Leela Vyas

SMS Medical College, Jeypore, Rajasthan, India

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Publications (16)3.28 Total impact

  • Aruna Vyas · Nazneen Pathan · Rajni Sharma · Leela Vyas
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    ABSTRACT: Because of the widespread prevalence of the various cutaneous mycoses in a tropical country like India, it is important to know their patterns of etiology and clinical presentations. The present study was conducted in order to identify the clinical pattern of various cutaneous mycoses and the common etiological agents affecting the study populations admitted in SMS Hospital, Jaipur, in North India. Skin scrapings and hair and nail samples of 160 patients with clinical suspicion of dermatophytosis were collected and subjected to direct microscopy and were cultured in Sabouraud's dextrose agar. Fungal species were identified by macroscopic and microscopic examination. Data were presented as simple descriptive statistics (SPSS, Version 17.0 (Chicago Il, USA). Epi Info Version 3.5.1 (CDC, Atlanta, Georgia, USA). Among the 160 clinically suspected patients of cutaneous mycoses, 60 (37.5%) were confirmed by culture. Dermatophytes and non-dermatophytes (NDM) were isolated from 66.6% (40/60) and 33.3% (20/60) of the positive cultures, respectively. Tinea capitis (50%) 30/60 was the most frequent clinical pattern and genus Trichophyton violaceum 32.5% (13/40) was the most common isolate in dermatophytosis-positive samples. Among the patients positive for NDM by culture, Tinea unguium 35% (7/20) was the most common clinical presentation and Aspergillus species 40% (8/20) were the most common etiological agents isolated. Although dermatophtes have been isolated from the cases of cutaneous mycoses all over the world with various frequencies, the role of NDM in the different cutaneous infections other than those of nail infections need to be evaluated.
    No preview · Article · Oct 2013
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    ABSTRACT: The present study was carried out to determine the seropositivity of IgM antibodies to toxoplasma and to assess its role in pregnancy wastage in women with bad obstetric history. This study was conducted at a tertiary care hospital in West of Rajasthan. The study population consisted of 250 women aged 18-35 years with history of two or more pregnancy wastages in the form of abortions, stillbirths, preterm deliveries and /or congenital anomalies. Fifty healthy women with no bad obstetric history were taken as controls. Serum samples obtained from these cases were evaluated for IgM antibodies to toxoplasma by ELISA method. The overall seropositivity of IgM antibodies to toxoplasma was found to be 55/250(22%) among the study group. Among the control group seroprositivity was 1/50(2%). The difference was statistically significant (P=0.00092). Maximum number of patients under study had history of abortion 187/250 (74.8%) followed by congenital anomalies 34/250 (13.3%), still births 15/250(6%) and preterm deliveries 14/250 (5.6%). Seropositivity for IgM antibodies to toxoplasma was maximum among abortion cases 47/187(25.13%) followed by congenital anomalies 5/34 (14.7%), still births 2/15 (13.33%) and preterm deliveries 1/14 (7.14%). The presence of Toxoplasma IgM antibodies to toxoplasma in the serum of cases with abortions (47/187) showed a significant association ( p=0.039). History of contact with animals particularly cats was significant in seropositive cases. (p=0.003) The current study reveals a significant correlation between IgM toxoplasma antibodies to toxoplasma and pregnancy wastage.
    No preview · Article · Sep 2012 · Journal of Pure and Applied Microbiology
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    Full-text · Article · Jan 2012 · Indian Journal of Sexually Transmitted Diseases and AIDS
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    ABSTRACT: Objective: Rapid diagnosis of genital tuberculosis (GTB) is essential as it is an important cause of infertility among women. Diagnosis can be done by imaging techniques, direct visualization by endoscopy, serology, histopathology, culture and polymerase chain reaction (PCR) tests. Laparoscopy detects macroscopic changes only; histology is only suggestive and not confirmatory unless acid fast bacilli (AFB) are demonstrated in the lesion but sensitivity is poor in paucibacillary disease. Culture methods are the gold standard but slow growth of most pathogenic mycobacteria delays the diagnosis. PCR can rapidly detect even few copies of DNA with high sensitivity and specificity. Aim: Comparative evaluation of AFB smear examination, culture in Middlebrook 7H9 media and IS 6110 based real-time PCR assay for the detection of mycobacteria in various female genital samples. Materials and methods: A total of 555 female genital samples like endometrial and fallopian tube biopsies, menstrual blood and vaginal discharge were processed by modified Petroff’s method. The deposit was used for detection of mycobacteria by AFB smear, culture on Middlebrook 7H9 media and IS6110 based real time PCR. Results: Out of 555 samples, 25.22 % (140/555) were positive by the combination of all the methods used. Overall positivity by real-time PCR alone was 23.78% (132/555), by culture 8.28% (46/555) and 2.70% (15/555) by AFB smear examination. Out of total positives, 94.28% (132/140) were positive by PCR alone, 32.85% (46/140) by culture and 10.71% (15/140) by AFB smear. Eight (5.71%) culture positive samples were negative by smear and PCR, six of these were nontubercular mycobacteria (NTM) and two samples had PCR inhibitors as confirmed by spiking with positive DNA. Contamination was observed in 25/555 (4.5%) which were reported negative by culture but three of these were PCR positive. AFB smear results were available in 1 hour, PCR in 1 day and culture in 4 to 6 weeks. Conclusion: PCR was found to be the most rapid and sensitive (94.28%) method, 9-fold more sensitive than smear examination and 3 fold than the culture for detection of mycobacteria. Results were available in 4 to 6 weeks time for culture but in only 1 day by PCR. IS 6110 PCR can detect only MTB and not the NTM. Use of multiplex PCR with genus and MTB specific primers will increase the sensitivity of test but care needs to be taken to prevent false positivity due to cross contamination and false negative due to PCR inhibitors.
    Full-text · Article · Jan 2012 · Journal of SAFOG
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    ABSTRACT: Objective – To analyze the clinico-demographic variables in patients of swine influenza A 2009 (H1N1).Study design – Hospital based cross-sectional study. Methodology- Throat Swab were collected from 150 patients presenting with influenza like illness (ILI) at S.M.S. and attached group of hospitals. RNA isolation was done, using QIAamp viral mini kit (Qiagen GmBh). Real time reverse transcriptase polymerase chain reaction (rRT-PCR) was done using one step RT- PCR kit of Applied Biosystem that discriminates the Novel H1N1 virus from seasonal influenza virus.Results- Among 150 suspected cases 22(14.66%) were positive for swine influenza A (H1N1), while 55 (36.66%) were positive for seasonal influenza A. The male to female ratio was 2.6:1 and 1.4:1 for swine influenza A (H1N1) and influenza A respectively. Among the swine influenza A (H1N1) positive cases, the most common presenting symptoms were fever (95%) and cough (86.35%) followed by sore throat (63.6%) and shortness of breath (59.09%). Risk factors for getting Influenza A 2009 (H1N1) infection were underlying lung disease & presence of co-morbidities like diabetes, hypertension, obesity. There were 1(4.5%) mortality due to Acute Respiratory Distress Syndrome (ARDS) among H1N1 positive cases. Conclusion The present study reveals that even in the post pandemic phase swine influenza A (H1N1) is still continuing to circulate. Among the suspected patients 14.6% had swine influenza A positivity and 36.66% had seasonal influenza A positivity. Hence there is still need to test suspected patients specially those with underlying risk factors and also carry on regular surveillance for Influenza viruses in patients presenting with influenza like illness.
    No preview · Article · Jan 2012
  • B. Sharma · R. Sharma · N. Pal · L. Vyas
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    ABSTRACT: Infection is an important cause of mortality in the late post burn period. Burn wound swab culture helps in identifying microorganisms and selection of appropriate antibiotics. This aids in control of infection and morbidity, which facilitates early discharge from hospital and reduces the cost of treatment. The present retrospective study of burn wound swab culture was undertaken to determine the bacteriological profile and the antibiotic sensitivity pattern in burn unit of our hospital. Burn wound swabs were cultured and identified by conventional methods. Antibiotic susceptibility was performed by Kirby Bauer disk diffusion method. Wound swab yielded very high culture positivity (98.6%) from 665 of total specimens. Gram-negative bacilli were responsible for majority of infections in which Pseudomonas spp. (61.95%) was the most frequently isolated, followed by Enterobacter spp.(19.73%). Gram-positive cocci were isolated from 14.13% samples. Pan resistance to commonly used antibiotics was observed in 45 (10.92%) isolates of Pseudomonas spp. and 35 (10.9%) isolates of other gram-negative. Pseudomonas spp. showed maximum sensitivity to piperacillin-tazobactam (69.8%) while other gram-negative isolates to meropenem, cefoperazone-sulbactam and piperacillin-tazobactam. Gram-positive cocci were sensitive to vancomycin and linezolid.
    No preview · Article · Oct 2011 · Journal of Pure and Applied Microbiology
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    ABSTRACT: In developing countries like ours with a large number of tuberculosis (TB) cases and limited resources, the diagnosis of TB relies primarily on smear microscopy for Acid Fast Bacilli (AFB) but its sensitivity is limited in paucibacillary cases. To evaluate the increase in efficacy of smear microscopy when smears are prepared from clinical samples after concentration by Petroff's method and stained by Auramine O (AO) fluorescent dye as against Ziehl Neelsen (ZN) staining of similar taking culture as the gold standard. Smears were prepared from 393 clinical samples both by direct and after Petroff's concentration and examined by fluorescent microscopy and Ziehl Neelsen method .The concentrated material was also cultured on Lowenstein Jensen media and the results of the two microscopy methods were compared with the culture results taken as the gold standard. Mycobacterial growth was detected in 137 (35.77%) specimens, out of which three were non-tubercular mycobacteria. Using culture as the reference method, the sensitivity of direct staining was 55.55% for ZN and 71.85% for AO. Direct fluorescent microscopy detected 9.29% paucibacillary sputum samples that were missed on ZN staining. On concentration, the sensitivity increased by 6.67% for ZN and 11.11% for AO. The sensitivity of AFB smear microscopy increased by 27.41% and was statistically significant (p = < .001) when both methods were combined. The specificity was 99.19% for both ZN and AO. Fluorescent microscopy has higher sensitivity and comparable specificity which is further enhanced by concentration. Now with the advent of newer inexpensive Light Emitting Diode (LED) based fluorescent microscopes (FM), which are easier to use, fluorescent microscopy can be widely used even in peripheral laboratories where culture facilities are not available.
    Full-text · Article · Apr 2011 · The Indian journal of tuberculosis
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    ABSTRACT: Pyrazinamide is an important front line antimycobacterial drug, which is also being used in the treatment of multi drug resistant tuberculosis along with second line drugs in DOTS plus programme. Conventional testing of pyrazinamide on solid medium is difficult as it is active at acidic pH. Therefore, there is a need for a rapid and simple method for susceptibility testing of pyrazinamide. This study was carried out to compare pyrazinamide susceptibility testing by MGIT 960 and two rapid pyrazinamidase activity tests. Pyrazinamide susceptibility was tested in 136 clinical isolates of Mycobacterium tuberculosis by MGIT 960 and pyrazinamidase activity was tested by classical Wayne's method and modified PZase agar method. There was 88.9 per cent concordance between MGIT 960 and classical Wayne's method and 93.38 per cent with modified method for pyrazinamidase activity. Using MGIT 960 results as gold standard the sensitivity and specificity of Wayne's method was 88.15 and 90 per cent respectively and that of modified method was 89.4 and 98.3 per cent. Our study demonstrates that the modified pyrazinamidase activity test can be used as a screening test to detect resistance to pyrazinamide specially in resource limited settings but confirmation of susceptibility should be done by standard methods like MGIT 960.
    Full-text · Article · Jul 2010 · The Indian Journal of Medical Research
  • Babita Sharma · Nita Pal · Bharti Malhotra · Leela Vyas
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    ABSTRACT: Tuberculosis is caused by Mycobacterium tuberculosis (M.tb) as well as Non-tubercular mycobacterium (NTM) with similar clinical presentation. Infections due to NTM are reported to have increased in the past few years. Growth of M.tb is inhibited by p-Nitrobenzoic acid (PNB), whereas, NTM are resistant. One hundred and nine isolates from various clinical samples were identified up to species level by their growth rate, pigmentation, and a battery of biochemical tests, including niacin accumulation, nitrate reduction, and heat-stable catalase (68°C) reactions. Para-nitrobenzoic acid (PNB) inhibition test was performed to differentiate between M.tb and NTM. PNB was added to the Lowenstein-Jensen (LJ) medium and BACTEC™ MIGIT (Mycobacteria Growth Indicator Tube)960 medium to a final concentration of 500 μg/ml. All the M.tb isolates, including Mycobacterium tuberculosis H37Rv (standard strain), were inhibited by PNB on both LJ and MGIT 960. Of the NTM isolates, all were resistant to PNB on MGIT 960 and on LJ PNB, except one isolate of Mycobacterium marinum that was resistant to MGIT 960 PNB, but was susceptible to LJ PNB. The reporting time for M.tb ranged from 4-11 days (median 5.9 days) by MGIT 960 and for NTM it was 2-10 days with an average of 4.5 days. This study was carried out to establish the accuracy and efficiency of MGIT 960 PNB and to differentiate between M.tb and NTM.
    No preview · Article · Jul 2010 · Journal of laboratory physicians
  • N Pal · B Sharma · R Sharma · L Vyas
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    ABSTRACT: Macrolide (MLS B ) resistance is the most widespread and clinically important mechanism of resistance encountered with Gram-positive organisms. Resistance may be constitutive (cMLS B phenotype) or inducible (iMLS B phenotype). The iMLS B phenotypes are not differentiated by using standard susceptibility test methods, but can be distinguished by erythromycin-clindamycin disk approximation test (D-test) and demonstration of resistance genes by molecular methods. To demonstrate in vitro inducible clindamycin resistance (iMLS B ) in erythromycin-resistant (ER) and clindamycin-susceptible (CLI-S) clinical isolates of Staphylococci spp., and interpretation of susceptibility tests to guide therapy. Eight hundred and fifty-one isolates of Staphylococci spp. were recovered from various clinical specimens. All the Staphylococcal spp. were identified by conventional microbiological methods including colony morphology, Gram stain, catalase, slide coagulase and tube coagulase. Antibiotic susceptibility testing was performed by Kirby Bauer disc diffusion method. Erythromycin-resistant isolates were examined for inducible clindamycin resistance (iMLS B ) by using double disk approximation test (D-test) at 15 mm disk separation. The Staphylococci spp. isolated were 379 S. aureus [31.60% methicillin-resistant S. aureus (MRSA), 12.92% methicillin-sensitive S. aureus (MSSA)] and 472 coagulase-negative Staphylococci (CNS) [37.60% methicillin-resistant coagulase-negative Staphylococci (MRCNS), 17.86% methicillin-sensitive coagulase-negative Staphylococci (MSCNS)]. Four hundred and thirty (50.52%) Staphylococcal spp. isolates showed erythromycin resistance. Constitutive resistance was demonstrated in 202 (46.97%), inducible clindamycin resistance (iMLS B ) in 101 (23.48%), and non-inducible (MS) in 127 (29.53%). Two distinct induction phenotypes, D (18.13%) and D + (5.34%) were observed. All iMLS B isolates were susceptible to linezolid and vancomycin while 78.78% to ciprofloxacin. Fifty percent of Staphylococcal spp. were ER among which 23.48% were iMLS B phenotypes. Eighty-seven per cent of iMLS B phenotypes were observed to be methicillin-resistant. The high frequency of methicillin resistance isolates (87.12%) with in vitro inducible clindamycin resistance at our institute raises concern of clindamycin treatment failures with methicillin-resistant infections. So we recommend that microbiology laboratories should include the D-test for inducible resistance to clindamycin in the routine antibiotic susceptibility testing.
    No preview · Article · Jul 2010 · Journal of Postgraduate Medicine
  • Nita Pal · Rajni Sharma · Suman Rishi · Leela Vyas
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    ABSTRACT: The culture results of 4,807 blood and 383 sterile body fluid specimens received in our laboratory during a 54-month period, were analyzed to determine the time required for culture to become positive, time at which a culture could safely be considered negative, and the spectrum of isolated organisms. The specimens were processed by automated BACTEC 9120 culture system. A total of 1,677 clinically significant microorganisms were isolated. Gram positive and negative bacterial isolation rates were found to be 62.55% and 32.20%, respectively. Yeasts were recovered in 5.24%. False positivity rate was 1.5%. Clinically significant isolates recovered on day four and five were 97.81% and 99.88%, respectively. At day five, the sensitivity was 99.94% and negative predictive value 99.96%. Our data support a five-day incubation protocol for recovery of all clinically significant organisms with sensitivity reduced by 0.06%, when compared with a six-day protocol.
    No preview · Article · Jul 2009 · Journal of laboratory physicians
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    ABSTRACT: The study was conducted to analyze previous six-year prevalence data of HIV infection in the Northwest region of India and predict future trends for a couple of years. The study was conducted to aid SACS and NACO to plan and arrange resources for the future scenario. All the attendees of ICTC, Jaipur, from January 2002 to December 2007 were included and variables like age, sex, marital status, occupation, place of residence, pattern of risk behavior and HIV serostatus were studied. As per the strategy and policy prescribed by NACO, tests (E/R/S) were performed on the serum samples. Data was collected; compiled and analyzed using standard statistical methods. Future trends of HIV-prevalence in north-west India were anticipated. The overall positivity rates among attendees of ICTC, were found to be 12.2% (386/3161), 11.8% (519/4381), 11.1% (649/5867), 13% (908/6983), 14% (1385/9911) and 17.34% (1756/10133) in the years 2002, 2003, 2004, 2005, 2006 and 2007 respectively. Future trends for the next couple of years depict further increase in prevalence without any plateau. Epidemiological studies should be carried out in various settings to understand the role and complex relations of innumerable behavioral, social and demographic factors, which will help, interrupt and control the transmission of HIV/ AIDS.
    Full-text · Article · Jul 2009 · Indian Journal of Community Medicine
  • Monika Rathore · Leela Vyas · A K Bhardwaj
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    ABSTRACT: A community-based study was carried out to assess the prevalence of reproductive tract infections (RTIs) among ever married rural women aged 15 -45 years at village Naila during 2002. Six hundred houses were surveyed and all the eligible women residing in these houses were interviewed by MPWs and Interns and were offered medical examinations at rural health training centre, Naila. At least one symptom related to RTIs was found in 471(55%) out of 859 women. Only 50% (432/859) women gave consent for their gynaecological and microbiological examinations. Out of 432 women examined 61% (263/432) had at least one type of RTIs. Out of 263 cases, 43% had cervicitis, 26% had bacterial vaginitis, 14% had fungal infection, 8% had trichomonas vaginitis, 22% had pelvic inflammatory disease and 19% had cervical erosion. Prevalence of RTI was significantly associated with age, personal hygiene, material used for menstrual blood, gravida status, type of attendance at child birth, invasive contraceptives, gynaecological surgery but caste, literacy status and place of deliveries were not significantly associated with RTI status in the present study.
    No preview · Article · Mar 2007 · Journal of the Indian Medical Association
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    M Rathore · L Vyas · A K Bhardwaj
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    ABSTRACT: This paper compares the findings of both the procedures i.e. 'interview-based household survey' (self-reported morbidity) and 'observed morbidity approach' based on Per speculum/Per vaginal examinations. The study revealed that self-reported morbidity in this study was as high as 98 per cent, the moan age of the women was 15 years and mean age of cohabitation was 17 yours It was observed that 64 per cent of the deliveries took place in homes and at least half of them (50%) was conducted by untrained persons. The study further revealed that the prevalence rate of RTIs was 57.6 per cent by interview-based approach and 61 per cent by observed morbidity method. The authors conclude that interview-based household survey is the most appropriate approach to estimate the prevalence of RTI. particularly in developing countries Keywords: Reproductive tract infection (RTI), Household survey, Observed morbidity, Prevalence rate, Multi-purpose worker (MPW).
    Preview · Article · Apr 2006 · Health and population; perspectives and issues
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    ABSTRACT: To find prevalence of drug resistance in Mycobacterium tuberculosis isolated from patients attending SMS Medical College, Jaipur during 1997-99. Sputum samples from 164 patients with pulmonary tuberculosis were processed and cultured on Lowenstein Jensen medium and M. tuberculosis isolates were tested for drug sensitivity. M. tuberculosis was isolated in 122/164 (74.3%) samples and comprised 97.6% (122/125) of mycobacterial isolates. There were only three isolates of nontuberculous mycobacteria -one each of M. kansasii, M. avium and M. fortutium. Primary drug resistance in M. tuberculosis was estimated to be 3/44 (6.8%) to rifampicin, 6/44 (13.6%) to isoniazid and 2 strains (4.5%) were multi drug resistant i.e. resistant to both rifampicin and isoniazid. Among the isolates from cases with previous history of treatment of varying duration (acquired drug resistance) resistance to rifampicin was estimated to be 28.2% and for isoniazid to be 39.7%. 24.3% strains of these drug resistant isolates were multi drug resistant. While this information may not reflect true prevalence of drug resistance in the region this may help in further planning long term surveillance studies to know the trend of drug resistance in this area.
    No preview · Article · Jan 2002 · Indian Journal of Medical Microbiology
  • B. Malhotra · S. Pathak · L. Vyas

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