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National Rabies Control Programme, India, is in operation since 2012-2013 without much impact due to poor funding and no set policy for the rabies prevention and control. An effort was made to develop a draft policy paper which can help the Government of India to develop a national rabies vaccination policy for humans and for achieving the goal of zero dog-mediated human rabies deaths by the year 2030. A technical stakeholders meeting was held under the chairmanship of the Drug Controller General of India at New Delhi in December 2017 to discuss the problems and solutions for providing essential rabies postexposure prophylaxis (PEP). The following problems and dilemmas were identified: frequent shortages of life-saving rabies vaccines and rabies immunoglobulin for PEP; as rabies vaccines are mostly procured by the state governments that often face resource crunch and hurdles in logistics within the states; production levels of rabies biologicals in the public sector are low; and the export of rabies biologicals from the private sector needs to be critically evaluated in the context of frequent stock-outs in the domestic market and also the national vaccine security.

COVID-19 has laid an impact on every sector of the world. Howsoever severe, vaccines have acted as the sole source of a protective guard to prevent the further spread of the COVID-19 pandemic. In this research, the authors broadly focus on the trends in the vaccination drive of India. The paper revolves around a prediction and evaluation approach, which depending on the past and the current trends of daily vaccinations, obtain comparable results using a self-built recurrent neural network of LSTM layers for this study on time series evaluation. Through the neural network, the study predicts the exact vaccination figures likely to be achieved 1 year after vaccine introduction in the Indian subcontinent. The gathered data from January 16, 2021, until September 30, 2021, follow effective visualization of how the model outputs resemble the vaccination numbers for October 2021 and the predictions until January 16, 2022. Finally, the paper follows an extensive data analysis keeping in mind, the analogy of the number of COVID-19 cases and deaths before and after the vaccination system was centralized, to prove how sustainable the framework has been so far. [ABSTRACT FROM AUTHOR]

Diagnosing extrapulmonary tuberculosis (EPTB) is challenging. Immunohistochemistry or immunocytochemistry has been used to diagnose tuberculosis (TB) by detection of MPT64 antigen from various extrapulmonary specimens and has shown good diagnostic performance in our previous studies. The test can distinguish between disease caused by Mycobacterium tuberculosis (Mtb) complex and nontuberculous mycobacteria and can be applied on formalin‐fixed paraffin‐embedded tissue. As the antibodies previously used were in limited supply, a new batch of polyclonal antibodies was developed for scale‐up and evaluated for the first time in this study. Our aim was to assess the diagnostic accuracy of the MPT64 test with reproduced antibodies in the high burden settings of Pakistan and India. Patients were enrolled prospectively. Samples from suspected sites of infection were collected and subjected to histopathologic and/or cytologic evaluation, routine TB diagnostics, GeneXpert MTB/RIF (Xpert), and the MPT64 antigen detection test. Patients were followed until the end of treatment. Based on a composite reference standard (CRS), 556 patients were categorized as TB cases and 175 as non‐TB cases. The MPT64 test performed well on biopsies with a sensitivity and specificity of 94% and 75%, respectively, against a CRS. For cytology samples, the sensitivity was low (36%), whereas the specificity was 81%. Overall, the MPT64 test showed higher sensitivity (73%) than Xpert (38%) and Mtb culture (33%). The test performed equally well in adults and children. We found an additive diagnostic value of the MPT64 test in conjunction with histology and molecular tests, increasing the yield for EPTB. In conclusion, immunochemical staining with MPT64 antibodies improves the diagnosis of EPTB in high burden settings and could be a valuable addition to routine diagnostics. [ABSTRACT FROM AUTHOR]

Background: Leptospirosis is a reemerging zoonosis affecting humans and animals worldwide in tropical and subtropical countries. The study was conducted to estimate the seroprevalence of leptospirosis in high-risk occupational groups (cattle farm workers, poultry farm workers, and slaughterhouse workers) in the state of Gujarat and to determine related risk factors for leptospirosis. Methods: Using an interview-guided questionnaire, a cross-sectional study was conducted involving 123 people in high-risk occupational groups (namely, cattle farm workers, poultry farm workers, and slaughterhouse workers) from five districts of the state of Gujarat, India. The participants' serum samples were screened for antileptospiral antibodies by using Immunoglobulin G (IgG) and Immunoglobulin M (IgM) enzyme-linked immunosorbent assays (ELISAs) followed by a microscopic agglutination test (MAT). The Chi-square (χ²) test and odds ratio were calculated using IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, N.Y., USA) to ascertain the associated risk factors. Results: Regarding demographic information, this study included 104 men and 19 women in high-risk occupational groups. The overall seroprevalence of antileptospiral antibodies in these high-risk workers was 46.3%. The seroprevalence was the highest among poultry farm workers (56.6%), followed by cattle farm workers (54.5%) and slaughterhouse workers (25.6%). The MAT in combination with IgM is adequate for the serological diagnosis of leptospirosis, but we have also employed IgG ELISA to understand the chronic infection in these high-risk occupational groups as exposure was both past and present. Tests were conducted for antibodies against various Leptospira serovars in the major serogroups; frequent serovars included Hurstbridge, Panama, Javanica, Tarassovi, Copenhageni, Pomona, and Weaveri, among others. The significant (P < 0.05) risk factors associated with leptospirosis in these high-risk occupations reported to be living in field areas, the presence of livestock in the neighborhood, working in slaughterhouses, drinking water from natural water resources, contact with animals such as dogs or livestock, and wounds during occupational practice. Conclusion: Considering the high seroprevalence of leptospirosis, high-risk occupational groups should be regularly screened for potential development of the fatal disease. Hurstbridge was found to be the most prevalent serovar in the studied population, followed by Panama, Javanica, and Tarassovi. [ABSTRACT FROM AUTHOR]

BACKGROUND: Anti-glutamate decarboxylase 65 antibody-associated cerebellar ataxia (anti-GAD65Ab-associated CA) is the most widely studied immune-mediated CA. There are few case series evaluating the clinical, radiological, treatment profile, and outcome of anti-GAD65Ab-associated CA. OBJECTIVE: To study the clinical, radiological profile, associated neoplasm, treatment outcome, and prognosis in patients diagnosed with anti-GAD65Ab-associated CA. METHODS: A retrospective descriptive analysis of a cohort of patients diagnosed with anti-GAD65Abassociated CA was performed and analyzed. RESULTS: Thirteen patients were selected for the analysis with female predominance (70%). The mean age at presentation was 47.5 ± 11.1 years (range, 29-65 years), and the median duration of the symptoms was 4 months. All 13 patients (100%) had gait ataxia. Ten patients had limb ataxia along with gait ataxia (75%). Seven patients had cerebellar dysarthria (54%). Four patients (31%) had gazeevoked jerky nystagmus. Five patients (39%) were diagnosed with type 2 diabetes mellitus, and one patient had hypothyroidism in addition to type 2 diabetes mellitus. Brain magnetic resonance imaging was normal in seven (54%) patients, and pure cerebellar atrophy was observed in six patients. One patient was detected with a colon neoplasm. All 13 patients received intravenous methylprednisolone, followed by oral steroids over 3 months. Six patients (50%) received plasma exchange along with intravenous methylprednisolone. Favorable outcomes (modified Rankin scale score =2) were observed in five patients and poor outcomes in two; six patients were lost to follow-up after the first admission. CONCLUSION: Anti-GAD65Ab-associated CA presents as subacute to chronic progressive CA with a favorable outcome with immunotherapy. Anti-GAD antibodies should be assessed in serum or cerebrospinal fluid in patients presenting subacute to chronic sporadic CA. The occurrence of a systemic neoplasm is rare in anti-GAD65Ab-associated CA. [ABSTRACT FROM AUTHOR]

Introduction: In view of ever-increasing end-stage renal disease (ESRD) population but inadequate availability of suitable donors, ABO-incompatible (ABOi) transplantation can be an important void filler. However, at present, ABOi transplantation is limited to a few centers in India and there is a lack of adequate experience and expertise to guide this program to other centers in the country. Methods: Data of all the ABOi transplants performed from 2012 to 2021 in a tertiary care hospital was retrospectively analyzed. The anti-ABO antibody (IgG) titers (≤1:4) were considered safe before transplantation. Desensitization included rituximab, plasma exchange, or selective immunoadsorption column. Tacrolimus and mycophenolate mofetil were initiated at day -7. Induction agents included ATG, ATLG, basiliximab, or no induction. Postoperatively, anti-ABO titers were done daily for 2 weeks. Results: A total of 202 patients underwent transplantation; of these, 195 patients whose data were for available for 12 months were included in the study. Mean duration of follow-up was 28.9 ± 21.7 months. UTI was the most common source of infection, occurring in almost half (46.1%) of the patients. Antibody-mediated rejection (ABMR; 15%) was common in the first year. Patient survival was 86.6% (169/195) at 1 year. Sepsis was the most common of death in more than two-thirds of the population, including coronavirus disease 2019 (COVID-19)-associated mortality in nine patients (4.6%). Death-censored graft survival was 89.3% (174/195). AMR was the leading cause of graft loss in almost half of the patients. Conclusion: ABOi should be considered in ESRD patients for whom suitable ABO-compatible donor is not available. Higher rate of rejection and infection are still a major concern. [ABSTRACT FROM AUTHOR]

Repeated serological testing tells about the change in the overall infection in a community. This study aimed to evaluate changes in antibody prevalence and kinetics in a closed cohort over six months in different sub-populations in India. The study included 10,000 participants from rural and urban areas in five states and measured SARS-CoV-2 antibodies in serum in three follow-up rounds. The overall seroprevalence increased from 73.9% in round one to 90.7% in round two and 92.9% in round three. Among seropositive rural participants in round one, 98.2% remained positive in round two, and this percentage remained stable in urban and tribal areas in round three. The results showed high antibody prevalence that increased over time and was not different based on area, age group, or sex. Vaccinated individuals had higher antibody prevalence, and nearly all participants had antibody positivity for up to six months. [ABSTRACT FROM AUTHOR]

Information about several papers discussed during the 2nd Indian Society of Transfusion Medicine (ISTM) Annual Conference, TRANSMEDCON 2013, held in Bangalore, India is presented. Topics discussed include the preparation of random donor platelets (RDPs) using the Buffy Coat method, the factors that affects cryoprecipitate (CRYOPPT), and the emergence of leukoreduction during cardiac surgery.

Background: In January 2011, human cases with hemorrhagic manifestations in the hospital staff were reported from a tertiary care hospital in Ahmadabad, India. This paper reports a detailed epidemiological investigation of nosocomial outbreak from the affected area of Ahmadabad, Gujarat, India. Principal Findings: Samples from 3 suspected cases, 83 contacts, Hyalomma ticks and livestock were screened for Crimean- Congo hemorrhagic fever (CCHF) virus by qRT-PCR of which samples of two medical professionals (case C and E) and the husband of the index case (case D) were positive for CCHFV. The sensitivity and specificity of indigenous developed IgM ELISA to screen CCHFV specific antibodies in human serum was 75.0% and 97.5% respectively as compared to commercial kit. About 17.0% domestic animals from Kolat, Ahmadabad were positive for IgG antibodies while only two cattle and a goat showed positivity by qRT-PCR. Surprisingly, 43.0% domestic animals (Buffalo, cattle, sheep and goat) showed IgG antibodies in the adjoining village Jivanpara but only one of the buffalo was positive for CCHFV. The Hyalomma anatolicum anatolicum ticks were positive in PCR and virus isolation. CCHFV was isolated from the blood sample of case C, E in Vero E-6 cells and Swiss albino mice. In partial nucleocapsid gene phylogeny from CCHFV positive human samples of the years 2010 and 2011, livestock and ticks showed this virus was similar to Tajikistan (strain TAJ/H08966), which belongs in the Asian/middle east genetic lineage IV. Conclusions: The likely source of CCHFV was identified as virus infected Hyalomma ticks and livestock at the rural village residence of the primary case (case A). In addition, retrospective sample analysis revealed the existence of CCHFV in Gujarat and Rajasthan states before this outbreak. An indigenous developed IgM ELISA kit will be of great use for screening this virus in India. [ABSTRACT FROM AUTHOR]

Background: Dynamic models of infection transmission can project future disease burden within a population. Few dynamic measles models have been developed for low-income countries, where measles disease burden is highest. Our objective was to review the literature on measles epidemiology in low-income countries, with a particular focus on data that are needed to parameterize dynamic models. Methods: We included age-stratified case reporting and seroprevalence studies with fair to good sample sizes for mostly urban African and Indian populations. We emphasized studies conducted before widespread immunization. We summarized age-stratified attack rates and seroprevalence profiles across these populations. Using the study data, we fitted a "representative" seroprevalence profile for African and Indian settings. We also used a catalytic model to estimate the age-dependent force of infection for individual African and Indian studies where seroprevalence was surveyed. We used these data to quantify the effects of population density on the basic reproductive number R0. Results: The peak attack rate usually occurred at age 1 year in Africa, and 1 to 2 years in India, which is earlier than in developed countries before mass vaccination. Approximately 60% of children were seropositive for measles antibody by age 2 in Africa and India, according to the representative seroprevalence profiles. A statistically significant decline in the force of infection with age was found in 4 of 6 Indian seroprevalence studies, but not in 2 African studies. This implies that the classic threshold result describing the critical proportion immune (pc) required to eradicate an infectious disease, pc = 1-1/R0, may overestimate the required proportion immune to eradicate measles in some developing country populations. A possible, though not statistically significant, positive relation between population density and R0 for various Indian and African populations was also found. These populations also showed a similar pattern of waning of maternal antibodies. Attack rates in rural Indian populations show little dependence on vaccine coverage or population density compared to urban Indian populations. Estimated R0 values varied widely across populations which has further implications for measles elimination. Conclusions: It is possible to develop a broadly informative dynamic model of measles transmission in lowincome country settings based on existing literature, though it may be difficult to develop a model that is closely tailored to any given country. Greater efforts to collect data specific to low-income countries would aid in control efforts by allowing highly population-specific models to be developed. [ABSTRACT FROM AUTHOR]

This study aimed to determine the prevalence and clinical characteristics of anti-HMGCR antibodies in idiopathic inflammatory myositis (IIM) at a tertiary care centre in northern India. Data (adult and children) were retrieved from the MyoCite dataset, identifying patients with polymyositis, dermatomyositis, and antibody-negative IIM whilst fulfilling the ACR/EULAR criteria. SLE, sarcoidosis, and systemic sclerosis were included for comparison as disease controls. The baseline clinical profile, laboratory tests, and muscle biopsies were retrieved and analysed. Descriptive statistics and non-parametric statistics were used for comparison. Among 128 IIM (112 adults, 16 children, M:F 1:2.8) of age 37 (24–47) years and 6 (3–17) months disease duration, 4 (3.6%) young adults tested positive for anti-HMGCR antibodies. All children and disease control tested negative for the antibody. Anti-HMGCR + IIM exhibited higher muscle enzymes [AST (367 vs 104 IU/L, p = 0.045), ALT (502 vs 78 IU/L, p = 0.004), and CPK (12,242 vs 699 IU/L, p = 0.001] except lactate dehydrogenase with less frequent systemic features such as fatigue than antibody-negative IIM. One young girl presented with a Limb–girdle muscular dystrophy (LGMD) with chronic pattern. None of the patients exhibited rashes, statin exposure, or cancer, though one had anti-Ro52 and mild disease. Our observations depict a younger population while affirming previous literature, including NM-like presentation, and chronic LGMD-like pattern of weakness in one case. Although a small number of children were included, ours is one of the few paediatric studies that evaluated HMGCR antibodies thus far. Further investigations in a larger Indian cohort are warranted to substantiate our findings. [ABSTRACT FROM AUTHOR]

The Delta and Kappa variants of SARS-CoV-2 co-emerged in India in late 2020, with the Delta variant underlying the resurgence of COVID-19, even in countries with high vaccination rates. In this study, we assess structural and biochemical aspects of viral fitness for these two variants using cryo-electron microscopy (cryo-EM), ACE2-binding and antibody neutralization analyses. Both variants demonstrate escape of antibodies targeting the N-terminal domain, an important immune hotspot for neutralizing epitopes. Compared to wild-type and Kappa lineages, Delta variant spike proteins show modest increase in ACE2 affinity, likely due to enhanced electrostatic complementarity at the RBD-ACE2 interface, which we characterize by cryo-EM. Unexpectedly, Kappa variant spike trimers form a structural head-to-head dimer-of-trimers assembly, which we demonstrate is a result of the E484Q mutation and with unknown biological implications. The combination of increased antibody escape and enhanced ACE2 binding provides an explanation, in part, for the rapid global dominance of the Delta variant. Saville, Mannar et al. provide a structural basis for enhanced antibody evasion and ACE2 binding by the Delta SARS-CoV-2 spike protein. They further identify a head-to-head dimer-of-trimers cryoEM reconstruction unique to the Kappa variant spike. [ABSTRACT FROM AUTHOR]

Background/Aim: Mumps is by vaccine preventable infectious disease characterised by parotitis. In India mumps vaccines are not currently used under National Immunisation Programme (NIP). Waning of vaccine-induced immunity is considered to play a central role in the re-emergence of mumps. The comprehensive data on the seroepidemiology of measles, mumps, and rubella (MMR) as well as studies which compare the antibody titre among mumps vaccine naive- and mumps vaccinated children are lacking. The aim of this study was to estimate and compare mumps specific antibody titre in children with and without MMR vaccine. Methods: In 2019/2020, blood samples were collected from 100 healthy children attending immunisation clinic in Government Medical College Kota and associated J K Lon Maternal and Child care hospital Kota. The samples were investigated for MMR IgG antibodies using ELISA. Results: Out of total 100 children included in the study, 32.27 % vaccinated and 4.83 % non-vaccinated children were positive for mumps IgG antibody in the age group of 6 months to 6 years of age. Children aged 6 to 12 years, vaccinated and non-vaccinated, had 31.57 % and 26.57 % positivity, respectively. The seroprevalence of measles, mumps and rubella antibodies among 50 MMR vaccinated children were 94 %, 64 %, and 96 %, respectively. A high measles and rubella seroprevalences were observed among all children age groups, suggesting an effective control program, while the mumps seroprevalence decreased significantly with age. Conclusion: The maximum vaccine effectiveness against mumps for 2 doses of MMR vaccine is ≈ 96 %. The herd immunity threshold to block mumps virus transmission is ≥ 86 %. In this study only 64 % of the vaccinated children were found to have IgG mumps antibodies. In view of morbidity following mumps infection there is a need to incorporate mumps vaccine along with measles and rubella vaccine in the NIP instead of MR. [ABSTRACT FROM AUTHOR]

Guillain‐Barré syndrome (GBS) is the commonest post‐infectious inflammatory peripheral neuropathy with undiscerned aetiology. The commonly reported antecedent infections implicated in India include Campylobacter jejuni, chikungunya, dengue, and Japanese encephalitis (JE). In this study from south India, we investigated the role of these four agents in triggering GBS. This case‐control study was performed on 150 treatment‐naive patients with GBS and 150 age and sex‐matched controls from the same community. IgM immunoreactivity for C. jejuni, chikungunya, and dengue was detected by enzyme‐linked immunosorbent assay (ELISA) in serum of patients with GBS and control subjects. Immunoreactivity against JE was detected in serum as well as cerebrospinal fluid (CSF) from patients (n = 150) and orthopaedic control (n = 45) subjects. The immunoreactivity against infections was compared between demyelinating and axonal subtypes of GBS. Overall, 119/150 patients with GBS had serological evidence of antecedent infection. Amongst those with evidence of antecedent infection, 24 (16%), 8 (5%), and 9 (6%) patients were exclusively immunoreactive to chikungunya, JE, and C. jejuni, respectively. In the remaining patients (78/119), immunoreactivity to multiple pathogens was noted. Immunoreactivity to C. jejuni infection was found in 32% of GBS patients compared to 2.7% controls (P <.001), whereas to chikungunya virus was reported in 66.7% of patients with GBS compared to 44.7% controls (P =.006). Anti‐dengue immunoreactivity was significantly associated with the demyelinating subtype of GBS. Patients positive for JE IgM (CSF) manifested demyelinating electrophysiology. In this large case‐control study, immunoreactivity against multiple infectious agents was observed in a subset of patients. Chikungunya was the commonest antecedent infection, followed by C. jejuni. [ABSTRACT FROM AUTHOR]

Background: Guillian--Barre' Syndrome (GBS) has been shown to be associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The aim of our study was to study the clinical profile and outcomes of GBS in COVID-19 from the Western region of India, the State of Maharashtra. Methods: This was a retrospective, multicenter observation study from different hospitals in Maharashtra beginning from March 2020 until November 2020. Results: We report 42 patients with COVID-19 GBS. Mean age was 59 years (range, 24--85 years). 31/42 (73.8%) were men. GBS was the presenting symptom in 14/42 (33%), while six of them remained asymptomatic for COVID-19 despite positive SARS-CoV-2 on nasopharyngeal swab reverse transcriptase polymerase chain reaction. The median interval between COVID-19 and GBS was 14 days (SD + 11), with minimum of 1 and maximum 40 days. Clinical presentation was like that of typical GBS. Electrophysiological studies showed a predominant demyelinating pattern in 25/42 (59.5%). Inflammatory markers were elevated in 35/42 (83.3%) and 38/42 (90.5%) had an Abnormal high-resolution CT (HRCT) chest. 14/42 (33.3%) patients required a ventilator, with nine deaths. Intravenous immunoglobulin was the mainstay of treatment for GBS. Majority had a good outcome and were walking independently or with minimal support at discharge. In subgroup analysis, the postinfectious group had a better outcome than the parainfectious group. Conclusion: GBS in COVID-19 occurs as both parainfectious and postinfectious GBS. Parainfectious GBS needs more rigorous monitoring and may benefit from COVID-19 specific treatment. Routine screening for SARS-CoV-2 should be implemented in patients with GBS in view of the ongoing pandemic. [ABSTRACT FROM AUTHOR]

An attempt has been made to detect airborne pollen of Lagerstroemia speciosa (LS) and Spathodea campanulata (SC) – two common avenue trees of India as potential sources of aeroallergens and also to identify the major IgE-reactive components present in them. The airborne pollen concentration was assessed using a Burkard sampler. A detailed questionnaire on clinical data of 1490 patients was recorded based on hospital data. We assessed the allergenicity of pollen by in vivo and in vitro tests. The correlation among meteorological factors, pollen seasons and allergenic potency of patients was assessed by multiple regression analysis. The sensitivity of patients to pollen antigens was highly correlated with pollen seasons. In SDS–PAGE, 15 protein bands were detected from LS pollen, while 14 bands from SC. The IgE-specific immunoblotting with patients' sera allergic to LS displayed five major allergens, while four major allergens were detected from SC. This would be the first report from India to prove the allergenic potentiality of airborne pollen of these two common avenue trees of India. [ABSTRACT FROM AUTHOR]

Context: Autoimmune encephalitis (AE) is an emerging cause of non-infective encephalitis, presentations of which vary widely. Traditionally the diagnosis of AE is based on detection of antibodies in a patient with clinical picture suggestive of AE. Aim: To evaluate the clinical characteristics and response to immunotherapy in patients with antibody negative autoimmune encephalitis and to compare them with definite cases. Settings and Design: A prospective follow-up study was done in patients presenting with presumptive symptoms of AE from January 2017 to January 2019. The study was done in a tertiary care institute of Northern India. Patients and Methods: Demographic and clinical parameters were noted and relevant investigations for management were done according to well-defined protocol. The patients were treated with immunomodulatory therapy in the form of steroids and/or intravenous immunoglobulins (IVIg). They were followed up for treatment response and relapse at 2 monthly intervals. Statistical Analysis Used: The data was expressed as either proportions or mean/median. Chi-square test/Independent T test was used to compare antibody positive and antibody negative group. Results: Out of 31 patients with presumptive AE, 16 patients tested positive for autoimmune antibodies (definite AE). Incidences of seizure, behavioral abnormalities, dementia and altered sensorium were similar between the 2 groups (p > 0.05). Complete or partial response was seen in all treated patients in both groups with no significant difference (p 0.716). CSF protein concentration and cellularity were higher in the definite group although only high protein concentration could reach statistical significance (p 0.002). Malignancy could be confirmed after extensive search in 2 out of 16 patients with definite AE and in 1 out of 15 antibody negative AE patients. Conclusions: Clinical presentation of antibody negative cases does not differ significantly from definite ones. Since treatment response is also similar in both the groups, starting immunotherapy in a patient presenting with presumptive symptoms of AE, while ruling out other common mimickers, seems to be the need of the hour in the management of this evolving entity. [ABSTRACT FROM AUTHOR]

Background: Patients with Post kala-azar dermal leishmaniasis (PKDL) are considered a reservoir of Leishmania donovani. It is imperative to identify and treat them early for control of visceral leishmaniasis (VL), a current priority in the Indian subcontinent. We explored trends in clinico-epidemiological features of PKDL cases over last two decades, for improving management of the disease.Methods: Clinically suspected cases were diagnosed with rK39 strip test followed by parasitological confirmation by microscopy and/or PCR/qPCR in skin tissue/slit aspirates. Patients were treated with antimonials till 2008 and subsequently with miltefosine.Results: The study indicated higher incidence of PKDL cases in areas of high endemicity for VL, with 20 % cases reporting no history of VL. Approximately 26 % cases of PKDL were initially misdiagnosed at primary health centers. Duration between onset of PKDL and diagnosis was above 12 months in 80 % cases. Diagnostic sensitivity was 32-36 % with microscopy and 96-100 % with PCR/qPCR. Compliance to treatment was over 85 % with miltefosine while 15 % with antimonials. Relapse rate with miltefosine was up to 13.2 %.Conclusions: PKDL patients tend to delay reporting and are often misdiagnosed. Confirmatory diagnosis using minimally invasive skin slit aspirate samples would help overcome such issues. There was a paradigm shift in compliance with miltefosine; however, increasing relapse rate indicated the need for newer therapies with oral formulations. [ABSTRACT FROM AUTHOR]

Background and Objectives Red cell antibody screening as a part of pretransfusion testing is not a routine practice in many developing countries. This study, was done to determine the incidence of allo- and auto-antibodies, assess their clinical significance and deliver antigen negative blood where warranted. Materials and Methods Red cell antibody screening was done as a part of pretransfusion testing at a tertiary care multispecialty hospital in India on 60 518 patients between August 2007 and July 2014 using column agglutination technology by gel. Results Red cell antibodies were detected in 0·95% ( n = 579). Of these, 0·54% ( n = 332) were alloantibodies and 0·4% ( n = 247) were auto-antibodies. Rh and Kell antibodies detected were anti-D( n = 140), anti-C( n = 10), anti-c( n = 12), anti-E( n = 21), anti-e( n = 4), anti-K( n = 10), anti-k( n = 2). Anti-M ( n = 30), anti-N( n = 1), anti-S( n = 7), anti-Le(a)( n = 23), anti-Le(b)( n = 6) and anti-Fy(a)( n = 7) were found. Dual antibodies anti-D&C( n = 36), anti-C&E( n = 1), anti-c&E( n = 2), anti-K&C( n = 1), anti-Jka&E( n = 1) and anti-Jka&D( n = 1) were also detected. Of the 332 alloantibodies detected only 9 could not be typed. Additionally, our study detected 247 auto-antibodies. Conclusion Implementation of red cell antibody screening routinely helped us understand the prevalence of antibodies in our region and showed that wider implementation at the national level is feasible and adds to blood safety. [ABSTRACT FROM AUTHOR]

Atopic dermatitis is a well-recognized clinical entity, several facets of which continue to be mystified. Accordingly, its etio-pathogenesis is largely elusive. It appears to be an outcome of interplay of several undertones, namely: genetics, maternal factor and inheritance, pregnancy/ intrauterine, environmental factors, immune dysregulation, immuno-globulins, role of diet, and infection. Besides, recent innovative breakthroughs consisting of nutritional supplementation, the highlights of which were considered worthwhile to take stock of to define its current status. An endeavor to enlighten the audience has been made for their benefit. [ABSTRACT FROM AUTHOR]

Aim To study the frequency of islet antibodies in a large cohort of clinic- and community-based patients with Type 2 diabetes in northern India. Methods We measured glutamic acid decarboxylase ( GAD) antibodies in 618 adults with Type 2 diabetes (378 patients with diabetes attending a hospital clinic, 240 patients diagnosed in a community survey) and in 192 healthy subjects residing in north India. Islet antigen 2 ( IA2) antibodies were also studied in a proportion of the patients with diabetes ( n = 492) and in a control population ( n = 191). GAD and IA2 antibodies were measured by immunoprecipitation of the respective 35S-labelled recombinant antigen. Results We found that GAD antibodies were present in nine (1.5%) patients with diabetes (clinic population: 0.8%, community study: 2.5%), a prevalence similar to that among the subjects without diabetes ( n = 2; 1%). IA2 antibodies were detected in seven patients with Type 2 diabetes (1.4%) and in two healthy control subjects (1.0%). The frequency of either GAD or IA2 antibodies was similar in people with and without diabetes (3.2 vs 2.1%). No subject was found to have both antibodies. Insulin requirement was higher among antibody-positive than among antibody-negative patients ( GAD antibody: 33 vs 6.3%; P = 0.001; GAD or IA2 antibody: 23.1 vs 6.4%; P = 0.02); however, other clinical features were similar in the two groups. Conclusions In the present north-Indian population with Type 2 diabetes, the overall prevalence of GAD antibodies and the prevalence of either GAD or IA2 antibodies were considerably lower than those reported in white European populations. [ABSTRACT FROM AUTHOR]

Introduction: Neurocysticercosis being a potential to human transmitted disease, is the major cause of seizures and a public health problem in tropical countries. Though India is known to be highly endemic, there are many provinces where reports are still unavailable thereby underestimating its actual burden. Materials and Methods: Anti-Cysticercus IgG antibodies in sera from cases presenting with seizures were screened by ELISA in a preliminary study in Odisha state which is a province in Eastern coastal India that was never explored before. Patients presenting with recent onset of seizures within age group 5 to 50 years, either local residents of Odisha or inhabitants from other parts of the country living for at least one year period in the study area were included. Results: The present study showed 43.75% cases with seizures to be confirmed neurocysticercosis (NCC) based on serology and brain imaging. However, statistically no association was established between anti-Cysticercus antibody detection and radio imaging characteristics (location, number of lesions, and stage). Conclusion: This is the first study in Odisha presenting a series of cases with serological evidence of exposure to the parasite along with imaging characteristics which was consistent with NCC. It is recommended that NCC must be considered for a differential diagnosis in each active epilepsy case irrespective of prior prevalence information in all unexplored provinces in India and other endemic regions; also a compulsory reporting is warranted in order to aid in quantifying its actual burden. [ABSTRACT FROM AUTHOR]

The article presents abstracts on blood transfusion including the issues and challenges in developing plateletphereris panel, the use of reminder card to encourage repeat blood donations, and equipment planning in multispecialty hospital-based blood bank.

Objective: To evaluate the effect of the second dose of measles vaccine on measles antibody status during childhood. Setting: Immunization centre of Under-five Clinic of the Department of Community Medicine at a tertiary-hospital. Design: Randomized Controlled trial. Methods: Blood samples were collected from all subjects for baseline measles serology by heel puncture at 9-12 months of age. All subjects were given the first dose of measeis vaccine. At second visit (3-5 months later), after collecting the blood sample from all, half the children were randomized to receive the second dose of measles vaccine (study group), followed by collection of the third sample six weeks later in all the subjects. Results: A total of 78 children were enrolled and 30 children in each group could be analyzed. 11(36.6%) children in the study group and 13 (43.3%) children in the control group had protective levels of measles IgG at baseline. Around 93.3 % of children in the study group had protective measles antibody titers as against 50% in the control group at the end of the trial. The Geometric Mean Titre (GMT) of measles IgG increased from 14.8NTU/mLto 18.2 NTU/mL from baseline to six weeks following receipt of the second dose of the vaccine in the study group, as compared to a decrease from 16.8 NTU/mL to 12.8 NTU/mL in the control group. Conclusions: A second dose of measles vaccine boosts the measles antibody status in the study population as compared to those who receive only a single dose. [ABSTRACT FROM AUTHOR]

Objective To assess the prevalence of the anti-red blood cell antibodies in the donor population of Delhi. Methods This prospective study was conducted in Regional Blood Transfusion Centre (RBTC), Lady Hardinge Medical College (LHMC) and associated hospitals from March 2010 to March 2011. Antibody screening of all donor serum/plasma was performed as routine immunohaematological procedure. Any positive sera were further investigated to identify the specificity of irregular erythrocyte antibody by commercially available red cell panel (ID-Dia Panel, Diamed-ID Microtyping System). The titres and thermal amplitude of the identified antibodies were evaluated. Results A total of 7756 donors were screened, of which 7648 donors were males (98.6%) and 108 were females (1.4%). The maximum number of donors belonged to age group of 26-30 years. A total of four donors showed presence of alloantibodies in their serum (0.05%). On antibody identification, two of them were anti-C, one was anti-Lewisa antibody and one was autoantibody. Discussion This study was conducted to highlight the significance of detecting irregular erythrocyte antibodies in healthy donors. [ABSTRACT FROM AUTHOR]

Background: The exposures of bio-aerosols have reported higher occupational health hazards, the association between serum total IgE levels and job categories and occupational health hazards of waste disposal area was limited. The present study was undertaken to assess the relationship between occupational health hazards and Serum total IgE in waste disposal area. Materials and Methods: One hundred eighty subjects working in waste disposal areas in different parts of Bangalore at Karnataka, India were enrolled into the study in 2009. Using questionnaire the respiratory morbidity and other work related problems in HWW was carried. The levels of serum total IgE in study subjects were determined by using Enzyme- linked -immunosorbent assay kits (DRG International Inc, USA). The differences of serum total IgE levels between the groups were computed by using nonparametric Mann-Whitney U test. SPSS 10.0 for windows version of statistical software was used in the analysis. Results: The levels of serum total IgE was significantly increased in landfill area (P=0.027) compose plant workers (P=0.020). The morbidity conditions such as respiratory and musculoskeletal found significantly higher in waste disposal workers as compared to controls. Conclusion: The levels of serum total IgE was significantly increased in land fill area and compose plant workers but no significant relationship was found between the levels of serum total IgE and occurrence of health related symptoms or past respiratory disease. [ABSTRACT FROM AUTHOR]

Introduction: Hemagglutination (HA) and hemagglutination inhibition (HI) assays are conventionally used for detection and identification of influenza viruses. HI assay is also used for detection of antibodies against influenza viruses. Primarily turkey or chicken erythrocytes [red blood cells (RBCs)] are used in these assays, as they are large, nucleated, and sediment fast, which makes it easy to determine the titer. Human influenza viruses agglutinate RBCs from chicken, human, and guinea pig, but not from horse. Human influenza viruses bind preferentially to sialic acid (SA) linked to galactose (Gal) by α 2, 6 linkage (SA α 2, 6-Gal), whereas avian influenza (AI) viruses bind preferentially to SA α 2, 3-Gal linkages. With this background, the present study was undertaken to study erythrocyte binding preferences and receptor specificities of AI viruses isolated from India. Materials and methods: A total of nine AI virus isolates (four subtypes) from India and three reference AI strains (three subtypes) were tested in HA and HI assays against mammalian and avian erythrocytes. The erythrocytes from turkey, chicken, goose, guinea pig and horse were used in the study. The receptor specificity determination assays were performed using goose and turkey RBCs. The amino acids present at 190 helix, 130 and 220 loops of the receptor-binding domain of the hemagglutinin protein were analyzed to correlate amino acid changes with the receptor specificity. Results: All tested highly pathogenic avian influenza (HPAI) H5N1 viruses reacted with all five types of RBCs in the HA assay; AI H9N2 and H5N2 viruses did not react with horse RBCs. For H5N1 viruses guinea pig and goose RBCs were best for both HA and HI assays. For H9N2 viruses, guinea pig, fowl and turkey RBCs were suitable. For other tested AI subtypes, avian and guinea pig RBCs were better. Eight isolates of H5N1, one H4N6 and one H7N1 virus showed preference to avian sialic acid receptors. Importantly, two isolates of HPAI H5N1, H9N2 and H11N1 viruses showed receptor specificity preference to both avian and mammalian sialic acid (α-2, 3 and α-2, 6) receptors. Conclusions: Use of different types of RBCs resulted in titer variations in HA and HI assays. This showed that RBCs giving optimum HA and HI titers would increase sensitivity of detection and would be more appropriate for identification and antigenic analysis of AI viruses. Analysis of 16 amino acids in the receptor-binding domain of the hemagglutinin of HPAI H5N1 viruses revealed that the only variation observed was in S221P amino acid position. Two H5N1 viruses showed S221P amino acid change, out of which only one H5N1 virus showed preference to α 2, 6 sialic acid receptor. One H5N1 virus isolate with amino acid S at 221 position, showed preference to α 2,3 as well as α 2,6 sialic acid receptors. This indicated that factor(s) other than S221P mutation in the hemagglutinin are probably involved in determining receptor specificity of H5N1 viruses. This is the first report of receptor specificity and erythrocyte binding preferences of AI viruses from India. [ABSTRACT FROM AUTHOR]

Introduction: More than 70 outbreaks of the highly pathogenic avian influenza (HPAI) H5N1 have been reported in poultry in the western and north-eastern parts of India. Therefore, in view of the recent HPAI H5N1 outbreaks in poultry, active AI surveillance encompassing wild, resident, migratory birds and poultry was undertaken during 2009-2011 in the State of West Bengal. Methods: A total of 5722 samples were collected from West Bengal; 3522 samples (2906 fecal droppings + 616 other environmental samples) were from migratory birds and 2200 samples [1604 tracheal, cloacal swabs, environmental samples, tissue samples + 596 blood (serum)] were from domestic ducks and poultry. All tracheal, cloacal and environmental samples were processed for virus isolation. Virus isolates were detected using hemagglutination assay and identified using hemagglutination inhibition (HI) and reverse transcriptase polymerase chain reaction (RT-PCR) assays. Sequencing and phylogenetic analysis of partial region of the hemagglutinin and neuraminidase genes was done. Intravenous pathogenicity index assays were performed in chickens to assess pathogenicity of AI virus isolates. Serum samples were tested for detection of antibodies against AI viruses using HI assay. Results: A total of 57 AI H9N2, 15 AI H4N6 and 15 Newcastle Disease (NDV) viruses were isolated from chickens, from both backyard and wet poultry markets; AI H4N6 viruses were isolated from backyard chickens and domestic ducks. Characterization of AI H9N2 and H4N6 viruses revealed that they were of low pathogenicity. Domestic ducks were positive for antibodies against H5 and H7 viruses while chickens were positive for presence of antibodies against AI H9N2 and NDV. Conclusions: In the current scenario of HPAI H5N1 outbreaks in West Bengal, this report shows presence of low pathogenic AI H9N2 and H4N6 viruses in chickens and domestic ducks during the period 2009-2011. This is the first report of isolation of H4N6 from India. Antibodies against AI H5 and H7 in ducks highlight the probable role of domestic ducks in the transmission of AI viruses. Human infections of H9N2 have been reported from China and Hong Kong. This necessitates implementation of prevention and control measures to limit the spread of AI viruses. [ABSTRACT FROM AUTHOR]

Background: The ILEP Nerve Function Impairment in Reaction (INFIR) is a cohort study designed to identify predictors of reactions and nerve function impairment (NFI) in leprosy. Aim of the Study: Antibodies to mycobacteria, nerve components and serum cytokine were measured as potential markers for their possible association with reactions and NFI. Patients and Methods: 303 newly diagnosed leprosy patients from two centres in North India were enrolled. Antibodies to PGL-1, LAM (IgG1 and IgG3), ceramide, S100 and TNFα levels were measured using ELISA techniques. Results: S-100, PGL IgG and IgM antibody levels were lowest in patients with BT leprosy and highest in patients with lepromatous leprosy. LAM IgG1 and LAM IgG3 antibody levels were highest in patients with BL leprosy. Ceramide antibody levels were not correlated with type of leprosy. Levels of all the antibodies tested and TNF α were lowest in patients with only skin reaction. PGL IgM antibody levels were elevated in patients with skin reactions and NFI. Old sensory NFI is associated with significant elevation of PGL IgG, LAM IgG and S100 antibody levels. Conclusion: These results reveal that the antibody response to mycobacterial antigens, nerve antigens and cytokines are in a dynamic flux and could collectively contribute to NFI in leprosy. The association of multiple markers with old NFI may indicate the contribution of different pathological processes. Author Summary: Leprosy is one of the oldest known diseases. In spite of the established fact that it is least infectious and a completely curable disease, the social stigma associated with it still lingers in many countries and remains a major obstacle to self reporting and early treatment. The nerve damage that occurs in leprosy is the most serious aspect of this disease as nerve damage leads to progressive impairment and disability. It is important to identify markers of nerve damage so that preventive measures can be taken. This prospective cohort study was designed to look at the potential association of some serological markers with reactions and nerve function impairment. Three hundred and three newly diagnosed patients from north India were recruited for this study. The study attempts to reflect a model of nerve damage initiated by mycobacterial antigens and maintained by ongoing inflammation through cytokines such as Tumour Necrosis Factor alpha and perhaps extended by antibodies against nerve components. [ABSTRACT FROM AUTHOR]

Objective: Celiac disease is an important cause of chronic diarrhea, failure to thrive, and anemia in children. Mode of presentation of celiac disease has changed in last few years. Study was conducted to determine the mode of clinical presentation of a large group of patients with celiac disease and whether there has been a change in the presentation with the time. Methods: A prospective study was conducted on 134 children diagnosed to be having celiac disease in the Pediatric Gastroenterology, PGIMER, Chandigarh, from July 1st 2006 to December 31st 2007. Their detailed clinical profile was recorded on a pretested proforma and all patients underwent hemogram, liver function tests, IgA anti-tissue transglutaminase(anti tTG), and upper gastro-intestinal endoscopy. Findings: Major symptoms at presentation were diarrhea (54.5%), failure to thrive (52.2%), abdominal distension (41%), anemia (40%), pain abdomen (19.4%), vomiting (15.7%) and constipation (2.2% of cases). 60.4% of patients had short stature. Anemia was microcytic hypochromic in 79.1% of patients, and dimorphic in 20.9%. Serum transaminases were raised in 38.8 % of cases. The mean serum anti tTG level was 164.24U/ml (Range 0-749 U/ml) and levels correlated with the severity of small intestinal damage on biopsy. 15 patients were negative for the serology but 8 out of them had IgA deficiency and all had histopathology suggestive of celiac disease. Conclusion: Classical presentation of celiac disease is less commonly encountered these days probably related to the more widespread use of serologic testing and early recognition of atypical manifestations of celiac disease. [ABSTRACT FROM AUTHOR]

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Narcissus tazetta is found growing naturally in the different places of Himachal Pradesh, India. Narcissus samples showing chlorosis were collected from Shimla, Solan, Kangra, and Kullu districts of Himachal Pradesh. Positive results for the presence of a potyvirus were shown by samples collected from Kangra district with ELISA using potyvirus group specific antibodies and RT-PCR using potyvirus group specific primers. An approximately 800 bp RT-PCR amplified fragment was cloned and sequenced. Sequence analysis confirmed the identity of the virus infecting Narcissus as a potyvirus. Sequence analysis and phylogenetic analysis demonstrated that the virus infecting Narcissus is a potyvirus and has close resemblance with Narcissus late season yellows (NLSYV) and Narcissus yellow stripe potyviruses (NYSV) reported from China, but is distinct from both of them. The data will help in complete characterization of a distinct potyvirus infecting Narcissus in India. [ABSTRACT FROM AUTHOR]

Background: Rubella vaccination is not yet included in National Immunization Schedule in India. Serosurvey is frequently used to assess epidemiologic pattern of Rubella in a community. Serosurveys in different parts of India have found that 6-47% of women are susceptible for Rubella infection. The present serosurveillance was conducted in Jammu, India, in two public schools. Objective: To determine serological status of Rubella antibodies of school girls and assessment of immunogenicity and reactogenicity of Rubella immunization in seronegative girls. Materials and Methods: The current study was conducted to determine Rubella serostatus in peripubertal schoolgirls aged 11-18 years and also to assess immunogenicity and safety of Rubella vaccine (R-Vac) of Serum Institute of India Ltd., Pune, in seronegative girls. For screening, pre-vaccination serum Rubella IgG antibodies were determined and to assess immunogenicity of the vaccine, post-vaccination IgG antibodies were compared with pre-vaccination levels. Safety assessment was done for a period of 8 weeks, post-vaccination. Results: A total of 90 (32.7%) seronegative girls were vaccinated. All girls (100%) became seropositive, post-vaccination. Clinically relevant and statistically significant increase in anti-Rubella IgG titres was observed. The adverse events were mild and self-limiting. Conclusions: R-Vac vaccine used in the study demonstrated an excellent safety and immunogenicity profile. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is the most common malignancy affecting females worldwide but conventional risk factors are able to explain only a small proportion of these cases. A possible viral etiology for breast cancer has been proposed and Epstein-Barr Virus (EBV) is a widely researched candidate virus. The aim of the present study, first one of its kind from India, was to determine if there is a greater association of EBV infection with breast cancer patients as compared to patients with benign breast diseases. Methods: We looked for expression of Epstein-Barr Virus Nuclear Antigen-1 (EBNA-1) in breast cancer tissue specimens by employing immunohistochemistry (IHC). We also measured levels of anti-EBNA-1 Immunoglobulin (IgG) antibodies in stored sera of these patients using commercial Enzyme linked Immunosorbent Assay (ELISA) kit. Patients with benign breast diseases were used as a comparison group for both immunohistochemical and serological analysis. Results: 58 cases of malignant breast disease and 63 of benign breast disease (controls) were included in the study. Using manufacturer determined cut-off of 3 IU/ml, 50/55 tested (90.9%) cases and 27/33 tested (81.8%) controls were seropositive for anti-EBNA-1 IgG. Mean antibody levels were significantly higher for cases (54.22 IU/ml) as compared to controls (18.68 IU/ml). IHC for EBNA-1 was positive in 28/51 cases (54.9%). No IHC positivity was noted in the tested 30 controls. Our results show that EBNA-1 expression is seen in a significant proportion of breast cancer tissue specimens from rural India and as compared to patients with benign breast diseases these patients also have a higher immunological response against EBNA-1. [ABSTRACT FROM AUTHOR]

Background: Simple biomarkers are required to identify TB in both HIV-TB+ and HIV+TB+ patients. Earlier studies have identified the M. tuberculosis Malate Synthase (MS) and MPT51 as immunodominant antigens in TB patients. One goal of these investigations was to evaluate the sensitivity and specificity of anti-MS and -MPT51 antibodies as biomarkers for TB in HIV-TB+ and HIV+TB+ patients from a TB-endemic setting. Earlier studies also demonstrated the presence of these biomarkers during incipient subclinical TB. If these biomarkers correlate with incipient TB, their prevalence should be higher in asymptomatic HIV+ subjects who are at a high-risk for TB. The second goal was to compare the prevalence of these biomarkers in asymptomatic, CD4+ T cell-matched HIV+TB- subjects from India who are at high-risk for TB with similar subjects from US who are at low-risk for TB. Methods and Results: Anti-MS and -MPT51 antibodies were assessed in sera from 480 subjects including PPD+ or PPD- healthy subjects, healthy community members, and HIV-TB+ and HIV+TB+ patients from India. Results demonstrate high sensitivity (∼80%) of detection of smear-positive HIV-TB+ and HIV+TB+ patients, and high specificity (>97%) with PPD+ subjects and endemic controls. While ∼45% of the asymptomatic HIV+TB- patients at high-risk for TB tested biomarkerpositive, .97% of the HIV+TB- subjects at low risk for TB tested negative. Although the current studies are hampered by lack of knowledge of the outcome, these results provide strong support for the potential of these biomarkers to detect incipient, subclinical TB in HIV+ subjects. Conclusions: These biomarkers provide high sensitivity and specificity for TB diagnosis in a TB endemic setting. Their performance is not compromised by concurrent HIV infection, site of TB and absence of pulmonary manifestations in HIV+TB+ patients. Results also demonstrate the potential of these biomarkers for identifying incipient subclinical TB in HIV+TB- subjects at high-risk for TB. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a chronic, relapsing, pruritic dermatitis frequently associated with the hyperproduction of IgE to various allergens. Identifi cation of these allergens is possible by various laboratory investigations. Aim: The present study was designed to assess these allergen-specifi c antibodies in the diagnosis of AD in the Indian context. Methods: This prospective study comprised 50 patients of AD. The diagnosis was made clinically after satisfying Hanifi n and Rajka's criteria. Serum IgE levels were estimated and specifi c IgE antibodies were measured for 20 food allergens and aeroallergens. Results: Serum IgE was elevated in 88% of the patients. The highest elevation of mean IgE levels was seen in the 10-20 years age group. Sixty fi ve percent of the children under the age of ten years were positive to one or more food allergens. Food allergens were more often positive in the ≤10 years age group and specifi c antibodies to inhalants were seen more frequently in the older age groups. Specifi c antibodies to apples were found in all age groups. Conclusion: Antibodies against apples and hazelnuts were the more commonly seen specifi c antibodies in children. Incidence of positivity was much higher in children when compared to earlier studies. Identifi cation of food allergens can be an important factor in the diagnosis of AD in children in India. Positivity to inhalant allergens in the older age groups was lower in this study. The allergen profi le with regard to inhalants in Indian patients was similar to that of earlier studies. [ABSTRACT FROM AUTHOR]

The extreme variability at the Killer cell Immunoglobulin-like Receptor ( KIR) locus along with that of the genes encoding their ligands, HLA class I, appears to modulate risk for viral, autoimmune, and malignant diseases, and reproductive failure. Differences in KIR gene and haplotype frequencies across world populations may reflect some combination of ancestral genotypes, locale-specific selection pressures, and genetic drift. We genotyped unrelated healthy Parsis and Maharashtrian Hindus, neighboring peoples from Western India. These two populations showed remarkable similarity in KIR gene frequencies despite their distinct ethnic background and the fairly recent migration of Parsis to Western India from Persia around 900 A.D. One clear exception is KIR3DS1, which is found at a significantly higher frequency in the Parsis than in the Maharashtrians, previously characterized North Indians, and most other world populations. The high KIR3DS1 frequency of Parsis corresponds with a low frequency of its putative HLA-B ligand group, an inverse correlation that has been observed previously across other world populations. Thus, KIR3DS1 frequency in Parsis may be a remnant of their distinct ancestral Persian origin. KIR gene frequencies and profiles of the Parsis and Maharashtrians were more similar to one another than they were to North Indians, suggesting a potential effect of local environmental factors on KIR evolution and/or some degree of admixture between Parsis and populations from Western India. Overall, these data support other studies indicating the rapid evolution of the KIR locus and the apparent dependency of this evolution on the loci encoding HLA class I ligands. [ABSTRACT FROM AUTHOR]

Background: The magnitude of reproductive morbidity associated with sexually transmitted Chlamydia trachomatis infection is enormous. Association of antibodies to chlamydial heat shock proteins (cHSP) 60 and 10 with various disease sequelae such as infertility or ectopic pregnancy has been reported. Cell-mediated immunity is essential in resolution and in protection to Chlamydia as well as is involved in the immunopathogenesis of chlamydial diseases. To date only peripheral cell mediated immune responses have been evaluated for cHSP60. These studies suggest cHSPs as important factors involved in immunopathological condition associated with infection. Hence study of specific cytokine responses of mononuclear cells from the infectious site to cHSP60 and cHSP10 may elucidate their actual role in the cause of immunopathogenesis and the disease outcome. Methods: Female patients (n = 368) attending the gynecology out patient department of Safdarjung hospital, New Delhi were enrolled for the study and were clinically characterized into two groups; chlamydia positive fertile women (n = 63) and chlamydia positive infertile women (n = 70). Uninfected healthy women with no infertility problem were enrolled as controls (n = 39). cHSP60 and cHSP10 specific cytokine responses (Interferon (IFN)-gamma, Interleukin (IL)-10, Tumor Necrosis Factor (TNF)-alpha, IL-13 and IL-4) were assessed by ELISA in stimulated cervical mononuclear cell supernatants. Results: cHSP60 and cHSP10 stimulation results in significant increase in IFN-gamma (P = 0.006 and P = 0.04 respectively) and IL-10 levels (P = 0.04) in infertile group as compared to fertile group. A significant cHSP60 specific increase in TNF-alpha levels (P = 0.0008) was observed in infertile group as compared to fertile group. cHSP60 and cHSP10 specific IFN-gamma and IL-10 levels were significantly correlated (P < 0.0001, r = 0.54 and P = 0.004, r = 0.33 respectively) in infertile group. Conclusion: Our results suggest that exposure to chlamydial heat shock proteins (cHSP60 and cHSP10) could significantly affect mucosal immune function by increasing the release of IFN-gamma, IL-10 and TNF-alpha by cervical mononuclear cells. [ABSTRACT FROM AUTHOR]

The discordant cases of seronegative, but culture and proviral HIV-2 DNA positive were found in Mumbai, India. This was corroborated by the successful isolation of HIV-2-RNA in culture medium, HIV-2 cDNA sequence determination and the detection of the antigen. The sequence of the isolated HIV-2 genomic RNA does not seem to be altered to the extent that the change will alter antibody binding. Furthermore, antibody from the same individual (even at 8 months from initial sampling) from whom HIV-2 was isolated did not react with the antigen of this strain. Those evidences imply that extremely low or non-production of the antibody may be due to suboptimal immune stimulation due to extremely slow HIV-2 replication. This low virus-load may be responsible for the negative antibody results in the HIV-2 carriers. [ABSTRACT FROM AUTHOR]

Two vaccines inducing antibodies against human chorionic gonadotropin (hCG) have completed Phase I clinical trials, indicating the reversibility and safety of these vaccines. One is currently in Phase II efficacy trials in women in three major centres in India. The available data suggest that the vaccine prevents pregnancy above antibody titres of 50 ng/ml hCG bioneutralization capacity. [ABSTRACT FROM AUTHOR]

A long-term immunogenicity study of a single dose live attenuated H2 strain hepatitis A vaccine is being conducted in healthy Indian children at KEM Hospital, Pune. 131 of the original 143 children vaccinated in 2004, were evaluated for anti-HAV antibodies 30 months post vaccination (2007). Seroprotective antibody levels ≥20 mIU/mL were demonstrated in 87.8% subjects with an overall GMT of 92.02mIU/mL. No hepatitis like illness was recorded in any of the subjects since vaccination [ABSTRACT FROM AUTHOR]

Background: The purpose of antibody screening is to detect red cell antibodies other than expected Anti-A and Anti-B i.e. unexpected antibodies. AABB WHO guidelines emphasize the screening of donor blood in order to prevent transfusion reactions. This study will provide us the statistical data regarding the prevalence of such unexpected antibodies in general populations. At the same time it will also guide us whether to go for sophisticated and costly procedures such as Gel Technology for detection and identification of unexpected antibodies especially in the state of 'Himachal Pradesh' where majority of the blood banks are small blood banks processing about 200 units of blood per month. No such study has been conducted in the state and hence the present study is planned. Aims and Objectives: To demonstrate the frequency of unexpected antibodies in blood donors with the conventional techniques in order to select safe and appropriate blood for transfusion. Modern techniques and policies for screening which are currently available are expensive and not available in most of the peripheral blood banks. This study will highlight the usefulness of conventional techniques for antibody screening which can be practiced even in the smaller blood banks. Methodology: Blood samples of Voluntary donors were collected in Blood Bank of IGMC Shimla. These samples were tested for unexpected antibodies in the donor serum by the conventional tube techniques by saline IAT and albumin IAT. Auto controls were set up in all cases to rule out the cold and warm reactive autoantibodies. Due to the lack of facilities, the identification of unexpected antibodies was not planned in the present study. Results: 950 samples were tested. None of the samples was found positive for unexpected antibodies by conventional tube technique using methods of Saline IAT and Albumin IAT. Conclusion: Out of 950 samples none of the samples was found positive for unexpected antibodies. This reflects the prevalence of unexpected antibodies in general population, which seems to be very low. However the study is in progress. In the present scenario, the state of Himachal Pradesh is having 15 blood banks out of which 14 are Govt. run blood banks. Most of the blood banks are small blood banks with annual collection/processing of less than 2000 blood units. Gel technology and antibody identification facilities are not available even in Medical College Blood Bank at present. Keeping in view very low prevalence of unexpected antibodies as evident from the present study which includes the donors from the different parts of the state, it is concluded that the sophisticated and expansive equipments required for antibody screening should be installed in the large or Medical College level Blood Banks where the no. of samples for processing is high. The smaller blood banks may however perform antibody screening by conventional tube technique. [ABSTRACT FROM AUTHOR]

Background: Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. There is paucity of data on prevalence of RBC alloimmunization in transfused recipients from our region as pre-transfusion antibody screen is not routinely performed. Aims and Objectives : To assess prevalence of RBC alloimmunization in transfused patient population at a tertiary care hospital in North India population at a tertiary care hospital in North India. Materials and Methods: Antibody screening was carried out in 331 transfused patients prior to cross-matching with commercial three-cell panel (Diacell, Diamed SA, Cressier-sur-Morat, Switzerland) by tube method using saline indirect antiglobulin test. Antibody screen positive samples were analyzed for the specificity of the alloantibody with eleven-cell identification panel (Diapanel, Diamed SA, Cressier-sur-Morat, Switzerland). Antigen negative cross-match compatible blood was transfused if the antibody was clinically significant, whereas for clinically insignificant antibodies cross-match compatible blood at anti-human globulin phase was issued for transfusion. Results: The overall prevalence of RBC alloimmunization in transfused patients was 3.6% (12/331) with anti-D being the most common specificity (50%) followed by anti-c (25%), anti-Jka (8.3%), anti-Lea (8.3%) and anti-M (8.3%). The highest prevalence of alloimmunization was observed in patients of obstetrics (2/24, 8.3%) followed by hematology speciality (4/89, 4.5%). Only 16.7% (2/12) of the antibodies detected were clinically insignificant and had Leb and M specificity respectively. Conclusions: Majority of alloantibodies detected in our study were clinically significant. Thus, pre-transfusion antibody screen on patients' sample prior to cross-match needs to be initiated in India to ensure safe transfusion practice. [ABSTRACT FROM AUTHOR]

Examines the occurrence of tobacco rattle virus in gladiolus in India. Characteristics of tobacco rattle virus; Identification of notched leaf blade margin symptoms; Reaction of plants with polyclonal antibodies.