Publications by authors named "Rashmi Kumari"

153 Publications

Public knowledge, attitudes, and practices toward COVID-19: An online cross-sectional study in the Union territory of Jammu and Kashmir.

J Family Med Prim Care 2021 Mar 8;10(3):1155-1160. Epub 2021 Apr 8.

Department of Community Medicine, RP Govt. Medical College Tanda, Kangra, Himachal Pradesh, India.

Background: COVID-19, since its emergence, has become a global health problem with countries adopting unprecedented measures to control the spread of this pandemic. Adherence of the populations to control measures is affected by their knowledge, attitude, and practices (KAP) towards the disease. It was with this aim that the present study was conducted among the residents of UT of J&K to assess their KAP toward COVID-19.

Methodology: A cross-sectional online survey of 464 J&K residents was conducted between 1 May and 10 May 2020. Survey Monkey tool was used to develop a link and KAP questionnaire was used for data collection. The survey instrument consisted of demographic characteristics, 11 items on knowledge, 5 items on attitudes, and 7 items on practices. Data collected was represented in descriptive statistics, and one-way analysis of variance was the test of significance.

Results: Mean knowledge, attitude, and practice scores were 7.69 ± 0.74, 4.70 ± 0.57, and 4.32 ± 0.68, respectively, among the respondents. Majority (99%) knew the sign and symptoms, mode of transmission of the disease and avoided attending large gatherings. Use of mask was almost universal and about 38% were taking supplements like vitamins or herbal medicines. Good knowledge, positive attitude, and appropriate practices among the respondents about COVID-19 suggest that community based health education programs play a key role in containment and mitigation of this disease.

Conclusion: Sustained messaging and updates from the national and local health authorities on COVID-19 to the public are likely to help control the transmission of the disease.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_1332_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140228PMC
March 2021

Haemlacria: A mini case series of a rare condition.

J Family Med Prim Care 2021 Feb 27;10(2):1061-1063. Epub 2021 Feb 27.

Cornea, Refractive and Ocular Surface Services, Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.

Haemlacria is a rare condition which is not widely mentioned in literature. In this mini case series, we describe two cases with this presentation. Both the patients were women with unilateral presentation of haemlacria in the right eye. Case one was diagnosed with photosensitivity, while case two was assumed to be due to an undiagnosed systemic illness which led to her mortality. Careful history, systemic examination, slit- lamp biomicroscopy, fundus examination, relevant haematological tests like coagulation profile, liver function test along with nasolacrimal duct probing with syringing and appropriate imaging may be needed to arrive at a diagno sis. Though many cases are idiopathic yet this can be a sign of an underlying life-threatening disease.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_1491_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8138395PMC
February 2021

Vaginal Closure Before Colpotomy with an Endo-Stapler to Prevent Tumor Spillage in Laparoscopic Surgery for Gynecological Malignancy.

JSLS 2021 Apr-Jun;25(2)

Department of Gynecological Endoscopy, Eva Women's Hospital, Ahmedabad, India.

Background And Objectives: The aim of this study was to define new techniques for performing vaginal closure with endo-staplers to prevent tumor spillage during laparoscopic surgeries for endometrial cancer and early stage cervical cancer.

Methods: Thirteen patients were retrospectively studied for the use of endo-staplers for vaginal closure before colpotomy during laparoscopic surgeries for endometrial cancer and early stage cervical cancer to prevent tumor spillage.

Results: There were no short-term or any long-term complication related to the use of the endo-staplers for colpotomy in the surgeries included in this study.

Conclusion: Use of the endo-staplers to close the vagina before colpotomy according to the technique described is safe and feasible, with prevention of gross spillage of any malignant cells in the peritoneal cavity or vagina, which will further have a favorable oncologic outcome.
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http://dx.doi.org/10.4293/JSLS.2020.00094DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088333PMC
June 2021

Pigmented trichilemmoma: A potential mimicker.

Australas J Dermatol 2021 May 10. Epub 2021 May 10.

Department of Pathology, AIIMS, Bhubaneswar, India.

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http://dx.doi.org/10.1111/ajd.13622DOI Listing
May 2021

Dermoscopic features of basal cell carcinoma in skin of color: A retrospective cross-sectional study from Puducherry, South India.

Indian J Dermatol Venereol Leprol 2021 Apr 23:1-7. Epub 2021 Apr 23.

Department of Pathology, AIIMS, Bhubaneswar, Odisha, India.

Background: Dermoscopy is useful in the diagnosis of basal cell carcinoma (BCC). However, most descriptions of the dermoscopic features of BCCs are in Caucasians (skin types I-III) and there is a paucity of data in dark-skinned Indian patients.

Aims: The aim of this study was to describe the various dermoscopic features of BCC in dark-skinned patients from South India and correlate these with the histopathologic subtypes.

Methods: A retrospective observational study of biopsy-proven cases of BCC was conducted at a tertiary care center in South India using nonpolarized contact dermoscopy.

Results: Sixty BCCs in 35 patients predominantly of skin phototypes IV or V were studied. These included 32 nodular, 27 superficial and 1 infiltrative type of BCC. The most common dermoscopic features noted were maple leaf-like areas (61.7%), blue-white veils (53.4%), ulceration (48.4%) and short fine telangiectases (46.7%). Ulceration, blue-white veils and arborizing vessels were significantly associated with nodular BCCs, while maple leaf-like areas, red-white structureless areas, multiple small erosions and spoke wheel areas were noted with superficial BCCs.

Limitations: The limitations of this study include its retrospective nature, the use of only nonpolarized light for examination, the lack of other histopathological variants of BCC as well as the lack of a comparison group.

Conclusion: We report a dermoscopic study of BCC in dark-skinned patients from Puducherry, South India. The blue-white veil was observed in half of the patients and was significantly associated with nodular BCCs. The addition of the blue-white veil to the diagnostic criteria for pigmented BCC could improve the diagnostic accuracy of dermoscopy in Indian patients.
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http://dx.doi.org/10.25259/IJDVL_420_20DOI Listing
April 2021

Dermoscopy of Bowen's disease: A case series of five patients.

Indian J Dermatol Venereol Leprol 2021 Apr 23:1-5. Epub 2021 Apr 23.

Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

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http://dx.doi.org/10.25259/IJDVL_987_20DOI Listing
April 2021

Neutrophil in diabetic stroke: emerging therapeutic strategies.

Neural Regen Res 2021 Nov;16(11):2206-2208

Department of Neurology, College of Medicine, Penn State University, Hershey, PA, USA.

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http://dx.doi.org/10.4103/1673-5374.310677DOI Listing
November 2021

Utility of high-frequency ultrasound in assessing cutaneous edema in venous ulcer patients.

Skin Res Technol 2021 Mar 25. Epub 2021 Mar 25.

Department of Dermatology and STD, JIPMER, Puducherry, India.

Background: High-frequency ultrasound (HFUS) using a 20 MHz probe is a non-invasive assessment tool. Its utility in dermatology for diagnosis of disease or for monitoring of treatment response in various dermatological conditions is still being explored. Edema secondary to venous hypertension is the main pathogenic factor in the development of venous leg ulcers. However, there is no objective method for assessment of degree of edema. In this study, we explore the utility of high-frequency ultrasound in assessing cutaneous edema and for monitoring its improvement with compression therapy among patients with venous ulcer.

Materials And Methods: Twenty patients with venous ulcer were enrolled in the study. Measurement of cutaneous edema was done at baseline and after 2 weeks of compression therapy in all patients. The 3 levels of measurement were dorsum of foot (low site, L1), 4 cm proximal to the medial malleolus (middle site, L2), and the medial aspect of the calf between the medial malleolus and the knee (upper site, L3).

Results: Baseline subepidermal low echogenic band (SLEB) measurements were 2.46 ± 0.69 mm, 2.94 ± 0.65 mm, and 2.66 ± 0.64 mm at L1, L2, and L3, respectively. There was a significant reduction in SLEB measurement after compression therapy ( p values 0.008, 0.002, and 0.003 at L1, L2, and L3, respectively). The mean percentage reduction in SLEB at level of medial malleolus (mid level - 29.61 ± 12.24) was higher than the other 2 sites (L1-22.45 ± 15.83 and L3 were 27.57 ± 12.34).

Conclusion: Cutaneous ultrasound aids in accurate assessment of level and severity of edema. Hence, it can be utilized in trials to objectively assess the adequacy of treatment for patients with venous insufficiency.
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http://dx.doi.org/10.1111/srt.13040DOI Listing
March 2021

Dermoscopic Appearance of an Annular Subacute Cutaneous Lupus Erythematosus.

Dermatol Pract Concept 2021 Mar 8;11(2):e2021013. Epub 2021 Mar 8.

Department of Pathology, AIIMS, Bhubaneswar, India.

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http://dx.doi.org/10.5826/dpc.1102a13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943201PMC
March 2021

Is there a need to cover all households under health insurance schemes: A cross-sectional study in a rural area of Jammu.

J Family Med Prim Care 2020 Dec 31;9(12):6228-6233. Epub 2020 Dec 31.

Department of Community Medicine, Dr RPGMC, Tanda, H.P, India.

Background: For tackling unforeseen health expenditure and improving healthcare accessibility in general, it is important that people should not only be aware but also be covered under health insurance schemes. The present study was conducted with the aim to assess the health expenditure, health insurance awareness, and coverage among rural households.

Materials And Methods: This was a community-based cross-sectional study carried out in randomly selected families falling under a rural health block in Jammu district of Jammu & Kashmir, Union Territory. A predesigned, pretested, and semistructured questionnaire was used for data collection.

Results: A total of 380 families were surveyed, of which 14.5% belonged to the priority household group. Among the priority and nonpriority households, 8.80% and 5.69% of monthly income were spent on health-related activities and 9.91% of household expenditure was on health. A total of 24.32% of priority households had even borrowed money to meet health expenditures. A total of 28.15% families had heard about the Ayushman Bharat scheme. Attitude towards health insurance was positive in both groups. A total of 29.23% of nonpriority households and 14.54% of priority households had health insurance coverage.

Conclusion: A significant proportion of household expenditure was health related. The absence of good insurance coverage raises the need for policies and laws to cover all the households under health insurance schemes.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_958_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7928096PMC
December 2020

Evaluation of sporozoite and macroschizont antigen (Spm2) of Theileria annulata for its diagnostic potential.

Ticks Tick Borne Dis 2021 07 19;12(4):101691. Epub 2021 Feb 19.

Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, 781039, Assam, India. Electronic address:

Theileria are tick-borne apicomplexan parasites, which mainly infect ruminants in tropical and subtropical regions of the world. The present study was directed to investigate the serological methods for the diagnosis of theileriosis in crossbred cattle. Blood samples (n = 176) were collected from the regional cattle populations of Bihar state situated at the Gangetic plains of India. Microscopic examination of blood smears from the cattle revealed the presence of tick-borne infectious organisms (Theileria and Anaplasma) in the region. PCR-based detection of Tams1 (Theileria annulata merozoite surface antigen) gene and the sequencing of 18S rRNA amplicon from the blood samples confirmed T. annulata as the primary causative agent of theileriosis in cattle of the Bihar region. Similarly, the amplification of the msp5 gene confirmed Anaplasma marginale infection. For the large-scale epidemiological investigation, sporozoite and macroschizont (spm2) partial gene from T. annulata was cloned in pET-28a (+) vector and overexpressed in E. coli BL21 cells. Overexpressed recombinant-Spm2 (43 kDa) was purified by Ni-NTA affinity chromatography and was used for immunodetection of theileriosis in cattle serum samples. Sequence analysis of the cloned partial spm2 gene in this study showed multiple SNPs (single nucleotide polymorphisms) in T. annulata. Recombinant-Spm2 antigen was explicitly recognised by the immunoglobulins (IgG) of the cattle naturally infected with Theileria. Further, an indirect enzyme-linked immunosorbent assay (ELISA) was developed using partial r-Spm2 antigen that exhibited high sensitivity (100 %) and specificity (90.9 %). Thus, this study suggests that partial r-Spm2 can be used as a diagnostic antigen for seroepidemiological studies of T. annulata infection in crossbred cattle.
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http://dx.doi.org/10.1016/j.ttbdis.2021.101691DOI Listing
July 2021

Laparoscopic Hemostasis of Intractable Delayed Postpartum Hemorrhage.

Cureus 2021 Jan 25;13(1):e12892. Epub 2021 Jan 25.

Internal Medicine, Gujarat Adani Institute of Medical Sciences, Bhuj, IND.

Postpartum hemorrhage (PPH) is associated with considerable morbidity and mortality, particularly when relaparotomy is necessary. The etiology of spontaneous intractable PPH in a hemodynamically stable patient is poorly understood and remains open to speculation. Secondary, or delayed, PPH is usually defined as the excessive bleeding from the genital tract, with a loss of 500 ml or more of blood occurring after the first 24 hours after delivery until the sixth week of puerperium. In this report, we present three cases of severe, diffuse postpartum bleeding unresponsive to conventional hemostatic measures, which were successfully managed laparoscopically at our center. In all three cases, hemostasis was accomplished by using a laparoscopic procedure: with the excision of cervical stump bleeding in the first case, bilateral uterine artery ligation accompanied by laparoscopic hysterectomy in the second case, and bilateral internal iliac artery ligation in the third case.
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http://dx.doi.org/10.7759/cureus.12892DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903204PMC
January 2021

Emerging trends in aggregation induced emissive luminogens as bacterial theranostics.

J Drug Target 2021 Feb 18:1-15. Epub 2021 Feb 18.

Department of Chemistry, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India.

The emergence and spread of pathogenic bacteria, particularly antibiotic-resistant strains pose grave global concerns worldwide, which demand for the rapid development of highly selective and sensitive strategies for specific bacterial detection, identification, imaging and therapy. The fascinating feature of aggregation-induced emissive molecules (AIEgens) to display fluorescence in aggregate form can be suitably coupled with nanotechnology for developing theranostic AIE dots that can offer convenient and customised functions such as sensing, imaging, detection, discrimination and cell kill of different bacterial types. The initial section of the article reveals the necessity for incorporating diagnostic imaging with antibacterial therapy, while the latter part delivers mechanistic insights on the benefits of AIE fluorophores in theranostic applications. Further, the review illustrates the recent advancements of AIEgens as theranostic nanolights in bacterial detection, identification and eradication. The review is organised according to the different classes of AIE-active bacterial theranostics such as carrier-free nanoprodrugs, nanomachines for synergistic imaging-guided cancer treatment and bacterial kill, AIE polymers, bioconjugates and nanoparticle carriers. By elucidating their design principles and applications, as well as highlighting the recent trends and perspectives that can be further explored, we hope to instill more research interest in AIE bacterial theranostics for future translational research.HighlightsCombination of aggregation induced emissive fluorophores and nanotechnology for developing bacterial theranostics.AIE theranostics with customised functions for bacterial imaging, detection, discrimination and cell kill.
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http://dx.doi.org/10.1080/1061186X.2021.1888111DOI Listing
February 2021

Dermoscopy of lichen planus pigmentosus: A case series.

J Am Acad Dermatol 2021 Feb 4. Epub 2021 Feb 4.

Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

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http://dx.doi.org/10.1016/j.jaad.2021.01.092DOI Listing
February 2021

Transcriptome Sequencing in the Preoptic Region of Rat Dams Reveals a Role of Androgen Receptor in the Control of Maternal Behavior.

Int J Mol Sci 2021 Feb 3;22(4). Epub 2021 Feb 3.

MTA-ELTE Laboratory of Molecular and Systems Neurobiology, Department of Physiology and Neurobiology, Institute of Biology, Eötvös Loránd University, H-1117 Budapest, Hungary.

(1) Background: Preoptic region of hypothalamus is responsible to control maternal behavior, which was hypothesized to be associated with gene expressional changes. (2) Methods: Transcriptome sequencing was first applied in the preoptic region of rat dams in comparison to a control group of mothers whose pups were taken away immediately after parturition and did not exhibit caring behavior 10 days later. (3) Results: Differentially expressed genes were found and validated by quantitative RT-PCR, among them NACHT and WD repeat domain containing 1 (Nwd1) is known to control androgen receptor (AR) protein levels. The distribution of Nwd1 mRNA and AR was similar in the preoptic area. Therefore, we focused on this steroid hormone receptor and found its reduced protein level in rat dams. To establish the function of AR in maternal behavior, its antagonist was administered intracerebroventricularly into mother rats and increased pup-directed behavior of the animals. (4) Conclusions: AR levels are suppressed in the preoptic area of mothers possibly mediated by altered Nwd1 expression in order to allow sustained high-level care for the pups. Thus, our study first implicated the AR in the control of maternal behaviors.
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http://dx.doi.org/10.3390/ijms22041517DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7913516PMC
February 2021

Dermoscopy in the diagnosis of generalized acute cutaneous lupus erythematosus.

Int J Dermatol 2021 Jan 7. Epub 2021 Jan 7.

Department of Pathology, AIIMS, Bhubaneswar, India.

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http://dx.doi.org/10.1111/ijd.15413DOI Listing
January 2021

A mechanistic insight into benefits of aggregation induced emissive luminogens in cancer.

J Drug Target 2021 Jan 5:1-17. Epub 2021 Jan 5.

Department of Chemistry, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India.

Exploration of advanced chemotheranostics that benefit from a combined strategy of cancer diagnosis and chemotherapy simultaneously is highly valued and will expose novel possibilities in modifying treatment and reduce side effects. In recent years, nanodrug delivery systems that incorporate aggregation-induced emissive luminogens (AIEgens) have been developed to track and monitor anticancer drug release, trace translocation processes and predict chemotherapeutic responses. There are several classes of AIEgen based chemotheranostics such us stimuli-responsive nanoprodrugs, pH-sensitive mesoporous silica nanocarriers, supramolecular polymer systems, drug encapsulated carriers, carrier-free nanodrugs, self-indicating drug delivery nanomachines and AIEgen-prodrug co-assembly. The present review conveys mechanistic insight into the benefits of AIEgens in the theranostic application by illustrating the recent breakthroughs in chemotheranostic nanomedicines that incorporate these unique fluorophores as signal reporters. The perspectives that can be further explored are also highlighted with the hope to instil more research interest in the advancement of AIE active cancer chemotheranostics for imaging and treatment .HIGHLIGHTSAggregation induced emissive materials (AIEgens) exhibit unique advantages over conventional luminogens for synergistic diagnosis and chemotherapy of cancer .The combination of AIE and nanotechnology offers an excellent platform to fabricate advanced chemotheranostics for cancer therapy.
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http://dx.doi.org/10.1080/1061186X.2020.1868479DOI Listing
January 2021

Pigmented infundibulocystic basal cell carcinoma: A diagnostic challenge in dark skin.

Australas J Dermatol 2021 May 3;62(2):e349-e351. Epub 2021 Jan 3.

Department of Pathology, AIIMS, Bhubaneswar, India.

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http://dx.doi.org/10.1111/ajd.13540DOI Listing
May 2021

Lasers in Glaucoma: an Overview.

Int Ophthalmol 2021 Mar 19;41(3):1111-1128. Epub 2020 Nov 19.

Department of Ophthalmology , SKMCH, Muzaffarpur, India.

Lasers have been in use as a treatment modality of glaucoma for more than last four decades. Each passing year has added newer dimensions to the existing laser technologies enhancing their safety and efficacy profile. This has become possible due to continuous research and innovations with proper understanding of the mechanism of action of different variety of lasers as treatment options. Each category of glaucoma has different underlying pathologies. Adequate knowledge and understanding of indications, limitations and hazards of these laser procedures are must before their application for improvising outcome. Recent years have witnessed a revolution this field. A thorough literature search was conducted in PubMed, Medline, the Cochrane Library Database, EMBASE, and Scopus and Google Scholar until May 2020 using the keywords, and all the articles pertaining to the relevant topics were included in this review. Purpose of this review is to summarize the important laser procedures currently in use for managing glaucoma along with updating the readers with recent advances in laser technologies, their extended applications and also analyzing possible future implications.
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http://dx.doi.org/10.1007/s10792-020-01654-4DOI Listing
March 2021

Unusual Histopathological Features in a Case of Seronegative Lues Maligna.

Am J Dermatopathol 2021 May;43(5):396-397

Department of Pathology, JIPMER, Puducherry, India.

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http://dx.doi.org/10.1097/DAD.0000000000001835DOI Listing
May 2021

Linear Comedonal Epidermolytic Nevus: A Rare Entity.

Am J Dermatopathol 2021 May;43(5):397-399

Department of Dermatology, Venereology and Leprology, JIPMER, Puducherry, India.

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http://dx.doi.org/10.1097/DAD.0000000000001836DOI Listing
May 2021

Linear comedonal Darier disease: A rare variant.

Australas J Dermatol 2021 May 9;62(2):e318-e319. Epub 2020 Oct 9.

Department of Pathology, AIIMS, Bhubaneswar, India.

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http://dx.doi.org/10.1111/ajd.13468DOI Listing
May 2021

Dermoscopic examination of a case of pigmented intraepithelial carcinoma on the palm.

Australas J Dermatol 2021 Feb 27;62(1):e153-e155. Epub 2020 Sep 27.

Department of Pathology, AIIMS, Bhubaneswar, India.

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http://dx.doi.org/10.1111/ajd.13465DOI Listing
February 2021

Topical Betamethasone Valerate As a Prophylactic Agent to Prevent Acute Radiation Dermatitis in Head and Neck Malignancies: A Randomized, Open-Label, Phase 3 Trial.

Int J Radiat Oncol Biol Phys 2021 01 24;109(1):151-160. Epub 2020 Aug 24.

Department of Dermatology and STD, RCC, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Purpose: We assessed the role of topical betamethasone as a prophylactic agent in patients receiving radiation for head and neck malignancies.

Methods And Materials: This randomized, open-label, phase 3 trial was completed at a single research institute. Patients receiving curative radiation for head and neck cancer were randomized into 2 groups of 75 patients each by computer-generated permuted block random assignment. Patients in the test arm applied 0.1% topical betamethasone valerate cream once a day, after radiation. Patients in the control arm received best supportive care. The Radiation Therapy Oncology Group acute toxicity grading scale was used to assess radiation dermatitis after every fifth fraction until completion and at 2 weeks after treatment. Primary outcome in both arms was the proportion of patients who developed grade 2 and 3 acute skin reaction. The trial is registered at the Central Trial Registry of India (CTRI/2017/04/008298).

Results: Between April 15, 2017, and October 30, 2018,150 patients were randomized into the study, with 75 patients in each arm. Fourteen patients in the test arm and 15 patients in the control arm did not complete the intended treatment. Per the intention-to-treat analysis, 25 of 75 patients (33.3%) and 38 of 75 patients (50.7%) developed grade 2 or greater radiation dermatitis in the test and control arms, respectively (absolute difference, 17.4%; 95% confidence interval, 4%-30%; P = .032). Fifteen of 75 patients (20%) developed grade 3 reactions in the test arm compared with 18 of 75 patients (24%) in the control arm (absolute difference, 4%; 95% confidence interval, 7%-15%; P = .554).

Conclusion: Although prophylactic use of betamethasone significantly reduced the composite outcome of the proportion of patients developing grade 2 and grade 3 radiation dermatitis, it did not reduce the proportion of patients developing the clinically significant outcome of grade 3 radiation dermatitis.
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http://dx.doi.org/10.1016/j.ijrobp.2020.08.040DOI Listing
January 2021

Vitamin K deficiency bleeding of newborn masquerading haemophilia B.

Sudan J Paediatr 2020 ;20(2):176-180

Department of Community Medicine, Dr RML Institute of Medical Sciences, Lucknow, India.

The term infant is remarkably resistant to bleeding despite physiologically low levels of procoagulant proteins. However, because of their unique haemostatic systems, neonates are vulnerable to haemorrhagic disorders. The prevention of early vitamin K deficiency bleeding (VKDB) of newborn by oral or parenteral administration of vitamin K has been well established. However, rarely, a newborn can present with bleeding manifestations even after routine vitamin K prophylaxis at birth. A 2-day-old healthy male baby presented with catastrophic pulmonary haemorrhage with severely deranged coagulation profile even after receiving vitamin K prophylaxis at birth. His presentation, initial laboratory findings and course in the hospital were very much in favour of haemophilia B, but follow-up factor IX level and clinical exome sequencing did not confirm it. However, protein induced in vitamin K absence-II was found to be raised just before the discharge, and we concluded this case as a rare presentation of classical VKDB.
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http://dx.doi.org/10.24911/SJP.106-1584209747DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7423306PMC
January 2020

Diagnosis of idiopathic T-cell pseudolymphoma: A continuous challenge.

Australas J Dermatol 2021 Feb 20;62(1):e142-e144. Epub 2020 Aug 20.

Department of Pathology, AIIMS, Bhubaneswar, India.

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http://dx.doi.org/10.1111/ajd.13445DOI Listing
February 2021

Comparative Genomic Analysis of Rapidly Evolving SARS-CoV-2 Reveals Mosaic Pattern of Phylogeographical Distribution.

mSystems 2020 Jul 28;5(4). Epub 2020 Jul 28.

The Energy and Resources Institute, New Delhi, India

The outbreak of coronavirus disease 2019 (COVID-19) that started in Wuhan, China, in December 2019 has spread worldwide, emerging as a global pandemic. The severe respiratory pneumonia caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has so far claimed more than 0.38 million lives and has impacted human lives worldwide. However, as the novel SARS-CoV-2 virus displays high transmission rates, the underlying genomic severity is required to be fully understood. We studied the complete genomes of 95 SARS-CoV-2 strains from different geographical regions worldwide to uncover the pattern of the spread of the virus. We show that there is no direct transmission pattern of the virus among neighboring countries, suggesting that its spread is a result of travel of infected humans to different countries. We revealed unique single nucleotide polymorphisms (SNPs) in nonstructural protein 13 (nsp13), nsp14, nsp15, and nsp16 (ORF1b polyproteins) and in the S-protein within 10 viral isolates from the United States. These viral proteins are involved in RNA replication and binding with the human receptors, indicating that the viral variants that are circulating in the population of the United States are different from those circulating in the populations of other countries. In addition, we found an amino acid addition in nsp16 (mRNA cap-1 methyltransferase) of a U.S. isolate (GenBank accession no. MT188341.1) leading to a shift in the amino acid frame from position 2540 onward. Through comparative structural analysis of the wild-type and mutant proteins, we showed that this addition of a phenylalanine residue renders the protein in the mutant less stable, which might affect mRNA cap-1 methyltransferase function. We further analyzed the SARS-CoV-2-human interactome, which revealed that the interferon signaling pathway is targeted by orf1ab during infection and that it also interacts with NF-κB-repressing factor (NKRF), which is a potential regulator of interleukin-8 (IL-8). We propose that targeting this interaction may subsequently improve the health condition of COVID-19 patients. Our analysis also emphasized that SARS-CoV-2 manipulates spliceosome machinery during infection; hence, targeting splicing might affect viral replication. In conclusion, the replicative machinery of SARS-CoV-2 is targeting interferon and the notch signaling pathway along with spliceosome machinery to evade host challenges. The COVID-19 pandemic continues to storm the world, with over 6.5 million cases worldwide. The severity of the disease varies with the territories and is mainly influenced by population density and age factor. In this study, we analyzed the transmission pattern of 95 SARS-CoV-2 genomes isolated from 11 different countries. Our study also revealed several nonsynonymous mutations in ORF1b and S-proteins and the impact on their structural stability. Our analysis showed the manipulation of host system by viral proteins through SARS-CoV-2-human protein interactome, which can be useful to understand the impact of virus on human health.
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http://dx.doi.org/10.1128/mSystems.00505-20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7394360PMC
July 2020

Pulmonary Manifestations in Systemic Sclerosis: Hospital-Based Descriptive Study.

Cureus 2020 Jun 16;12(6):e8649. Epub 2020 Jun 16.

Internal Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.

Introduction Prevalence of systemic sclerosis (SSc)-related organ injury is difficult to estimate as it occurs early in SSc, even though patients are often asymptomatic. As the patients with organ damage have a poor prognosis, all the patients should be carefully evaluated and followed‑up in the initial periods. This facilitates the early identification and initiation of appropriate therapy. This study emphasizes on different clinical manifestations and early predictors of lung involvement by using clinical, radiological, and pulmonary function tests in a tertiary care centre.   Materials and methods A total of 53 SSc cases, who satisfied American College of Rheumatology (ACR) 2013 criteria, without any overlap syndromes were included in the study. All patients underwent thorough clinical examination along with Modified Rodnan Scoring (MRS) assessment, nailfold capillaroscopy (NFC), chest X-ray (CXR), HRCT thorax, 2D-echocardiography, spirometry and diffusion lung study by carbon monoxide (DLco). Results Out of 53 patients, four were male and 49 were female. Twenty-one patients had limited SSc (lcSSc) and 32 had diffuse SSc (dcSSc). Eighty-three per cent of subjects presented with skin manifestations and 34% with respiratory complaints. Reticulonodular opacities and ground glassing were the predominant radiological abnormalities suggestive of non-specific interstitial pneumonia (NSIP) followed by usual interstitial pneumonia (UIP). Pulmonary hypertension was predominant in patients with lcSSc. Thirty-eight patients had a restrictive pattern of spirometry. Forty-four patients showed deranged DLco, among which two patients showed an isolated decrease in DLco. Thirty-seven patients had abnormal NFC among which dropout pattern was predominant. MRS was significantly correlated with pulmonary involvement by DLco and HRCT. Conclusions SSc can affect the lungs even before developing obvious clinical pulmonary manifestations. DLco and HRCT play a critical role in detecting early lung involvement and predicting the outcomes in SSc. Higher modified Rodnan's score, which has a significant correlation with DLco and HRCT can be used to predict early visceral involvement in resource-limited settings.
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http://dx.doi.org/10.7759/cureus.8649DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366045PMC
June 2020

The role of neutrophils in mediating stroke injury in the diabetic db/db mouse brain following hypoxia-ischemia.

Neurochem Int 2020 10 9;139:104790. Epub 2020 Jul 9.

Dept of Neural & Behavioral Sciences, College of Medicine, Penn State University, Hershey Medical Center, Hershey, PA, USA.

Diabetic mice exhibit increased mortality and morbidity following stroke. Recent studies from our laboratory have indicated that increased morbidity in diabetic db/db mice relative to their non-diabetic db/+ littermates is associated with increased levels of MMP-9 protease activity, increased blood-brain barrier (BBB) permeability, and greater neutrophil infiltration following hypoxic/ischemic (H/I) insult. Neutrophils are a major source of proteases and reactive oxygen species and studies have reported neutrophil depletion/inhibition is protective in certain models of experimental stroke. The objective of the current study is to determine the role of neutrophils in the increased morbidity seen in db/db mice following acute ischemic stroke. In this study, we found a significant increase in circulating neutrophils in the db/db mice at 4 h post H/I, which bound to endothelial cells in the ipsilateral hemisphere and infiltrated into brain tissue by 24 h of recovery. Depletion of circulating neutrophils resulted in reduced neutrophil concentrations in blood and in the ipsilateral hemispheres of the brain of both db/+ and db/db mice and decreased the levels of MMP-9 within the infarcted area. This resulted in smaller infarct size in the db/db mice compared to non-treated controls but did not affect stroke outcome in db/+ mice. While there was a significant correlation between neutrophil number and the levels of MMP-9 in the ipsilateral hemisphere of control and diabetic mice, surprisingly, neutrophil depletion had no effect on BBB permeability in either group. Thus, the current study suggests that neutrophil depletion reduces MMP-9 protease levels and improves stroke outcome in db/db mice but not in their db/+ counterparts.
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http://dx.doi.org/10.1016/j.neuint.2020.104790DOI Listing
October 2020

Secretion and Function of Pituitary Prolactin in Evolutionary Perspective.

Front Neurosci 2020 16;14:621. Epub 2020 Jun 16.

MTA-ELTE Laboratory of Molecular and Systems Neurobiology, Department of Physiology and Neurobiology, Institute of Biology, Eötvös Loránd University, Budapest, Hungary.

The hypothalamo-pituitary system developed in early vertebrates. Prolactin is an ancient vertebrate hormone released from the pituitary that exerts particularly diverse functions. The purpose of the review is to take a comparative approach in the description of prolactin, its secretion from pituitary lactotrophs, and hormonal functions. Since the reproductive and osmoregulatory roles of prolactin are best established in a variety of species, these functions are the primary subjects of discussion. Different types of prolactin and prolactin receptors developed during vertebrate evolution, which will be described in this review. The signal transduction of prolactin receptors is well conserved among vertebrates enabling us to describe the whole subphylum. Then, the review focuses on the regulation of prolactin release in mammals as we have the most knowledge on this class of vertebrates. Prolactin secretion in response to different reproductive stimuli, such as estrogen-induced release, mating, pregnancy and suckling is detailed. Reproduction in birds is different from that in mammals in several aspects. Prolactin is released during incubation in avian species whose regulation and functional significance are discussed. Little information is available on prolactin in reptiles and amphibians; therefore, they are mentioned only in specific cases to explain certain evolutionary aspects. In turn, the osmoregulatory function of prolactin is well established in fish. The different types of pituitary prolactin in fish play particularly important roles in the adaptation of eutherian species to fresh water environments. To achieve this function, prolactin is released from lactotrophs in hyposmolarity, as they are directly osmosensitive in fish. In turn, the released prolactin acts on branchial epithelia, especially ionocytes of the gill to retain salt and excrete water. This review will highlight the points where comparative data give new ideas or suggest new approaches for investigation in other taxa.
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http://dx.doi.org/10.3389/fnins.2020.00621DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308720PMC
June 2020