Raised levels of Il-6, Il-17a, and Il-22 in fatal leptospirosis.

Clinical manifestations of leptospirosis range from mild, common cold-like illness, to a life-threatening condition. The host immune response has been hypothesized to play a major role in leptospirosis outcome. Increased levels of inflammatory mediators, such as cytokines, may promote tissue damage that lead to increased disease severity. The question is whether cytokines levels may predict the outcome of leptospirosis and guide patient management. This study aimed to assess the association between Th1-, Th2-, and Th17-related cytokines with the clinical outcome of patients with leptospirosis. Different cytokine levels were measured in fifty-two plasma samples of hospitalized patients diagnosed with leptospirosis in Malaysia (January 2016-December 2017). Patients were divided into two separate categories: survived (n = 40) and fatal outcome (n = 12). Nineteen plasma samples from healthy individuals were obtained as controls. Cytokine quantification was performed using Simple Plex™ assays from ProteinSimple (San Jose, CA, USA). Measurements were done in triplicate and statistical analysis was performed using GraphPad software and SPSS v20. IL-6 (p = 0.033), IL-17A (p = 0.022), and IL-22 (p = 0.046) were significantly elevated in fatal cases. IL-17A concentration (OR 1.115; 95% CI 1.010-1.231) appeared to be an independent predictor of fatality of leptospirosis. Significantly higher levels of TNF-α (p ≤ 0.0001), IL-6 (p ≤ 0.0001), IL-10 (p ≤ 0.0001), IL-12 (p ≤ 0.0001), IL17A (p ≤ 0.0001), and IL-18 (p ≤ 0.0001) were observed among leptospirosis patients in comparison with healthy controls. Our study shows that certain cytokine levels may serve as possible prognostic biomarkers in leptospirosis patients.

Enhancing Trichomonas vaginalis Identification in Cytology Students through Gamification.

Background and Objective: Trichomonas vaginalis is a causative agent of trichomoniasis, a sexually transmitted disease. In the cytology course context, students are taught to identify the cytomorphological characteristics of this organism. However, the limited learning period hinders their ability to recognize this infection effectively. This study intended to evaluate the efficacy of gamification by utilizing a web-based online game to enhance students' capacity to recognize Trichomonas vaginalis infection in cytology. Materials and Methods: The study involved 50 Medical Laboratory Technology students who were randomly assigned to three groups. Group 1 (G1) participants received an interactive web-based online game called CytoUniverse, which comprised three components: a story-based game, a cytomorphology game, and a quiz focusing on Trichomonas vaginalis infection in cytology. Group 2 (G2) participants received the same information from a video lecture. Group 3 (G3) received both the web-based online game and the video lecture. The participants were assessed before the intervention (T1) and after the intervention (T2) to measure the effectiveness of the respective learning methods. IBM SPSS version 28 and GraphPad Prism version 9.0 were used to collect, tabulate, and analyze the data. By using descriptive analysis, the normality of the data was checked. Knowledge score and age were described as mean and standard deviation (SD) for numerical data. On the contrary, the categorical data, such as gender and group categories, were reported as frequencies and percentages. Fisher's exact test, paired t-test, and one-way ANOVA test were used in this study to determine the significance between groups. Results: The study's results indicated a statistically significant improvement (P < 0.05) in knowledge scores at T2 compared to T1 for both G1 and G2 when compared to G3. However, there were no significant differences in knowledge scores between all groups for T1 or T2. Conclusions: In conclusion, gamification through a web-based online game may improve understanding of Trichomonas vaginalis infection. It looks to be a promising strategy for boosting students' knowledge and awareness to recognize Trichomonas vaginalis infection in cytology.

Elevated levels of IL-8 in fatal leptospirosis.

Leptospirosis causes a wide range of clinical outcomes, including organ failure and death. Early treatment significantly increases the chances of cure. Interleukin-8 (IL-8) is a chemoattractant cytokine for neutrophil and is associated with multiple organ failure. Research has indicated IL-8 to be raised in severe and fatal cases of leptospirosis, but its suitability as a prognostic biomarker has yet to be confirmed. This study aimed to evaluate the significance of IL-8 with the clinical outcomes of leptospirosis patients. Plasma IL-8 was measured in fifty-two samples from hospitalized patients and nineteen healthy controls. The comparisons were made between mild, severe-survived and fatal groups identified by clinical or laboratory findings. IL-8 was significantly higher in fatal (p = 0.01) compared to mild cases. IL-8 was also significantly higher in fatal (p = 0.02) when compared to survived cases of leptospirosis. IL-8 levels in the plasma of fatal leptospirosis cases were significantly elevated compared to survived cases and may serve as a potential prognostic biomarker in determining the possible outcome of leptospirosis patients.