Jyotsana Agarwal

Dr. Ram Manohar Lohia Institute of Medical Sciences

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Rajni Kapoor

King George's Medical University

Anumesh K. Pathak

Dr. Ram Manohar Lohia Institute of Medical Sciences

Swasti Tiwari

Sanjay Gandhi Post Graduate Institute of Medical Sciences

Anita Malik

King George's Medical University

Sugandha Srivastava

King George's Medical University

Swastika Suvirya

King George's Medical University

Anupam Das

Dr. Ram Manohar Lohia Institute of Medical Sciences

Harshita Yadav

Dr. Ram Manohar Lohia Institute of Medical Sciences

Shipra Dobhal

Dr. Ram Manohar Lohia Institute of Medical Sciences

Surya Kant

King George's Medical University

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King George's Medical University

Dr. Ram Manohar Lohia Institute of Medical Sciences

Sanjay Gandhi Post Graduate Institute of Medical Sciences

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Institute of Medical Sciences

All India Institute of Medical Sciences

Post Graduate Institute of Medical Education and Research

All India Institute of Medical Sciences Raipur

All India Institute of Medical Sciences Bhopal

Illinois Archaeological Survey

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Comparative analysis of salivary microbiota in diabetic and non-diabetic individuals of North India using metagenomics

Journal of Oral Biology and Craniofacial Research (2023)

Jyotsana Agarwal Pragya Pandey Shailendra K. Saxena Swatantra Kumar

Saliva, an oral secretion is considered an essential biological modulator involved in maintaining oral homeostasis. Increased glucose levels in diabetic patients' saliva may have an impact on diversity of microbes. Comparing the salivary microflora of diabetic and non-diabetic cohorts will help in diagnosis and risk assessment of oral health complications. This will provide greater knowledge about the contribution of oral microbes to the development of oral illnesses. The association between salivary microbiota and diabetic state is less explored in the North Indian population, hence current observational study was performed to analyze the salivary microflora of diabetic and non-diabetic individuals using metagenomic analysis.This single-center non-randomized observational trial was conducted in Uttar Pradesh, India. Participants were enrolled into either diabetic (n = 68) or non-diabetic groups (n = 68) based on their diabetes status. Following saliva collection, DNA was extracted and metagenomic sequencing was performed.Phylum Bacteroidetes and Fusobacteria were significantly abundant in diabetic individuals (p < 0.0001), while Proteobacteria was significantly higher among non-diabetic individuals (p < 0.0001). No statistical difference in phylum Actinobacteria and Firmicutes among diabetics and non-diabetics. Veillonella, Prevotella, Porphyromonas, Leptotrichia, Lactobacillus, and Streptococcus were greater in diabetics whereas the abundance of Capnocytophaga and Neisseria was more among non-diabetics (p < 0.05).The genera Veillonella, Prevotella, Porphyromonas, Leptotrichia, Lactobacillus, and Streptococcus were comparatively over the odds with the diabetics in India. The association between microbiota in diabetic population and risk related to increase in occurrence of caries, gingivitis, and periodontitis in diabetic population prevalence should be investigated.

Veillonella

Fusobacteria

Capnocytophaga

Prevotella

10.1016/j.jobcr.2023.12.003

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Citations (6)

Epidermal Growth Factor Receptor Mutations detection by Mutant Specific Immunohistochemistry in North Indian Lung Cancer population

International Journal of Research and Development in Pharmacy and Life Sciences (2017)

Priyanka Gaur Sandeep Bhattacharya Surya Kant RAS Kushwaha Jyotsana Agarwal

10.21276/ijrdpl.2278-0238.2017.6(6).2796-2799

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Citations (1)

Authors′ reply

Annals of Cardiac Anaesthesia (2013)

DeepakK Tempe Sanjula Virmani Jyotsana Agarwal Manisha Hemrajani Subodh Satyarthi

10.4103/0971-9784.114243

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Effect of midazolam premedication on the dose of propofol for laryngeal mask airway insertion in children

Journal of Anaesthesiology Clinical Pharmacology (2010)

Priyesh Bhaskar Anita Malik Rajni Kapoor Monica Kohli Jyotsana Agarwal

The present study was conducted on 120 pediatric patients of ASA Grade I and II of either sex aged 3-12 years scheduled for pediatric surgeries under general anaesthesia. PATIENTS #ENTITYSTARTX00026;All patients were randomly divided into Group A and Group B. Group A was further divided into 3 subgroups of unpremedicated patients who received 3, 4 and 5 mg kg (-1) propofol only designated as A1, A2 and A3 respectively. Group B was further divided into subgroups of premedicated patients with midazolam (0.05 mg kg (-1) ) intravenous and received 3, 4 and 5 mg kg (-1) propofol designated as B1, B2 and B3 respectively.Results showed that increasing dose of propofol decreases the adverse events like inadequate jaw relaxation, limb movements, coughing, gagging and laryngospasm. Midazolam when added to propofol further reduces the incidence of adverse events and provides more favorable environment for insertion of LMA. At higher doses of propofol (5 mg kg (-1) ), hypotension is a major problem due to its cardiovascular depressant action. Therefore, 4 mg kg (-1) propofol along with midazolam is the optimum dose because there is more hemodynamic stability and we get better conditions for LMA insertion.Midazolam is an effective premedication in children which is synergistic with propofol and reduces its effective dose, required for LMA insertion.

Midazolam

Laryngospasm

Premedication

10.4103/0970-9185.74595

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Age Group-Specific Assessment of Changing Seroepidemiology of Hepatitis A Virus Infection in North India

Cureus (2022)

Jyotsana Agarwal Sugandha Srivastava Bhanu P Verma Palak Mehrotra

Introduction Routine immunization against hepatitis A virus (HAV) infection has not been warranted in India, but an epidemiological shift from hyperendemicity to intermediate endemicity has been detected in recent years. The present study was planned to gather the age group-specific seroprevalence data of hepatitis A IgG antibodies in various age groups and evaluate any early trends of seroepidemiological shift. Method This was a hospital-based cross-sectional study. The detection of IgG antibodies for hepatitis A was done using an HAV Ab kit (Dia.Pro, Milan, Italy) in sera of individuals from >1 to 80 years of age and consenting to participate. Data on sociodemographic factors and potentially predisposing factors of HAV was collected on a predesigned questionnaire. At the time of final analysis, patients were divided into three groups children one to <18 years, adults ≥18 to <60 years, and old ≥60 to 80 years for comparative analysis. Result A total of 1,250 patients were included in the final analysis (129 children, 928 adults, and 193 old). The male/female ratio of the study participants was 1.4:1. The majority (85%) of them came from rural and semi-urban areas. They generally had lower socioeconomic status (SES) with poor literacy rates. Most of the enrolled cases (n=800/1,250, 64%) reported the use of groundwater, and 58.7% (n=734/1,250) consume water without any purification. Of the study participants, 90.8% reported the use of toilets for defecation, and 96.7% of the cases use soap for handwashing after defecation. The majority of adult (90%) and old age (99%) participants were seropositive for anti-HAV IgG antibodies as compared to children (80%). No significant differences were observed in the seropositivity rates and the SES class of the study participants. Conclusion About 20% of children did not have anti-HAV IgG antibodies in the present study, indicating that they are not exposed to HAV. This could be because of their better living conditions such as the availability of safe drinking water and improved sanitation and hygiene. We support the current guidelines of the Indian Academy of Pediatrics (IAP), which recommends immunization for hepatitis A vaccination at 12 months of age. Adult vaccination is not needed in North India.

Seroprevalence

10.7759/cureus.30792

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Development of RNA-based assay for rapid detection of SARS-CoV-2 in clinical samples

bioRxiv (Cold Spring Harbor Laboratory) (2020)

Vinod Kumar Suman Mishra Rajni Sharma Jyotsana Agarwal Ujjala Ghoshal

Abstract The ongoing spread of pandemic coronavirus disease (COVID-19) is caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). In the lack of specific drugs or vaccines for SARS-CoV-2, demands rapid diagnosis and management are crucial for controlling the outbreak in the community. Here we report the development of the first rapid-colorimetric assay capable of detecting SARS-CoV-2 in the human nasopharyngeal RNA sample in less than 30 minutes. We utilized a nanomaterial-based optical sensing platform to detect RNA-dependent RNA polymerase ( RdRp ) gene of SARS-CoV-2, where the formation of oligo probe-target hybrid led to salt-induced aggregation and changes in gold-colloid color from pink to blue in visible range. Accordingly, we found a change in colloid color from pink to blue in assay containing nasopharyngeal RNA sample from the subject with clinically diagnosed COVID-19. The colloid retained pink color when the test includes samples from COVID-19 negative subjects or human papillomavirus (HPV) infected women. The results were validated using nasopharangeal RNA samples from suspected COVID-19 subjects (n=136). Using RT-PCR as gold standard, the assay was found to have 85.29% sensitivity and 94.12% specificity. The optimized method has detection limit as little as 0.5 ng of SARS-CoV-2 RNA. Overall, the developed assay rapidly detects SARS-CoV-2 RNA in clinical samples in a cost-effective manner and would be useful in pandemic management by facilitating mass screening.

Gold standard (test)

Coronavirus

10.1101/2020.06.30.172833

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Citations (19)

Comparative Evaluation of Two Different Doses of Dexmedetomidine for Tympanoplasty under Monitored Anaesthesia Care

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH (2018)

Hemlata Hemlata Jyotsana Agarwal Sunil Kumar Tripathi Rajni Kapoor Shobhana Jafa

Dexmedetomidine

10.7860/jcdr/2018/35818.11878

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Role of Ceftazidime-Avibactam in Urinary Tract Infections Caused by Carbapenem-Resistant Enterobacterales

Cureus (2024)

Shipra Dobhal Manodeep Sen Harshita Yadav Jyotsana Agarwal Anupam Das

Introduction Urinary tract infections (UTIs) are one of the most common bacterial infections encountered in community and healthcare settings. Increasing antimicrobial resistance patterns worldwide have limited the treatment options available. Overuse of carbapenems which were considered as the last resort for multi-drug resistant UTIs over the past decade has led to the emergence of carbapenem-resistant Enterobacterales (CRE). Ceftazidime-avibactam is a novel beta-lactam inhibitor combination drug indicated for the treatment of complicated UTIs caused by CRE. Materials and methods This was a prospective, observational study conducted in the Department of Microbiology at Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow from January 1, 2022, to June 30, 2022. A total of 1716 urine samples were processed for identification and antimicrobial susceptibility testing. This research was approved by the Institutional Ethics Committee (IEC) of Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India, under IEC number 140/20. Isolates belonging to Enterobacterales and showing resistance to carbapenems were selected for further processing. Epidemiological details and the antimicrobial susceptibility profile of all patients with CRE uropathogens were compared. These isolates were then tested for susceptibility to ceftazidime-avibactam (30/20 μg) disc using the Kirby-Bauer disc diffusion method. A subset (n= 20) of CRE isolates were chosen for gene detection using multiplex polymerase chain reaction followed by synergy testing using ceftazidime-avibactam and aztreonam gradient strip-based susceptibility testing. Results In the 1716 samples processed, only 28.1% samples had significant growth out of which 15.3% isolates belonged to Enterobacterales and showed in-vitro resistance to imipenem/meropenem. CRE were approximately two times more common in men as compared to women in the age group of 41-60 years (31.1%). The majority were inpatient samples (72%). The antimicrobial susceptibility profile of the CRE uropathogens showed maximum susceptibility to fosfomycin (66.7%), nitrofurantoin (30.7%), and aminoglycosides (13.5%) and maximum resistance to norfloxacin (100%), cefazolin (98.7%), and netilmicin (98.7%). Ceftazidime-avibactam had an in vitro resistance of 91.9%. The most common gene detected was NDM followed by KPC. The isolates that were resistant to ceftazidime-avibactam and positive for NDM gene (n=20) on being tested for phenotypic synergy using ceftazidime-avibactam and aztreonam E strips showed 100% susceptibility. Conclusion Carbapenem-resistant gram-negative pathogens have become a major healthcare burden. They limit the treatment options available thereby increasing the morbidity and mortality in patients. Carbapenems which were at one time considered as the last line of treatment are deemed ineffective by these superbugs. CRE are among the most dreaded infectious agents. Ceftazidime-avibactam has been suggested as a therapeutic option for the management of CRE but in our study ceftazidime-avibactam alone had a high in-vitro resistance. Nonetheless, the combination of ceftazidime-avibactam and aztreonam showed good in-vitro susceptibility. Synergistic combination of these two antimicrobials can be considered as a treatment option, especially in regions where NDM is prevalent. Research is still limited regarding the clinical efficacy of this combination.

Ceftazidime/avibactam

Carbapenem

Avibactam

Enterobacteriaceae Infections

10.7759/cureus.75221

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Clinico-epidemiological profile and high-risk sexual behavior among clients attending sexually transmitted infection clinic at a tertiary care hospital in North India

Indian Journal of Sexually Transmitted Diseases and AIDS (2018)

Swastika Suvirya Mukesh Shukla Sucheta Pathania AK Singhal Jyotsana Agarwal

Sexually transmitted infections (STIs) are one of the most catastrophic events of health causing huge psychosocial and economic morbidity consequences.The study aims to study the clinico-epidemiological profile and high-risk sexual behavior among clients attending STI clinic at tertiary care hospital in North India.The present study was conducted at STI clinic, King George's Medical University, Lucknow, Uttar Pradesh. Data from 1283 clients attending STI clinic between August 2015 and July 2016 were compiled using master client register and STI/reproductive tract infection patient-wise register, and a final completed data set of these patients was analyzed according to the aims and objectives.On analyzing the various factors associated with high-risk sexual behavior among clients attending STI clinic marital status, sexual preference and employment status were found to be significantly associated with high-risk sexual behavior (P < 0.05). On multivariate analysis, unmarried/divorced/widow/separated marital status (odds ratio [OR]: 14.72; 95% confidence interval [CI]: 1.89-114.17; P = 0.00) and unemployed status (OR: 6.10; 95% CI: 2.00-18.60; P = 0.02) were found to be independent predictors of high-risk sexual behavior (unprotected sex).Based on findings of study, it is highly recommended to provide periodic screening to these STI patients for assessment of their sexual behavior along with specific counseling session.

Tertiary care

10.4103/ijstd.ijstd_21_17

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Citations (4)

Erythematous candidiasis leading to systemic manifestations of human immunodeficiency virus co-infection with secondary syphilis: A diagnostic and therapeutic dilemma

European Journal of Dentistry (2015)

Swastika Suvirya Rahul Gandhi Jyotsana Agarwal Ranjitkumar Patil

The intensification of human immunodeficiency virus (HIV) and rising frequency of immunocompromised individuals have resulted in a resurgence of opportunistic infections. The most common opportunistic oral fungal infection in HIV-positive individuals is oral candidiasis. The classical presentation is as white scrapable form called as thrush, which is easily diagnosed and treated. The clinician is presented with a diagnostic and management dilemma when these lesions appear in new facades such as erythematous candidiasis, the latter's prevalence with HIV and AIDS being well established. In this case report, we present a case of Erythematous Candidiasis, which was associated with type 1 HIV co-infected with syphilis. We highlight the diagnostic importance of a naive looking manifestation of the tongue which was followed by a series of challenging presentations of secondary syphilis. Since the patient had a negative Veneral Disease Research Laboratory and left us with a management dilemma, the article also features the importance of prozone phenomenon (seen in 2% cases of secondary syphilis), and it's higher association with HIV co-infected individuals. With confusing clinical oral manifestations associated with these diseases, the dentist might be the first person to encounter such lesions, who should be able to recognize erythematous candidiasis and correlate them with the underlying pathology.

10.4103/1305-7456.163219

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Citations (4)