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Objectives A retrospective study was undertaken to investigate the circulating dengue virus (DENV) serotypes and genotypes in India in 2018. Methods In total, 4963 samples referred to virus research diagnostic laboratories (n=21), the Indian Council of Medical Research-National Institute of Virology (ICMR-NIV) and ICMR-NIV field units (n=2) for diagnosis of dengue in 2018 were tested using a real-time reverse transcription polymerase chain reaction assay for the presence of DENV serotypes. Representative samples were sequenced for the envelope (E) gene. Results Regional diversity was observed with regard to the dominant circulating serotypes. DENV-2 was found to be the most common serotype in many states. Thrombocytopenia, petechiae and malaise were associated with DENV-2 infection. Phylogenetic analyses of DENV E gene sequences revealed the circulation of genotypes I and V of DENV-1, two lineages of DENV-2 genotype IV, DENV-3 genotype III and DENV-4 genotype I. Conclusions This study found regional differences in the prevalence of circulating DENV serotypes in India, and provides baseline data for continuous molecular surveillance. Molecular surveillance may have implications for predicting large-scale outbreaks of dengue if regional shifts in the predominantly circulating serotypes and genotypes are detected during the early phase of the dengue season.

Introduction: Over the years HCV infection has proved to be one of the leading causes of public health issue as a result of high morbidity and mortality rate worldwide. Hence prevention or early detection has proved to be of great use to tackle the disease. Since the introduction of rapid screening assays, they have been used widely worldwide. Hence this study was conducted to compare rapid ICT test with ELISA for the effective detection of anti-HCV antibodies in patients on haemodialysis (HD). Material and methods: A total of 109 HD patients suffering from chronic kidney disease were recruited. This study was conducted from July 2019 to March 2022. Sera of all the patients was tested for anti HCV antibodies by rapid ICT and further tested by ELISA. Results: In our study results obtained show that the seroprevalence of anti-HCV was 26.6% i.e. 29 patients via rapid ICT and 35.8% i.e. 39 patients via ELISA depicting a signicant difference of sensitivity and specicity of ELISA over ICT testing. Conclusion: The results indicated that the rapid ICTkits for HCV have a limited efciency and should be backed by superior supplemental methods like ELISAand PCR where possible.

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Introduction: Hepatitis C virus infection in one of the blood borne infections that patients on maintenance hemodialysis acquire during the course of hemodialysis. The patients on hemodialysis develop viral hepatitis and also there is no vaccine for HCV, therefore it becomes crucial to early diagnose and start anti-viral therapy among these patients. Methods:All patients were tested for anti-HCV antibody by using Merilisa HCV ELISAkit Results: In this study a total of 109 patients were recruited. Out of 109, 64(58.7%) were males and 45(41.3%) were females. Majority of the patients 42(38.5%) were in 41-60 years age group. A total of 35.8% patients were tested positive for anti-HCV antibody by ELISA. Among seropositive patients highest positivity (53.8%) was found among 41-60 years age group. Conclusion: HCV positivity was found to be associated with duration of dialysis. Majority of the HCV positive patients belonged to 41-60 years age group.

During March to June 2021 India has experienced a deadly second wave of COVID-19 with an increased number of post-vaccination breakthrough infections reported across the country. To understand the possible reason of these breakthroughs we collected 677 clinical samples (throat swab/ nasal swabs) of individuals who had received two doses (n=592) and one dose (n=85) of vaccines (Covishield and Covaxin,) and tested positive for COVID-19, from 17 states/Union Territories of country. These cases were telephonically interviewed and clinical data was analyzed. A total of 511 SARS-CoV-2 genomes were recovered with genome coverage of higher than 98% from both the cases. Analysis of both the cases determined that 86.69% (n=443) of them belonged to the Delta variant along with Alpha, Kappa, Delta AY.1 and Delta AY.2. The Delta variant clustered into 4 distinct sub-lineages. Sub-lineage–I had mutations: ORF1ab-A1306S, P2046L, P2287S, V2930L, T3255I, T3446A, G5063S, P5401L, A6319V and N-G215C; Sub-lineage –II : ORF1ab- P309L, A3209V, V3718A, G5063S, P5401L and ORF7a-L116F; Sub-lineage –III : ORF1ab- A3209V, V3718A, T3750I, G5063S, P5401L and Spike-A222V; Sub-lineage –IV ORF1ab- P309L, D2980N, F3138S and spike - K77T. This study indicated that majority of the clinical cases in the breakthrough were infected with the Delta variant and only 9.8% cases required hospitalization while fatality was observed in only 0.4% cases. This clearly suggests that the vaccination does provide reduction in hospital admission and mortality.

In this study, we are trying to find out viral aetiology in paediatric age group patients from 1 month to 15 years of age in Western Rajasthan region.A total of 105 patients from 1 month to 15 years were recruited into this study. CSF samples were collected and were processed by multiplex real-time PCR for detection of various predefined panels of viral agents. ELISA was also done for all samples for detection of dengue, JE, measles and mumps.A total of 32 samples out of 105 were tested positive for viral agents. Viral aetiology detected in this study were Adenovirus (n ​= ​2), EBV (n ​= ​1), HHV-1 (n ​= ​10), HHV-6 (N ​= ​5), Parechovirus (n ​= ​1), Parvovirus B19 (n ​= ​7), Dengue (n ​= ​2) and Measles (n ​= ​1). Mixed infections were also detected, HHV-1 and HHV-6 (n ​= ​2), HHV-1 and Parvovirus B19 (n ​= ​1). In 73 patients no viral aetiology could be detected.Parvovirus B19 is sporadically prevalent in this geographical region. In this study, HHV-6 was also found which has not been reported earlier from India.

Introduction: Dermatophytes are most common infectious agents causing superficial mycosis worldwide. A number of topical as well as systemic antifungal drugs are available for treatment of dermatophytosis. Superficial mycosis caused by dermatophytes can be easily treated by topical or oral antifungal drugs, but in the course of time, an increased number of treatment failure cases are appearing. Possible cause for treatment failure could be poor patient compliance, poor drug penetration into affected lesion, and also drug resistance in dermatophytes. The aim of this study is to investigate minimum inhibitory concentration and clinical correlation in treatment failure cases of dermatophytosis. Methods: Skin, hair and nail samples were collected from treatment failure cases of dermatophytosis. A total 75 isolates were tested for MIC against four antifungal drugs in the study. Fluconazole, itraconazole, ketoconazole and terbinafine were the antifungal drugs tested using broth microdilution method. MIC50 and MIC90 values were recorded. Results: A total of 75 dermatophytic isolates were tested. Dermatophytic isolates in this study were Trichophyton mentagrophytes (n = 31), T. rubrum (n = 13), T. tonsurans (n = 12), T. verrucosum (n = 9), M. gypseum (n = 5), E. floccosum (n = 4) and T. violaceum (n = 1). MIC90 value for fluconazole and terbinafine was significantly higher. Conclusion: MIC of 17.33% isolates for fluconazole and 33.33% isolates for terbinafine were lower than cut-off value, which indicates that not all treatment failure cases are due to drug resistance.

Gastroenteritis in human by Salmonella enterica subspecies diarizonae is rare and usually observed in neonates and children with history of contact with reptiles. Salmonella enterica subspecies diarizonae were isolated from two young adult male patients with symptoms of acute gastroenteritis. The isolates were identified by Vitek 2 compact system and agglutination by specific antisera. The isolates were susceptible to Amikacin, Imipenam, Cefazolin and Ceftazidime. Patient rapidly responded to Amikacin and Ceftazidime therapy. Arizona group Salmonella should be looked in cases of gastroenteritis whenever there is history of proximity with reptiles.

Acute Febrile Encephalopathy is a clinical term used to describe patients presenting with short febrile illnesses with altered mental states. Demographic distribution plays an essential role in the diagnosis of viral etiologies. One hundred ve suspected AFE cases were enrolled in the study. A detailed history by predesigned performa and laboratory investigations was obtained for data collection. Viral etiology was diagnosed in 32 (30.48%) cases. The male to female ratio was 1.39:1. Total 56.25% of positive cases were from the lower class, 28.13% from the middle class, and 15.63% from the upper class. 24 (75%) cases from rural, while only 8 (25%) of the urban population showed viral etiologies. In 19 (59.4%) cases were either history of incomplete vaccination or not vaccinated, 13 (40.6%) cases had a history of complete immunization among positive cases. The predominant clinical feature was fever (100%) followed by seizures 66(62.86%), vomiting 37(35.24%), headache 14(13.33%), paresis in 16(15.24%) and altered sensorium in 29(27.62%), respectively. To conclude, the etiologic panorama of AFE varies with several factors such as time and demographical location, age, and immunization status. There is an urgent need to conduct more studies to prole the viral etiologies according to their prevalence in geographical areas so the treatment can be tailored accordingly and prophylaxis treatment or immunization can be boosted in the population at risk of getting the disease.

Nocardia spp. are filamentous Gram positive bacteria that are ubiquitous soil saprophytes. The majority of nocardial infections occur in severely immunocompromised patients who are particularly susceptible to pulmonary disease and dissemination. Extrapulmonary nocardiosis is relatively common and can occur through hematogenous dissemination or a contiguous spread of necrotizing pneumonitis. Primary cutaneous and soft tissue nocardiosis can result from traumatic injury to the skin that involves contamination with soil. After skin inoculation, a superficial abscess or localized cellulitis can develop. Co-trimoxazole is the drug of choice for all types of nocardiosis. We are reporting a case of Nocardia cyriacigeorgica presenting as cellulitis followed tooth extraction.

Crimean Congo hemorrhagic fever (CCHF) is a zoonotic viral disease presenting with fever and hemorrhagic manifestations in humans. After several outbreaks of CCHF being reported from Gujarat since 2011 till 2019 and from Rajasthan in 2014 and 2015, the present study reports the CCHF outbreak which was recorded from five human cases in three districts Jodhpur, Jaisalmer, and Sirohi of Rajasthan state since August 2019 till November 2019. A high percent of positivity was recorded in livestock animal samples for the CCHFV IgG antibody. CCHF virus (CCHFV) positive human blood samples and Hyalomma tick pool samples were sequenced using next-generation sequencing method. Two different M segment genotypes, encoding glycoprotein precursor, were identified from tick pools in the study: first from Asian and second from African lineage. The L gene (polymerase) and the S gene (nucleocapsid) clustered in the Asian lineage. The present study illustrates the existence of two different CCHFV lineages being circulating within the Hyalomma tick pools in the Rajasthan state, India. We also observed 3.56% amino acid changes between the death and the survived case of CCHFV in the M gene. This report also sets an alarm to enhance human, tick and livestock surveillance in other districts of Rajasthan and nearby states of India. Biosafety measures, barrier nursing along with the availability of personal protective equipment and ribavirin drug will always be a mainstay in preventing nosocomial infection for proper case management.

CONTEXT: Viral hepatitis has become the most common viral infections encountered in dialysis patients. Patients undergoing haemodialysis (HD) have a significantly increased risk of exposure to hepatitis B, hepatitis C, HIV and other blood-borne viruses. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the most important causes of morbidity and mortality among HD patients. Patients on routine maintenance HD fail to maintain protective titres against HBV that further poses the risk of developing viral hepatitis. In this study, we are studying the prevalence of HBV and HCV infection among patients undergoing maintenance HD. SETTING AND DESIGN: This was a cross-sectional study. METHODS: This study aims to detect and compare the seroprevalence of HBV and HCV infection among chronic HD patients. This study was conducted from July 2015 to January 2017. All patients (n = 150) of various age groups admitted during the study period for maintenance HD at our tertiary care hospital were included. Viral markers were detected using third-generation enzyme-linked immunosorbent assay kits available commercially. STATISTICAL ANALYSIS USED: Statistical analysis was done with the help of statistical package for SPSS. RESULTS: Out of 150 patients recruited into the study, 7 (4%) were positive for hepatitis B surface antigen and 29 (19.33%) were positive for HCV. One (0.67%) patient was found positive for both HBV and HCV infections. In this study, the duration of dialysis was significantly correlated with seropositivity for both HCV and HBV (P ≤ 0.0001). The number of blood units transfused was also found to be significantly associated with seropositivity (P ≤ 0.0001). CONCLUSIONS: The prevalence of HCV is more common compared to HBV infection in HD patients. Seropositivity significantly correlates with duration of dialysis. The number of blood units transfused is also significantly associated with seropositivity.

Background: Dengue fever (DF) is a common mosquito borne disease caused by dengue virus and is transmitted by Aedes mosquito. It is one of the major public health problems in India which affects all levels of society, but the burden of disease is a higher in poor people who live together in communities. Aim of present study is aimed to assess the prevalence and epidemiological characteristics of cases of DF in Tertiary Care Hospitals in Jodhpur, Rajasthan.Methods: A cross-sectional study was conducted in all cases of DF registered in the associated group of Hospitals of Dr. S.N. Medical College, Jodhpur from 1st January 2018 to 31st December 2018. Rapid immune-chromatographic card test and MAC ELISA test method was used to detect dengue non-structural protein 1 (NS1) antigen and dengue immunoglobulin M (IgM) antibodies in the Viral Research Diagnostic Laboratory (VRDL) of Department of Microbiology, Dr. S.N. Medical College to confirm the diagnosis. Results: Out of 2701 patients, 541 patients were tested serologically positive for DF (NS1, IgM). The highest number of suspected cases (1061) was reported in the month of October, 2018 out of whom 228 were positive. Maximum number of dengue cases reported were males belonging to 31-40 years age group from urban area. Fever was the main complaint in all the cases followed by vomiting, headache, and abdominal pain.Conclusion: Dengue is one of the major public health problems in India. A large number of cases are reported in the monsoon and post-monsoon period in the months from September to December. Measures can be taken both at personal and government level to reduce morbidity and mortality from dengue.

The aqueous penetration of orally administered Ciprofloxacin (CPX) was studied in twenty-two human volunteers undergoing cataract surgery. CPX in a dose of 250 mg, was given p.o. at 12 hourly intervals in 3 groups such that a maximum dose of 0.5 grams was delivered in one group, 1.0 grams in another and 1.5 grams in the last group. A fourth group consisted of 6 individuals who were controls and received lactose tablets. Twelve hours after the last dosing aqueous samples were collected and assayed by the Grove-Randall technique. The aqueous penetration of Ciprofloxacin achieved was 1.51 +/- 0.15 mgL-1 in group II and 2.49 +/- 0.52 mgL-1 in group III. In group I, the aqueous concentration was experimentally indeterminate and the control samples in group IV did not show any antibacterial activity. Divided oral doses of 1.5 grams of CPX were found to produce an aqueous titre up to 2.5 times the MIC of Ps. aeruginosa.