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Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Methods This is a retrospective observational study with (n = 433) samples. Nasopharyngeal and oropharyngeal swabs were collected from clinically suspected cases of mucormycosis. These were then subjected to Xpert® Xpress SARS-CoV-2 test. Those samples which tested positive were included in this study. A history sheet form was designed and filled up for 238 patients who were admitted and could be traced properly. Results Total number of SARS CoV-2 positive samples was 296 out of 433 samples. Among the tested 66% (287/433) were male and 34% (146/433) were female. Relative positivity was higher among women 74% (107/144) than men 66% (189/285). Amongst 238 admitted patients, 83.1% patients (198/238) completed treatment and were discharged while 13.9% (33/238) succumbed during management. Diabetes was found to be most common risk factor at 88.65% (211/238) followed by hypertension 36.5% (87/238), and corticosteroid use 26.89% (64/238). Type 2 DM was the most frequent with 96% (203/211) and only 4% (8/211) patients having Type 1 DM. Amongst the diabetics, 74.8% (158/211) were on medication (oral hypoglycemic agent/insulin/both), and 16.6% (35/158) of them were non-compliant to treatment. Most common clinical presentation was facial swelling 66.8% (159/238) followed by facial pain 52.52% (125/238) and headache 34.45% (82/238). Microscopy findings either nasal or palatal scraping was positive in 69.75% (166/238) cases with aseptate hyphae in 95% (157/166) patients while septate hyphae were seen in 3% (5/166). Both aseptate and septate hyphae were present in 2% (4/166 patients). Amongst the deceased patients 91% (30/33) had diabetes mellitus exclusively of Type 2 and among them, 33% (10/30) were not on any anti-diabetic medication. It was also observed that among the deceased people who were on anti-diabetic medication, 45% (9/20) were non-compliant to the treatment. Combinedly 63.33% (19/30) diabetics were on inadequate blood sugar level control which might be strongly contributing to mortality. Conclusion Percentage of clinically suspected mucor patients who were COVID-19 positive was 67%. Although male patients were twice more tested than females but females were proportionately more positive for SARS-CoV2. Type 2 diabetes mellitus was the lead risk factor, with facial swelling being the predominant presentation. Interestingly, fungal smear was positive in 166 out of 238 patients. Despite the best management, the mortality rate was 13.86% in such patients. It was also seen that untreated or non-compliance to anti-diabetic treatment resulted in increased mortality. Hence, it's necessary to review cases of COVID-19-associated mucormycosis for prompt management and to reduce morbidities and mortality.

Environmental surfaces are potential source of SARS-CoV2 transmission. The study assessed the efficacy of hospital disinfection policy and contamination of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) RNA in COVID management Hospital. Inanimate surfaces from both patient areas (n = 70) and non-patient areas (n = 39) were sampled through surface swabbing and subjected to Reverse transcriptase PCR. Out of the 70 samples collected from the COVID hospital, SARS-CoV2 RNA positivity of 17.5% (7/40) and 6.7% (2/30) was seen in high risk and moderate risk area respectively. Samples from Non COVID related patient area such as CD ward and administrative block were assessed and the SARS CoV-2 RNA positivity was 0% and 10% respectively. Among the total 8 environmental surface samples positive for SARS-CoV2 RNA detected from the area surrounding the SARS-CoV2 infected patients, maximum positivity of 31.8% (7/22) was found among the environmental samples collected around the patients with 20 Ct value in nasopharyngeal swab samples followed by 3.3% positivity (1/30) around patients with Ct value ranging from 20 to 25 whereas no SARS-CoV2 RNA (0/5) was detected around the patient with 25 Ct value. Nearly 50% (2/4) of the surface samples came positive from the resident PPE and mobile of the treating doctors which largely elaborates the need for stringent doffing measurement and hand hygiene policy post doffing. The study emphasizes the necessity of frequent and aggressive disinfection policy to prevent nosocomial infection in such high risk areas within close vicinity of the patients.

Acute respiratory infections due to viral or bacterial etiology can cause 60 deaths per one lakh population. Viral etiology is more common as compared to bacterial, but lack of definite diagnosis leads to increased usage of empirical antibiotics. During the first wave of the COVID-19 pandemic, there was a need to identify co-infections especially in severe acute respiratory illness (SARI) patients to identify it as one of the cofactors for increased severity of illness and to identify the causative agents in COVID-19 negative individuals. The SARS CoV-2 real time PCR was carried out using ICMR approved kits and the other respiratory viruses were detected using the multiplex commercially available real time kit. A total of 186 patients presenting with either SARI (89.8%) or influenza like illness (10.2%) were included in the study. Out of these, 43 (23.1%) were positive for SARS CoV-2 RNA and 2 (4.6%) patients with SARI showed concomitant infection with either human rhinovirus or human respiratory syncytial virus . Out of 143 patients negative for SARS CoV-2, 35 (24.5%) were positive for one or more microbial infections and 28 (19.6%) infected with other respiratory viral infection most common being human rhinovirus. The results suggest that viral coinfections are significantly higher among COVID-19 negative individuals (24.5% vs 4.6%) presenting with respiratory illness as compared to COVID-19 positive individuals possibly due to viral interference and competitive advantage of SARS-CoV-2 in modulating the host immunity. Further detailed research is required for the understanding of mechanisms of viral co-infection.

Multisystem inflammatory syndrome (MIS-C) in children is a febrile illness that has overlapping presentation with other locally prevalent illnesses. Clinicolaboratory profile of children admitted with MIS-C and dengue were compared to understand their presentation at the outset.This was a retrospective study of children ≤ 12 y admitted with MIS-C (WHO definition) or laboratory-confirmed dengue between August 2020 and January 2021 at a tertiary center in North India.A total of 84 children (MIS-C - 40; dengue - 44) were included. The mean (SD) age [83.5 (39) vs. 91.6 (35) mo] was comparable. Rash (72.5% vs. 22.7%), conjunctival injection (60% vs. 2.3%), oral mucocutaneous changes (27.5% vs. 0) and gallop rhythm (15% vs. 0) were seen more frequently with MIS-C, while petechiae [29.5% vs. 7.5%], myalgia (38.6% vs. 10%), headache (22.7% vs. 2.5%), and hepatomegaly (68.2% vs. 27.5%) were more common with dengue. Children with MIS-C had significantly higher C-reactive protein (124 vs. 3.2 mg/L) and interleukin 6 (95.3 vs. 20.7 ng/mL), while those with dengue had higher hemoglobin (12 vs. 10.2 g/dL) lower mean platelet count (26 vs. 140 × 10In hospitalized children with acute febrile illness, the presence of mucocutaneous features and highly elevated CRP could distinguish MIS-C from dengue. The presence of petechiae, hepatomegaly, and hemoconcentration may favor a diagnosis of dengue.

This paper introduces a new optimization technique known as Swine Influenza Model based Optimization (SIMBO). It is mimicked from Susceptible-Infectious-Recovered (SIR) models of swine flu. The development of SIMBO follows through treatment (SIMBO-T), vaccination (SIMBO-V) and quarantine (SIMBO-Q) based on probability. The SIMBO variants can be used to optimize complex multimodal functions with improved convergence and accuracy. Firstly, swine flue test based on the dynamic threshold identifies a confirmed case of swine flue. After a confirmed case of swine flue in the community, the susceptible are advised to go for the swine flue vaccination to acquire immunity. The confirmed case of swine flue is quarantined from the population. The suspected cases are treated with antiviral. The amount of antiviral drugs given to individual is dependent on patients with or without complications as well as current health of individual. In SIMBO-V and SIMBO-Q, state of the individual is updated directly through vaccination/quarantine and indirectly through treatment. The nonlinear momentum factors restrict the individuals' treatment and state inside the defined limits without checking the health every day. SIMBO variants can easily be implemented on parallel computer architecture without having over burden or modifications. The SIMBO-T, SIMBO-V and SIMBO-Q are tested with thirteen standard benchmark functions and results are compared with other optimization techniques. The results validate that, the SIMBO variants perform comparably better. The performance of SIMBO variants are evaluated in terms of quality of optima, number of times heating stopping criteria, convergence, Fitness Evaluations (FEs), t-test, statistical parameters and analysis of variance test (ANOVA). A real time application in video motion estimation is also considered by authors to test the efficiency of the SIMBO variants. The results of motion estimation using proposed variants seems to be faster than the published methods by maintaining similar peak signal to noise ratio.

The aetiology of sudden deafness remains unknown even though some evidences suggest that it could be viral in origin. This study aimed to find out the relationship between viral infections and sudden sensorineural hearing loss.32 patients presenting with sudden deafness and 10 healthy controls were included in the study. IgM antibodies to varicella zoster virus, measles, cytomegalovirus and herpes simplex virus were detected using micro ELISA.Overall, 7(21.8%) patients showed seropositivity to one or more viruses. Virus specific IgM antibodies against measles and varicella zoster could be demonstrated in 4 (12.5%) and 3 (9.4%) patients respectively. None of the samples were found to be positive for herpes simplex virus (HSV) and human cytomegalovirus (HCMV) specific IgM antibodies. Controls were negative for all the viruses tested. The difference in seropositivity between the patient and control group was not statistically significant (p0.05).Thus, this study suggests that sudden deafness is not commonly associated with a systemic viral infection.

Respiratory syncytial virus (RSV) has been reported as a leading cause of upper and lower viral respiratory tract infection in high-risk adult populations. We prospectively studied 48 patients with hematological malignancies over a period of 2 years. Throat and nasal washings were subjected to immunofluorescence and cell culture for virus isolation. Of these 48 patients, 31 had acute leukemia, 6 had chronic leukemia, 10 had lymphoma and one had multiple myeloma. The median age of the patients was 20 years with a male to female ratio of 4:1. No RSV was detected in any of the samples. RSV was not found as a major cause of community acquired upper respiratory tract infections in adults with hematological malignancies in India.

Hepatitis E virus (HEV) infection is of major public health concern in the developing countries, including the Indian subcontinent, due to epidemics of large proportions, increased morbidity and high mortality, especially in pregnant women. This study shows the findings of two different epidemics that occurred due to HEV.Blood samples were collected from 116 suspected HEV patients. Sera were separated and tested for hepatitis A virus HAV immunoglobulin M (IgM), hepatitis B virus surface antigen, hepatitis C virus (HCV) antibody and HEV IgM by Micro ELISA. 15 acute samples were subjected to reverse transcriptase polymerase chain reaction (RT-PCR) for the detection of HEV ribonucleic acid (RNA).Of the 116 blood samples collected, 68 (58.6 percent) were positive for HEV IgM antibodies. Mixed infections of HEV with HAV and HCV were detected in three (4.4 percent) and five (7.4 percent) cases, respectively. 15 HEV IgM-positive acute blood samples subjected to RT-PCR showed the presence of specific 343 bp amplified HEV ORF1 gene product in five cases. No untoward effects were observed in the five HEV-infected pregnant women during their follow-up.This study confirms the HEV aetiology and highlights a major disease outbreak that occurred due to mixing of drinking water with sewerage.

Sub acute sclerosing pan-encephalitis (SSPE) is a slowly progressive inflammatory disorder of the central nervous system. A decline in frequency has been noticed in most of the developed countries, whereas it continues to be high in developing countries. Though a number of studies have been carried out, the exact trend of SSPE is still not clear. Hence the present study was carried out to analyze the trend of SSPE over the past ten years in and around Chandigarh. A total of 205 patients with clinical features suggestive of SSPE were enrolled for the study during Jan'92 to Dec. 2001. Measles specific antibodies were detected in blood and CSF by HAI method. 114 patients were found to be positive for measles specific HAI antibody with a male preponderance. The number of SSPE cases were found to be more during the period 1992-95 in comparison to the next 6 years (p0.05). The high incidence of SSPE in our country could be due to improper vaccine coverage, poor cold chain maintenance or circulation of atypical measles virus strain.

Dengue viral infection is one of the most important public health problem in tropical countries.An outbreak of dengue fever was investigated in a periurban slum area of Chandigarh, India, during September to December, 2002.Blood samples from 218 patients and 30 apparently healthy contacts were tested for dengue-specific immunoglobulin M (IgM) and IgG antibodies including 80 acute samples collected within 5 days of illness were subjected for virus isolation in newborn mice. The average temperature, rainfall, and humidity of the epidemic year were compared with the number of dengue cases.statistical significance was found out using c2-test.A total of 76 cases were positive by either dengue IgM capture assay (n = 57) or virus isolation (n = 17) or both (n = 2). Fifteen of nineteen viral isolates subjected for typing by type-specific multiplex reverse transcription-polymerase chain reaction were found to be of dengue virus. High rainfall and humidity with the temperature range from 21 degrees C to 33 degrees C during the months of August and September might have favored the breeding of mosquitoes, thus leading to an increase in the number of dengue cases in October and November, 2002.The present outbreak thus emphasizes the need for continuous sero epidemiological and entomological surveillance for the timely implementation of effective dengue control programme.

A study was carried out to find out a) the seroprevalence of herpes simplex viral infections (HSV) in and around Chandigarh city, North India and the probable age of acquisition of infection; b) the usefulness of salivary antibody detection in seroprevalence studies; c) role of HSV immunofluorescence antibodies in the sero-diagnosis of herpes simplex encephalitis (HSE) patients. Single blood samples from 306 and paired blood and saliva samples from 48 apparently healthy individuals as well as paired blood and C.S.F. samples from 50 clinically suspected patients of HSE were included in the study proper. The subjects belonged to6 months to30 years age group. Serum, saliva and C.S.F. samples were subjected to in house standardized indirect immunofluorescence test for the detection of HSV antibody. The overall seropositivity was 59.3%, which increased from 37.5% in children less than 10-years of age to 88.9% in individuals above 30 years of age (p0.001). The maximum titer in less than 10 years children and above 10 years subjects were found to be 40 and 160 respectively. The difference in percentage positivity of HSV antibody in these groups was statistically significant (p0.001). No difference in the seroprevalence rate was observed between different socio-economic groups and sex. Saliva in comparison to serum showed a sensitivity of 44% and specificity of 100% for the detection of HSV antibodies. Among the suspected HSE patients 4 (8%) could be serologically confirmed. This study indicated the endemicity of HSV infection in this locality. Indirect immunofluorescence test could detect intrathecal HSV antibodies in 8% of suspected HSE patients proving it to be a very useful rapid serodiagnostic tool. However, saliva testing showed limited sensitivity in HSV sero surveys.

Blood transfusion is indispensable in the management of many haematological diseases and has become the mainstay in major surgical procedures. Transfusion-transmitted infections have been a major threat to life since the dawn of transfusion therapy. The authors have highlighted the different viral, parasitic and bacterial infections associated with transfusion and have focussed on the precautionary measures that can be implemented for prevention of the infections along with a brief review of the literature.

Due to the devastating nature of acute retinal necrosis syndrome (ARNS), early diagnosis is essential. 5 cases of clinically diagnosed ARNA were investigated for CMC, herpes simplex and varicella zoster virus (VZV) infections. Of the three VZV IgM positive cases, two were positive in acute blood samples and one in vitreous fluid. Thus VZU can be incriminated as the causative agent of ARNS cases in North India.

To determine the viral agent involved in cases of acute encephalopathy in children during an outbreak in Northern India.Virological and serological studies using serum and cerebrospinal fluid specimens from patients.Serum and CSF specimens were tested by IgM ELISA for IgM antibodies to variety of viruses like Japanese encephalitis, West Nile, Dengue and Measles. The specimens were inoculated into Vero cell monolayer for virus isolation. The viral strains isolated were identified by indirect immunofluorescence test and qualitative in-vitro neutralization test using polyclonal and monoclonal antibodies to measles. Identity of the isolates was reconfirmed using RT-PCR method.Of the 28 specimens tested, 17 had IgM antibodies to measles. Commercial IgM ELISA kits confirmed the serological findings. Vero cell cultures yielded 4 isolates from CSF and 2 from serum specimens of six different patients. Cytopathic effect was typical of measles. Indirect imunofluorescence using polyclonal and monoclonal antibodies to measles HA protein, confirmed the measles etiology. Neutralization tests reconfirmed the measles strain isolation. RT-PCR amplified product was confirmed as measles.The isolation of measles virus from CSF and serum of children with acute encephalopathy without rash proved the etiological role of measles virus in this outbreak.

BACKGROUND AND PURPOSE: An increased incidence of intestinal helminthic infections has been observed in patients with viral encephalitis in endemic areas. Both Japanese B encephalitis (JE) and neurocysticercosis (NCC) share some common socio-demographic and ecologic factors, and pigs act as the intermediate carrier for both. Our purpose was to show the coexistence of JE and NCC in brain on MR images and highlight the possible role of NCC as an amplifier of JE. METHODS: MR images from 10 cases of coexistent JE and NCC were studied retrospectively. T1-weighted axial and sagittal, proton T2-weighted axial and coronal, and T2-weighted fluid-attenuated inversion recovery axial and coronal sections of the brain were evaluated. NCC was diagnosed on the basis of neuroimaging. Diagnostic serologic testing for JE was conducted using paired blood and CSF samples. RESULTS: The JE changes were bilateral and asymmetrical and were more severe on the side harboring the solitary cyst or the side bearing the greater number of cysts or lodging the degenerating cyst. In each of nine of 10 cases, at least one degenerating cyst was found on the side of predominant JE pathologic abnormality. CONCLUSION: The study suggests that the co-occurrence of JE and NCC is not just a chance coincidence. NCC apparently predisposes a person to JE infection and is a positive modulator of the encephalitic process. The study shows a spectrum of MR imaging findings of coexistent JE and NCC.

A total of 6418 samples were received between January 1993 to December 1998 from patients with hepatitis. Blood samples were also collected from 946 apparently healthy subjects. All these samples were tested for Hepatitis B surface antigen (HBsAg) by third generation micro ELISA. The overall HBsAg prevalence rate was 12.8%. The highest prevalence was noted in renal transplant patients (21.7%) followed by patients with acute hepatic disease (15.3%), pregnancy with jaundice (9.4%), chronic renal failure (8.8%), nephrotic syndrome (3.1%), whereas the prevalence rate in control group was 2.4%. The prevalence rate of HBsAg was higher in subjects between 21 to 30 years of age with a male preponderance (Male:Female = 2.8:1).

A study on sero prevalence of Japanese Encephalitis (JE) and West Nile (WN) viruses in pigs was carried out in and around Chandigarh. A total of 158 blood samples collected (June, 1995-March, 1996) from batches of pigs were screened for antibodies against JE and WN viral antigens by haemagglutination inhibition and complement fixation tests. In Chandigarh out of 13 pigs, 5 had JE and one WN HAI antibodies. Similarly, the sera of 14 and 1 pigs in Punjab and 29 and 3 pigs in Haryana were positive for JE and WN HAI antibodies respectively. In total JE specific HAI antibodies were found in 30.3% and CF antibodies in 12.5% of pigs whereas WN specific HAI antibodies were obtained in 3.2% and only one pig had CF antibodies. The results show that JE and WN viral infections are prevalent in pig population in and around Chandigarh.