Journal of Communicable Diseases (E-ISSN: 2581-351X & P-ISSN: 0019-5138)

Correlation between MicroRNA-155 Expression and Viral Load in Severe COVID-19 Patients

2025-02-07T09:49:27+00:00

Background: The SARS-CoV-2 virus causes COVID-19, a respiratory syndrome. It causes inflammation and damages several organs in the body. miRNAs play a role in regulating the infection resulting from SARS-CoV-2. MicroRNA-155, a kind of microRNA linked to viral defences, can affect the immune responses during COVID-19.
Objectives: Examination of the involvement of microRNA-155 in the development and severity of COVID-19, as well as finding the correlation between microRNA-155 and viral load (copies/mL) in severe cases of the disease.
Materials and Method: A case-control research study was performed between October 2022 and June 2023. It included a cohort of 120 hospitalised individuals with severe cases of COVID-19, together with 115 individuals with mild cases of COVID-19 and apparently healthy individuals. A real-time PCR procedure was applied to determine microRNA-155 expression in the studied groups and the viral load (copies/mL) in severe cases of the disease.
Results: MicroRNA-155 was expressed in severe cases threefold more than its expression in mild cases of COVID-19 and healthy individuals. Also, a strong association was demonstrated between microRNA-155 and viral load (copies/mL) in severe COVID-19.
Conclusion: MicroRNA-155 could be used as a biomarker for severe COVID-19 conditions and could have a role in disease severity and infectious particles of the virus. Since it is positively correlated with viral load (copies/mL) in severe cases of the disease.

How to cite this article:
Al-Nuaimi B N, Al-Azzawi R H. Correlation
between MicroRNA-155 Expression and Viral
Load in Severe COVID-19 Patients. J Commun
Dis. 2024;56(4):1-7.

DOI: https://doi.org/10.24321/0019.5138.202463

Diagnosis of Genital Tuberculosis in Infertile Women: A Comparative Study from a Tertiary Care Centre

2025-02-07T09:50:40+00:00

Introduction: Female genital tuberculosis (FGTB) is a significant cause of infertility, particularly in TB-endemic regions. Primarily affecting young women, FGTB can lead to serious complications in reproductive organs. Prevalence data is often elusive, with rates ranging from 1% in some countries to 48.5% among infertile women in northern India.
Materials and Method: This study included 80 women with unexplained infertility and suspected genital tuberculosis (GTB). Imaging techniques (ultrasonography, hysterosalpingography, hysteroscopy, and
laparoscopy) were used to identify GTB indicators. The Interferon Gamma Release Assay (IGRA) assessed latent TB infection. Endometrial biopsies were processed for GeneXpert, polymerase chain reaction (PCR), and culture tests. Diagnostic accuracy was evaluated by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Results: This study assessed 80 women suspected of GTB, with a mean age of 29.4 years; 72% had primary infertility. Clinical symptoms were present in 55% of cases, including menstrual irregularities (30%) and chronic pelvic pain (20%). Imaging findings showed GTB-related abnormalities in 45% (ultrasonography) and tubal abnormalities in 69% (hysterosalpingography). Laparoscopy indicated GTB in 40% of the women examined.
Laboratory diagnostics revealed IGRA positivity in 56.5% (sensitivity: 80%, specificity: 95%), GeneXpert in 24% (sensitivity: 60%, specificity: 100%), PCR in 29% (sensitivity: 72%, specificity: 100%), and histopathology in
32% (sensitivity: 70%, specificity: 100%). Combining IGRA, GeneXpert, and histopathology improved diagnostic yield to 85% in inconclusive imaging cases.
Conclusion: The study highlights the value of a multimodal diagnostic approach for detecting GTB in infertile women. Integrating clinical evaluations, imaging, and laboratory tests significantly enhances diagnostic accuracy, warranting further research to refine these methods and improve reproductive outcomes for women affected by GTB.

How to cite this article:
Jena K S, Bhushan S, Dar A F, Agarwal K J, Siddiqui
H. Diagnosis of Genital Tuberculosis in Infertile
Women: A Comparative Study from a Tertiary
Care Centre. J Commun Dis. 2024;56(4):8-13.

DOI: https://doi.org/10.24321/0019.5138.202464

Dominance of Dengue Viral Serotypes in India: A Comprehensive Study

2025-02-07T10:53:00+00:00

Introduction: Dengue is a global health threat exacerbated by the diversity of DENV serotypes and their shifting dominance. This study investigates the changing patterns of DENV serotypes and their clinical implications in India over a 12-year period. The objective of the present study is to analyse the epidemiological trends, serotype distribution, and clinical characteristics of dengue infections in India from 2010 to 2022.
Methods and Material: A total of 3,800 patients with dengue were studied across rural and urban settings in India. Data were collected on clinical presentations, serotype distribution, and diagnostic results, including
RT-PCR, NS1 antigen, and antibody tests. Patients were categorised based on serotype prevalence and infection type (single or concurrent).
Results: The serotype distribution revealed that DENV-2 was the predominant serotype from 2010 to 2018. However, a shift to DENV-3 dominance was observed from 2019 to 2022. The clinical findings showed
that 63% of RTPCR-positive patients had dengue fever (DF) and 37% had dengue-like fever. NS1 antigen was present in 91% of RTPCR-positive cases. Only 8.9% had both NS1 and IgM, while none had detectable IgG or IgM + IgG. Clinical symptoms included high fever, retro-orbital pain, rashes, ascites, and hepatomegaly. Thrombocytopenia was present in 82% of patients, with additional findings of low leucocyte counts, anaemia, and elevated transaminase levels. Among the concurrent infections, various serotype combinations were observed, indicating a high incidence of concurrent infections.
Conclusion: To conclude, the study highlights a significant shift from DENV-2 to DENV-3 dominance in recent years, correlating with changes in environmental factors such as monsoon patterns. The findings underscore
the need for continuous surveillance and adaptive management strategies to address the evolving dengue epidemiology effectively.

How to cite this article:
Kumar V C S, Prasad B S, Kalappanavar N K,
Jayasimha V L, Ananya V S. Dominance of Dengue
Viral Serotypes in India: A Comprehensive Study.
J Commun Dis. 2024;56(4):14-22.

DOI: https://doi.org/10.24321/0019.5138.202465

Epidemiological Determinants of COVID-19 Infection in South Indian Population

2025-02-07T10:57:58+00:00

Introduction: The COVID-19 pandemic, caused by SARS-CoV-2, has had a significant global impact. In South India, particularly during the second wave in 2021, the situati on worsened due to factors such as high populati on density, urbanisation, and healthcare disparities. This study aims to explore the epidemiological determinants of COVID-19 infection in South India.
Methodology: A cross-secti onal online survey was conducted among 317 individuals from South India. Parti cipants, aged 18-65, were selected based on their willingness to parti cipate, with data collected on demographics, health conditi ons, behavioural factors, and COVID- 19-related informati on. Stati sti cal analysis was performed to identify significant epidemiological factors contributi ng to COVID-19 infection.
Results: The sample consisted of 56.01% males and 43.99% females, with 68.67% being healthcare/ frontline workers. The majority (55.06%) lived in rural areas. Key fi ndings included 44.94% of parti cipants having travelled during the pandemic and 38.92% involved in essenti al services. Mental health issues like anxiety (10.44%) and concentrati on diffi culti es (10.76%) were common. Self-medicati on with vitamin C (16.51%) and
prophylacti c medicati on use (7.91%) were reported. Socio-economic factors and mental health challenges were associated with an increased risk of COVID-19 infecti on. Occupati on, travel, mental health, and socio-economic status signifi cantly impacted COVID-19 transmission. Healthcare workers were especially vulnerable, highlighti ng the need for targeted interventi ons.
Conclusion: This study emphasises the role of socio-economic and behavioural factors in the spread of COVID-19 in South India. Tailored public health strategies, focusing on healthcare access, mental health, and public educati on, are essential for mitigating future pandemics.

How to cite this article:
Arun A, Thendral R, Rakesh A, Nag A, Nath A R, Thankachan B, S Mayookha. Epidemiological Determinants of COVID-19 Infection in South Indian Population. J Commun Dis. 2024;56(4):23-30.

DOI: https://doi.org/10.24321/0019.5138.202466

Evaluation of Diagnostic Modalities and Clinical Profiles of Cervical Tuberculous Lymphadenitis in a Medical College in Jharkhand

2025-02-07T10:59:29+00:00

Introduction: Tuberculosis (TB) is a major global health issue, with extrapulmonary TB (EPTB) making up 15–20% of cases, and tuberculous lymphadenopathy being the most common form. Diagnosing cervical lymphadenitis, often presenting as painless neck lumps, is difficult due to its paucibacillary nature. Traditional methods like smear microscopy and culture have low sensitivity, so advanced diagnostics like PCR, histopathology, FNAC, and Xpert MTB/ RIF are needed. This study aimed to assess the clinical features and diagnostic accuracy of these methods in smear-negative cervical tuberculous lymphadenitis.

Materials and Method: A total of 100 individuals with 10–80 years of age with cervical lymphadenopathy were included in the study in the Department of Microbiology of a medical college in Dumka, Jharkhand. Samples from FNAC or incision biopsy were obtained and prepared for Ziehl-Neelsen (ZN) staining, culture using the MGIT 960 system, Xpert MTB/ RIF, and PCR. A histopathological examination was also conducted. The diagnostic performance of each modality was assessed against a composite reference standard including culture, histopathology, radiological findings, or treatment response. SPSS version 25 was used to examine the data.

Results: The study population’s mean age was 59.55 years, and the male-to-female ratio was 1:1.17. Xpert MTB/ RIF identified 26% of cases, PCR detected 21%, and MGIT 960 identified 18%. The combined use of these modalities improved diagnostic accuracy. Sensitivity and specificity were highest for PCR compared to the composite reference standard.

Conclusion: The enhanced diagnosis of Mycobacterium TB in neck tuberculous lymphadenitis is possible when a multimodal diagnosis strategy combining conventional and molecular methods is used.

How to cite this article:
Kumari P, Thakur J K, Jha A K, Yadav S P. Evaluation of Diagnostic Modalities and Clinical Profiles of Cervical Tuberculous Lymphadenitis in a Medical College in Jharkhand. J Commun Dis. 2024;56(4):31-36.

DOI: https://doi.org/10.24321/0019.5138.202467

Evaluation of Larvicidal Activity of Homoeopathic Formulations Against Aedes aegypti (Diptera- Culicidae)

2025-02-07T11:03:53+00:00

Mosquito-borne diseases, including dengue fever, Zika, and chikungunya, present significant public health challenges, particularly in tropical and subtropical regions. Aedes aegypti, the primary vector for these diseases, necessitates effective control methods. Traditional mosquito control approaches face issues like resistance development and environmental harm, prompting the search for safer alternatives. This study evaluates the larvicidal activity of homeopathic formulations with six plant-based components: Azadirachta indica, Camphor, Eucalyptus globulus, Ocimum sanctum, Areca catechu, and Nigella sativa. Three formulations were tested: Formulation 1 (equal proportions of all extracts), Formulation 2 (higher proportions of Azadirachta indica and Areca catechu), and Formulation 3 (only Azadirachta indica and Areca catechu). Larvicidal efficacy was assessed using late third to early fourth instar larvae of Aedes aegypti, with ethanol as a vehicle control. Results showed significant larvicidal activity for all formulations, with Formulation 2 exhibiting the highest efficacy (LC50: 85.57 µg/ml, LC90: 261.52 µg/ml). Statistical analysis confirmed the potency of Formulation 2, highlighting its potential as a natural insecticide. The study underscores the promise of plant-based homeopathic formulations as eco-friendly alternatives to synthetic insecticides, aiming to reduce environmental impact and mitigate resistance development.

DOI: https://doi.org/10.24321/0019.5138.202468

Improved Grey Wolf Optimisation-Based Feature Fusion Deep Neural Network for Chest Disease Detection

2025-02-11T12:17:41+00:00

Introduction: Automated diagnosis of COVID-19 is an emergent need in the domain of medical image analysis. COVID-19 is an obstructive pulmonary disease and its common symptoms include cold, fever and cough. COVID-19 is a communicable disease and due to its transmissible characteristics, it rapidly transfers and
affects a large number of populations. Conventional analysis of chest X-ray (CXR) images plays a significant role in the detection of abnormal lung regions, but it is a time-consuming and complicated task to examine CXR images of thousands of COVID-19 patients for a radiologist. Consequently, there is a requirement of a fast,
accurate, and reliable computer-aided diagnosis system (CAD).
Method: The primary goal of this study is the selection of the most prominent features of input CXR images to improve classification accuracy. Metaheuristic algorithms are always the best choice for solving the issue of feature selection. In order to obtain the optimal feature subset from the extracted deep ResNet50 and MobileNetV2 features set, a dimension learning hunting-based Grey Wolf Optimisation (GWO) algorithm has been proposed in this study.
Results: Experimentation work shows that IGWO selects minimum 823 features and using these features the obtained COVID-19 image classification accuracy is 98.78% which is comparatively more than the accuracy obtained in case of PSO(98.47%) and GWO(97.78%).
Conclusion: The obtained results indicate that the Improved version of GWO provides better classification accuracy as com- pared to the other original versions of GWO and Particle Swarm Optimisation (PSO) feature selection algorithms.

How to cite this article:
Bohmrah M K, Kaur H. Improved Grey Wolf
Optimisation-Based Feature Fusion Deep Neural
Network for Chest Disease Detection. J Commun
Dis. 2024;56(4):43-56.

https://doi.org/10.24321/0019.5138.202469

Increasing Trend of Scrub Typhus in Madhya Pradesh: A Four-Year Retrospective Analysis

2025-02-11T12:14:23+00:00

Background: In a region known as the ‘tsutsugamushi triangle’, concentrated in Southeast and Pacific Asia, the geographic distribution of endemic scrub typhus is linked to the spread of the reservoir mite. Scrub typhus appears to be particularly prevalent in the tsutsugamushi triangle, which spans around 13 million km2 area and is bordered on the east by Japan, China, the Philippines, tropical Australia in the south, on the west by India, Pakistan, possibly Tibet, Afghanistan, and southern parts of the USSR in the north.
Methodology: This study aims to find the trend of occurrence of scrub typhus in various districts of Madhya Pradesh from 2017 to 2020. It is a retrospective observational study conducted among all laboratory-
confirmed IgM ELISA patients positive for scrub typhus in Madhya Pradesh. Data was collected from the Integrated Disease Surveillance Program (IDSP) database on zoonotic diseases.
Results: According to statistics, in 2017, 29% of cases were found to be in rural areas and 71% in urban areas. In 2018, 97% of cases in rural areas and 3% in urban areas were recorded. Similarly, in 2019, 90% of instances were recorded in rural areas and 10% in urban areas, while in 2020, 97% of cases were reported in rural areas and 3% in urban areas.
Conclusion: The epidemiological data presented here can aid in the creation and timely implementation of public health strategies to lower the prevalence of scrub typhus in Madhya Pradesh.

How to cite this article:
Bijlwan A, Kumar S, Sinha V, Kaurav Y S, Singh
S K, Goyal S. Increasing Trend of Scrub Typhus
in Madhya Pradesh: A Four-Year Retrospective
Analysis. J Commun Dis. 2024;56(4):57-61.

DOI: https://doi.org/10.24321/0019.5138.202470

Long-Term Sequelae of COVID-19: A Six-Month Follow-Up Study at a Tertiary Care Centre in South Kerala

2025-02-07T11:08:36+00:00

Background: COVID-19, emerging in December 2019, has manifested as a significant global health concern. While its acute phase is extensively documented, the long-term effects post-recovery remain less understood, particularly in specific regions such as Kerala, India. This study investigates the prolonged complications encountered by COVID-19 survivors from a tertiary care centre in South Kerala.
Objectives: This research aimed to determine the prevalence and clinical characteristics of post-COVID complications among survivors in South Kerala.
Method: A prospective observational study was conducted from March 2021 to September 2022, involving 184 participants who recovered from COVID-19. All participants were over 18 years of age and had confirmed COVID-19 recovery. Data collection involved interviews and examinations using a validated questionnaire one month post- recovery, continuing monthly for six months. Data on medical history, symptoms, and clinical investigations were gathered, followed by statistical analysis using SPSS 2.0.
Results: The cohort consisted of 184 participants, with an average age of 51.5 years and 52.2% male. Among them, 46.2% had mild COVID-19, 36.4% moderate, and 17.4% critical illness. Co-morbidities were prevalent: hypertension (35.9%), diabetes (35.3%), and coronary artery disease (10.9%).At one month post-recovery, 69% experienced post-COVID complications, with fatigue (43.5%) being most common. By six months, complications reduced to 22.8%, showcasing the importance of supportive care in recovery.
Conclusion: This study underscores the necessity for continuous medical support and monitoring of COVID-19 survivors to manage long-term health challenges effectively. Identifying post-COVID symptoms enables healthcare providers to customise follow-up care, highlighting the need for evidence-based guidelines to address post-COVID syndrome.

How to cite this article:

George A M, Asokan A G, Kuriakose M E. Long- Term Sequelae of COVID-19: A Six-Month Follow-
Up Study at a Tertiary Care Centre in South Kerala.J Commun Dis. 2024;56(4):62-69.

DOI: https://doi.org/10.24321/0019.5138.202471

Molecular Identification of Adhesion Gene Fima in Porphyromonas Gingivalis Isolated From Periodontitis Patients in Misan City

2025-02-07T11:11:59+00:00

Introduction: Porphyromonas gingivalis is an anaerobic, gram-negative bacterium that promotes oral dysbiosis and alters host defence mechanisms, contributing to the pathogenesis of periodontitis. The goal of the present study was to isolate and identify pathogenic P. gingivalis from gingivitis and periodontitis patients.
Method: Fifty swabs were collected from periodontitis patients attending Special Dental Center, Misan City, Iraq. Porphyromonas gingivalis was identified by PCR and its presence was clinically correlated with periodontal disease. The resistance of P. gingivalis was also tested against antibiotics (ciprofloxacin 5 mcg, carbenicillin 25 mcg, cefoxitin 30 mcg, doxycycline 30 mcg, and nalidixic acid 30 mcg).
Results: P. gingivalis was found to be associated with periodontal diseases. The strains were resistant to the antibiotics used in this study.
Conclusion: P. gingivalis is responsible for causing gingivitis and periodontitis in humans. The higher age groups are more commonly affected by it. Its strains were found to be resistant to the antibiotics
used in this study.

How to cite this article:
Faroq Z F, Ali M A A, Jabar S K. Molecular
Identification of Adhesion Gene Fima in
Porphyromonas Gingivalis Isolated From
Periodontitis Patients in Misan City. J Commun
Dis. 2024;56(4):70-75.

DOI: https://doi.org/10.24321/0019.5138.202472

Prescription Pattern Analysis of Tuberculosis Treatment at a Tertiary Care Hospital: A Cross- Sectional Study

2025-02-07T11:13:27+00:00

Objective: Prescription analysis of tuberculosis (TB) is essential for optimising treatment and combating contagious conditions brought on by TB-causing Mycobacterium. TB remains a significant health challenge, particularly in high-burden countries like India. Prescription analysis evaluates the patterns of anti-tubercular medication use, aiming to ensure rational drug use and improve patient outcomes. This study is essential in cases when treatment regimens are complex, such as with extensively drug-resistant TB and multi-drug-resistant TB. By understanding prescription patterns, healthcare professionals can lessen drug resistance and improve the effectiveness of TB treatment programmes.
Materials and Method: This observational cross-sectional study was carried out in January and February 2021 and aimed to assess the prescription patterns in TB treatment at a hospital in Ranchi. The study included 119 patients, excluding critically ill individuals and those unwilling to provide informed consent. Data on socio-demographic features, prescribed medications, hospitalisation duration, and comorbid conditions were collected.
Results: The study revealed a male predominance (63.02%) and the
majority of participants aged 19–30 years (31.09%). Most respondents
were illiterate (39.49%) and from rural areas (89.91%). Levofloxacin
was the most commonly prescribed medication (98.32%), with isoniazid
being the least prescribed (87.39%). Eight treatment regimens were
identified, with R3 (isoniazid, rifampicin, pyrazinamide, ethambutol,
streptomycin injection, and levofloxacin) being the most prevalent
(82.35%). The average hospitalisation duration was 4.01 ± 2.12 months.
Comorbid conditions were present in 20.17% of patients, diabetes
(41.7%) and epilepsy (25%) being the most common.
Conclusion: This study highlights that the practice of irrational use of
drugs is common and there is an urgent need for prescription pattern
analysis in promoting rational drug use in TB treatment.

How to cite this article:
Mangal S, Dasgupta S, Ray M, Saha S, Maji
H S, Indu R. Prescription Pattern Analysis
of Tuberculosis Treatment at a Tertiary Care
Hospital: A Cross-Sectional Study. J Commun
Dis. 2024;56(4):76-80.

DOI: https://doi.org/10.24321/0019.5138.202473

Stress Coping and Its Influencing Factors in Persons Living with HIV/ AIDS (PLHA)

2025-02-07T11:15:08+00:00

Introduction: Worldwide, the HIV/AIDS epidemic is continuing to be a
threat to the mankind. It is highly significant to understand protective
factors like stress coping among People Living with HIV/ AIDS (PLHA)
Objective: The aim of the study is to study stress coping and its
influencing factors in PLHA.
Methods: A total of 750 PLHAs were registered in the district. Among
these, 210 participants were selected using simple random sampling

method for this cross-sectional study. The researcher used the scale-
stress coping resources inventory by Kenneth B Matheny and Christopher

J McCarthy. Data analysis was done using descriptive statistics and tests.
Results: The overall score for stress coping skills revealed that 63.8% of
the respondents had above-average stress coping, 36.2% had average

stress coping and none were reported as having superior or below-
average stress coping. The study also illustrated that stress coping is

being influenced by occupation, marital status and religious belief.
Conclusion: A significant number of respondents were found to be
having average stress coping which indicates the need for strengthening
the coping.

How to cite this article:
Sobhith V K, Solomon M D. Stress Coping and Its
Influencing Factors in Persons Living with HIV/
AIDS (PLHA). J Commun Dis. 2024;56(4):81-85.

DOI: https://doi.org/10.24321/0019.5138.202474

A Study of Platelet Parameters and Their Correlation with Different Clinical Manifestations of Tuberculosis: A Pre- and Post-Treatment Analysis

2025-02-12T04:40:22+00:00

Introduction: Recent studies show that platelets play a pivotal role in
the pathogenesis of chronic diseases. However, the exact variation of
platelet parameters in different manifestations of tuberculosis has not
yet been studied effectively.
Objectives: To explore the variation of platelet count, Mean Platelet
Volume (MPV), and Platelet Distribution Width (PDW) in tuberculosis
and the changes in indices after 2 months of initiation of antitubercular
treatment
Materials and Methods: This was a cross sectional study where the
haematological reports of 150 patients attending the Department
of Pulmonary Medicine were studied. The platelet indices of these
patients were followed up 2 months after initiation of treatment and
compared with the initial data.
Results: Out of the 150 treatment naïve patients, 97 were of pulmonary
tuberculosis with no drug resistance. Their initial mean platelet count
was 1,07,000/mm3

, which increased to 2,52,000 after 2 months. The
initial mean PDW was 21.2 reduced to 17.7 after two months of
treatment. The initial MPV was 12 fL, which became 11.2 fL after
two months. In the remaining 53 patients including those with drug
resistance, tubercular pleural effusion, and military tuberculosis, the
initial mean platelet count, PDW, and MPV were 95000/mm3
, 25.2 and

7.1 fL that transformed to a mean of 1,18,000/mm3

, 19.7 and 7.7 fL

respectively, 2 months after initiating treatment.
Conclusion: This study indicates a tendency towards thrombocytopaenia
in tuberculosis patients and an increase in PDW. However following
the initiation of treatment, the platelet count increased rapidly with
a decrease in other indices.

How to cite this article:
Gangopadhyay G, Siddiqui B, Baneen U, Gautam
S, Ali A M D. A Study of Platelet Parameters
and Their Correlation with Different Clinical
Manifestations of Tuberculosis: A Pre- and
Post-Treatment Analysis. J Commun Dis.
2024;56(4):105-109.

DOI: https://doi.org/10.24321/0019.5138.202479

Analysis of Extended Spectrum Beta-Lactamase Producing Gram-Negative Bacilli: Bacteriological Insights from Clinical Samples

2025-02-11T11:48:49+00:00

Background: Antimicrobial resistance is a pressing concern in healthcare,
driven by new resistance mechanisms, poor infection control, and
antibiotic misuse. Proper antibiotic use is crucial for improving patient
outcomes. However, inadequate practices foster resistance among
bacteria that produce Extended Spectrum Beta-Lactamase (ESBL).

Objective: This study aims to detect and identify ESBL-producing gram-
negative bacteria (GNB), offering insights for better management and

surveillance.
Methodology: In this study, clinical samples from patients admitted

between 2021 and 2024 underwent standard culture procedures. Gram-
negative isolates were tested for ESBL production using recommended

methods. Genomic DNA was extracted from bacterial isolates, followed
by plasmid extraction and gel electrophoresis. Specific primers targeted
bla gene sequences for TEM, OXA, SHV, and CTX-M. PCR reactions were
conducted Under UV light, visualised with ethidium bromide staining,
using agarose gel electrophoresis.
Results: In this analysis, predominant isolates of GNB were from urine
(64%), exudates (26%), and respiratory (10%) samples. Out of 144
ESBL-producing GNB obtained, 40% of the isolates were positive for
the blaTEM gene, 27% for blaCTX-M, and 14% for blaSHV.
Conclusion: ESBL-producing GNB are widespread in the gut, and highly
resistant. Among 2356 isolates, Escherichia coli and Klebsiella species
prevailed. ESBLs, mainly in E. coli and Klebsiella, pose therapeutic
challenges, necessitating updated therapy strategies and prudent
cephalosporin use. Routine testing for ESBL detection is crucial in
clinical labs for effective control.

How to cite this article:
Louis J M, Selvabai A P, Shanmugam P,
Muthukrishnan I, Kumar M. Analysis of Extended

Spectrum Beta-Lactamase Producing Gram-
Negative Bacilli: Bacteriological Insights from

Clinical Samples. J Commun Dis. 2024;56(4):110-
116.

DOI: https://doi.org/10.24321/0019.5138.202480

Correlation of Epstein Barr Virus Infection and Related Immune Response among Iraqi Patients with Hashimoto’s Thyroiditis

2025-02-11T12:13:22+00:00

Background: Hashimoto's thyroiditis (HT), an autoimmune thyroid gland disease and the leading cause of hypothyroidism in developed countries. HT may develop at any stage of life, especially between the ages of 30 and 50 years, and affects females more than males within a ratio of 10:1. The HT prevalence is approximately 2 percent across all age groups, with an annual incidence of 0.3 to 1.5 cases per 1,000 individuals. The TH etiology is multifactorial, incorporating both genetic and environmental factors. New evidence suggests that viral infection and uncontrolled related immune response may serve as triggering of HT. The Epstein-Barr virus (EBV) is a double-stranded DNA virus that demonstrates a distinctive tropism towards B lymphocytes and can modulate and evade the immune system. Emerging evidence linked EBV to the onset or development of HT.

Disrupting the Status Quo: Nitric Oxide’s Role in Tackling Pseudomonas aeruginosa Infections

2025-02-09T06:07:03+00:00

Background: Antibiotic resistance in gram-negative organisms,
particularly Pseudomonas aeruginosa, presents a formidable challenge
in healthcare settings due to its biofilm-forming ability. This study
investigates the influence of nitric oxide (NO) on P. aeruginosa biofilms,
with a focus on the expression of biofilm-related genes (pslA, pelA,
and algD).
Method: 71 isolates of P. aeruginosa were obtained from clinical
specimens and subjected to biofilm formation assays and exposure
to NO using sodium nitroprusside (SNP) as a donor. Gene expression
analysis was conducted using quantitative reverse transcription-PCR.
A scanning electron microscope (SEM) was used to visualise biofilm
morphology.
Results: SNP exposure disrupted biofilm formation in most isolates,
although some showed resilience. SEM revealed significant biofilm
disruption post-NO treatment. Gene expression analysis indicated varied
responses to NO, with some isolates showing increased expression of
biofilm-related genes while others exhibiting downregulation.
Conclusion: Albeit nitric oxide disrupted P. aeruginosa biofilms, its
impact on gene expression varies among isolates. Understanding
these dynamics could help develop targeted therapeutic strategies
for biofilm-associated infections.

How to cite this article:
Abdulrahman Z T, Al-Mathkhury H J F. Disrupting
the Status Quo: Nitric Oxide’s Role in Tackling
Pseudomonas aeruginosa Infections. J Commun
Dis. 2024;56(4):124-131.

DOI: https://doi.org/10.24321/0019.5138.202482

Estimation of Immunoglobulins in Iraqi SARS-CoV-2-Infected Mothers and Their Infants

2025-02-11T12:11:11+00:00

Objectives: The study aimed to estimate the levels of specific
immunoglobulins (IgG, IgM, and IgA) in mothers and their infants
affected by COVID-19 and to examine the impact of vaccination on
antibody levels.
Method: It was a case-control study conducted among Iraqi pregnant
women who gave birth at Saint Raphael Hospital in Baghdad. A total of
148 Iraqi pregnant women were included, with 122 females previously
infected with SARS-CoV-2 (group 1) and 26 healthy controls (group 2).
Blood samples were collected from mothers before birth and from
newborns after birth. The diagnosis of COVID-19 in patients was based
on clinical characteristics and PCR results. IgG, IgM, and IgA were
detected using the ELISA technique. Real-time PCR was used to detect
SARS-CoV-2 RNA in nasopharyngeal swabs.
Results: IgG was detected in both mothers and their infants, while
IgA was detected in mothers only. IgM was not detected in either
mothers or infants. The study also examined the impact of vaccination
on antibody levels.
Conclusions: The study concludes that IgG and IgA were identified only
in mothers, with IgM being undetectable in both mothers and their
infants. The most robust immune responses were observed in mothers
who had received the AstraZeneca vaccine.

How to cite this article:
Sayah S N, Al-azzawi R H. Estimation of
Immunoglobulins in Iraqi SARS-CoV-2-Infected
Mothers and Their Infants. J Commun Dis.
2024;56(4):132-138.

DOI: https://doi.org/10.24321/0019.5138.202483

Immunological Profiling of Toll-Like Receptor 3, Interferon-Alpha, and Antimicrobial Peptide LL-37 in Response to COVID-19 Infection and Vaccination in Iraqi Patients

2025-02-09T06:21:10+00:00

Performance Analysis of AI-Assisted Chest Radiography for COVID-19 Pneumonia Diagnosis in Resource-Limited Settings

2025-02-09T06:29:57+00:00

Introduction: Chest radiography (CXR) is commonly used for diagnosing
lung and cardiothoracic disorders, including coronavirus disease
(COVID-19) pneumonia. However, its diagnostic accuracy during the
early COVID-19 stages was limited. Artificial intelligence (AI) can enhance
CXR analysis and diagnostic accuracy.
Objective: To evaluate AI in X-ray diagnostics for COVID-19 patients
in Kyrgyzstan.
Methods: Three radiologists reviewed CXR reports of pneumonia patients
and healthy individuals. An AI system with the MedVit deep learning
model identified COVID-19 pneumonia, and its reports were compared
to radiologists’ interpretations to evaluate diagnostic accuracy.
Results: AI’s performance in detecting pneumonia matched that of
radiologists, with 88.31% sensitivity and 96.67% specificity. High
Youden index values indicated quality. AI can enhance X-ray accuracy,
especially in resource-limited settings, though challenges like data
quality, standardization, and ethics must be addressed for widespread
adoption.
Conclusion: Collaboration between radiologists and AI can enhance
radiological reports for patients with COVID-19 pneumonia, particularly
in rural areas with staff shortages.

How to cite this article:
Emilov B, Sorokin A, Chubakov T, Baitelieva
A, Salibaev O, Chubakov, Zhumabekova A.
Performance Analysis of AI-Assisted Chest
Radiography for COVID-19 Pneumonia
Diagnosis in Resource-Limited Settings. J
Commun Dis. 2024;56(4):146-152.

DOI: https://doi.org/10.24321/0019.5138.202485

Relaparotomy for Peritonitis Following Liver Surgery in Alveococcosis and Echinococcosis: A Retrospective Analysis of 924 Cases

2025-02-11T11:49:27+00:00

Introduction: Hepatic cystic echinococcosis and alveolar echinococcosis
are common parasitic liver diseases worldwide.
Objective: To assess the effectiveness of surgical treatment in patients
with cystic echinococcosis and alveolar echinococcosis
Methods: This retrospective study examined 924 patients who underwent
surgery for hepatic echinococcosis and alveolar echinococcosis. Peritonitis
cases were identified using clinical, laboratory, and imaging criteria. The
surgical approach involved relaparotomy, abdominal cavity revision,
infection source elimination, cavity drainage, and detoxification therapy.
Descriptive statistics were used for data analysis. This retrospective
study examined 924 patients and 12 patients who underwent surgery
for hepatic cystic echinococcosis and alveolar echinococcosis
Results: Closed echinococcectomy (EE) was the most common surgery,
performed in 513 patients. Among the 625 patients with complications
following hepatic surgery, 36 (5.8%) developed diffuse peritonitis. During
the reoperation for peritonitis, a thorough approach included revising the
abdominal cavity, eliminating the infection source, draining the cavity,
and administering aggressive detoxification and anti-inflammatory
therapy. Regional lymphatic stimulation was performed during multiple
surgeries to enhance lymphatic drainage, reduce inflammation, and
restore gastrointestinal function.
Conclusion: The findings contribute to the understanding of surgical
management for parasitic liver cysts and emphasise the need for further
research to improve treatment outcomes and reduce recurrence rates.

How to cite this article:
Abdiev A, Arsen T ,Ulan I, Akeshov A, Saparov S,
Mamatov N, Vityala Y. Relaparotomy for Peritonitis
Following Liver Surgery in Alveococcosis and
Echinococcosis: A Retrospective Analysis of 924
Cases. J Commun Dis. 2024;56(4):153-157.

DOI: https://doi.org/10.24321/0019.5138.202486

Adult Vaccination for Preventing Communicable Diseases in an Urban Community of Delhi

2025-02-11T10:15:32+00:00

Introduction: Vaccination is a cornerstone of public health; significantly
reducing the burden of infectious diseases. While childhood immunisation
programmes have made substantial progress, adult vaccination often
receives less attention.
Objective: To assess the knowledge, attitudes, and practices concerning
adult vaccination against infectious diseases among adults of an urban
community in Delhi
Methods: Systematic random sampling was used to collect the required
sample from an urban community. Data collection was done by using
a self-designed pre-tested and pre-validated questionnaire. Data
was entered and analysed in Microsoft Excel software for statistical
processing and suitably presented. To determine the association,
the chi-square test was employed. A p value of less than 0.05 was
considered significant.
Results: The awareness regarding adult vaccination against communicable
diseases was as high as 87%. Tetanus vaccine was the most commonly
known (89%), followed by rabies (68%), hepatitis B (58%), influenza
(21%) and pneumococcus (11%). 84% had received any vaccine during
adulthood, tetanus being the most commonly received (83%). Lack of
knowledge about the other available vaccines and lack of prescription by
healthcare providers were identified as the major barriers to vaccination.
Conclusion: A high level of awareness and good acceptance was there
for a few vaccines. Therefore, IEC for other vaccines for infectious
diseases may be used in urban communities to generate demand.

Priyanka, Srivastava N, Kishore J. Adult Vaccination
for Preventing Communicable Diseases in an
Urban Community of Delhi. J Commun Dis.
2024;56(4):158-165.

DOI: https://doi.org/10.24321/0019.5138.202487

Apoptosis Induction and Expression of Apoptotic- Related and CCL3, CCL4 and CCL8 Genes in Lymphocytes and Neutrophils Exposed to the Leishmania infantum Parasite

2025-02-12T05:45:31+00:00

Application of the Homotopy Perturbation Method for Analysing the Spread of the Nipah Virus

2025-02-11T10:48:39+00:00

Correlation between IL-10 and IL-23 Levels and Aerobic and Anaerobic Bacteria Isolated from Diabetic Foot Ulcer Patients in Mosul City

2025-02-11T11:13:20+00:00

Introduction: The occurrence of Foot ulcers among diabetes Mellitus
is a common complication and its prevention is of utmost importance.
Aims: To find a relationship between the levels of interleukins 10 and
23 and the bacterial species isolated from diabetic foot ulcer patients
to identify the antibiotics used to treat the ulcers the bacterial species
that are resistant to antibiotics. Methodology The study was conducted
at Al-Salam Teaching Hospital in the city of Mosul during the period
from December 1, 2022 to the end of June 2023. The study included
65 samples from patients between the ages of 35 and 80 years.

Results: Of 65 participants, there were 40 males and 25 females , re-
vealing a significantly higher incidence of diabetic foot ulcers in males

compared to females in cases of type 2 diabetes. The investigation in-
cluded an evaluation of IL-10 and IL-23 levels and the results showed no

significant difference in the IL-23 levels between patients and controls,
while significant negative differences in IL-10 levels were observed.
The results of antibiotic susceptibility tests conducted on diabetic foot
ulcer isolates showed the presence of bacteria at the site of diabetic
ulcers that were resistant to multiple antibiotics.
Conclusion: We conclude from this study that there is a relationship

between the levels of IL -10 and IL 23 and the increase in the devel-
opment of inflammation in diabetic foot ulcer patients. It was seen

that there are bacterial species that are resistant to antibiotics. The
development of a new drug is needed to treat bacterial infections in
antibiotic-resistant diabetic foot ulcer patients.

How to cite this article:
Khalil R I, Mohsi S N, Nayyef, S H. Correlation
between IL-10 and IL-23 Levels and Aerobic
and Anaerobic Bacteria Isolated from Diabetic
Foot Ulcer Patients in Mosul City. J Commun Dis.
2024;56(4):177-183.

DOI: https://doi.org/10.24321/0019.5138.202490

Shigellosis: A Comprehensive Review: History, Symptoms, Pathophysiology, Cause for the Disease, Diagnosis, Transmission, Epidemiology, Treatment, and Prevention Measures

2025-02-11T11:50:05+00:00

Shigellosis, caused by the bacterium of the genus Shigella, is a significant global public health concern due to its high morbidity and mortality rates, particularly in low-resource settings. This review provides a comprehensive overview of shigellosis, encompassing its historical context, clinical manifestations, underlying pathophysiology, and factors contributing to its emergence and spread. The disease primarily manifests with symptoms ranging from mild diarrhoea to severe dysentery, often accompanied by fever and abdominal cramps. Shigella bacteria invade the lining of the intestines, causing inflammation and disrupting normal gastrointestinal function. The disease is predominantly transmitted through faecal-oral routes, emphasising the critical importance of sanitation and hygiene measures in prevention. Epidemiologically, shigellosis exhibits a wide global distribution, with higher incidences observed in regions with limited access to clean water and sanitation
facilities. Prompt diagnosis via stool culture or molecular techniques is essential for effective treatment and public health surveillance. Although
various antibiotics are available for treatment, rising antibiotic resistance
poses a growing challenge. Vaccination presents a promising avenue for
shigellosis prevention; however, the development of an effective and
widely accessible vaccine remains a priority. The review also addresses
practical considerations such as vaccine pricing and safety, particularly
in pregnancy. Understanding the nuances of shigellosis, including its
historical context, clinical presentation, and prevention strategies,
is pivotal in guiding healthcare interventions and policy decisions to
mitigate its impact on global health.

How to cite this article:
Rajappa M C, Susai J K, Solomom G G, Kanta J
A H, Vezhaventhan V, Palanivel P. Shigellosis:
A Comprehensive Review: History, Symptoms,
Pathophysiology, Cause for the Disease,
Diagnosis, Transmission, Epidemiology,
Treatment, and Prevention Measures. J Commun
Dis. 2024;56(4):86-93.

DOI: https://doi.org/10.24321/0019.5138.202475

A Rare Case of Subacute Sclerosing Panencephalitis Presenting as Schizophrenia - A Case Report

2025-02-07T11:28:49+00:00

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive and
often fatal late neurological manifestation of measles infection which
occurs after a latent period of several years after primary infection in
immunocompetent hosts. It is characterised by mental state changes,
myoclonus and often ataxia. In this case, an 18-year-old male presented
with mood swings, irritability, and cognitive decline, leading to an
initial misdiagnosis of schizophrenia. The misdiagnosis stemmed from
overlapping psychiatric symptoms, such as behavioural changes,
forgetfulness, and decreased attention, as well as the absence of
prominent neurological findings at the onset. The diagnosis is based
on the detection of intrathecal anti-measles antibodies of the IgG class
and the presence of the IgM class of antibodies usually confers a bad
prognosis. Pathological examination reveals inflammatory changes
in brain tissue, gliosis, demyelination and typical inclusion bodies
containing measles viral antigens or RNA.
Electroencephalographic findings in SSPE are highly characteristic
showing bilateral generalised high amplitude slow or sharp-slow wave
complexes. Therapeutic modalities often prove disappointing, the
outcome and prognosis is generally poor and most patients die over a
period ranging from several months to a few years. The cause of death
is generally respiratory tract infection or involvement of brain stem
centres controlling vital functions. Although the incidence of SSPE has
dramatically declined after successful immunisation programmes, it
still occurs in developing countries where coverage is lower. It is very
important to correctly diagnose and manage SSPE and not attribute
the symptoms to a mere psychiatric illness. Further research is highly
needed for early diagnosis and treatment options for these patients
to have a decent quality of life, which at present is difficult.

How to cite this article:

Gaur I. A Rare Case of Subacute Sclerosing Panencephalitis Presenting as Schizophrenia - A Case Report. J Commun Dis. 2024;56(4):94-96.

DOI: https://doi.org/10.24321/0019.5138.202476

Is Experience Better than Evidence? Tuberculous Laryngitis: A Case Report

2025-02-07T11:30:19+00:00

Introduction: Tuberculosis seldom affects the larynx without a lung infection. But in recent times, the incidence of laryngeal tuberculosis has risen due to HIV infection, conditions, and medications causing immunosuppression, resistant organisms and atypical mycobacteria. Although rare, this is the most common laryngeal granulomatous disease. This rare case report shows a patient with a laryngeal lesion who responded to empirical antitubercular medication after all tests were negative for tuberculosis.

Case Presentation: A 21-year-old woman reported to the otorhinolaryngology outpatient clinic with a 3-month history of insidious hoarseness of voice, dry cough, and foreign body sensation in the throat with associated right cervical lymphadenopathy.

Management And Outcome: Video laryngoscopy showed a nodular lesion in the anterior commissure extending to the whole of the anterior 2/3rd right vocal cord. Microlaryngeal surgery was done but the biopsy specimen was negative for tuberculosis. On ruling out other granulomatous diseases, anti-tubercular therapy was administered with which the patient recovered fully.

How to cite this article:

Kumar S B, Rajasekaran S, Muthukumar R,

Prabakaran S, Navin N R B, Balaji D, Gowathame

K, Adithya V. Is Experience Better than Evidence?

Tuberculous Laryngitis: A Case Report.

J Commun Dis. 2024;56(4):97-100

DOI: https://doi.org/10.24321/0019.5138.202477

Nontraumatic Gas Gangrene Caused by Clostridium perfringens - A Case Report

2025-02-07T11:32:03+00:00

This article focuses on a case of nontraumatic gas gangrene caused by Clostridium perfringens . A 54-year-old female patient presented to the outpatient department with a sudden onset of swelling and pain over the right foot. She gave no history of trauma. The patient was admitted and treatment commenced. All diagnostics were performed for the patient. Culture from the foot ulcer yielded the anaerobic bacterium Clostridium perfringens

, the causative agent of gas gangrene. Medical management and surgical intervention were done for this patient. The patient responded to the treatment and was discharged. This case highlights the typical presentation of nontraumatic gas gangrene emphasising the importance of high suspicion in patients

without evident trauma. In conclusion, Clostridium perfringens causing nontraumatic gas gangrene is a serious condition that needs immediate recognition and intervention. So early diagnosis, medical management and surgical interventions were crucial for favourable outcomes, which can reduce the mortality rate of the patients

How to cite this article:

Kumar P, Shanmugam P. Nontraumatic Gas Gangrene Caused by Clostridium perfringens

- A Case Report . J Commun Dis. 2024;56(4):102-104.

DOI: https://doi.org/10.24321/0019.5138.202478