Pub Date : 2020-07-01DOI: 10.4103/ijaai.ijaai_12_20
Raj Kumar, P. Mrigpuri, Indu Bisht, Kamal Singh, M. Kumar, S. Spalgais
BACKGROUND: Bronchial asthma (BA) is characterized by chronic airway inflammation. Many studies have shown a significant overlap between BA and allergic rhinitis (AR). Specific allergen immunotherapy (AIT) is effective for the treatment of BA and AR. Only limited studies have evaluated the role of immunological parameters to assess the response in patients on AIT. Hence, this study was done to assess the role of interleukin-4 (IL-4), IL-5, and IL-6 in the follow-up of patients of BA and AR on AIT. MATERIALS AND METHODS: This study was conducted on diagnosed cases of BA, AR, and BA with AR attending the outpatient department who were started on subcutaneous immunotherapy as per the standard Indian guidelines. Blood samples were collected at the beginning of the treatment and every 3 months thereafter for a period of 51 months, and serum IL-4, IL-5, and IL-6 levels were measured. RESULTS: In this study, 170 patients were enrolled over a period of 51 months. Out of 170, 80 (47.1%) patients had completed 1 year of treatment with AIT at the end of 51 months of follow-up. Significant reduction was observed in IL-4, IL-5, and IL-6 levels during the treatment with AIT over a period of 12 months. CONCLUSION: Our study suggests a possible role of IL-4, IL-5, and IL-6 in the follow-up of BA and AR patients; however, further studies are needed in this area.
{"title":"Role of immunological mediators in the follow-up of asthma and allergic rhinitis patients on allergen immunotherapy","authors":"Raj Kumar, P. Mrigpuri, Indu Bisht, Kamal Singh, M. Kumar, S. Spalgais","doi":"10.4103/ijaai.ijaai_12_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_12_20","url":null,"abstract":"BACKGROUND: Bronchial asthma (BA) is characterized by chronic airway inflammation. Many studies have shown a significant overlap between BA and allergic rhinitis (AR). Specific allergen immunotherapy (AIT) is effective for the treatment of BA and AR. Only limited studies have evaluated the role of immunological parameters to assess the response in patients on AIT. Hence, this study was done to assess the role of interleukin-4 (IL-4), IL-5, and IL-6 in the follow-up of patients of BA and AR on AIT. MATERIALS AND METHODS: This study was conducted on diagnosed cases of BA, AR, and BA with AR attending the outpatient department who were started on subcutaneous immunotherapy as per the standard Indian guidelines. Blood samples were collected at the beginning of the treatment and every 3 months thereafter for a period of 51 months, and serum IL-4, IL-5, and IL-6 levels were measured. RESULTS: In this study, 170 patients were enrolled over a period of 51 months. Out of 170, 80 (47.1%) patients had completed 1 year of treatment with AIT at the end of 51 months of follow-up. Significant reduction was observed in IL-4, IL-5, and IL-6 levels during the treatment with AIT over a period of 12 months. CONCLUSION: Our study suggests a possible role of IL-4, IL-5, and IL-6 in the follow-up of BA and AR patients; however, further studies are needed in this area.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"71 7 1","pages":"87 - 91"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83613514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/ijaai.ijaai_33_19
P. Kathuria, M. Rai, Neelam Kathuria
Hereditary angioedema (HAE) is a potentially life-threatening disorder, due to a mutation in complement one-inhibitor (C1-INH) gene, which blocks the activity of various components of complement – fibrinolytic and bradykinin control system. Our seven cases of HAE give different clinical presentations of TYPE I/II/III HAE as facial, abdominal, laryngeal, and genital involvement along with comorbidities (5 cases) such as hypothyroidism, rhinosinusitis, and hypothalamic–pituitary–adrenal suppression, and four cases have had history of recurrent abdominal attacks. Treatment with Pdc-INH concentrate and self-administrated Icatibant provides consistent and reliable efficacy in those who have had multiple successive HAE attacks, with the involvement of all body parts. However, if pdc-INH concentrate is not available, then fresh frozen plasma and androgens (Danazol) can be used in emergency. Our cases demonstrate the importance of diligent clinical and family history with special tests: C4, C1-INH quantitative, and C1-INH functional.
{"title":"Spectrum of diagnosis of hereditary angioedema: Seven case reports","authors":"P. Kathuria, M. Rai, Neelam Kathuria","doi":"10.4103/ijaai.ijaai_33_19","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_33_19","url":null,"abstract":"Hereditary angioedema (HAE) is a potentially life-threatening disorder, due to a mutation in complement one-inhibitor (C1-INH) gene, which blocks the activity of various components of complement – fibrinolytic and bradykinin control system. Our seven cases of HAE give different clinical presentations of TYPE I/II/III HAE as facial, abdominal, laryngeal, and genital involvement along with comorbidities (5 cases) such as hypothyroidism, rhinosinusitis, and hypothalamic–pituitary–adrenal suppression, and four cases have had history of recurrent abdominal attacks. Treatment with Pdc-INH concentrate and self-administrated Icatibant provides consistent and reliable efficacy in those who have had multiple successive HAE attacks, with the involvement of all body parts. However, if pdc-INH concentrate is not available, then fresh frozen plasma and androgens (Danazol) can be used in emergency. Our cases demonstrate the importance of diligent clinical and family history with special tests: C4, C1-INH quantitative, and C1-INH functional.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"259 1","pages":"49 - 52"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74367207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/ijaai.ijaai_14_19
K. Chauhan, Shetanshu Srivastava, R. Prasad
BACKGROUND: Children with asthma have a high prevalence of environmental allergies. Sensitization to various allergens, especially to indoor allergens is crucial for effective measures for asthma management. Indian data on allergic sensitization in children is scarce, necessitating the need of the study. METHODS: A Cross-sectional study was conducted to determine the indoor allergen sensitization in 100 asthmatic children aged 5 to 15 yrs. They underwent skin prick test for indoor allergen house dust mite cockroach, cat, dog dander, house fly, candida, aspergillus, and mosquito. RESULTS: In the study sensitization to house dust mite was 93%. 39% were sensitized to Candida 36% to cockroach,23% housefly and 22%to dog dander and Aspergillus and 13% to mosquito and cat dander. Allergen sensitivity rate for atleast one allergen was 94% which was significant. Mean No. of allergens for which sensitization was seen is 2.57±1.77. Comorbidities were present in 35% of cases.7% had urticarial and allergic conjunctivitis each. CONCLUSION: Asthmatic children showed high sensitization to indoor allergen and the most common allergen found was house dust mite
{"title":"Sensitization to indoor allergens in children with bronchial asthma","authors":"K. Chauhan, Shetanshu Srivastava, R. Prasad","doi":"10.4103/ijaai.ijaai_14_19","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_14_19","url":null,"abstract":"BACKGROUND: Children with asthma have a high prevalence of environmental allergies. Sensitization to various allergens, especially to indoor allergens is crucial for effective measures for asthma management. Indian data on allergic sensitization in children is scarce, necessitating the need of the study. METHODS: A Cross-sectional study was conducted to determine the indoor allergen sensitization in 100 asthmatic children aged 5 to 15 yrs. They underwent skin prick test for indoor allergen house dust mite cockroach, cat, dog dander, house fly, candida, aspergillus, and mosquito. RESULTS: In the study sensitization to house dust mite was 93%. 39% were sensitized to Candida 36% to cockroach,23% housefly and 22%to dog dander and Aspergillus and 13% to mosquito and cat dander. Allergen sensitivity rate for atleast one allergen was 94% which was significant. Mean No. of allergens for which sensitization was seen is 2.57±1.77. Comorbidities were present in 35% of cases.7% had urticarial and allergic conjunctivitis each. CONCLUSION: Asthmatic children showed high sensitization to indoor allergen and the most common allergen found was house dust mite","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"37 1","pages":"39 - 42"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84086203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/ijaai.ijaai_22_20
Shalini Gandhi, Sandeep Sharma, Purva Shoor, J. Sorout, Abhay Raina, R. Raina, Urvashi Miglani, U. Chaudhari, Shivi Srivastava
There is a new public health crises threatening globally with the emergence and spread of 2019 novel coronavirus or the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is the seventh member of the coronavirus (CoV) family, which infects humans and to which the Middle East Respiratory Syndrome CoV (MERS)-and SARS-CoV also belong. SARS-CoV-2 is a newly emerging human infectious CoV that causes COVID-19, which has been recognized as a pandemic by the World Health Organization on March 11. The most recent outbreak initially presented as pneumonia of unknown etiology as COVID-19 is a pneumonia-like disease with a group of symptoms including fever, dry cough and shortness of breath in a cluster of patients in December 2019 Wuhan, China. The body's immune system tries to protect the body from this pathogen. And as due to its surge in the body, various respiratory and other system-related complications increased. Therefore, in this article, COVID-19 immunopathogenesis is briefly reviewed. Through this review, we try to explain the molecular immune pathogenesis and diagnosis of COVID-19 (SARS-CoV-2) infection, based on the recent research progress of SARS-CoV-2 and the knowledge from researches on SARS-CoV and MERS-CoV.
{"title":"Covid-19 immune mechanisms: A systematic review","authors":"Shalini Gandhi, Sandeep Sharma, Purva Shoor, J. Sorout, Abhay Raina, R. Raina, Urvashi Miglani, U. Chaudhari, Shivi Srivastava","doi":"10.4103/ijaai.ijaai_22_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_22_20","url":null,"abstract":"There is a new public health crises threatening globally with the emergence and spread of 2019 novel coronavirus or the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is the seventh member of the coronavirus (CoV) family, which infects humans and to which the Middle East Respiratory Syndrome CoV (MERS)-and SARS-CoV also belong. SARS-CoV-2 is a newly emerging human infectious CoV that causes COVID-19, which has been recognized as a pandemic by the World Health Organization on March 11. The most recent outbreak initially presented as pneumonia of unknown etiology as COVID-19 is a pneumonia-like disease with a group of symptoms including fever, dry cough and shortness of breath in a cluster of patients in December 2019 Wuhan, China. The body's immune system tries to protect the body from this pathogen. And as due to its surge in the body, various respiratory and other system-related complications increased. Therefore, in this article, COVID-19 immunopathogenesis is briefly reviewed. Through this review, we try to explain the molecular immune pathogenesis and diagnosis of COVID-19 (SARS-CoV-2) infection, based on the recent research progress of SARS-CoV-2 and the knowledge from researches on SARS-CoV and MERS-CoV.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"11 1","pages":"23 - 27"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75787720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/ijaai.ijaai_29_20
S. Katiyar, Sandeep Katiyar
Inhaled therapy is the cornerstone in the management of obstructive airway diseases (OADs). Nebulization is often used for the delivery of bronchodilators and corticosteroids among the elderly and children. The present pandemic of coronavirus disease 2019 (COVID-19), caused by a newly identified, highly contagious, novel coronavirus, called severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), is responsible for great morbidity and mortality globally. There is a great concern regarding person-to-person transmissibility of this virus. There is also a great concern of viral transmission of this virus to the health-care personnel and the bystanders through aerosol-generating procedures including frequently used nebulization therapy. Most of the patients with OAD, during the current pandemic, who were undergoing nebulization therapy, on getting infected with SARS-CoV-2 or on its suspicion, have been shifted to other handheld devices out of fear of transmission of infection. Presently, there exist not enough evidences either on the safety or on the risk of transmissibility of SARS-CoV-2 during nebulization in COVID-19 patients. In addition, there are concerns about nebulization in OAD cases even in the absence of COVID-19 and about the use of inhaled or systemic corticosteroids in these cases. We have made some observations based on all the current information available related to these issues, which may help provide some guidance in the use of nebulizer therapy and also discussed the measures to be taken to minimize the risk of infection, if any, during the procedure.
{"title":"Nebulization in the pandemic of coronavirus disease 2019","authors":"S. Katiyar, Sandeep Katiyar","doi":"10.4103/ijaai.ijaai_29_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_29_20","url":null,"abstract":"Inhaled therapy is the cornerstone in the management of obstructive airway diseases (OADs). Nebulization is often used for the delivery of bronchodilators and corticosteroids among the elderly and children. The present pandemic of coronavirus disease 2019 (COVID-19), caused by a newly identified, highly contagious, novel coronavirus, called severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), is responsible for great morbidity and mortality globally. There is a great concern regarding person-to-person transmissibility of this virus. There is also a great concern of viral transmission of this virus to the health-care personnel and the bystanders through aerosol-generating procedures including frequently used nebulization therapy. Most of the patients with OAD, during the current pandemic, who were undergoing nebulization therapy, on getting infected with SARS-CoV-2 or on its suspicion, have been shifted to other handheld devices out of fear of transmission of infection. Presently, there exist not enough evidences either on the safety or on the risk of transmissibility of SARS-CoV-2 during nebulization in COVID-19 patients. In addition, there are concerns about nebulization in OAD cases even in the absence of COVID-19 and about the use of inhaled or systemic corticosteroids in these cases. We have made some observations based on all the current information available related to these issues, which may help provide some guidance in the use of nebulizer therapy and also discussed the measures to be taken to minimize the risk of infection, if any, during the procedure.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"139 1","pages":"8 - 14"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86547870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/ijaai.ijaai_34_19
A. Agarwal
Immunoglobulin M (IgM) is the first antibody to be produced during an immune response, and most of the primary humoral immune response is mediated by IgM. Selective IgM deficiency (sIgMD) is a rare immune disorder that has been reported in the association with serious infections. Patients with sIgMD may be asymptomatic; however, approximately 80% of patients present with infections with bacteria, viruses, or protozoa or with an associated allergic, malignant, or autoimmune condition. sIgMD is usually identified when evaluating a patient for recurrent or serious infections. Attempts should be made to document the infection, as well as the responsible organism, whenever possible. It is a diagnosis of exclusion, and formal diagnostic criteria have not been established. We report three adult cases that were diagnosed to have sIgMD during the evaluation for serious polymicrobial infections with bacteria, fungi, mycobacterium, and viruses. One of them was diagnosed to have associated lymphocytic leukemia. All were successfully managed with intravenous Immunoglobulin (Ig), antibiotics, antiviral, supportive treatment, and discharged. We conclude that patients presenting with polymicrobial infections with encapsulated bacteria, fungi, mycobacterium, and viruses should be evaluated for specific antibody deficiency responses, and they appear to improve clinically on Ig therapy. It appears that the disorder is underdiagnosed.
{"title":"Selective immunoglobulin M deficiency: An underestimated immunodeficiency disorder – not so rare","authors":"A. Agarwal","doi":"10.4103/ijaai.ijaai_34_19","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_34_19","url":null,"abstract":"Immunoglobulin M (IgM) is the first antibody to be produced during an immune response, and most of the primary humoral immune response is mediated by IgM. Selective IgM deficiency (sIgMD) is a rare immune disorder that has been reported in the association with serious infections. Patients with sIgMD may be asymptomatic; however, approximately 80% of patients present with infections with bacteria, viruses, or protozoa or with an associated allergic, malignant, or autoimmune condition. sIgMD is usually identified when evaluating a patient for recurrent or serious infections. Attempts should be made to document the infection, as well as the responsible organism, whenever possible. It is a diagnosis of exclusion, and formal diagnostic criteria have not been established. We report three adult cases that were diagnosed to have sIgMD during the evaluation for serious polymicrobial infections with bacteria, fungi, mycobacterium, and viruses. One of them was diagnosed to have associated lymphocytic leukemia. All were successfully managed with intravenous Immunoglobulin (Ig), antibiotics, antiviral, supportive treatment, and discharged. We conclude that patients presenting with polymicrobial infections with encapsulated bacteria, fungi, mycobacterium, and viruses should be evaluated for specific antibody deficiency responses, and they appear to improve clinically on Ig therapy. It appears that the disorder is underdiagnosed.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"284 1","pages":"43 - 48"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76851407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/ijaai.ijaai_16_20
N. Sarangdhar, S. Gaur
{"title":"COVID-19: A global crisis","authors":"N. Sarangdhar, S. Gaur","doi":"10.4103/ijaai.ijaai_16_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_16_20","url":null,"abstract":"","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"32 1","pages":"1 - 4"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73863118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/ijaai.ijaai_17_20
S. Bhandari, Ajeet Singh, S. Banerjee, Raman Sharma, G. Rankawat, Vishal Gupta, P. Keswani, Ashwini Mathur, A. Agarwal, S. Sharma, P. Meena
PURPOSE: The present study was undertaken to investigate the behavioral distribution pattern and progression of coronavirus disease 2019 (COVID-19) across age and gender in the state of Rajasthan, India, inherently distinctive and native to localized part of the globe giving requisite information and paraphernalia to designate advisory board of the state to design and frame customized policy for demands of the state as per the trending pattern relative to age and sex distribution, profile of new infected cases, recovery rate, and case fatality rate. METHODS: The present ongoing study assessed patients admitted till April 22, 2020, across the state of Rajasthan, India, with reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 test. Analyses of the patients included characteristic age and gender distribution through the geographic identities of state along with the time trending pattern of newly infected patients, recovered patients, and case fatality rate. RESULTS: A total of 1888 sample patient population of RT-PCR-confirmed COVID-19 was evaluated, with the majority of sample patient population being in young adult age group with a mean age of 34.42 years. Nearly 11.65% of the patients were below 15 years of age, 34.79% were in the age range of 16–30 years, 25.90% were in the age group of 31–45 years, and 17.69% were in the age group of 46–60 years, with only 9.95% of the patient population being in the age group of above 60 years. Interestingly, 11.65% of patients with COVID-19 were in the pediatric age group. The percent of affected females (37.35%) was much less than that compared to males (62.65%), with an average sex ratio of 0.59. Across the sample patient population of 1888, 543 patients recovered fully, 25 patients died, and 1320 cases were active in the said time frame, with an average recovery rate of 28.76% and a case fatality rate of 1.32%, and the remaining 69.91% of the patient population made up the active case group. The timeline and the trending pattern of COVID-19 in the state of Rajasthan was suggestive of an increasing rise of number of new cases with antecedent mortality, though a reassuring concomitant rise in the recovery rate of patients could also be appreciated. The infective COVID-19 dictum of spread through contact could very well be appreciated in select geographic hotspots and/or zones, and 108 sample patient population was from out of Rajasthan. CONCLUSION: It was interesting to observe that majority of the resident population of the state of Rajasthan that was COVID-19 positive was in the young adult age group of 30–50 years inclusive of pediatric patients, an observation that is different from reports as documented from across the world. Male population seemed to be more prone to infection. The time frame in which the evaluation was done is suggestive of an increasing trend in the number of new cases with antecedent case fatality, though recovery was also on the rise indicative of a potentia
{"title":"The epidemiological and trending pattern of nCOVID-19 in the state of Rajasthan, India","authors":"S. Bhandari, Ajeet Singh, S. Banerjee, Raman Sharma, G. Rankawat, Vishal Gupta, P. Keswani, Ashwini Mathur, A. Agarwal, S. Sharma, P. Meena","doi":"10.4103/ijaai.ijaai_17_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_17_20","url":null,"abstract":"PURPOSE: The present study was undertaken to investigate the behavioral distribution pattern and progression of coronavirus disease 2019 (COVID-19) across age and gender in the state of Rajasthan, India, inherently distinctive and native to localized part of the globe giving requisite information and paraphernalia to designate advisory board of the state to design and frame customized policy for demands of the state as per the trending pattern relative to age and sex distribution, profile of new infected cases, recovery rate, and case fatality rate. METHODS: The present ongoing study assessed patients admitted till April 22, 2020, across the state of Rajasthan, India, with reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 test. Analyses of the patients included characteristic age and gender distribution through the geographic identities of state along with the time trending pattern of newly infected patients, recovered patients, and case fatality rate. RESULTS: A total of 1888 sample patient population of RT-PCR-confirmed COVID-19 was evaluated, with the majority of sample patient population being in young adult age group with a mean age of 34.42 years. Nearly 11.65% of the patients were below 15 years of age, 34.79% were in the age range of 16–30 years, 25.90% were in the age group of 31–45 years, and 17.69% were in the age group of 46–60 years, with only 9.95% of the patient population being in the age group of above 60 years. Interestingly, 11.65% of patients with COVID-19 were in the pediatric age group. The percent of affected females (37.35%) was much less than that compared to males (62.65%), with an average sex ratio of 0.59. Across the sample patient population of 1888, 543 patients recovered fully, 25 patients died, and 1320 cases were active in the said time frame, with an average recovery rate of 28.76% and a case fatality rate of 1.32%, and the remaining 69.91% of the patient population made up the active case group. The timeline and the trending pattern of COVID-19 in the state of Rajasthan was suggestive of an increasing rise of number of new cases with antecedent mortality, though a reassuring concomitant rise in the recovery rate of patients could also be appreciated. The infective COVID-19 dictum of spread through contact could very well be appreciated in select geographic hotspots and/or zones, and 108 sample patient population was from out of Rajasthan. CONCLUSION: It was interesting to observe that majority of the resident population of the state of Rajasthan that was COVID-19 positive was in the young adult age group of 30–50 years inclusive of pediatric patients, an observation that is different from reports as documented from across the world. Male population seemed to be more prone to infection. The time frame in which the evaluation was done is suggestive of an increasing trend in the number of new cases with antecedent case fatality, though recovery was also on the rise indicative of a potentia","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"76 1","pages":"28 - 33"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75199762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/ijaai.ijaai_20_20
Nagaraju Kuravi, K. Nagaraju, Venkata Voorakaranam
Coronavirus disease 2019 (COVID 19) is caused by the novel coronavirus, which has affected 184 countries and the WHO has declared it a pandemic on March 2020. Allergic diseases such as allergic rhinitis and asthma are exaggerated by viral infections. Symptoms of allergic diseases overlap with COVID 19. Current recommendations include following social distancing and frequent hand washing. Confusion exists regarding the use of corticosteroids, biologicals, and immunotherapy for the treatment of allergic diseases during COVID 19 season. Due to the use of Personal Protective Equipments, reports of contact dermatitis are emerging among health-care workers. Remote consultation, like telemedicine, is a valuable tool in this pandemic. This article aims to provide guidance on the management of allergic diseases taking into consideration existing evidence and guidelines from international organizations and the feasibility of implementation in India.
{"title":"Management of asthma and allergic diseases during the coronavirus disease 2019 pandemic in India","authors":"Nagaraju Kuravi, K. Nagaraju, Venkata Voorakaranam","doi":"10.4103/ijaai.ijaai_20_20","DOIUrl":"https://doi.org/10.4103/ijaai.ijaai_20_20","url":null,"abstract":"Coronavirus disease 2019 (COVID 19) is caused by the novel coronavirus, which has affected 184 countries and the WHO has declared it a pandemic on March 2020. Allergic diseases such as allergic rhinitis and asthma are exaggerated by viral infections. Symptoms of allergic diseases overlap with COVID 19. Current recommendations include following social distancing and frequent hand washing. Confusion exists regarding the use of corticosteroids, biologicals, and immunotherapy for the treatment of allergic diseases during COVID 19 season. Due to the use of Personal Protective Equipments, reports of contact dermatitis are emerging among health-care workers. Remote consultation, like telemedicine, is a valuable tool in this pandemic. This article aims to provide guidance on the management of allergic diseases taking into consideration existing evidence and guidelines from international organizations and the feasibility of implementation in India.","PeriodicalId":53075,"journal":{"name":"Indian Journal of Allergy Asthma and Immunology","volume":"125 1","pages":"15 - 22"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89883041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/ijaai.ijaai_28_19
Anshika Jindal, Y. Rathore, Shubhra Jain, V. Jain, V. Joshi
INTRODUCTION: Allergic bronchopulmonary aspergillosis (ABPA) is an immunologically mediated lung disease, predominantly in patients with asthma and is caused by hypersensitivity to colonized dimorphic fungus Aspergillus, commonly Aspergillus fumigatus. Early diagnosis with recognition and treatment of chest radiographic infiltrates appears to prevent progression to end stage fibrosis. Many cases are mistreated as pulmonary tuberculosis or recurrent pneumonia and are deferred for specific treatment of ABPA. AIM AND OBJECTIVES: This study aims to know the clinical, radiological, and immunological profile of patients diagnosed with ABPA reporting to the Institute of Respiratory Disease, SMS College, Jaipur and Mahatma Gandhi Medical College, Jaipur. MATERIALS AND METHODS: Hospital-based prospective, observational, cross-sectional study was conducted in 48 Patients having history of bronchial asthma, pulmonary infiltrate/shadows on chest X-ray were subjected to routine investigations, immunological tests including modified skin prick test with specific IgE against A. fumigatus and specific precipitins against A. fumigatus. RESULT: In this study, maximum predominance with age group of 21–40 years irrespective of sexpattern. Maximum patients were having bronchial asthma of 2–10 years duration. Cough, breathlessness, and wheezing were main clinical features. In 80% cases, total eosinophilic counts were more than 1000.58.4% sputum were fungal culture positive, maximum for A. fumigatus. All cases showed modified kinprick test positivity against A. fumigatus. Maximum patients high-resolution computed tomography chest had central bronchiectasis. 37% cases had raised total serum IgE (range 1000–5000). Specific IgE against A. fumigatus were positive in 24 patients. 87.5% patients were positive for specific precipitins. CONCLUSION: In this study, ABPA was found more commonly in people with chronic asthma of productive age group, i.e., 20–40 years and farmers by occupation. Most of the people were diagnosed as having pulmonary tuberculosis and deferred specific treatment for a long time. More knowledge about ABPA to physicians could possibly cut short the time between suffering, diagnosis, and proper treatment of these patients.
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