DocumentsDate added
Original article
Majumdar Tapan1*, Bhattacharya Sibabrata2,Barman Debasis2, Baidya Subrata3
Affiliation:-
1 Associate Professor,2Assistant Professor, Department of Microbiology, 3Associate Professor, Department of Community Medicine, Agartala Goverment Medical College, P.O :-Kunjavan, Agartala, Tripura.-799006, India
The name of the Department and Institution to which the work should be attributed:-
Department of Microbiology,
Department of Community Medicine Agartala Goverment Medical College, P.O- Kunjavan, Agartala, Tripura.-799006, India
Author contributions:
All the authors equally to this paper
*Correspondence to:
Dr Tapan Majumdar.
Associate Professor, Department of Microbiology, Agartala Govt. Medical College, P.O- Kunjavan, Agartala, Tripura. PIN-799006, India.
Abstract:
Tripura experienced first outbreak of meningococcal infection in 2009. The outbreak started from the 3rd week of January 2009 and lasted till august 2009 with its peak in the month of may 2009.During this period number of confirmed cases was 285 with 62 deaths with an attack rate of 8.4/lakh and a case fatality rate (CFR) of 22%.As per the geographical clustering of cases, maximum were reported from Chawmanu block of Dhalai district where a total of 125 case were reported with 31 deaths and the CFR was reported to be 25% with an attack rate of 351/lakh. Strategy adopted for outbreak response was Chemotherapy, Chemoprophylaxis, Strengthening of laboratory diagnostics, Limited reactive use of Vaccine and Intensive IEC activity. The study was undertaken with the objective of follow up of trends in meningococcal infection in outbreak prone area in order to prevent further outbreak and also observe the impact of vaccination in the affected area. Though the laboratory investigation reports shows a declining trends but infection still continues to occur during the subsequent years with no reports of clustering of cases from any part of Tripura. 71 cases in 2010, 10 cases in 2011, 5 cases in 2012 and till April 2013 no cases were reported. Provision of easy access to effective treatment and reactive vaccination with a polysaccharide vaccine after an outbreak though resulted in reducing the infection rate but has not prevented the occurrence of infection and death (13 in 2010, 04 in 2011,03 in 2012). Molecular insight of the circulating clones, provision of conjugate vaccine and enhanced surveillance is the need of the hour for effective control of outbreak due to meningococcal infection.
Key words: Immunoprophylaxis; Chemoprohylaxis; Meningococcal infection; Outbreak; Surveillance.
REFERENCES
1.Cartwright KAV, Stuart JM, Robinson PM.Meningococcal carriage in close contacts of cases,Epidemol infect 1991;106:133-141.
2.Wolfe RE,Birbara CA:Meningococcal infection at an army training centre.Am J Med 1968:44:243-255.
3.Powars D, Larsen R, Johnson J et al. Epidemic meningococcimea and purpura fulminans with induced protein C deficiency.Clin Infect Dis 1993; 17:254-261
4.Kasper D.L,Braunwalte, Fauci AS.,Hausu SL,Longo DL,Jameson JL: Harrisons principles of medicine:16th edition ;Vol 1:P 849-855.
5.Chanteau S, Rose A.M.C., Djibo S., Nato F., Boisier P.: Biological diagnosis of meningococcal meningitis in the African meningitis belt: Current epidemic strategy and new perspectives , 2007;Vaccine 25S A 30-A 36 www.sciencedirect.com
6.Danet C, Fermon F., Hewison C; Management of epidemic meningococcal meningtitis , 4th edition ,2008. P13-20, 23-24.
7.Manchanda V,Gupta S,Bhalla P. Meningococcal disease: history, epidemiology, pathogenesis, clinical manifestations, diagnosis, antimicrobial susceptibility and prevention. Indian J Med Microbiol [serial online] 2006 [cited 2010 Jan 25]: 24:7-19
8.CDC Alert, Special Issue on Meningococcal disease; April 2005, Vol 9: No 4, p 1-8.
9.T Majumder, S Bhattacharya, D Barman, R Begum. Laboratory confirmed outbreak of meningococcal infections in Tripura. Indian J of Med Microbiology; 2011; vol 29; 74-76.
10.Koneman E.W., Janda W.M.,Schreckenberger P.C., Jr..Winn W.C:Colors atlas and Text book of Diagnostic Microbiology:5th Edition:1997: p491-538.
11.Collee J.G, fraser AG, marmion B.P., Simmons A:Mackie and McCartney Practical medical Microbiology,14th edition:1999:p77-80,286-287,296.
12.Bio-Rad, France: manufactures protocol p 1-12.
13.Leinonen M and Herva E. The latex agglutination test for the diagnosis of meningococcal and Haemophilus influenzae meningitis. Scand. J. Infect. , 1977, 9 187-191.
Article citation:-
Majumdar Tapan, Bhattacharya Sibabrata, Barman Debasis,Baidya Subrata. Impact of vaccination following outbreak of meningococcal infection in Tripura, India. Journal of pharmaceutical and biomedical sciences (J Pharm Biomed Sci.) 2013 November;36(36):1853-1859. Available at http: //www.jpbms.info.
Copyright © 2013 Majumdar Tapan. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Research article
Kirtilaxmi K. Benachinmardi1, *C.Panduranga2, V.Srinivasamurthy3,Sharath N Burugina4, Vani B.R5, Navaneeth. B.V6
Affiliation:-
1Tutor/Lecturer, Department of Microbiology, ESIC Medical College and PGIMSR, Rajajinagar, Bangalore-560010,India.
2Assistant Professor, Department of Pathology, ESIC Medical College and PGIMSR, Rajajinagar, Bangalore-560010,India.
3Professor and Head, Department of Pathology, ESIC Medical College and PGIMSR, Rajajinagar, Bangalore-560010.India.
4Assistant Professor, Department of Community Medicine, ESIC Medical College and PGIMSR, Rajajinagar, Bangalore-560010,India.
5Associate Professor, Department of Pathology, ESIC Medical College and PGIMSR, Rajajinagar, Bangalore-560010,India.
6Professor and Head, Department of Microbiology, ESIC Medical College and PGIMSR, Rajajinagar, Bangalore-560010,India.
Corresponding author:
Dr. C. Panduranga, M.D.,
Assistant Professor, Department of Pathology, ESIC Medical College and PGIMSR, Rajajinagar, Bangalore-560010, Karnataka, India. Contact no:-+91 9480710942
Abstract:
Back ground: Dengue viral infection is one of the common arboviral infections in tropical and subtropical countries. Hematological examination is an essential step in the management of these patients and in few cases it can give a clue to the underlying diseases. Hence this study was undertaken at a tertiary care hospital to document the hematological changes in acute dengue fever.
Materials and Methods: This a prospective study conducted between April to September 2013. Simultaneously the blood samples were subjected for serological examination for NS1 antigen and IgM antibody by ELISA and hematological examination by autoanalyser.
Results: A total of 150 serologically proven cases of dengue cases were observed during the study period. 21.3% were less than 12 years and 78.75% were more than twelve years of age. Male to female ratio was 1.34. Thrombocytopenia was the most common change observed in 79%. Under 12 years 25% patients showed increase HCT, 62.5% had leucopenia, 18.8% had neutropenia and 80% showed atypical lymphocytes. Above 12 years haematocrit increase was seen in 3% of male and 2% of female patients, 55 % had decreased total count, 29.5% had neutropenia and 90% showed presence of atypical lymphocytes.
Conclusion: Thrombocytopenia is the most common hematological change followed by leucopenia, neutropenia and presence of atypical lymphocytes. Hematological changes are more reflected in children than in adults.
Key words: Dengue fever; thrombocytopenia; neutropenia; leucopenia; NS1 antigen.
Article citation:
Kirtilaxmi K. Benachinmardi,C.Panduranga,V.Srinivasamurthy,Sharath N Burugina,Vani B.R,Navaneeth. B.V. Hematological profile in acute dengue infection: A study at tertiary care teaching hospital. Journal of pharmaceutical and biomedical sciences (J Pharm Biomed Sci.) 2013 November 36(36):1866-1870. Available at www.jpbms.info.
REFERENCES
1.Chaturvedi UC, Nagar R. Dengue and dengue haemorrhagic fever: Indian perspective. J Biosci. 2008;33(4):429-41.
2.Banerjee M, Chatterjee T, Choudary GS, Srinivas V, Kataria VK. Dengue: A Clinicohaematological Profile. Medical Journal Armed Forces India. 2008; 64 (4): 333-6.
3.Shu PY, Huang JH. Current advances in dengue diagnosis. Clin Diagn Lab Immunol. 2004 Jul;11(4):642-50.
4.Kalayanarooj S, Vaughn DW, Nimmannitya S, Green S, Suntayakorn S, Kunentrasai N, etal. Early clinical and laboratory indicators of acute dengue illness. J Infect Dis. 1997 Aug;176(2):313-21.
5.Jameel T, Mehmood K, Mujtaba G, Choudhry N, Afzal N, Paul RF.Changing haematological parameters in dengue viral infections. J Ayub Med Coll Abbottabad. 2012 Jan-Mar;24(1):3-6.
6.Ahmed S, Arif F, Yahya Y, Rehman A, Abbas K, Ashraf S. Dengue fever outbreak in Karachi 2006--a study of profile and outcome of children under 15 years of age. J Pak Med Assoc. 2008 Jan;58(1):4-8.
7.Jain A, Shah AN, Patel P, Desai M, Somani S, Parikh P, et al. A clinic- Hematological Profile of Dengue Outbreak Among Healthcare Professional In a tertiary care hospital of Ahmadabad with analysis on economic impact. National Journal of Community Medicine. 2013; 4(2):286-90.
8.La Russa VF, Innis BL. Mechanisms of dengue virus induced bone marrow suppression. Baillieres Clin Haematol.1995;8(1):249–70.
9.Kamath SR, Ranjit S. Clinical features complications and atypical manifestations of children with severe forms of dengue hemorrhagic fever in South India. Indian J Pediatr 2006;73:889–95.
10.Batra P, Saha A, Chaturvedi P, Vilhekar KY, Mendiratta DK, Outbreak of Dengue infection in Rural Maharashtra. Indian J Paediatr 2007; 74: 794-5.
11.Guzman MG, Kouri G. Dengue: an Update. THE LANCET Infectious Diseases 2002; 2: 33-41.
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Source of support: Nil
Copyright © 2013 C.Panduranga. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Research article
Pandav Amitkumar B.1,*,Nilkanth Somesh P. 2,Lanjewar Dhaneshwar N.3,
Bhagwat Rajendra V. 4
Affiliation:-
1Assistant Professor, Department of Pathology, Government MedicalCollege, Miraj. Maharashtra India
2Resident Pathology, Government Medical College, Miraj. Maharashtra India
3Professor, Department of pathology Government Medical College, Miraj. Maharashtra India
4Professor, Department of Medicine, Government Medical College, Miraj. And Incharge ART center P.V.P.Government Hospital, Sangli. Maharashtra, India
Author’s contributions- all the authors contributed equally to this paper
The name of the department(s) and institution(s) to which the work should be attributed:
Government Medical College & Hospital, Miraj, Sangli. Maharashtra, India
P.V.P.Government Hospital, Sangli. Maharashtra, India
Corresponding author:-
Dr. Pandav Amitkumar Bapuso
Assistant Professor, Department of Pathology, Government Medical College, Miraj, Maharashtra, India- 416410.Contact no: +91- 9881979069
Abstract:
Introduction: Haematologic manifestations are characteristic of the natural history of HIV infection. Clinically significant haematological abnormalities are common in persons with HIV infection. They have major morbidity in themselves, adversely altering patient's quality of life and hinder treatment of both the primary viral infection and the secondary infections and neoplastic complications.
Material and methods: This is a prospective cross sectional study of 713 HIV positive patients, conducted in the Department of Pathology of Government Medical College and Hospital Miraj and Padmabhushan Vasantdada patil General Hospital Sangli between the period August 2008 and July 2010. The hematological parameters were obtained by processing whole blood on Abacus Diatron Electronic Cell counter. Demographical and clinical data of the patient was also obtained. Data obtained from Electronic counter, peripheral smear examination and BD FACScan flow cytometer was put together and analyzed.
Results: Anaemia was the most common haematological abnormality observed. The overall prevalence of anaemia, neutropenia, thrombocytopenia, lymphopenia, leucopenia and pancytopenia was 44%, 2.3%, 6.7%, 7.4%, 5% and 1.1% respectively. The prevalence of all haematological abnormalities was higher in patients with advanced disease, CD4 count <200/ µl. ART was associated with lower prevalence of all haematological abnormalities. Eosinophilia was observed in 23% of patients and was associated directly with advanced stage of the disease, ART and CD4 count.
Conclusion: Prevalence of haematological abnormalities in HIV positive patients is significantly high even in this HAART era. ART is associated with reduced prevalence of all haematological abnormalities and has therapeutic and preventive implications.
Key words: Anaemia; ART; HAART; HIV; AIDS; Eosinophilia.
REFERENCES
1.UNAIDS Report on the Global AIDS Epidemic 2010 [homepage on the Internet]. [cited 2010 Dec 7]; Available from http://www.unaids.org/documents/20101123_GlobalReport_em.pdf
2.Annual Report 2009-10. Department of AIDS Control, Ministry of Health and Family welfare [homepage on the internet]. [cited 2010 Dec 7]; Available from http://www.nacoonline.org/upload/AR%202009-10/NACO_AR_English%20corrected.pdf.
3.Ranga S, Prakash I, Khurana SK, Talib VH. Haematological manifestation of HIV infection. Indian J Pathol Microbiol 1997; 40:417-31.
4.Patwardhan MS, Golwilkar AS, Abhyankar JR, Atre MC. Hematological profile of HIV positive patients. Indian J Pathol Microbiol 2002; 45:147-150.
5.Dikshit B, Wanchu A, Sachdeva RK, Sharma A, Das R. Profile of hematological abnormalities of Indian HIV infected individuals. BMC Blood Disorders 2009; 9:5-10.
6.Attili SVS, Singh VP, Rai M, Varma DV, Gulati AK, Sundar S. Hematological profile of HIV patients in relation to immune status – a hospital-based cohort from Varanasi, North India. Turk J Hematol 2008; 25:13-19.
7.Sullivan PS, Hanson DL, Chu SY, et al: Epidemiology of anemia in human immunodeficiency virus infected persons: Results from the Multistate Adult and Adolescent Spectrum of HIV Disease Surveillance Project. Blood 1998; 91:301-8.
8.Lewis SM. Reference ranges and normal values. In: Lewis SM, Bain BJ, Bates I, eds. Dacie and Lewis Practical Haematology. 10 th ed. Churchill Livingstone, Elsevier Ltd,Philadelphia Inc. 2006; 11-24.
9.Omoregie R, Omokaro EU, Palmer O, Ogefere HO, Egbeobauwaye A, et al Prevalence of anaemia among HIV-infected patients in Benin City, Nigeria. Tanzania Journal of Health Research 2009; 11: 1-4.
10.Greer JP,Foerster JF, Lukens JN, Rodgers GM, Paraskevas F, Glader B eds. Wintrobe’s Clinical Hematology. 11 th ed. Lippincott Williams & Wilkins.2004;1777-1800
11.Berhane K, Karim R, Cohen MH: Impact of highly active antiretroviral therapy on anemia and relationship between anemia and survival in a large cohort of HIV-infected women: Women's Interagency HIV Study. J Acquir Immune DeficSyndr 2004; 37:1245-1252.
12.Mocroft A, Kirk O, Barton SE, et al: Anaemia is an independent predictive marker for clinical prognosis in HIV infected patients from across Europe. AIDS 1999; 13:943-50.
13.Amegor OF, Bigilia DA, Oyesola OA, Oyesola TO, Buseni ST. Hematological changes in HIV patients placed on Anti Retroviral Therapy in Markurdi, Benue State of Nigeria. Asian J. Epidemiol. 2009; 2: 97-103.
14.Huang SS, Barbour JD, Deeks SG, Huang JS, Grant RM, et al: Reversal of human immunodeficiency virus type 1 associated hematosuppression by effective antiretroviral therapy.Clin Infect Dis 2000; 30:504-10.
15.Semba RD, Shah N, Vlahov D. Improvement of Anemia Among HIV-Infected Injection Drug Users Receiving Highly Active Antiretroviral Therapy. JAIDS 2001;26:315–19.
16.Kreuzer KA, Rockstroh JK, Jelkmann W, et al. Inadequate erythropoietin response to anaemia in HIV patients: relationship to serum levels of tumour necrosis factor-alpha, interleukin-6 and their soluble receptors. Br J Haematol1997;96:235–39.
17.Murphy M, Perussia B, Trinchieri G. Effects of recombinant tumor necrosis factor, lymphotoxin, and immune interferon on proliferation and differentiation of enriched hematopoietic precursor cells. Exp Hematol 1988;16:131–38.
18.Amirayan-Chevillard N, Tissot-Dupont H, Capo C, et al. Impact of highly active anti-retroviral therapy (HAART) on cytokine production and monocyte subsets in HIV-infected patients. ClinExpImmunol2000;120:107–12.
19.Bini EJ, Cohen J. Impact of protease inhibitors on the outcome of human immunodeficiency virus-infected patients with chronic diarrhea. Am J Gastroenterol1999;94:3553–59.
20.Maggi P, Larocca AM, Quarto M,Serio G, Brandonisio O, et al. Effect of antiretroviral therapy on cryptosporidiosis and microsporidiosis in patients infected with human immunodeficiency virus type 1. Eur J Clin Microbiol Infect Dis 2000;19:213–7.
21.Semba RD, Tang AM. Micronutrients and the pathogenesis of human immunodeficiency virus infection. Br J Nutr1999;81: 181–9.
22.Tang AM, Smit E, Semba RD, Shah N, Lyles CM, et al. Improved antioxidant status among HIV-infected injecting drug users on potent antiretroviral therapy. J Acquir Immune DeficSyndr2000;23:321–6.
23.Mylonakis E, Dickinson BP, Mileno MD,Flanigan T, Schiffman. FJ, et al. Persistent parvovirus B19 related anemia of seven years’ duration in an HIVinfected patient: complete remission associated with highly active antiretroviral therapy. Am J Hematol 1999;60:164–6.
24.Scapellato PG, Palumbo AM, Del Valle S. Improvement of anemia by parvovirus B19 in a patient with AIDS after combined antiretroviral therapy [letter]. Mayo ClinProc2000;75:215–6.
25.Maschke M, Kastrup O, Esser S,Ross B, Henge U, et al. Incidence and prevalence of neurological disorders associated with HIV since the introduction of highly active antiretroviral therapy (HAART). J NeurolNeurosurg Psychiatry 2000;69:376–80.
26.Pluda JM, Mitsuya H, Yarchoan R. Hematologic effects of AIDS therapies. Hemat Oncol Clin North Am 1991;5:229–48.
27.Sloand EM, Maciejewski J, Kumar P,Kim S, Chaudhuri A, et al. Protease inhibitors stimulate hematopoiesis and decrease apoptosis and ICE expression in CD34+ cells. Blood 2000;96:2735–39.
28.Bagnara GP,.Zauli G, Giovannini M, Re MC, Furlini G andLa PlacaM, Early loss of circulating hemopoietic progenitor cells in HIV-1-infected subjects. Exp. Hematol1990; 18: 426–30.
29.Leiderman IZ, Greenberg ML, Adelsberg BR, Siegel FP. A glycoprotein inhibitor of in vitro granulopoiesis associated with AIDS. Blood 1987; 70: 1267-72.
30.Mauss S, Steinmetz HT, Willers R, Manegold C, Kochanek M, et al. Induction of granulocyte colony-stimulating factor by acute febrile infection but not by neutropenia in HIV seropositive individuals. J Acquir Immune DeficSyndr 1997; 14(5): 430-34.
31.Karcher DS, Frost AR: The bone marrow in human immunodeficiency virus (HIV)-related disease. Morphology and clinical correlation.Am J Clin Pathol 1991; 95: 63-71
32.Moore DAJ, Benepal T, Portsmouth S, Gill J, Gazzard BG: Etiology and natural history of neutropenia in human immunodeficiency virus disease: A prospective study. Clin Infect Dis 2001; 32: 469-75.
33.Meynard JL, Guiguet M, Arsac S, Frottier J, Meyohas MC. Frequency and risk factors of infectious complications in neutropenic patients infected with HIV. AIDS 1997; 11: 995-8.
34.Levine AM, Karim R, Mack W, Gravink DJ, Anastos K, Young M, et al. Neutropenia in Human Immunodeficiency Virus Infection. Arch. Intern. Med 2006; 166: 405-10.
35.Attili SVS, Singh VP, Rai M, Varma DV, Gulati AK, Sundar S. Hematological profile of HIV patients in relation to immune status – a hospital-based cohort from Varanasi, North India. Turk J Hematol 2008; 25:13-19.
36.Sullivan PS, Hanson DL, Chu SY,Jones JL, Ciesielski CA.: Surveillance for thrombocytopenia in persons infected with HIV: Results from the multistate Adult and Adolescent Spectrum of Disease Project. J Acquir Immune DeficSyndr 1997;14:374-79.
37.Pechere M, Samii K, Hirschel B: HIV related thrombocytopenia. N Engl J Med 1993; 328: 1785
38.Ballem PJ, Belzberg A, Devine DV. Kinetic studies of the mechanism of thrombocytopenia in patients with human immunodeficiency virus infection. N Engl J Med 1992; 327: 1779-84.
39.Kouri YH, Borkowsky W, Nardi M, Karpatkin S, Basch RS. Human megakaryocytes have a CD4+ molecule capable of binding human immunodeficiency virus-1. Blood1993; 81:2664-70.
40.Zucker-Franklin D, Seremetis S, Heng ZY. Internalization of human immunodeficiency virus type I and other retroviruses by megakaryocytes and platelets. Blood 1990;75: 1920–23.
41.Wang J-F, Liu Z-Y, Groopman JE: The alpha-chemokine receptor CXCR4 is expressed on the megakaryocytic lineage from progenitor to platelets, and modulates migration and adhesion. Blood 1998; 92: 756-64.
42.Carbonara S, Fiorentino G, Serio G, Maggi P, Ingravallo G, et al. Response of Severe HIV-Associated Thrombocytopenia to Highly Active Antiretroviral Therapy Including Protease Inhibitors. Journal of Infection 2001 :42: 251-56
43.Caso JAA, Mingo CS, Tena JG: Effect of highly active antiretroviral therapy on thrombocytopenia in patients with HIV infection. N Engl J Med 1999;16:1239
44.Murphy MF, Metcalfe P, Waters AH, Carne CA, Weller IVD, Linch DC and Smith A. (1987), Incidence and mechanism of neutropenia and thrombocytopenia in patients with human immunodeficiency virus infection. British Journal of Haematology.1987;66: 337–40.
45.Tietz A, Sponagel L, Erb P, Bucher H, Battegay M, Zimmerli W. Eosinophilia in patients infected with Human Immunodeficiency Virus. Eur J Clin Microbiol Infect Dis.1997;16: 675-77.
46.Clerici M, Shearer GM. The Th 1-Th2 hypothesis of HIV infection: new insights. Immunol Today 1994; 15:575-81.
47.Clerici M, Hakim FT, Venzon DJ, et al. Changes in interleukin-7 and interleukin-4 production in asymptomatic human immunodeficiency virus-seropositive individuals. J Clin Invest 1993; 91:759-65.
48.Cohen AJ, Steigbigel RT Eosinophilia in Patients Infected with Human Immunodeficiency Virus. JID1996;174:615-18.
Article citation:-
Pandav Amitkumar B.,Nilkanth Somesh P.,Lanjewar Dhaneshwar N.,Bhagwat Rajendra V.. Haematological profile of HIV-positive patients in relation to immune status and Stage of the disease - A hospital-based cohort from Western India. Journal of pharmaceutical and biomedical sciences (J Pharm Biomed Sci.) 2013 November 35(35): 1877-1886. Available at www.jpbms.info.
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Source of support: Nil
Copyright © 2013 Pandav Amitkumar B. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Research article
Shankar M Bakkannavar, MD DCL 1,*, Pratik V Taravadi, MD 2,Pavanchand Shetty,MD3,Raghavendra Babu YP, MD4, Vinod C Nayak, MD1, Pradeep Kumar G, MD, Dip. Cr.L5,
Affiliation:-
1Associate Professor, Department of Forensic Medicine and Toxicology, Kasturba Medical College, Manipal, Manipal University, India.
2Assistant Professor, Department of Forensic Medicine and Toxicology, K.S. Hegde Medical Academy, Nitte University, Mangalore, India
3Assistant Professor, Department of Forensic Medicine and Toxicology, Kasturba Medical College, Manipal,Manipal University, India.
4Associate Professor, Department of Forensic Medicine and Toxicology, Kasturba Medical College, Mangalore, Manipal University, India.
5Professor, Department of Forensic Medicine and Toxicology, Kasturba Medical College, Manipal,Manipal University, India.
Author’s contributions- all the authors contributed equally to this paper
The name of the department(s) and institution(s) to which the work should be attributed:
Department of Forensic Medicine & Toxicology
Kasturba Medical College, Manipal University, Manipal-576104, India.
Corresponding author:-
Dr Shankar MBakkannavar
Associate Professor
Department of Forensic Medicine & Toxicology
Kasturba Medical College, Manipal-576104, India.
Phone No.+91-820-2922450 (O) +91-9845303881 (M)
Abstract:
Teeth play an important role in the field of forensic investigations. Their ability to survive in mass disasters makes them an important tool in identification of the victim. Though the morphology and structure is similar in both males and females, there are subtle differences. Variation in dental size can give a clue about differences between the sexes.Many authors have measured the width of teeth in both males and females and found certain variations. Canines, reported to survive in air crash and hurricane disasters, are perhaps the most stable teeth in the oral cavity because of the labiolingual thickness of crown and the root anchorage in the alveolar process of the jaws. Not only the Mesio-distal width of canines but also the intercanine distances help in identifying the gender as a part of identification. Measurement of inter-caninedistances of the mandible and maxilla provides good evidence of sex identification due to dimorphism.
Key words: Identification; Inter-canine distance; Mandibular; Sexual Dimorphism.
REFERENCES
1.Marin Vodanović, JelenaDumančić, Željko Demo, DamirMihelić. Determination of Sex by Discriminant Function Analysis of Mandibles From two Croatian Archaeological Sites. The online ActaStomatologica Croatia, 2006; 40(3): 263-277.
2.Camps F. E. Gradwohl's Legal Medicine. In: Identification by the skeletal structures. 3rd edn. Bristol: John Wright and Sons Ltd, 1976:110.
3.William PL, Bannister LH, Dyson M, Berry MM, Collins P, Dussek JE, Fergusson MWJ. Gray’s Anatomy; The Teeth. 39th edn. London: Churchill Livingstone, 2006: 590-602.
4.Kaushal S, Patnaik VVG, Agnihotri G. Mandibular Canines in Sex Determination. J. Anat. Soc. India, 2003; 52(2): 119-124.
5.MuzafferAtes, FeryalKaraman, Mehmet YasarIscan, Tamer Lu¨tfu¨ Erdem. Sexual differences in Turkish dentition. Legal Medicine 8, 2006: 288–292.
6.Kaushal S., Patnaik V.V.G, Sood V, Agnihotri G. Sex Determination In North Indians Using Mandibular Canine Index. J.Indian Academy of Forensic Medicine, 2004; 26(2): 45-49.
7.Kavitha H. Sex determination in tooth. (MDS Dissertation) Chennai: The Tamil Nadu M.G.R. Medical University; 2005.
8.Bossert Walter A. and Marks Herbert H. Prevalence and characteristics of periodontal disease in 12,800 persons under periodic dental observation. The Journal of the American Dental Association, 1956; 52: 429-442.
9.Anderson DL, Thompson GW. Interrelationship and sex differences of dental and skeletal measurements. J Dent Res 1973; 52: 431-38.
10.Al- Rifaiy Mohammed Q, Abdullah Aleem M, Igbal Ashraf, Khan Nazeer. Dimorphism of Mandibular and Maxillary Canine Teeth in Establishing Sex identity.Saudi Dental Journal, 1997; 9(1): 17 – 20.
11.Proffit WR, Field HW Jr, Ackerman JL, Thompson PM, Tullock SAC. The later stages of development. In: Contemporary orthodontics. St. Louis:CV Mosby Co. 1986: 84.
12.Yogitha R, Aruna N, RemadeviBalasubramanyam. Journal of the Anatomical Society of India. Abstract 217. Vol. 54, No 1. 2005.
13.Sherfudhin H, Abdullah MA, Khan N. A cross – sectional study of canine dimorphism in establishing sex identity: comparison of two statistical methods. Journal of Oral Rehabilitation 1996; 23: 627 – 31.
14.Muller M, Lupi- Pegurier L, Quatrehomme G, Bolla M. Odontometric method useful in determining gender and dental alignment. Forensic Science International 2001; 121: 194 – 7.
15.Aggarwal B, Vasudeva K, Kaushal S. Chhabra U, Singla S. Gender based comparison of intercanine distance of mandibular permanent canine in different populations.JPAFMAT 2008; 2: 6 – 9.
16.Yadav S. et al. Mandibular canine index in establishing sex identity. Indian Journal of Dental Research. 2002; 13 (3 & 4): 143-146.
17.Hashim HA, Al-Ghamdi SAF. Tooth widths and Arch Dimensions in Normal and Malocclusion Samples. An Odontometric Study. J Contemp Dent Pract. 2005; (6)2: 36 – 51.
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Source of support: Nil
Article citation:-
Shankar M Bakkannavar, Pratik V Taravadi,Pavanchand Shetty, Raghavendra Babu YP, Vinod C Nayak,Pradeep Kumar G. Gender Differentiation using Inter-Canine Distances among South Indians. Journal of pharmaceutical and biomedical sciences (J Pharm Biomed Sci.) 2013 November 35(35): 1860-1865. Available at www.jpbms.info.
Copyright © 2013 Shankar M Bakkannavar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original article
Mahajan Shikhaa1,*, Pandey Rajesh2, Kaur Harnam4, Bhaskar Neeru2,
Ishaq Sheikh3, Sodhi S. Kuldeep4, Singh Jasbir4
Affiliation:-
1Assistant Professor, Department of Biochemistry, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India
2Associate professor, Department of Biochemistry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, India
3P.G. student, Department of Biochemistry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, India
4Professor, Department of Biochemistry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, India
The name of the department(s) and institution(s) to which the work should be attributed:
1.Department of Biochemistry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, India
2.Department of Biochemistry, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India
Corresponding author:-
Dr. Shikhaa Mahajan.
Assistant Professor,
Department of Biochemistry, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Solan, Himachal Pradesh, India.
Phone number: +91-8059931702, +91-9467630796.
Abstract:
Background: Subclinical hypothyroidism is defined as elevated serum TSH and normal total T4 and T3 levels.
Aim: Evaluate burden of SCH in apparently healthy rural subjects residing in and around village Mullana in Haryana, India.
Settings and design: Community based Prospective Cross-sectional study was conducted in rural setting of Haryana. 500 subjects were selected randomly by planned systematic simple random sampling method.
Material and Methods: Serum T3, T4 and TSH were estimated by ELISA. Two grades of SCH: grade II and III were created based on the value of TSH. An individual was said to be in grade II of SCH when serum TSH value was between 6.0–12.0 µIU/ml and in grade III of SCH when serum TSH value was >12.0 µIU/ml. Logistic Model was built by using the of Forward Wald criterion.
Statistical analysis used: The count and percentages were calculated for each group by entering the data in SPSS version 12 [SPSS v12 (SPSS Inc, Chicago, IL)]. Bar charts and tables were prepared in microsoft excel 2007 software program.
Results: Out of 500 apparently healthy subjects, 12.2% were SCH positive with 10% males and 14.4% females. SCH was more in females than males. Predominance of grade II subjects. Logistic Model showed if serum T4 of any individual is known, we can find out whether he/she is SCH positive or negative.
Conclusions: High occurrence of SCH especially in women suggests that thyroid hormone estimation should be considered during routine evaluation in asymptomatic people especially in a susceptible population
Key words: Thyroid; Thyroid stimulating hormone; Thyroxine; Triiodothyronine; Subclinical hypothyroidism.
REFERENCES
1.Demers LM, Spencer C, The Thyroid: Pathophysiology and Thyroid Function Testing, in: Burtis CA, Ashwood ER, Bruns DE (Eds.), TEITZ Textbook of Clinical Chemistry and Molecular Diagnostics, Elsevier, a division of Reed Elsevier India Pvt Ltd., New Delhi, 2006, pp. 2053-95.
2.Nananda F, Surks MI, Daniels GH, Subclinical thyroid disease-clinical applications, JAMA. 291 (2004) 239-243.
3.Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, McDermott MT, Consensus statement: subclinical thyroid dysfunction: a joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and the Endocrine Society, J. Clin. Endocrinol. Metab. 90 (2005) 581–585.
4.Biondi B, Cooper DS, The clinical significance of subclinical thyroid dysfunction, Endocr. Rev. 29 (2008) 76-131.
5.Karmisholt J, Anderson S, Laurberg P, Variation in thyroid function in subclinical hypothyroidism: importance of clinical follow-up and therapy, Euro. J. Endocrinol. 164 (2011) 317-23.
6.Diez JJ, Iglesias P, Burnam KD, Spontaneous normalization of thyrotropin concentrations in patients with subclinical hypothyroidism, J. Clin. Endocrinol. Metab. 90 (2005) 4124-4127.
7.Brenta G, Vaisman M, Sgarbi JA, Bergoglio LM, Andrada NC, Bravo PP, et al, Task force on hypothyroidism of the Latin American thyroid society, clinical practice guidelines for the management of hypothyroidism, Arq. Bras. Endocrinol. Metabol. 57 (2013) 265.
8.Hirsch D, Levy S, Nadler V, Kopel V, Shainberg B, Toledano Y, Pregnancy outcomes in women with severe hypothyroidism, Eur. J. Endocrinol. 169 (2013) 313-20.
9.Dhanwal DK, Prasad S, Agarwal AK, Dixit V, Banerjee AK, High prevalence of subclinical hypothyroidism during first trimester of pregnancy in North India, Indian J. Endocr. Metab. 17 (2013) 281-4.
10.Menicucci D, Sebastiani L, Comparini A, Pingitore A, Ghelarducci B, L'abbate A, et al, Minimal changes of thyroid axis activity influence brain functions in young females affected by subclinical hypothyroidism. Arch. Ital. Biol. 151 (2013) 1474.
11.Mark H, Redfern CC, Sox HC, Screening for thyroid disease, Ann. Intern. Med. 129 (1998) 141-3.
12.Friedman MN, Screening for thyroid disease, Ann. Intern. Med. 130 (1999) 161-2.
13.WHO web article: 7.11.3 iodine deficiency disorders [homepage on internet]. Available at: http://wcd.nic.in/research/nti1947/7.11.3%20Iodine%20deficiency%20%20pr%20%208.2%20new.pdf. Accessed on 1 August 2013.
14.Kapil U, Nayar D, Singh C, Profile of iodine content of salt at trader level in the selected districts of India: Part II – Haryana, IJMCH. 8 (1997) 56-7.
15.Park K. Nutrition And Health, in: Park’s textbook of preventive and social medicine, M/S Banarasidas Bhanot Publishers, India, 2007, pp. 480-33.
16.Sterling L, Diagnosis and treatment of thyroid disease, Cleveland CRC Press, 1975, pp. 9-51.
17.Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch. Intern. Med. 160 (2000) 526–34.
18.Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA et al, Serum TSH,T(4),and thyroid antibodies in the United States population(1988 to 1994): National Health and Nutrition Examination Survey (NHANES III), J. Clin. Endocrinol. Metab. 87 (2002) 489–99.
19.Hak AE, Pols HAP, Visser TJ, Drexhage HA, Hofman A, Witteman JCM, Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study, Ann. Intern. Med. 132 (2000) 270–8.
20.Johnson JL, Duick DS, Diabetes and thyroid disease: A likely combination, Diabetes Spectr. 15 (2002) 140-142.
21.Davis Kibirige, Kenneth Luzinda, Richard Ssekitoleko. Spectrum of lithium induced thyroid abnormalities: a current perspective, Thyroid Research 6 (2013) 3.
22.Wilson S, Parle VJ, Roberts ML, Roalfe KA , Hobbs R, Clark , et al, Prevalence of Subclinical Thyroid Dysfunction and Its Relation to Socioeconomic Deprivation in the Elderly: A Community-Based Cross-Sectional Survey, JCEM. 91 (2006) 4809.
23.Fatourechi V, Subclinical hypothyroidism: an update for primary care physicians, Mayo Clinic proceedings 84 (2009) 65-71.
24.Huber G, Staub JJ, Meier C, Mitrache C, Guglielmetti M, Huber P, et al, Prospective study of the spontaneous course of subclinical hypothyroidism: prognostic value of thyrotropin, thyroid reserve, and thyroid antibodies, J. Clin. Endocrinol. Metab. 87 (2002) 3221-26.
25.Bashir H, Farooq R, Bhat MH, Majid S, Increased prevalence of subclinical hypothyroidism in females in mountainous valley of Kashmir, Indian. J. Endocrinol. Metab. 17 (2013) 276-80.
26.Staub JJ, Althaus BU, Engler H, Ryff AS , Trabucco P, Marquardt K, et al, Spectrum of subclinical and overt hypothyroidism: Effect on thyrotropin, prolactin, and thyroid reserve, and metabolic impact on peripheral target tissues, Am. J. Med. 92 (1992) 631-42.
27.Chu JW, Crapo LM, The treatment of subclinical hypothyroidism is seldom necessary, J. Clin. Endocrinol. Metab. 86 (2001) 4591-9.
28.Bianco AC, Salvatore D, Gereben B, Berry MJ, Larsen PR, Biochemistry, cellular and molecular biology, and physiological roles of the iodothyronine selenodeiodinases, Endocr. Rev. 23 (2002) 38–89.
29.Karmisholt J, Andersen S, Laurberg P, Variation in thyroid function in subclinical hypothyroidism:importance of clinical follow-up and therapy, Eur. J. Endocrinol. 164 (2011) 317–323.
Competing interest / Conflict of interest
The author(s) have no competing interests for financial support, publication of this research, patents and royalties through this collaborative research. All authors were equally involved in discussed research work. There is no financial conflict with the subject matter discussed in the manuscript.
Source of support: Nil
Copyright © 2013. Mahajan Shikhaa, Pandey Rajesh, Kaur Harnam, Bhaskar Neeru, Ishaq Sheikh, Sodhi S. Kuldeep, Singh Jasbir. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.