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In Search of Scrub Typhus: A Prospective Analysis of Clinical and Epidemiological Profile of Patients from a Tertiary Care Hospital in New Delhi

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Advances in Infectious Diseases 2015年第4期5卷 140-147页

作者： Nitin Gupta Rama Chaudhry Sushil K. Kabra rakesh lodha Bijay R. Mirdha Bimal K. Das Naveet Wig Vishnubhatla Sreenivas Department of Microbiology All India Institute of Medical Sciences New Delhi India Department of Paediatrics All India Institute of Medical Sciences New Delhi India Department of Medicine All India Institute of Medical Sciences New Delhi India Department of Biostatistics All India Institute of Medical Sciences New Delhi India

Introduction: Scrub typhus is a febrile illness caused by Orientia tsutsugamushi which is transmitted by the larval stage of trombiculid mites. It has varied manifestations ranging from mild disease to fatal illness. The classical manifestations include fever, rash, lymphadenopathy and eschar. Serology is the preferred diagnostic tool with indirect immunofluorescence assay (IFA) as the current gold standard. Material & Methods: A total of 229 clinically suspected cases of Scrub typhus from 15th of October 2013 to 15th of October 2015 were enrolled in the study. Clinical, epidemiological and laboratory data of the patients were collected and analysed. The method for diagnosis was IgM immunofluorescence assay. Results: A total of 33 cases (14.4%) of scrub typhus were detected. Most of the cases (87%) presented in the months of September to November. Fever of >39°C was seen in all 33 cases. Rash and eschar were seen in 24.2% and 18.2% cases, respectively. Lymphadenopathy (18.2%), hepatomegaly (48.5%), splenomegaly (21.2%) and icterus (15.2%) were seen in some cases. Pulmonary manifestations were noted in 69.7% of cases. Acute kidney injury (18.2%), encephalitis (21.2%), and myocarditis (15.15%) were the other complications observed. Common haematological abnormalities noted in patients of scrub typhus were anaemia (45.6%), leucocytosis (45.6%), thrombocytopenia (48.5%) and transaminitis (54.5%). 10 cases were treated by azithromycin while doxycycline was used for treatment in 28 cases. Conclusion: The nonspecific symptoms and lack of classical manifestations make the diagnosis of scrub typhus difficult. There is a definite need to increase awareness and heighten the suspicion, especially in the light of increasing number of patients presenting with atypical manifestations.

关键词： Scrub Typhus India Epidemiology

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Chronic serotonin syndrome:A retrospective study

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World Journal of Psychiatry 2021年第4期11卷 124-132页

作者： Sanjay Prakash Chaturbhuj Rathore Kaushik Rana Diptangshu Roychowdhury Deepali lodha Department of Neurology Smt.B.K.Shah Medical Institute and Research CentreSumandeep VdyapeethVadodara 391760India Department of Psychiatry Smt.B.K.Shah Medical Institute and Research CentreSumandeep VdyapeethVadodara 391760India Department of Medicine Smt.B.K.Shah Medical Institute and Research CentreSumandeep VdyapeethVadodara 391760India

BACKGROUND Serotonin syndrome(SS)is an underdiagnosed drug-induced clinical syndrome resulting from the excess intrasynaptic concentration of *** limited information is available about chronic *** To evaluate the epidemiological,clinical,and other aspects of the insidious onset *** We retrospectively evaluated 14 consecutive adult patients(>18 years)who had complaints for more than 6 wk at the time of consultation and met the Hunter criteria for *** The mean age was 41.1 years(range:21-61 years),with a male preponderance(64%).Although tremors were observed in all patients,this was a presenting complaint in only 43%of *** body pain,insomnia,and restlessness were common presenting features(50%each).Other common clinical features were stiffness of the limbs(43%),diaphoresis(43%),gait disturbances(36%),bowel disturbances(36%),dizziness(29%),sexual dysfunctions(21%),incoordination(14%),and fatigue(14%)The mean duration of symptoms before the diagnosis of SS was 13.5±5.8 wk(range:6-24 wk).Amitriptyline was the most common drug(n=6,43%),followed by tramadol(n=5,36%)and sodium valproate(n=5,36%).All patients received cyproheptadine,a 5-hydroxytryptamine2A antagonist,as treatment and noted an excellent response CONCLUSION This study represents the largest study on chronic *** suggest that patients receiving serotonergic drugs should be physically examined for the presence of SS upon the development of new symptoms.

关键词： Serotonin syndrome Serotonin toxicity Cyproheptadine Serotonergic agents Serotonin Clonus

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Cardiac Mass and Hypertrophic Cardiomyopathy as Aggressive Presentation of Primary Cardiac Lymphoma: A Case Report

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Journal of Cancer Therapy 2012年第3期3卷 183-186页

作者： Mehandi Haran Evbu Enakpene Ankur lodha Department of Cardiology Maimonides Medical Center New York USA Department of Critical Care Medicine Maimonides Medical Center New York USA Department of Medicine Maimonides Medical Center New York USA

Primary cardiac lymphoma is very rare. This disease occurs mainly in immunocompromised patients and rarely in the immunocompetent. With the advent of echocardiogram, computed tomography and magnetic resonance imaging, more cases are being diagnosed ante-mortem although the prognosis still remains poor. These cardiac tumors provide unique diagnostic and therapeutic challenges. We present an interesting case of primary cardiac lymphoma diagnosed antemortem in an 81 year old immunocompetent female presenting as a large mass in the right atrium, right ventricle and encasing the right coronary artery;and asymmetric left ventricular hypertrophy, a variant of hypertrophic cardiomyopathy. Patient responded very well to chemotherapy with subsequent regression of the cardiac mass and ventricular hypertrophy.

关键词： Primary Cardiac Lymphoma Asymmetric Left Ventricular Hypertrophy Chemotherapy

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Intracranial Abscesses: An Institutional Study

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Open Journal of Modern Neurosurgery 2020年第2期10卷 297-306页

作者： Yogendra Singh Tarun Kumar Gupta Gaurav Jaiswal Krishna lodha Neurosurgery Department R.N.T Medical College Udaipur Rajasthan India

Background: Brain abscess is defined as a focal intracranial infection that is initiated as an area of cerebritis and evolves into a collection of pus surrounded by a vascularized capsule. These are complications of head trauma, neurosurgical operations, meningitis, and otogenic, mastoid, and paranasal air sinus infections. Management involves both medical and surgical treatment. Surgical management includes either aspiration or excision of lesions larger than 2.5 cm in diameter, depending on brain location. However, literature on surgical treatment is replete with several procedures which, on their own, may not determine outcome. Aim: Aim is to study the epidemiology, management and outcome of various treatment modalities of brain abscess in our institute. Material and Methods: We conducted a retrospective study of demographic data as well as indications, treatment modalities, and outcomes of various surgical procedures for evacuation of intracranial abscesses in patients admitted to our Neuro-intensive care unit at R.N.T. Medical College, Udaipur, Rajasthan, India from January 2013 to June 2019. Results: We carried out 53 procedures in 43 (30 male and 13 female) patients with various intracranial abscesses. Most abscesses [16, i.e. 37%] occurred in the second decade and second most common in the first decade [15, i.e. 34%]. In infants 4 (9%) cases of intracranial abscesses were present. None of the infants had features of congenital heart disease. The predisposing factors were mostly otolaryngologic (15) or posttraumatic (8). Most commonly abscesses were located in frontal 13 (30%) followed by cerebellar 9 (21%). Burr hole evacuation was done in 74% of cases. 3 patients (7% of cases) died. Prognosis appears to worsen with ventriculitis, multiple abscesses especially in infants, and immunosuppression. Conclusion: In conclusion, brain abscess still continues to be a formidable challenge, with prognosis that dramatically improved over the last decades due to advances

关键词： Brain Abscess Aspiration Cerebritis

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Proteomics: A Successful Approach to Understand the Molecular Mechanism of Plant-Pathogen Interaction

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American Journal of Plant Sciences 2013年第6期4卷 1212-1226页

作者： Tushar Dilipchand lodha Padmalochan Hembram Nitile Tep, Jolly Basak Department of Biotechnology Visva-Bharati University Santiniketan India.

In recent years, proteomics has played a key role in identifying changes in protein levels in plant hosts upon infection by pathogenic organisms and in characterizing cellular and extracellular virulence and pathogenicity factors produced by pathogens. Proteomics offers a constantly evolving set of novel techniques to study all aspects of protein structure and function. Proteomics aims to find out the identity and amount of each and every protein present in a cell and actual function mediating specific cellular processes. Structural proteomics elucidates the development and application of experimental approaches to define the primary, secondary and tertiary structures of proteins, while functional proteomics refers to the development and application of global (proteome wide or system-wide) experimental approaches to assess protein function. A detail understanding of plant defense response using successful combination of proteomic techniques and other high throughput techniques of cell biology, biochemistry as well as genomics is needed for practical application to secure and stabilize yield of many crop plants. This review starts with a brief introduction to gel- and non gel-based proteomic techniques followed by the basics of plant-pathogen interaction, the use of proteomics in recent pasts to decipher the mysteries of plant-pathogen interaction, and ends with the future prospects of this technology.

关键词： Proteome Plant-Pathogen Interaction Systemic Acquired Resistance Mass Spectrometry Pathogenicity Related Proteins

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SOIL SOLARIZATION AND BRASSICA AMENDMENTS: SOIL DISINFESTATION ALTERNATIVES IN HOT ARID REGION

SOIL SOLARIZATION AND BRASSICA AMENDMENTS: SOIL DISINFESTATI...

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The ⅩⅤth International Plant Protection Congress

作者： S.ISRAEL S.lodha Central Arid Zone Research Institute Jodhpur 342003 India Central Arid Zone Research Institute Jodhpur 342003 India

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加拿大新生儿重症监护室院内感染及其变化趋势对胎龄<33周早产儿预后的影响（英文）

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中国当代儿科杂志 2015年第10期17卷 1019-1027页

作者： Caitlin Jantzen Abhay lodha Mirea Lucia Shoo K Lee Xiang Y Ye Koravangattu Sankaran 姚跃 Department of Pediatrics Royal University Hospital and College of Medicine University of SaskatchewanSaskatoon Canada Department of Pediatrics and Community Health Sciences University of Calgary Maternal and Infant Care Research Centre Mount Sinai Hospital University of Toronto Canada 不详

败血症是新生儿重症监护室（NICU）的危重病症及造成新生儿死亡的重要原因之一,根据其发病时间,可分为早发（生后2 d内）和晚发（生后2 d后）。其中晚发的新生儿败血症,一般考虑为院内感染（NI）。胎龄越小,出生体重越低,NI的发生率越高... 详细信息

败血症是新生儿重症监护室（NICU）的危重病症及造成新生儿死亡的重要原因之一,根据其发病时间,可分为早发（生后2 d内）和晚发（生后2 d后）。其中晚发的新生儿败血症,一般考虑为院内感染（NI）。胎龄越小,出生体重越低,NI的发生率越高。NI的发生率在加拿大各NICU之间差别较大,与各中心医护人员的相关诊疗行为密切相关。在国家卫生研究院＂基于循证医学的医疗质量改进项目＂的推动下,2003～2009年间加拿大全国NICU总的NI率明显下降,但不同中心各自感染率的变化趋势仍极为不同。本研究纳入了加拿大全国共24家NICU在2008～2012年间所有收入院的胎龄〈33周的早产儿共18 961名,探讨NI率的变化趋势以及其与早产儿预后的关系。

关键词：新生儿重症监护室早产儿预后院内感染加拿大胎龄新生儿败血症 NICU 国家卫生研究院

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血管加压素输入对于儿茶酚胺抵抗性的脓毒性休克患儿的治疗效果

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世界核心医学期刊文摘（儿科学分册） 2006年第A3期2卷 10-10页

作者： Vasudevan A. lodha R. Kabra S.K. 李开 Department of Paediatrics All India Inst. of Medical Sciences Ansari Nagar New Delhi 110029 India

Aim: To describe use of vasopressin infusion for catecholamine-refractory septic shock in children. Methods: We report successful use of vasopressin infusion in three children with septic shock, in whom hypotension and poor perfusion persisted despite use of multiple infusions of vasopressors and inotropes. Results: All three had a rapid improvement in hypotension and perfusion after starting vasopressin infusion, allowing tapering of other infusions. Two children recovered completely. Conclusions: Vasopressin appears to be useful in treatment of catecholamine-refractory septic shock in children.

关键词：血管加压素脓毒性休克抵抗性儿茶酚血管升压类药物低灌注药物注入

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