Free radicals have been found to play an important role in obsessive-compulsive disorder (OCD). So, we measured the oxidative/antioxidative status of OCD patients, and assessed its use as a biological marker. The study was carried out on 20 healthy and 20 OCD subjects, aged between 20 and 40 years. Biochemical parameters of all subjects were assessed and compared. A significant difference in superoxide dismutase (SOD) levels was observed between the OCD and control groups (p < 0.05); malondialdehyde (MDA) levels were also significantly higher in OCD subjects (p < 0.05). Our study found an overall oxidative imbalance in OCD, leaning towards the antioxidant side in sufferers (specifically towards SOD). SOD has a protective role in overcoming oxidative stress; therefore, oxidative stress could have a pathophysiological role in OCD. Therapy specifically targeting MDA production will have a beneficial effect in overcoming the oxidative stress, anxiety and affective disorder which may be associated with OCD.

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The folding mechanisms for β-barrel membrane proteins present unique challenges because acquisition of both secondary and tertiary structure is coupled with insertion into the bilayer. For the porins in Escherichia coli outer membrane, the assembly pathway also includes association into homotrimers. We study the folding pathway for purified LamB protein in detergent and observe extreme hysteresis in unfolding and refolding, as indicated by the shift in intrinsic fluorescence. The strong hysteresis is not seen in unfolding and refolding a mutant LamB protein lacking the disulfide bond, as it unfolds at much lower denaturant concentrations than wild type LamB protein. The disulfide bond is proposed to stabilize the structure of LamB protein by clasping together the two sides of Loop 1 as it lines the inner cavity of the barrel. In addition we find that low pH promotes dissociation of the LamB trimer to folded monomers, which run at about one third the size of the native trimer during SDS PAGE and are much more resistant to trypsin than the unfolded protein. We postulate the loss at low pH of two salt bridges between Loop 2 of the neighboring subunit and the inner wall of the monomer barrel destabilizes the quaternary structure.

A bstract Introduction World Health Organization proposes severe acute respiratory infection (SARI) case definition for coronavirus disease 2019 (COVID-19) surveillance; however, early differentiation between SARI etiologies remains challenging. We aimed to investigate the spectrum and outcome of SARI and compare COVID-19 to non-COVID-19 causes. Patients and methods A prospective cohort study was conducted between March 15, 2020, to August 15, 2020, at an adult medical emergency in North India. SARI was diagnosed using a “modified” case definition—febrile respiratory symptoms or radiographic evidence of pneumonia or acute respiratory distress syndrome of ≤14 days duration, along with a need for hospitalization and in the absence of an alternative etiology that fully explains the illness. COVID-19 was diagnosed with reverse transcription-polymerase chain reaction testing. Results In total, 95/212 (44.8%) cases had COVID-19. Community-acquired pneumonia ( n = 57), exacerbation of chronic lung disease ( n = 11), heart failure ( n = 11), tropical febrile illnesses ( n = 10), and influenza A ( n = 5) were common non-COVID-19 causes. No between-group differences were apparent in age ≥60 years, comorbidities, oxygenation, leukocytosis, lymphopenia, acute physiology and chronic health evaluation (APACHE)-II score, CURB-65 score, and ventilator requirement at 24-hour. Bilateral lung distribution and middle-lower zones involvement in radiography predicted COVID-19. The median hospital stay was longer with COVID-19 (12 versus 5 days, p = 0.000); however, mortality was similar (31.6% versus 28.2%, p = 0.593). Independent mortality predictors were higher mean APACHE II in COVID-19 and early ventilator requirement in non-COVID-19 cases. Conclusions COVID-19 has similar severity and mortality as non-COVID-19 SARI but requires an extended hospital stay. Including radiography in the SARI definition might improve COVID-19 surveillance. How to cite this article Pannu AK, Kumar M, Singh P, Shaji A, Ghosh A, Behera A, et al . Severe Acute Respiratory Infection Surveillance during the Initial Phase of the COVID-19 Outbreak in North India: A Comparison of COVID-19 to Other SARI Causes. Indian J Crit Care Med 2021;25(7):761–767.

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