preyavichyapugdee Veerasak Punyapornwithaya 《Viruses》2022,14(10)
LSD is an important transboundary disease affecting the cattle industry worldwide. The objectives of this study were to determine trends and significant change points, and to forecast the number of LSD outbreak reports in Africa, Europe, and Asia. LSD outbreak report data (January 2005 to January 2022) from the World Organization for Animal Health were analyzed. We determined statistically significant change points in the data using binary segmentation, and forecast the number of LSD reports using auto-regressive moving average (ARIMA) and neural network auto-regressive (NNAR) models. Four significant change points were identified for each continent. The year between the third and fourth change points (2016–2019) in the African data was the period with the highest mean of number of LSD reports. All change points of LSD outbreaks in Europe corresponded with massive outbreaks during 2015–2017. Asia had the highest number of LSD reports in 2019 after the third detected change point in 2018. For the next three years (2022–2024), both ARIMA and NNAR forecast a rise in the number of LSD reports in Africa and a steady number in Europe. However, ARIMA predicts a stable number of outbreaks in Asia, whereas NNAR predicts an increase in 2023–2024. This study provides information that contributes to a better understanding of the epidemiology of LSD. 相似文献
19.
Neuro-ophthalmological manifestations of diabetes mellitus during COVID-19-related lockdown in India
Akkayasamy Kowsalya Sameer Chaudhary Sagnik Sen Maheshkumar Shanmugam Jayasri K Narayanamoorthy Shreya Jain Balagiri Sundar 《Indian journal of ophthalmology》2022,70(9):3398
Purpose:The coronavirus disease 19 (COVID-19) pandemic has resulted in a huge impact on the health care system. Diversion of health care workforce toward management of a high number of COVID-19 cases and lockdown restrictions have affected the follow-up of patients. The objective of this study was to analyze the impact of this situation on the control of diabetes, eventually resulting in related neuro-ophthalmological complications.Methods:This retrospective case series included diabetic patients visiting the neuro-ophthalmology clinic at a tertiary care eye center in India from 25 March 2020 to 25 September 2020 during the lockdown. The incidence of diabetes-related neuro-ophthalmological complications, including third, fourth, sixth nerve palsies and non-arteritic anterior ischemic optic neuropathy (NAION) was evaluated and compared with that of the same period during 2019.Results:Overall disease incidence rate was significantly higher in the year 2020 (60.2%) compared to the previous year of 2019 (29.8%). The proportion of third nerve palsy (4.8% vs 16.3%, P < 0.001) and NAION (0.3% vs 14.3%, P < 0.001) had increased. Even though the percentage of sixth nerve palsy was 25% in 2020, this was not significantly different from 2019. There was a reduction in the percentage of fourth nerve palsy cases from the year 2019 to 2020.Conclusion:There was a significant increase in diabetes-related neuro-ophthalmic complications during the COVID-19 lockdown. This can possibly be attributed to worsening of glycemic control in diabetic patients. 相似文献
20.
Meghana Janardhan Sandeep Trehan Neena Chaudhary Ashwin Bhasarkar 《Indian journal of otolaryngology and head and neck surgery》2023,75(2):600
Introduction: The COVID-19 pandemic has presented an unmatched challenge to the ENT residency programs to adapt to a form of web-based learning process and stimulation-based training. It also focuses on the mental stress underwent and the viewpoint of the residents to the paradigm shift in clinical care and academics. Methods: An anonymous questionnaire was created in an online survey generator with 22 questions with limited options (yes/no) and was circulated through email and what’s app which has been responded to by 240 ENT residents throughout the country. The questionnaire was divided into five sections, demographics, knowledge about COVID-19 and its management, impact on clinical activity, academics and mental well-being section. Results: Out of 240 respondents, 190(79.2%) were junior residents and 50(20.8%) were senior residents. Although many of them knew the necessary precautions to be taken, 94(39.8%) turned out to be positive themselves with the high fear of transmitting to their family members. Three-fourth participants suggested extending the training period after graduation for the loss incurred. However, half of them sought an opportunity to train themselves for the management of communicable disease, 95% of the residents opined that they are having a negative impact on the job performance due to loss of surgical hands-on which has been drastically reduced. Conclusion: The issues mentioned have been addressed through STEPs - Safety of the residents, Time utilisation by research, Education continuation by online web learning and stimulatory programs, psychological support for mental well-being.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12070-022-03377-7. 相似文献