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In the current era, COVID-19 has become the most familiar term in the whole world. It is caused by the novel coronavirus SARS-CoV-2 which is a mutated congener of SARS COV and MERS COV. As per epidemiological studies, 83959 cases have been recorded only in China with 4637 deaths. More than 215 countries including Korea, Iran, Italy, Germany, Algeria, South Africa, Senegal, Nigeria etc have recorded over nine million deaths due to this pandemic. Diagnosis of COVID-19 can be carried out by several ways like identifying the increased level of lactate dehydrogenase, creatinine kinase, alanine and aspartate dehydrogenase in blood. IgG and IgM antibody detection is a key parameter in detection of SARS CoV-2. The real-time reverse transcriptase-polymerase chain reaction or RT-qPCR test is so far considered the most reliable diagnostic method. Recently, two current approaches get widely used in diagnosis for SARS CoV-2 namely “FELUDA” and “SHERLOCK” offering a cheap and less time taking procedure for the detection of SARS CoV-2. In FELUDA a protein called FnCas9 and a guide RNA (g RNA) helps in recognizing the viral gene which is contained by the sample whereas SHERLOK is associated with Cas12 protein.

To compare the immunogenicity and safety of an investigational typhoid Vi conjugate vaccine (Test TCV) with a marketed typhoid Vi conjugate vaccine (Comparator TCV).Randomized, controlled trial.Tertiary care and multispecialty hospitals.240 healthy subjects of 6 months to 45 years. Pediatric (18 years) subjects were enrolled after day 21 safety assessment of adult subjects.Participants received a single-dose of test TCV or comparator TCV at baseline and were followed up for 6 weeks post-vaccination.Primary variable was to demonstrate non-inferiority of the test TCV with the comparator TCV for seroconversion post-vaccination (³4-fold rise in antibody titre). Secondary variables were seroconversion in the adult and pediatric cohorts, and geometric mean titre of antibodies while the safety was based on reported adverse events.A total of 117 subjects (Adult-58, Pediatric-59) and 119 subjects (Adult-60, Pediatric-59) in test and comparator group, respectively completed the study. The seroconversion rate with test TCV (overall-94.8%, adult-96.6% and pediatric-93.1%) was non-inferior to comparator TCV (overall-91.6%, adult-91.7% and pediatric-91.5%). The geometric mean titres of antibodies (EU/mL) at baseline (test TCV: overall-7.6, adult-10.0, and pediatric-5.7; and comparator TCV: overall-8.0, adult-12.0, and pediatric-5.3) and at end of study (test TCV: overall-1121.0, adult-1411.0 and pediatric-891.1; and comparator TCV: overall-1104.0, adult-1199.0 and pediatric-1014.0) were also comparable between the groups (P0.05 for all). The most common adverse event was injection-site pain followed by fever in both the groups.The immunogenicity and safety of test TCV is comparable to already marketed comparator TCV.

A lyophilized bovine-human rotavirus reassortant pentavalent vaccine (BRV-PV, Rotasiil®) was licensed in 2016. A liquid formulation of this vaccine (LBRV-PV, Rotasiil - Liquid) was subsequently developed and was tested for non-inferiority to Rotasiil® and for lot-to-lot consistency.This Phase II/III, open label, randomized study was conducted at seven sites across India from November 2017 to June 2018. Participants were randomized into four arms; Lots A, B, and C of LBRV-PV and Rotasiil® in 1:1:1:1 ratio. Three doses of study vaccines were given at 6, 10, and 14 weeks of age. Blood samples were collected four weeks after the third dose to assess rotavirus IgA antibody levels. Non-inferiority of LBRV-PV to Rotasiil was proven if the lower limit two-sided 95% confidence interval (CI) of geometric mean concentration (GMC) ratio was at least 0.5. Lot-to-lot consistency was proven if 95% CI of the GMC ratios of three lots were between 0.5 and 2. Solicited reactions were collected by using diary cards.Of the 1500 randomized infants, 1436 infants completed the study. The IgA GMC ratio of LBRV-PV to Rotasiil® was 1.19 (95% CI 0.96, 1.48). The corresponding IgA seropositivity rates were 60.41% (57.41, 63.35) and 52.75% (47.48, 57.97). The IgA GMC ratios among the three LBRV-PV lots were: Lot A versus Lot B: 1.34 (1.03, 1.75); Lot A versus Lot C: 1.22 (0.93, 1.60); and Lot B versus Lot C: 0.91 (0.69, 1.19). The 95% CIs for the GMC ratios were between 0.69 and 1.75. The incidence of solicited reactions was comparable across the four arms. Only one serious adverse event of gastroenteritis event in the Rotasiil® group was causally related.The immunological non-inferiority of LBRV-PV against Rotasiil® as well as lot-to-lot consistency of LBRV-PV was demonstrated. LBRV-PV had safety profile similar to Rotasiil®.Clinical Trials.Gov [NCT03474055] and Clinical Trial Registry of India [CTRI/2017/10/010104].

Aim: The aim of this study was to assess the clinico-epidemiological profile, etiology, and imaging findings in neonatal stroke (NS). Materials and Methods: This was a retrospective, observational study on neonates presenting with stroke between August 2014 and July 2016 to a tertiary care hospital in eastern India. Results: In all, 43 neonates were analyzed, with a male-to-female ratio of 2.3:1. About 88% babies were born at term and the rest were preterm. In 37%, the etiology of stroke was related to hypoxic injury, 21% had sepsis, and 35% had idiopathic causes. Seizures were the most common mode of presentation (62%) followed by poor feeding, abnormal tone, recurrent apnea, encephalopathy, and hemiparesis. There was an almost equal prevalence of ischemic stroke (53%) and hemorrhagic stroke (HS). Middle cerebral artery territory was the primary site of involvement in arterial ischemic stroke, and intra ventricular hemorrhage was the most common presentation of HS. Conclusion: NS is an acute emergency with high morbidity and mortality. Magnetic resonance imaging helps in diagnosis and prognostication in the absence or paucity of focal neurological signs in neonates.

Background Vaccination is considered as the most cost effective method for preventing infectious diseases. Low grade fever is a known adverse effect of vaccination. In India, it is a common clinical practice to prescribe paracetamol either prophylactically or therapeutically to manage fever. Some studies have shown that paracetamol interferes with antibody responses following immunization. This manuscript reports the outcome of a post hoc analysis of data from a clinical trial of a pentavalent vaccine in Indian infants where paracetamol was not used or was used either as prophylaxis or for treatment of fever. Methods Pre and post vaccine antibody levels against Diphtheria, Tetanus, Pertussis, Hepatitis B, Haemophilus influenzae type B were assessed in no paracetamol and paracetamol groups. The paracetamol group was further divided into prophylactic and treatment groups. Results Similar rates of seroprotection/seroresponse for anti-D, anti-T, anti-wP, anti-PT, anti-HBs and anti-PRP were observed in all the groups. There was no clear tendency for difference in percentage seroprotection/seroresponse and geometric mean (GM) titers in any of the groups. Conclusion The study found no evidence that paracetamol usage either as prophylactic or for treatment impact immunological responses to DTwP-HepB-Hib combination vaccine. [Clinical trial registry of India (study registration number CTRI/2012/08/002872 )].

This was a prospective observational study to evaluate abnormalities in lipid profile in 50 children with transfusion dependent thalassemia. Dyslipidemia characterized by high triglycerides, low high density lipoprotein (HDL), and high total cholesterol: HDL ratio was noted. These pro atherogenic risk factors may be lead to significant cardiovascular morbidity in these patients.

This hospital-based study describes the antibiotic sensitivity of 66 S. aureus isolates from the admitted children (age 0-18 y) in a tertiary hospital of Kolkata, India. Methicillin-resistant S. aureus constituted 16.7% (n=11) of the isolates. Clindamycin-resistance was observed in 60% and 82% of methicillin-sensitive and methicillin-resistant strains, respectively.

Ascaris infestation that too causing biliary obstruction is very rare in infancy even in endemic area. Adult Ascaris diameter (3-6 mm) is more than the average diameter of CBD in paediatric population, which is 1.27 +/- 0.67 mm. We are reporting a baby of seven months who presented with conjugated hypebilirubinemia and pancreatitis due to Round Worm in CBD.

A newly developed bovine-human reassortant pentavalent vaccine (BRV-PV, ROTASIIL®) was tested for its potential effect on the immunogenicity of concomitantly administered EPI vaccines in infants in a randomized controlled study in India.In this Phase III, multicenter, open label, randomized, controlled study, three doses of BRV-PV or two doses of Rotarix® and one dose of placebo were given to healthy infants at 6, 10, and 14 weeks of age. Subjects also received three doses of DTwP-HepB-Hib (diphtheria, tetanus, whole-cell pertussis, hepatitis B, and haemophilus influenzae type b conjugate - pentavalent vaccine) and oral polio vaccine concomitantly at 6, 10, and 14 weeks of age and a single dose of inactivated polio vaccine at 14 weeks of age. Blood samples were collected four weeks after the final vaccination to assess immune responses to all the vaccines administered. For diphtheria, tetanus, hepatitis B, Hib, polio type 1, and polio type 3 antibodies, non-interference was to be supported if the lower limit of the two-sided 90% confidence interval (CI) for the seroprotection rate difference for the BRV-PV group minus the Rotarix® group was10.0%. For pertussis antibodies, non-interference was to be supported if the lower limit of the two-sided 90% CI for the ratio of geometric mean concentrations (GMCs) was0.5.A total of 1500 infants were randomized to either BRV-PV (1125 infants) or Rotarix® (375 infants), of which 1341 completed the study as per the protocol. More than 97% of subjects achieved seroprotective antibody titres against diphtheria, tetanus, hepatitis B, Hib, polio type 1, and polio type 3 in both groups. The difference in seroprotection rates between the BRV-PV group and the Rotarix® group for all these antibodies was less than 1%. The ratio of GMCs of anti-pertussis IgG concentrations for the BRV-PV group versus Rotarix® was 1.04 [90% CI: 0.90; 1.19].BRV-PV does not interfere with the immunogenicity of concomitantly administered routine infants vaccines.

Presumptive treatment of infections often results in irrational antimicrobial use resulting in detrimental spread of drug resistance and untoward side effects. A rapid diagnostic test (RDT) is a test that delivers a result earlier than conventional testing methods employed in the past to identify the offending microorganism. RDTs help in early definitive therapy, reduction in hospital stay and cost, and in degree of morbidity and mortality associated with the infection. To select a proper RDT, one should consider how specific and sensitive the test is. Most RDTs gives a qualitative result not quantitative; hence disease severity, monitoring of the disease, prognostication and therapeutic efficacy cannot be assessed. A RDT should be easy to perform, should not require sophisticated machines, and kits should be stable in extremes of temperature. RDTs may be of immense help in remote places where conventional diagnostic facilities are unavailable or lack quality. RDTs hold promise of reasonable diagnostic accuracy if done in a optimal clinical background. They should never be ordered as a shotgun approach to exclude all possible infections but should be used judiciously with appropriate interpretation.

Pentavalent combination vaccines are important tools to strengthen the immunization programs in numerous countries throughout the world. A large number of countries have recognized the value of combination vaccines and have introduced whole cell pentavalent vaccines into their immunization programs. A phase III, multi-center, randomized, single blinded study of a fully liquid pentavalent DTwP-HepB-Hib investigational vaccine (Shan5™) was conducted across India in 2 cohorts: 15 toddlers were evaluated for safety and immunogenicity following a single booster dose (Cohort 1) followed by 1085 infants (Cohort 2) evaluated for immunogenicity and safety following 3-dose primary immunization of the investigational vaccine or a locally licensed comparator vaccine (Pentavac SD). Immune consistency analysis among 3 lots of the investigational vaccine, and immune non-inferiority analysis of pooled (3 lots) data of investigational vaccine vs. comparator vaccine were carried out in cohort 2. The vaccines demonstrated comparable safety and immune responses in cohort 1. In cohort 2, equivalent immune consistency among 3 lots was observed for all antigens except whole cell pertussis antigens, where a marginal variation was observed which was linked to the low power of the test and concluded to not have any clinical significance. Immune non-inferiority against the comparator vaccine was demonstrated for all 5 antigens. Safety results were comparable between vaccine groups. This investigational, fully-liquid, whole-cell pertussis (wP) containing new pentavalent vaccine was found to be safe and immunologically non-inferior to the licensed comparator vaccine.

This observational, descriptive study was conducted on 260 dengue patients diagnosed as per the revised 2009 WHO guidelines in a tertiary-care hospital of eastern India between June and November 2015. Children were evaluated for clinical symptoms, signs, and laboratory parameters. Clinical variables viz., rash, nausea/vomiting, bleeding, oliguria, capillary leak and liver enlargement; and laboratory variables viz., rising haemoglobin, haematocrit, thrombocytopenia, blood urea, serum Creatinine, ALT, hypo albuminemia and cholesterol were found to be significantly associated with outcome.

Brucella has been known to cause pyrexia of unknown origin. 9-year-old boy with fever and abdominal pain; multiple abscesses within the liver on ultrasonography. IgM Antibodies against Brucella were raised in his serum sample, and Brucella serum agglutination test was positive. Immunological work-up suggested selective IgA deficiency. Reduction in size following treatment with trimethoprim-sulphamethoxazole, amikacin and doxycycline. Brucellosis should be considered as an etiology of liver abscess in patients not responding to conventional antibiotics.

Background Rotavirus infections, prevalent in human populations worldwide are mostly caused by Group A viruses. Live attenuated rotavirus vaccines are highly effective in preventing severe rotavirus gastroenteritis. However, the cost of these vaccines and local availability can be a barrier for widespread adoption in public health programs in developing countries where infants suffer a heavy burden of rotavirus related morbidity and mortality. A phase I/II study was carried out with the long term aim to produce a locally licensed vaccine which is equally safe and immunogenic as compared to available licensed vaccines. Methods This study was conducted in two cohorts. In the first cohort, 20 healthy adults were administered a single dose of the rotavirus vaccine (highest antigen concentration planned for infants) or placebo and were followed up for 10 days for safety. Following demonstration of safety in adult volunteers, 100 healthy infants were recruited (cohort 2) and randomly divided into five equal study groups. They were administered three doses of either the investigational rotavirus vaccine (BRV-TV) at one of the three antigen concentrations or Rotateq or Placebo at 6–8, 10–12 and 14–16 weeks of age. All infants were followed up for safety till 28 days after the third dose. Immune response to the vaccine, in terms of seroresponse and geometric mean concentrations, was compared across the five study groups. Results Increase in anti-rotavirus serum IgA antibodies from baseline, demonstrated higher immune response for all the three antigen concentrations of BRV-TV vaccine and RotaTeq in comparison with the placebo. Sero-response rates for placebo, BRV-TV dose-levels 10 5.0 FFU, 10 5.8 FFU, 10 6.4 FFU, and Rotateq at 28 days post third dose were 11.1%, 27.8%, 41.2%, 83.3%, and 63.2% respectively using the four-fold or more criteria. The BRV-TV vaccine arm corresponding to the highest antigen concentration of 10 6.4 FFU had a higher sero-response rate compared to the active comparator arm (RotaTeq), 28 days post each vaccine dose. The safety profile was comparable across the treatment groups. Conclusions Overall, the results showed that all three doses of BRV-TV vaccine were safe, well tolerated and displayed good immunogenicity (dose–response) in healthy Indian infants.

Dorsal dermal sinus (DDS) represents the spectrum of spinal dysraphism. Children may present with features of meningitis. A 13-month male child presented with features of meningitis and quadriparesis. Clinical examination revealed a small pit over the thoracic spine. MRI was suggestive of a DDS. Initially, the patient responded to antibiotics and methylprednisolone, which was given for resolving the mass effect. However, he had a recurrence of symptoms and underwent surgical exploration and resection of DSS with resolution of symptoms. Careful examination of the back is extremely essential in children with meningitis. Radiological investigation helps in visualisation of the DSS. Although rare in children, they may present with recurrent meningitis.

Disseminated Tuberculosis (DTB) refers to tubercular involvement of two or more non-contiguous sites and is commonly associated with immunocompromised state. It is an unusual presentation of Tuberculosis (TB), especially in the absence of immunodeficiency. 1.4% of patients with Pulmonary Tuberculosis (PTB) develop ocular manifestations but many patients with ocular TB have no evidence of PTB. Tuberculosis can cause a wide variety of ophthalmic findings, ranging from the ocular surface through the optic nerve and to the central nervous system. In this article, we report a case of Disseminated Tuberculosis with ocular involvement in a 5years old female. Our case is unique for the presence of bilateral squint, unilateral nebular type of corneal opacity, bilateral iritis with posterior synechiae and cataract at the same time. It lays emphasis on the fact that a patient with tuberculosis should be screened for multiple foci.

BACKGROUND Granulocytic sarcoma, an uncommon solid, extra-medullary tumor is a rare presentation of acute myeloid leukemia. CASE CHARACTERISTICS A seven-year old boy admitted to the hospital for treatment of leukemia having radiological findings of consolidation in one lung. OBSERVATION/INTERVENTION A bronchoalveolar lavage was done which was negative for tubercular, bacterial, and fungal infection but showed blast cells. OUTCOME On day seven of chemotherapy, a repeat chest x-ray showed resolution of the lesion. A high-resolution Computerized tomography of chest repeated after one month of induction showed resolution. MESSAGE A consolidation on chest radiograph in acute myeloid leukemia can be a granulocytic sarcoma of the lung; a bronchoalveolar lavage may be offered to confirm or refute this diagnosis.

The problem of malaria is further exacerbated by development of resistance to first line antimalarial chloroquine (CQ). This is mainly due to presumptive use of CQ with increase drug pressure. Hence every case of suspected malaria needs a parasitological diagnosis. Rapid diagnostic test (RDT) are ready to use test available even in remote parts which does not need any expertise. For management of uncomplicated vivax malaria CQ is still the drug of choice. Whereas, falciparum malaria should be treated with artemisinin based combination therapy (ACT). The choice of ACT will depend upon the geographical locality of the patient. For severe and complicated malaria irrespective of species parenteral artemisinin or quinine is the drug of choice with former being more effective.

The optical properties of tellurite based glass systems are composition dependent. For this purpose glass samples of the composition 70TeO2-(30–x)BaO-xZnCl2 with x = 5, 10, 15, 20 and 25 have been synthesized by rapid melt quenching technique. Glassy nature has been confirmed by X-ray diffraction pattern. The physical properties like density, molar volume and crystalline volume have been estimated and found that density decreases while the molar volume increases with increase in ZnCl2 content. The glass transition temperature decreases with increase in halide content due to increase in the non-bridging oxygen contribution. Direct allowed optical transitions are favourable in these glasses and the optical band gap energy (Eopt) has been observed to increase with increase in ZnCl2 content. The value of Urbach energy of these glasses shows increasing behaviour with ZnCl2 concentration indicating the breaking of weak bonds into defects. Metallization criterion for these materials shows that these glasses may ...

This hospital-based study describes the antibiotic sensitivity of 66 S. aureus isolates from the admitted children (age 0-18 y) in a tertiary hospital of Kolkata, India. Methicillin-resistant S. aureus constituted 16.7% (n=11) of the isolates. Clindamycin-resistance was observed in 60% and 82% of methicillin-sensitive and methicillin-resistant strains, respectively.

Rotavirus is the leading cause of severe and dehydrating diarrhea in children aged under 5 years. We undertook this hospital-based surveillance study to examine the possible relationship between the severity of diarrhea and the various G-group rotaviruses circulating in India. Stool samples (n = 2,051) were systematically collected from 4,711 children aged

An observational time-motion study investigated logistic, programmatic and safety-related advantages and limits in the delivery of a fully liquid DTP–HepB–Hib combination vaccine versus a lyophilized combination vaccine requiring reconstitution. The study was conducted in 2006, observing 312 child vaccinations in a tertiary hospital setting in Kolkata, India. The time for vaccination was on average 46 s (35.12%) lower with the fully liquid vaccine (p < 0.05). In addition, the fully liquid combination was easier and potentially safer to handle and as well tolerated as the lyophilized formulation. Fully liquid combination vaccines have the potential to simplify immunization schedules, contribute to better resource management and improve efficiency of immunization programs.

Glass composition 70 TeO2-(30-x) BaO – x ZnCl2; x = 5, 10, 15, 20 and 25 have been prepared by rapid melt quenching technique under controlled atmospheric conditions. Amorphous nature of the samples was confirmed by x-ray diffractogram. The glass transition temperature (Tg) has been determined using differential scanning calorimetry (DSC) and its value is observed to decrease with increase in ZnCl2 content. The peaks in the Raman and FTIR spectra have been estimated by deconvolutation of the spectra and each of deconvoluted spectra exhibits several peaks. IR and Raman spectra of the present glass system indicate that TeO2 exists as TeO3 trigonal pyramidal (tp), TeO4 trigonal bipyramidal (tbp) and TeO6 polyhedra structural units. With increase in zinc halide content, transformation of some of TeO4 structural units into TeO3 structural units is observed Increase in TeO3 structural units shows that non-bridging oxygen contribution increases which confirms the decrease in glass transition temperature.

Glass system 60 TeO2 – 10 B2O3-(30-x) Bi2O3-x ZnO with mole fraction x = 10, 15, 20, 25 and 30 were synthesized by conventional melt quenching technique under controlled atmospheric conditions. The glass transition temperature (Tg) has been determined using differential scanning Calorimetry (DSC) and its value is observed to increase with increase in ZnO content. This increase may be due to the increase in the concentration of the bridging oxygen (BO) atoms. IR and Raman spectra of the present glass system indicate that ZnO acts as network modifier and exists in ZnO4 units. TeO2 exists as TeO3, TeO4, and TeO3+1 structural units. Bismuth plays the role of network modifier with BiO6 octahedral structural units whereas B2O3 exists in the form of BO3 trigonal and BO4 tetrahedral structural units.