Introduction: Screening for critical congenital heart diseases (CCHD) with oxygen saturation (SpO2) by pulse oximeter often misses left-sided obstructive heart diseases. Objective: The role of perfusion index (PI) along with SpO2 in CCHD screening was studied. Methodology: The Masimo, RADICAL-7 pulse oximeter was used to record the SpO2 and PI in the right hand and left foot of asymptomatic babies at 24–72 h of life. Babies with SpO2 <95% or PI <0.7 were rechecked at an hourly interval for three recordings. SpO2 90–94% or PI <0.7 in all three recordings or SpO2 <90% at any one recording were considered as screen positive. An echocardiogram was done for screen-positive cases. Screen negative cases were clinically followed for 6 weeks. Result: Of 1011 screened babies, four were screen positive. One baby had PI <0.7 and SpO2 <90%. This baby had single ventricle, transposed great vessels, and interrupted aortic arch. Other three cases had SpO2 between 90% and 94% in all three recordings. Echocardiogram showed severe right ventricle outflow obstruction in 2 cases and normal heart in one baby. At follow-up, no baby had CCHD. Conclusion: In this study with small sample size, only one baby had left-sided obstructive lesion but also had single ventricle physiology. Hence, there was no difference in the diagnostic accuracy between SpO2 alone and SpO2 with PI in screening for CCHD. Thus, combining PI with SpO2 may improve CCHD screening using pulse oximeter, but large-scale study is needed.

Interplay between the apoptosis, DNA damage, and oxidative stress as a host response to dengue viral infections remains unclear. Peripheral blood mononuclear cells (PBMCs) were isolated from 60 dengue infected patients, 20 patients with febrile illness other than dengue (OFI) and 10 non-febrile illness (NFI) patients. DNA damage in the PBMCs was assessed using single cell gel electrophoresis and stages of apoptosis underwent by the PBMCs were studied by Annexin-PI staining using flow cytometry. Plasma levels of malondialdehyde levels were estimated using thiobarbituric acid assay. Dengue infected individuals had showed increased DNA damage than NFI and OFI controls at the time of admission. Annexin-PI staining revealed increased frequency of apoptotic cells in dengue infected PBMCs than controls during the admission time. Similar pattern was observed in samples collected around defervescence. Within the dengue cases, percentage of live cells was higher in non-severe dengue than severe dengue at both the time points. Follow-up samples in dengue showed less number of live cells and higher percentage of apoptotic cells with respect to their baseline and this was reversed in case of OFI. Plasma malondialdehyde levels were found to be relatively higher in dengue cases than controls at admission and around defervescence. Significant positive correlation between DNA damage, apoptosis, and plasma malondialdehyde levels might pave a way for understanding the complex interactions between virus and hosts response thereby aids in identifying plausible immunopathological links contributing to disease pathogenesis. © 2018 IUBMB Life, 70(11):1133-1143, 2018.

BACKGROUND AND OBJECTIVES: All the four serotypes of dengue virus are found in our country. Case fatality rates in endemic countries like India are 2.5%. During epidemics of dengue, attack rates among susceptible are 40-90%. Early recognition and prompt treatment are vital if disease related morbidity and mortality are to be limited. Clinical features that can be used in the initial assessment of febrile patients are essential tools for clinicians, especially in limited resource settings. Awareness of bradycardia as a clinical finding, could help in the early recognition of dengue and potentially reduce complications and death. METHOD AND RESULTS: The study was conducted in the Department of Medicine, Mysore Medical College & Research Institute, Mysore from the period of July 2010 to December 2010 who met the inclusion and exclusion criteria. A total of 100 patients of Dengue fever were analyzed. The most common age group affected in our study was 20-39 years (53%). The clinical spectrum of cases included 22% cases of Dengue fever (DF), 72% cases of Dengue Hemorrhagic fever (DHF), 6% cases of Dengue Shock Syndrome (DSS). Clinical pulse rate distribution amongst cases showed 27% with bradycardia, 61% with relative bradycardia, and 12% with tachycardia. Electrocardiographic changes in our study showed 37% with sinus bradycardia, 48% with normal sinus rhythm, 1% with first degree heart block, and 14% with sinus tachycardia. CONCLUSION: Bradycardia was a predominant occurrence amongst total of 100 cases of Dengue fever analyzed. 88% of the cases had bradycardia. (61% had relative bradycardia and 27% bradycardia. Majority of the patients on ECG showed sinus bradycardia (37%) and normal sinus rhythm (48%). Hence, awareness of bradycardia as a clinical finding, can help in the early recognition of dengue and potentially reduce complications and death associated with dengue virus infection.

BACKGROUNDThe number of people living with HIV/AIDS is on the rise, so are the problems like renal dysfunction which needs to be addressed. The study was aimed at providing data regarding prevalence and the association of certain modifiable and non-modifiable factors with renal function.

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