Browsing by Author "A.K. Gulati"

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A study on the socio demographic profile of the attendees at the integrated counseling and testing centre of institute of medical sciences BHU, Varanasi, Uttar Pradesh
(Indian Association of Preventive and Social Medicine, 2016) Rashmi Kumari; Mritunjay Kumar; A.K. Gulati; Shyam Sundar; S.C. Mohapatra
Introduction: Human Immunodeficiency Virus (HIV) counseling and testing services are a key entry point to the prevention of HIV infection and to the treatment and care of the people who are infected with HIV. The Integrated Counseling and Testing Centre (ICTC) services are a cost effective intervention in the prevention of HIV/AIDS. Aims: To study the socio demographic characteristics of the attendees at the ICTC centre. Material and Methods: Setting - ICTC of Institutes of Medical Sciences BHU, Varanasi, Study Design: A cross-sectional, record based study, Study duration: The study population included 41159 clients who attended the ICTC centres from January 2009 to December 2011. Results: An overall 12.85% of the ICTC attendees were HIV Seropositive subjects. During 2009 to 2011. i.e. during past 3 years total males tested for HIV at the ICTC were 23326, out of which 3202 were HIV+ve showing positivity rate of 13.7%, while total females tested were 16671 out of which 2063 were HIV+ve showing positivity rate of about 12.4%. Consecutively in the last three years maximum load of patients was from the age groups 35-49 years (19.13%) followed by 25-34 years (15.4%). Conclusion: People&s attitudes towards HIV are changing after the introduction of the ICTC, which plays a major role in the primary and secondary prevention of HIV. There is a more urgent need for the introduction of interventional measures like sex education and preventive education among the general population. © 2016, Indian Association of Preventive and Social Medicine. All rights reserved.
Acanthamoebae presenting as primary meningoencephalitis in AIDS
(2007) Mukesh Kumar; Ragini Jain; K. Tripathi; Ravi Tandon; A.K. Gulati; Atul Garg; Jaya Gart
A rare case of Acanthamoebae meningoencephalitis is diagnosed in cerebrospinal fluid (CSF) of a 24 years old male suffering from acquired immunodeficiency syndrome (AIDS) patient on the basis of bright field microscopy and culture growth on non-nutrient agar with Escherichia coli. This case illustrates that Acanthamoebae should be considered in the differential diagnosis of meningoencephalitis in AIDS in addition to tuberculosis and cryptococcus infection in tropical areas.
Adult polio‐like syndrome following Enterovirus 70 conjunctivitis (natural history of the disease)
(1983) B.C. Katiyar; S. Misra; R.B. Singh; A.K. Singh; Saroj Gupta; A.K. Gulati; Mrs.S. Christopher; T. Jacob John
ABSTRACT‐ During the Indian EV 70 conjunctivitis epidemic in 1981, 79 patients with neurological complications were evaluated by clinical, electro‐physiological, histopathological and virological studies. The disease was heralded by an attack of conjunctivitis and was followed, after a variable latent period, by a pre‐paralytic, paralytic, and post‐paralytic stage of slow recovery. The above events occurred in an orderly sequence. The paralysis affected the cranial nerves, limbs or both. The clinical course closely simulated poliomyelitis, without any evidence of radiculopathy or myelo‐pathy. Cranial nerve palsies were seen in approximately half of the patients. The electrophysiological and histological studies pointed towards the affection of anterior horn cells. The raised neutralizing antibody titres to Enterovirus 70, confirmed the aetiology of the disease. On the available data, we believe that this nosological entity should be considered under the general title of “polio‐like syndrome” following EV 70 conjunctivitis. On account of two epidemics in 1971 and 1981 with unfavourable prognosis and high resultant disability, and because of lack of specific therapy, it has become imperative to develop, as a top priority, a vaccine for immunization. 1983 Blackwell Munksgaard
Chlamydial serology and laparoscopic findings in infertile women.
(1994) M. Jain; S. Gupta; M. Singh; A.K. Gulati
Fifty-seven infertile women were studied for presence of chlamydial infection by detecting antichlamydial antibodies using indirect immunoperoxidase assay technique. Laparoscopy was performed in all of them. Inflammatory changes in fallopian tubes were present irrespective of serological status. Thus no rigid criteria for carrying out laparoscopy can be made. A high index of suspicion is required for detection of chlamydial infection as it runs an indolent course with no specific symptoms.
Clinical profile and Japanese encephalitis viral serological screening of children with acute encephalitis in Varanasi, India [3]
(Oxford University Press, 1998) B.K. Das; A.B. Ponkshe; A.K. Gulati; O.P. Mishra
[No abstract available]
Cryptococcal meningitis with an antecedent cutaneous Cryptococcal lesion
(Dermatology Online Journal, 2009) Ragini Tilak; Pradyot Prakash; Chaitanya Nigam; Vijai Tilak; I.S. Gambhir; A.K. Gulati
Cutaneous cryptococcosis, caused by an encapsulated yeast, Cryptococcus neoformans, is generally associated with concomitant systemic infection. Here we report a case of primary cutaneous cryptococcosis with spread to central nervous system in an HIV seronegative young boy. In the present case, a 17-year-old boy who was suffering from a non-healing ulcer on his right great toe for 5 months, presented with the signs and symptoms of meningitis. Cryptococcus neoformans var. gattii was isolated from the CSF of the patient. Amphotericin B administration produced recovery from the meningitis as well as from the ulcer. This case study suggests that primary cutaneous cryptococcosis can be diagnosed provisionally by a simple Gram stained smear and India ink examination in order to avoid occurrence of disseminated cryptococcosis, including meningial involvement, which may have a fatal outcome. © 2009 Dermatology Online Journal.
Detection of HBsAg in newborns.
(1990) M. Sarkar; A.K. Gulati; B.D. Bhatia
Cord blood samples collected from 150 newborns were tested for HBsAg using micro ELISA technique. Only 8 (5.3 per cent) out of 150 samples were found to be positive for HBsAg in variable titres. It is important to identify these HBsAg positive newborns so that appropriate measures could be adopted at the earliest to prevent the complications of HBsAg carriage.
Diarrhea, CD4 counts and enteric infections in a hospital - Based cohort of HIV-infected patients around Varanasi, India
(2006) Suresh V.S. Attili; A.K. Gulati; V.P. Singh; Datla Vivek Varma; M. Rai; Shyam Sundar
Background: As most of the studies in HIV patients with diarrhea were cross sectional, focusing on the etiological agents, we are reporting data on the rate of diarrhea, associations between diarrhea and CD4 counts and variation in frequency of identifying a pathogen with consistency of diarrhea and duration in a prospective hospital based study. Methods: Stool specimens were obtained between Jan 2001 and April 2003 from HIV infected adults with diarrhea presenting to Infectious Disease clinic, Banaras Hindu University, Varanasi. In all patients with diarrhea, specimens were examined by microscopy and cultures to identify pathogens. Results: During the study, 630 person years of observations with diarrhea were analyzed, 140 stool samples were collected representing 43% of episodes of reported diarrhea. Positivity of finding a pathogen from watery stools and formed stools were 40%&24% respectively (p < 0.01) probably due to associated inflammation is more in watery diarrhea. Patients having chronic diarrhea are 2.25 (95%Cl 1.52-2.81) times at more risk of developing other opportunistic infections compared to those who don't have. However this is not true with the acute diarrhea where risk of harboring the opportunistic infections remain same. Conclusion: Diarrhea was most strongly associated with low CD4 counts. Over two-thirds of diarrheal episodes were undiagnosed, suggesting that unidentified agents or primary HIV enteropathy are important causes of diarrhea in this population. There is a strong negative association between duration of diarrhea and CD4 levels. © 2006 Attili et al; licensee BioMed Central Ltd.
Drug resistance in Salmonella typhi in North India with special reference to ciprofloxacin [4]
(2000) Gopal Nath; Anjali Tikoo; Harmesh Manocha; Anil K. Tripathi; A.K. Gulati
[No abstract available]
Hematological profile of HIV patients in relation to immune status - A hospital-based cohort from Varanasi, North India
(2008) Suresh Venkata Satya Attili; V.P. Singh; Madhukar Rai; Datla Vivekananda Varma; A.K. Gulati; Shyam Sundar
Objectives: To study the spectrum of hematological manifestations and evaluate the relationship between various hematological manifestations and CD4 cell counts in a hospital-based cohort of HIV-infected adults in and around Varanasi, North India. Materials and Methods: The clinical and hematological profiles of the patients attending the Infectious Disease Clinic, Varanasi, India were recorded. The relationship between CD4 counts and various hematological manifestations was analyzed. Results: A total of 470 HIV-infected individuals were followed for 830 person years of observation (PYO). Rate of hematological episodes was 1047 episodes per 1000 PYO. CD4 rounts were significantly lower in individuals with severe anemia and neutropenia compared to those without. However, no relation could be established between thrombocytopenia and CD4 counts. In the above- mentioned population, CD4 levels were significantly lower in those with anemia/neutropenia harboring any particular disease compared to those who had the same disease without anemia/neutropenia. Conclusions: There is a strong negative association between CD4 counts and the severity of anemia and neutropenia in this population. They can be considered as good clinical indicators to predict and access the underlying immune status. Though fall in the CD4 levels during neutropenia is observed, it is difficult to comment since the estimations of CD4 rely on the total leukocyte counts. However, the relation between anemia and disease progression is straight forward and quite useful for the treating physician. © Turkish Society of Hematology.
Herpes Simplex Virus -1 Encephalitis in Eastern Uttar Pradesh
(1999) I.S. Gambhir; N.N. Singh; D.S. Singh; A.K. Gulati
• Objective : To study the proportion of HSV-1 encephalitis in acute viral encephalitis. • Methods : One hundred and five patients presenting with clinical diagnosis of acute viral encephalitis and with exclusion of other possible causes of acute inflammatory brain disease prevalent in the area by relevent laboratory investigations were included in the study. Ninety single CSF samples were tested for HSV-1 IgM antibodies by ELISA test supplied by Dia Medix Corporation, USA. CT Scan and EEG studies were carried out in 25 patients. • Results : Clinical and neuro investigational profile of patients suggested a low incidence of HSV-1 encephalitis in the study group. IgM antibodies were present in CSF sample of one patient only. • Conclusion : HSV-1 encephalitis constitutes a very low proportion (1.1%) of acute viral encephalitis cases seen in Eastern Uttar Pradesh (India).
HIV infection in Varanasi
(1999) A.K. Gulati; G. Nath
A total of 6038 serum samples collected from individuals staying/ residing in the eastern part of northern India, were screened for antibodies against HIV. The screening was done by ELISA and followed by confirmation of reactive samples by Western Blot. The seropositivity was detected in 154 (2.6%) persons. The prevalence amongst high risk groups was 68/ 1000 while it was 2.8/1000 in low risk population. The male to female ratio was 1.8 : 1 in seropositives. Increase by more than three folds in the prevalence was observed from 1994 (1.5%) to 1997 (5.0%). About 50% of the seropositives were in their third decade of life. Seropositives were predominantly (> 90%) from eastern Uttar Pradesh. Almost all the cases could be linked to Mumbai, one of the largest commercial and industrial centres of India.
Influence of Amoora rohituka on MCF-7 human mammary adenocarcinoma cells in vitro
(1994) T. Rabi; R.C. Gupta; A.K. Gulati
The ethanol extract of Amoora rohituka stem bark showed Cytotoxicity against MCF-7 cell lines derived from human mammary adenocarcinoma with a 50% inhibitory concentration (IC50) of 30 μm/ml, but with no activity against HEp-2 from a tumour of the larynx.
Maternal and cord blood measles antibody titres
(1982) G. Kaur; D.K. Agarwal; A.K. Gulati; A. Kalra; G.P. Katiyar; K.N. Agarwal
Analysis of 165 cord and maternal blood paired samples revealed that measles HI antibodies were absent in only one pair, suggesting that the measles virus was widely prevalent in the population studied. The majority of the pairs (80.5%) had either identical titres, or was within the range of plus or minus one dilution. The cord blood and maternal blood HI titres were not directly correlated. When the maternal blood HI titre was less than 1:26.3, cord blood values were higher while when the maternal blood HI titres were higher than 1:26.3, cord blood values were lower than the maternal values. Maternal undernutrition was not associated with lower levels of measles HI antibodies in either maternal or cord blood. However, cord blood HI titres were found to be low in relation to falling maternal serum albumin levels. There was no difference in the mean cord blood HI titres in the birth weight range (1800-3600 g) studied.
Non-specific vaginitis vis-a-vis Gardnerella vaginalis.
(1990) A. Ray; A.K. Gulati; L.K. Pandey; S. Pandey
One hundred patients of vaginitis along with 50 age matched control women were studied. Non-specific vaginitis (NSV) was diagnosed on the basis of the presence of at least any three of the four parameters which included presence of thin gray homogeneous discharge, pH of the discharge greater than or equal to 4.5, liberation of fishy odour from the discharge after adding 10 per cent KOH and presence of clue cells Using these criteria, NSV was diagnosed in 22 of the 100 patients and in 4 of 50 control women. Gardnerella vaginalis was cultured from 23 of the 26 women with NSV and 19 women without NSV (8 patients and 11 normal women). Women with NSV showed statistically significant difference in the presence of clue cells, amine test positivity and concentration of G. vaginalis as compared to women without NSV.
Prevalence of Helicobacter pylori in asymptomatic subjects-A nested PCR based study
(2008) Shrutkirti Mishra; Varsha Singh; G.R.K. Rao; V.K. Dixit; A.K. Gulati; Gopal Nath
The aim of the study was to see the prevalence of Helicobacter pylori in asymptomatic children and adults by using nested PCR which is considered to be more specific than serological methods. Saliva and stool samples of 137 healthy children (aged 8 months to 16 y) and 108 asymptomatic adults (aged 17-60 y) were collected. PCR with primers targeting Hsp60 gene sequence of H. pylori was used. H. pylori positivity with nested PCR was observed in 45.7% (112/245) of the saliva and 42.8% (105/245) of the stool specimens. Prevalence of H. pylori in saliva was found to be 2.1%, 22.7%, 55.9%, 56.0%, 68.9% and 62.9% in the age groups of <5 y, 6-10 y, 11-16 y, 17-30 y, 31-45 y and 45-60 y, respectively. The detection rates in stool were 4.25% in <5 y, 13.64% in 6-10 y, 50% in 11-16 y, 64% in 17-30 y, 58.62% in 31-45 y and 61.1% in 45-60 y of age groups. The most favourable age group for acquiring the infection was 11-16 y. H. pylori positivity increased with lowering of socioeconomic status. There was no gender bias in prevalence of the bacterium. © 2008 Elsevier B.V. All rights reserved.
Prevalence of HIV among Low and High Risk Population of Eastern Part of Northern India
(2001) Chiranjoy Mukhopadhyay; G. Nath; A.K. Gulati; S.C. Mohapatra
A total of 7904 persons visiting University Hospital of Banaras Hindu University (BHU), Varanasi, were screened for HIV antibody by ELISA and/or rapid test. The overall seroprevalence of HIV (3.17%) in this area was higher than that of Uttar Pradesh and India as a whole. The seroprevalence of HIV/AIDS among the high risk group (HRG) (6.42%) being significantly higher than low risk group (LRG) (0.37%). In the LRG, the prevalence among medical and surgical patients; and ANC (antenatal cases) was 1.17% and 0.14%, respectively. However, HIV infection was not detected in HCWs (healthcare workers), BHU students and foreigners. Among HRG, CSWs (commercial sex workers) had the highest prevalence (14.0%) and STD (sexually transmitted diseases) patients, the lowest prevalence (1.99%). The STD patients had significantly lower prevalence rate as compared to others in HRG. Majority of the HIV positives were found to be within the age group 15-44 years, with heterosexual mode as the main route of transmission. Seven HIV positive children were of 2-5 yr old age group. Majority of seropositive women (62.52%) were working in a low income jobs and were mainly infected by their spouses who was mostly migrating labourers of lower socioeconomic group and with less than primary level of education. Married females, being mainly the spouses of HIV positive males had the highest seropositivity (60.25%). These population people were directly transmitting the infection from the metropolitan cities to the rural areas of this region. Prevalence of HIV-2 was negligible as compared to HIV-1, the actual reason is yet to be explored.
Prevalence of methicillin resistant Staphylococcus aureus in a tertiary referral hospital in eastern Uttar Pradesh
(L.V. Prasad Eye Institute, 2003) S. Anupurba; M.R. Sen; G. Nath; B.M. Sharma; A.K. Gulati; T.M. Mohapatra
We report the prevalence of methicillin resistant Staphylococcus aureus (MRSA) infections and their antibiotic susceptibility pattern in our hospital located in eastern Uttar Pradesh. Out of total 549 strains of Staphylococcus aureus isolated from different clinical specimens 301 (54.85%) were found to be methicillin resistant. More than 80% of MRSA were found to be resistant to penicillin, cotrimoxazole, ciprofloxacin, gentamicin, erythromycin, tetracycline, 60.5% to amikacin and 47.5% to netilmicin. However, no strains were resistant to vancomycin. Many MRSA strains (32.0%) were multi-drug resistant. To reduce the prevalence of MRSA, the regular surveillance of hospital associated infection, monitoring of antibiotic sensitivity pattern and formulation of definite antibiotic policy may be helpful.
Pulmonary fungal ball in non-immunocompromised patient: A case report
(2007) Ragini Jain; D. Agarwal; T.K. Lahiri; Vijai Tilak; A.K. Gulati
Fungal ball caused by Aspergillus species is an opportunistic infection. We describe a case report of a patient with culture positive Aspergillus fumigatus who presented with complaints of cough and expectoration with recurrent episodes of haemoptysis. Tuberculosis is the commonest cause of haemoptysis in India. However fungal ball is also one of the leading cause of haemoptysis. Hence laboratory evaluation of haemoptysis should not only include work up for tuberculosis but sample should also be submitted for mycological evaluation.
Relationship between skin diseases and CD4 cell counts in a hospital-based cohort of HIV-infected adults in North India
(2008) V. Satya Suresh Attili; V.P. Singh; Shyam Sundar; A.K. Gulati; D.V. Varma; M. Rai
Background: Dermatological manifestations are seen at every stage of HIV/AIDS, and are often the presenting features. These manifestations not only act as markers but also reflect the underlying immune status. Objectives: To examine the relationship between various skin diseases and CD4 cell counts in a hospital-based cohort of HIV-infected adults in and around Varanasi, North India. Patients and methods: All HIV patients attending the SS (Sir Sunderlal) hospital, Varanasi, between January, 2001 and December, 2003 were studied. The relationship between CD4 counts and various skin diseases was analysed. Results: Rate of cutaneous diseases was 223 episodes per 1,000 PYO. CD4 counts were significantly lower in individuals with some skin diseases (warts, psoriasis, etc.) as compared to healthy HIV persons and some other skin disorders (dermatophyte skin infections, scabies, etc.). In HIV patients, there is a significant fall in the CD4 levels from baseline, when the patient develops a skin disease and recovery of CD4 is also prompt as soon as the patient recovers from the skin disease. Conclusion: There is a strong negative association between CD4 counts and the incidence and severity of skin disease in the HIV/AIDS patients. Fluctuations in CD4 levels observed during skin disease require further studies to establish the underlying pathophysiology. It may not be advisable to rely on CD4 levels in HIV patients having active skin disease, as transient but reversible fall in CD4 counts are known during the period of active skin disease.