SM KADRI

Abstract: Measles is a childhood disease that causes great morbidity and mortality in India and worldwide. Because measles surveillance in India is in its infancy, there is a paucity of countrywide data on circulating Measles virus genotypes. This study was conducted in 21 of 28 States and 2 of 7 Union Territories of India by MeaslesNetIndia, a national network of 27 centers and sentinel practitioners. MeaslesNetIndia investigated 52 measles outbreaks in geographically representative areas from 2005 through June 2010. All outbreaks were serologically confirmed by detection of antimeasles virus immunoglobulin M (IgM) antibodies in serum or oral fluid samples. Molecular studies, using World Health Organization (WHO)-recommended protocols obtained 203 N-gene, 40 H-gene, and 4 M-gene sequences during this period. Measles genotypes D4, D7, and D8 were found to be circulating in various parts of India during the study period. Further phylogenetic analysis revealed 4 lineages of Indian D8 genotypes: D8a, D8b, D8c, and D8d. This study generated a large, countrywide sequence database that can form the baseline for future molecular studies on measles virus transmission pathways in India. This study has created support and capabilities for countrywide measles molecular surveillance that must be carried forward.

Abstract: To study the profile of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in tertiary care hospital setting, representing almost the whole affected population in Kashmir valley of India.

Abstract: To study the status of zinc as a micronutrient in pulmonary tuberculosis, in our population, with the aim to see the effectiveness of therapy.

Abstract: Gujjar lung is a chronic lung disease caused due to the long-term exposure to pinewood smoke inhalation in Gujjar community and the people residing at the hilly regions of the Indian sub-continent. This is characterized clinically by progressive cough and dyspnea, distinct radiological patterns and pathological features of anthracotic nodules and fibrosis. A typical case with miliary mottling on chest radiograph is presented and the relevant literature reviewed.

Abstract: An earthquake struck Kashmir on 8 October 2005. A central team of public health specialists was sent to Kashmir to assess the public health measures required following the earthquake, and to assist in institution of public health measures.

Abstract: After about three decades, Chikungunya infection has re-emerged in India and the first cases were reported in December, 2005. The outbreak has currently affected about 8 states in the country. Although known to be commonly non fatal, since the present outbreak involved a large population, it has been raised as an issue of public health concern and also attracted wide media attention. The clinico-epidemiological and entomological review of the Chikungunya outbreak situation in Hyderabad and Nalgonda Districts of Andhra Pradesh, which started in December 2005, revealed that it is under control. However, preventive efforts need to continue and disease surveillance for early detection of potential outbreaks further strengthening. Given the significantly high House Index, all the three study areas remain at significant risk of outbreaks in the future if appropriate control measures are not put in place. Community support and participation is also crucial for the prevention of future outbreaks and improving the health and well being of population in the districts.

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Abstract: This syndrome is characterized by the presence of hypothyroidism with myxoedema, muscle stiffness and pseudo hypertrophy. We describe the disorder in a 21 year old male, who got admitted with complaints of generalized weakness, cold intolerance, constipation, and hoarse voice, difficulty in walking and progressive enlargement of muscles of thighs and back with crampy pains for two years. Examination revealed mild mental retardation, enlarged tongue, dry and rough skin, enlargement of thighs and back muscles, motor weakness in flexors of hips and knees with delayed relaxation of deep tendon reflexes. Investigations revealed evidence of hypothyroidism with marked elevation of muscle enzymes. Following institution of replacement therapy with thyroxine, the patient showed marked clinical and biochemical improvements after six months, but insignificant decrease in muscle mass. In this report we review relevant literature.

Abstract: Brucellosis is an important but neglected disease in India. This zoonotic disease is present in all livestock systems and increased demand for dairy products accompanied with changing and intensified farming practices has raised the concern for increased spread and intensified transmission of this infection to the human population with increased risk of disease. Brucellosis can be controlled by mass vaccination of livestock. Human brucellosis can be treated with a combination of antibiotics but is very difficult to diagnose and requires laboratory testing for confirmation. Only a few recent studies have addressed the prevalence and importance of brucellosis as a human disease problem in India. The disease may be overlooked and misdiagnosed because of the difficult diagnosis and the absence and lack of experience with laboratory testing. Alertness of medical staff is needed to recognize and diagnose the disease. Awareness of risk groups is needed to take appropriate preventive measures and to accept control measures.

Abstract: A total of 15 cases of prepubertal testicular tumours were reported by the department of pathology, Government Medical College, Srinagar, Kashmir over a period of 15 years, from January 1984 to December 1998. The cases included yolk sac tumour (10 cases; 67%), teratoma [(mature) 2 cases (13%)], rhabdomyosarcoma [(paratesticular) 2 cases (13%)] and NHL-Burkitt's lymphoma [one case (7%)]. The youngest patient was 10 months old and the oldest was of 14 years age. Ten cases (67%) occurred at or below the age of 4 years. The youngest patient had yolk sac tumour and oldest had rhabdomyosarcoma. In 2 cases both the testes were involved with one of these two cases having bilateral undescended testes.

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Abstract: Salmonella are a rare cause of infective endocarditis. This report describes a case where Salmonella typhi was isolated from the blood and urine of a patient with echocardiographically documented aortic valve disease and endocarditis. The patient was treated with two weeks of ceftriaxone (3 g/day) and amikacin (15 mg/kg/day), followed by a further two weeks of ceftriaxone (3 g/day) alone. He made a complete recovery.

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Abstract: Urinary tract infection happens to be common and is generally treated empirically by general practitioners, for which they need to be aware of the locally prevalent strains and their sensitivity pattern. Since over the last few decades the resistance pattern of urinary isolates has been showing dramatic changes all over the world, it was felt useful to study the existing microbiological pattern of the urinary tract infections in Kashmir valley and to assess the sensitivity profile of the isolated organisms to the generally used antibiotics for empirical therapy in primary health care settings. The retrospective analysis of 324 such samples which were found positive for pathological bacteria by the microbiology laboratory of Government Medical College, Srinagar, Kashmir revealed that 90.12% of the isolates were E. coli followed by klebsiella (7.72%) and staphylococcus (1.24%). Significantly 43.57% of the E. coli exhibited resistance to the commonly used antibiotics, and the most effective in-vitro agents were found to be amikacin followed by gentamicin among the injectables and ciprofloxacin among the orally administered ones. Other useful oral antibiotics were nitrofurantoin, chloramphenicol and nalidixic acid. The organisms showed resistance to currently preferred urinary antibiotics and chemotherapeutic agents like co-trimoxazole, norfloxacin, pefloxacin and cephalexin. Conclusion was that among the orally administered antibiotics ciprofloxacin remains the choice while other quinolones or derivatives have turned ineffective and among the injectables gentamicin is still effective.

Abstract: Over a period of 5 years from 1992 to 1997 a total of 3,532 patients of pyrexia of unknown origin (PUO) were subjected to Wright's tube agglutination test for brucellosis. Of the 3,532 patients tested, 28 (0.8%) were found seropositive for brucellosis. Males outnumbered females by a ratio of 3:1. Whereas the seroprevalence among males clearly was age-related, the seroprevalence among women was not. The highest number (43%) of positive males belonged to the age group 21-30 years. The majority of patients had titres of 1:160 or 1:256, high titres of 1:512 and 1:1024 were found in 21.4% patients.