Hepatitis B in Trans-Himalayan Tribal Population: High Prevalence, High Pediatric Burden, Virologic Patterns, and Implications for Public Health Interventions.

Background/aims: The prevalence of hepatitis B is higher in tribal populations, compared to non-tribal populations in India. Therefore, this study aimed to investigate the risk factors, virological and biochemical profile of patients with hepatitis B in a tribal population.

Methods: This study analyzed data collected from a community-based project conducted in Spiti, Himachal Pradesh, from July 2015 to 2017.

Identification of Missing Probes in rpoB gene in Rifampicin Resistant PTB and EPTB Cases Using Xpert MTB/RIF Assay in Sirmaur, Himachal Pradesh.

Introduction: India has the highest number of TB (27%) and MDR/RR-TB (24%) cases among the notified TB patients. Xpert MTB/ RIF assay is a fully automated cartridge-based real-time PCR to detect MTB and resistance to rifampicin within two hours using three specific primers and five unique molecular probes to target the rpoB gene. This study was done to detect RR-TB cases and frequency of missing probes, which target mutations in rpoB gene, in the different groups of study population in Sirmaur district of Himachal Pradesh.

A Concurrent Comparison of the Epidemiology and Clinical Presentation of Patients Hospitalized with Pandemic 2009 (H1N1) Influenza and Seasonal Influenza-A in Sub-himalayan Region of Himachal Pradesh.

Background: Pandemic influenza (H1N1) 2009 emerged in April 2009 and spread widely in India. Although an unprecedented number of cases required intensive care, comparative community-based studies with seasonal influenza strains have not shown any significant differences in clinical symptoms or severity.

Methods: The authors performed active surveillance on confirmed influenza-related admissions and compared the clinical profile of patients with pandemic (H1N1) 2009 influenza and patients with seasonal influenza at a tertiary care hospital in Shimla, Himachal Pradesh.

Predictors of Severity in Scrub Typhus.

Aims: To study predictors of severity in patients of scrub typhus admitted in a tertiary care hospital.

Material And Methods: Total 92 patients of scrub typhus were included in the study. The diagnosis was established by presence of IgM antibodies by Indirect Immunofluorescence Assay (IFA) test which is currently the reference standard for the diagnosis of scrub typhus.

Factors for Severe Outcome in Scrub Typhus: A Hospital Based Study in Sub Himalayan Region.

Background: Scrub typhus is a re-emerging zoonotic rickettsial infection. Mortality is approximately 15% in some areas due to missed or delayed diagnosis. There had been only few studies on the markers for the severity of the disease, so this study has been planned to provide the knowledge regarding various aspects of scrub typhus in adult age group to detect early signs of severity .

Epidemiology, clinical profile and role of rapid tests in the diagnosis of acute bacterial meningitis in children (aged 1-59 months).

Objectives: To study the epidemiology, clinical profile, and the role of rapid tests in the diagnosis of acute bacterial meningitis (ABM) in children (1-59 months).

Materials And Methods: A total of 250 cerebrospinal fluid (CSF) and 187 blood samples received from clinically suspected cases of ABM were processed based on standard microbiological protocols. CSF samples were also subjected to antigen and nucleic acid detection.

Are We Neglecting Nontuberculous Mycobacteria Just as Laboratory Contaminants? Time to Reevaluate Things.

Objectives: Nontuberculous mycobacteria (NTM) incidences are on the rise worldwide, including the tuberculosis endemic areas. They should be identified rapidly to the species level and should be carefully differentiated as contamination, colonization, or disease. This study was aimed at determining the prevalence and clinicoepidemiological profile of mycobacteriosis cases.

Immunochromatography in CSF improves data on surveillance of S. pneumoniae meningitis in India.

Introduction: Streptococcus pneumoniae is a significant cause of childhood bacterial meningitis in India. The United States Food and Drug Administration has licensed an immunochromatographic (ICT) test, BinaxNOW™, to detect the C polysaccharide antigen of S. pneumoniae in cerebrospinal fluids (CSF).

Evaluation of the TB-LAMP assay for the rapid diagnosis of pulmonary tuberculosis in Northern India.

Setting: A tertiary care hospital in North India.

Objective: To evaluate a commercial kit-based loop-mediated isothermal amplification (TB-LAMP) assay for the diagnosis of pulmonary tuberculosis (PTB).

Design: A total of 530 patients presenting with PTB symptoms were enrolled and one sputum sample was collected from each patient.

Clinical Profile and Complications of Scrub Typhus: Hospital-Based Study in Sub-Himalayan Region.

Background: Scrub typhus is a documented disease in Himachal Pradesh, but there have been no clinico-epidemiological studies in this area. The present study is done with IgM ELISA as a diagnostic test which has higher sensitivity and specificity as most of previous studies had used Weil Felix test as a diagnostic test.

Methodology: This was a prospective observational study.

Pattern of Clinical Presentation, Laboratory Findings and Mortality Risk Among Patients of Scrub Typhus in Western Himalayas.

Objective: To study the pattern of the clinical presentation, laboratory findings and mortality risk among patients infected by scrub typhus in Western Himalayan region of India.

Methods: We studied all serologically confirmed cases of scrub typhus admitted to our hospital from July 2010 through December 2011. Presence of IgM antibodies to scrub typhus antigens by ELISA was considered as serological confirmation of the diagnosis.

Clinical Profile of Scrub Typhus in Pregnancy in Sub-Himalayan Region.

Background: Scrub typhus is rare in pregnancy, but it has now become an important cause of febrile illness in pregnancy in sub-Himalayan region of India. Only a few case reports have been published so far, and they show adverse maternal and fetal outcomes. No consensus has been reached till now regarding treatment.

Typhoidal Salmonellae: Use of Multi-Locus Sequence Typing to Determine Population Structure.

Enteric fever is an invasive infection predominantly caused by Salmonella enterica serovars Typhi and Paratyphi A. The pathogens have evolved from other nontyphoidal salmonellaeto become invasive and host restricted. Emergence of antimicrobial resistance in typhoidal salmonellae in some countries is a major therapeutic concern as the travelers returning from endemic countries carry resistant strains to non endemic areas.

Outbreak of enteric fever due to Salmonella Paratyphi A variety durazzo (2,12:a:-) in a hilly region of North India: A report of 43 cases.

Enteric fever due to Salmonella Paratyphi A (SPA) is a global problem occurring as outbreaks at times. An unusual SPA (2,12:a:-) variety durazzo has been reported rarely. We report an outbreak of enteric fever due to this variety affecting 43 individuals.

Influenza A(H1N1)pdm09 cases in sub-Himalayan region, 2014-2015 India.

Current influenza A(H1N1)pdm09 strain severely involved many parts of the country. The study was conducted to analyze the clinicoepidemiological trend of influenza A(H1N1)pdm09 cases from October 2014 to March 2015. Samples processing was done as per the Center for Disease Control guidelines.

Clinico-Epidemiological Profile, Pandemic Influenza A H1N1/2009 and Seasonal Influenza, August 2009-March 2013, Himachal Pradesh, India.

Background: Novel influenza A (H1N1) virus emerged in April, 2009, spread rapidly to become pandemic by June, 2009.

Objective: To study the clinco-epidemiological profile of pH1N1and seasonal influenza (SI) from 2009 to 2013.

Materials And Methods: Retrospective, hospital-based study was done by reviewing medical records for collecting demographic and clinical profile of the study samples.

Current spectrum of oculomycosis in North India: A 5-year retrospective evaluation of clinical and microbiological profile.

Oculomycosis is a major cause of visual impairment. Eye pain, redness, discharge, diminution and photophobia are presenting features. We collected corneal scraping, vitreous, aqueous fluids and conjunctival swabs after the slit-lamp examination.

Genetic Diversity among Group A Streptococcus Isolated from Throats of Healthy and Symptomatic Children.

Background: Group A streptococcus (GAS) is the commonest bacterial cause of pharyngitis. Children in the age group of 5-15 years are most commonly affected. It can also colonize throats of healthy children in this age group.

Keratitis by Paecilomyces lilacinus: A case report from Sub-Himalayan region.

Paecilomyces lilacinus is a filamentous fungus found in soil and air, which is a rare cause of ocular infection. The majority of case reports involving P. lilacinus among healthy hosts are of endophthalmitis and keratitis.

Inducible Clindamycin Resistance among Clinical Isolates of Staphylococcus aureus from Sub Himalayan Region of India.

Introduction: Clindamycin is an alternative antibiotic in the treatment of Staphylococcus aureus (S.aureus) infections, both in infections by methicillin susceptible and resistant (MSSA and MRSA) strains. The major problem of use of clindamycin for staphylococcal infections is the presence of inducible clindamycin resistance that can lead to treatment failure in such infections.

Group B streptococcal meningitis in children beyond the neonatal period in sub-Himalayan India.

Objectives: To evaluate clinicolaboratory profile and the outcomes in children (1 to 59 months) diagnosed with Group B streptococcus (GBS) meningitis over a period of 1 year.

Materials And Methods: Cerebrospinal fluid (CSF) samples of 250 pediatric patients (1 to 59 months) admitted with suspected acute bacterial meningitis(ABM)were subjected to cell count, biochemical profile, culture, latex particle agglutination (LPA) and polymerase chain reaction (PCR). They were also evaluated for complications and were followed-up till 6 months after discharge.