Seroprevalence and risk factor analysis of brucellosis among dairy farmers in Aligarh region, North India: creating awareness of a neglected disease.

Introduction. Brucellosis, a globally distributed zoonotic disease, is caused by the Gram-negative bacteria known as Brucella. Humans acquire infection through direct contact with the blood, urine and placenta of animals, inhalation of dust or aerosols at infected animal farms, and raw milk and meat intake. This study aimed to assess the prevalence of brucellosis in dairy farmers in and around the Aligarh region of North India, to document various clinical signs and symptoms in Brucella-positive individuals, and to create awareness in dairy farmers concerning brucellosis and ways to prevent it. Methods. This was an observational study that included 125 dairy farmers in and around the Aligarh region. Serum samples were taken from this high-risk group after obtaining informed consent. Further, a pre-designed proforma was used to collect information about their knowledge, attitude and practices (KAP) concerning brucellosis and assess the risk factors for the disease. The Rose Bengal test (RBT), serum agglutination test (SAT) and enzyme-linked immunosorbent assay (ELISA) were performed to detect the seroprevalence of brucellosis. Result.Brucella infection was diagnosed in 64 (51.20 %) cases by indirect ELISA (IgM+IgG), 41 (32.8 %) by RBT and 4 (3.2 %) by SAT. Significant clustering of patients was seen in the 20-55 years age group. The most common symptoms in ELISA IgM-positive patients were joint pain (16.07 %), fatigue (14.28 %), anorexia (12.50 %), weight loss (8.92 %), malaise (5.35 %), undulant fever (3.57 %), night sweats (3.57 %) and headache (1.78 %). The findings of this study indicate that ELISA (IgM+IgG) exhibits great sensitivity as compared to SAT and RBT. KAP was very poor among dairy farmers. Conclusion. In India, Brucella is a frequent but severely underreported illness. ELISA is the most sensitive serological test for diagnosing brucellosis. No potential vaccine has yet been introduced for humans against brucellosis. Thus, it is necessary to impart awareness and sensitize high-risk groups concerning brucellosis.

Persistent Müllerian Duct Syndrome Diagnosed Incidentally: A Case Report.

Persistent Müllerian Duct syndrome is a rare male disorder of sexual development. The phenotypically and genotypically male patient presents with female internal organs (i.e., uterus, cervix, fallopian tubes and upper part of vagina) due to deficiency of anti-mullerian hormone or insensitivity of tissues to Anti Mullerian Hormone. We present a 19 year old male who came with complaint of right iliac fossa pain. He was investigated for acute appendicitis and on imaging, he was diagnosed to have bilateral cryptorchidism with rudimentary uterus. Computed tomography followed by pelvic ultrasonography was done which indicated two testes in abdomen and a soft tissue density structure, identified as a rudimentary uterus located posterior to the urinary bladder. CT scan findings were further confirmed by magnetic resonance imaging pelvis. A trial of stepwise orchidopexy followed by orchidectomy with removal of rudimentary uterus was performed laparoscopically. Additionally, he was counselled for long term sex hormone replacement and reproductive failure in future.

Trends and advances in pre- and post-harvest processing of linseed oil for quality food and health products.

Linseed is an ancient crop used for diverse purposes since the beginning of civilization. In recent times, linseed has emerged as a superfood due to its high content of health-promoting omega-3 fatty acids and other bioactive compounds. Among primary health effects, it has potential to manage hypertension, diabetes, osteoporosis, atherosclerosis, cancer, arthritis, neurological, cardiovascular diseases including blood cholesterol levels, constipation, diarrhea, and autoimmune disorders etc. due to the presence of omega-3 fatty acid, lignans, high dietary fibers, and proteins, whereas, secondary health effects comprise of relieving from various skin disorders. Due to these health-beneficial properties, interest in linseed oil necessitates the intensification of research efforts on various aspects. These include cultivation technology, varietal and genetic improvement, post-harvest processing, profiling of nutrients and bioactive compounds, pre-clinical and clinical studies, etc. The present review discussed the advances in linseed research including pre- and post-harvest processing. However, focus on the bioactive compounds present in linseed oil and their health effects are also presented. Linseed cultivation, pre- and post-harvest processing aspects are covered including climatic, edaphic, agronomic factors, type of cultivar and storage conditions etc, which impact the overall oil yield and its nutritional quality. Various emerging applications of linseed oil in functional food, nutraceutical, pharmaceutical, and cosmeceutical preparations were also presented in detail. Further, recommendations were made on linseed oil research in the field of genetics, breeding germplasm resources and genome editing for exploring its full applications as a nutrition and health product.

Rhino-orbito-cerebral mucormycosis during Covid-19 pandemic- a prospective observational study.

OBJECTIVE: An unprecedented rise in mucormycosis cases; apparently called 'an epidemic within a pandemic' was seen worldwide. Therefore, the following study was conducted to know the epidemiology, underlying risk factors, diagnostic approach, and possible outcome of mucormycosis during the Covid-19 pandemic. METHODS: A prospective observational study was conducted on patients with a high index of clinical suspicion of mucormycosis Data about demographics, co-morbidities, laboratory investigations, radiology, management, and outcomes were collected. RESULTS: We got 45 cases of proven Rhino-orbital-cerebral-mucormycosis (ROCM) from clinically suspected cases. Covid-19 was the most common underlying risk factor (n â€‹= â€‹41, 91.11%) followed by Diabetes mellitus (DM) (n â€‹= â€‹39; 86.67%). Steroids and oxygen usage were noted in 53.66% (n â€‹= â€‹22) and 41.46% (n â€‹= â€‹17) respectively. Among the 51 suspected cases of mucormycosis, 47 were supported by radiodiagnosis. Histopathology diagnosed the highest number of mucormycosis cases (n â€‹= â€‹44; 97.78%), followed by KOH examination (n â€‹= â€‹36; 80%) and Culture (n â€‹= â€‹28; 62.22%). The most common species isolated from the tissue samples was Rhizopus species (n â€‹= â€‹17; 60.71%), followed by Mucor species (n â€‹= â€‹7; 25%). The mortality rate was 17.14%. CONCLUSION: DM, Covid-19, and corticosteroids are the chief underlying risk factor for ROCM. Rhizopus spp. was the most dominant etiological agent. Early diagnosis and management with combined medical & surgical intervention have a better survival rate.

Satellite Epidemic of Covid-19 Associated Mucormycosis in India: A Multi-Site Observational Study.

BACKGROUND: Sudden upsurge in cases of COVID-19 Associated Mucormycosis (CAM) following the second wave of the COVID-19 pandemic was recorded in India. This study describes the clinical characteristics, management and outcomes of CAM cases, and factors associated with mortality. METHODS: Microbiologically confirmed CAM cases were enrolled from April 2021 to September 2021 from ten diverse geographical locations in India. Data were collected using a structured questionnaire and entered into a web portal designed specifically for this investigation. Bivariate analyses and logistic regression were conducted using R version 4.0.2. RESULTS: A total of 336 CAM patients were enrolled; the majority were male (n = 232, 69.1%), literate (n = 261, 77.7%), and employed (n = 224, 66.7%). The commonest presenting symptoms in our cohort of patients were oro-facial and ophthalmological in nature. The median (Interquartile Range; IQR) interval between COVID diagnosis and admission due to mucormycosis was 31 (18, 47) days, whereas the median duration of symptoms of CAM before hospitalization was 10 (5, 20) days. All CAM cases received antifungal treatment, and debridement (either surgical or endoscopic or both) was carried out in the majority of them (326, 97.02%). Twenty-three (6.9%) of the enrolled CAM cases expired. The odds of death in CAM patients increased with an increase in HbA1c level (aOR: 1.34, 95%CI: 1.05, 1.72) following adjustment for age, gender, education and employment status. CONCLUSION: A longer vigil of around 4-6 weeks post-COVID-19 diagnosis is suggested for earlier diagnosis of CAM. Better glycemic control may avert mortality in admitted CAM cases.

Face masks for respiratory viral illness prevention in healthcare settings: a concise systemic review and meta-analysis.

Background and Objectives: There are conflicting views regarding face mask guidelines amongst healthcare staff to prevent transmission of coronavirus disease 2019 (COVID-19), influenza and other respiratory viral infections (RVIs). We conducted a thorough meta-analysis to statistically compare mask use versus no mask use efficacy for RVIs in healthcare settings. Materials and Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used for selecting researches published between 2003 and June 2022 from different databases, including Publisher Medline (PubMed), Web of Science, etc.; 6 studies qualified for inclusion. Data was pooled from in vivo randomized control, case-control and observational studies dealing with the relationship between face mask use and no use by patients or health personnel and RVI prevention in healthcare setups. Results: The fixed and random-effects model was carried out to determine pooled odds ratios (ORs) and their respective 95 percent confidence intervals (CIs). The results revealed that wearing a face mask significantly reduced the risk of contracting a respiratory viral illness in hospital settings, with pooled OR (95% CI) of 0.11 (0.04 to 0.33) (probability value (P) <0.08). Conclusion: Masks largely succeeded in stopping respiratory virus transmission, as evidenced by the meta-analysis of 6 studies (a total of 927 individuals).

Cloning and comparative modeling identifies a highly stress tolerant Cu/Zn cytosolic super oxide dismutase 2 from a drought tolerant maize inbred line.

Plants have a complex system of stress response that deals with different types of stresses. Maize (Zea mays L.), one of the most important crops grown throughout the world, across a range of agro-ecological environments, employs complex mechanisms of gene regulation in response to drought stress. HKI 335 is a tropical maize inbred line showing remarkable adaptation to drought stress. Abiotic stresses, like drought, trigger the production of reactive oxygen species (ROS) due to the incomplete reduction or excitation of molecular oxygen, eventually leading to cell damage. Superoxide dismutase (SOD, EC 1.15.1.1) is a metalloenzyme that acts as the first line of defense against ROS. We cloned the Sod2 gene from HKI 335 inbred line and analyzed its protein through detailed in silico characterization. Our comparative modeling revealed that at the level of tertiary structure, the HKI 335 SOD2 protein is highly similar to Potentilla atrosanguinea SOD2, which had been previously identified as highly thermostable SOD that can tolerate autoclaving as well as sub-zero temperatures. We performed phylogenetic analysis, estimated physicochemical properties, post-translational modifications, protein-protein interactions, and domain composition of this SOD2. The phylogenetic analysis showed that orthologous sequences of SOD from different species were clustered into two clusters. Secondary structure prediction indicates that SOD2 is a soluble protein and no transmembrane domains have been found. Most of the beta sheets have RSA value greater than 2. The Ramachandran plot from PDBsum revealed that most of the residues fall in the highly favored region. It was estimated that the value of the instability index was less than 40, the value of the aliphatic index was extremely high and the GRAVY value lies between -2 and +2. We could identify only one phosphorylation site, located at position 20 with a score of 0.692. Overall, the unique stress-tolerant properties of the HKI 335 SOD2, may be one of the reasons contributing to the high drought tolerance trait exhibited by HKI 335 maize inbred line. Further research may reveal more insights into the drought adaptation mechanism in maize and the eventual deployment of the trait in maize hybrids.

Levothyroxine absorption test followed by directly observed treatment on an outpatient basis to address long-term high thyrotropin levels in a hypothyroid patient: a case report.

BACKGROUND: For the treatment of hypothyroidism, patients are usually placed on lifelong levothyroxine replacement therapy. Achieving clinical and biochemical euthyroid status is sometimes difficult because of several factors, including poor compliance or poor absorption of levothyroxine in the gut mucosa. CASE PRESENTATION: We present the case of a 45-year-old South Asian female with hypothyroidism on lifelong levothyroxine replacement. However, on her multiple follow-up visits over the past 2 years, it was noted that her thyrotropin level was never controlled and was not in range. A thorough history was unyielding in terms of compliance regarding levothyroxine medication and use of over-the-counter pills or mineral supplements that may interfere with the absorption of levothyroxine. Hence, we performed levothyroxine absorption test to rule out any malabsorption as well as document pseudo-malabsorption favoring drug nonadherence. Levothyroxine absorption test resulted in more than 56% absorption of levothyroxine; therefore, the patient was put on weekly directly observed treatment strategy resulting in normalization of thyrotropin levels on successive follow-ups. CONCLUSION: Directly observed treatment to replace levothyroxine once a week can be used as an alternative by health care professionals in patients in whom compliance to daily levothyroxine is the hidden cause of persistently raised thyrotropin. This strategy can reduce undue health burden on the patient and improve adherence to self-medication under confident supervision of the treating physician.

A case control investigation of COVID-19 associated mucormycosis in India.

BACKGROUND: Increased occurrence of mucormycosis during the second wave of COVID-19 pandemic in early 2021 in India prompted us to undertake a multi-site case-control investigation. The objectives were to examine the monthly trend of COVID-19 Associated Mucormycosis (CAM) cases among in-patients and to identify factors associated with development of CAM. METHODS: Eleven study sites were involved across India; archived records since 1st January 2021 till 30th September 2021 were used for trend analysis. The cases and controls were enrolled during 15th June 2021 to 30th September 2021. Data were collected using a semi-structured questionnaire. Among 1211 enrolled participants, 336 were CAM cases and 875 were COVID-19 positive non-mucormycosis controls. RESULTS: CAM-case admissions reached their peak in May 2021 like a satellite epidemic after a month of in-patient admission peak recorded due to COVID-19. The odds of developing CAM increased with the history of working in a dusty environment (adjusted odds ratio; aOR 3.24, 95% CI 1.34, 7.82), diabetes mellitus (aOR: 31.83, 95% CI 13.96, 72.63), longer duration of hospital stay (aOR: 1.06, 95% CI 1.02, 1.11) and use of methylprednisolone (aOR: 2.71, 95% CI 1.37, 5.37) following adjustment for age, gender, occupation, education, type of houses used for living, requirement of ventilatory support and route of steroid administration. Higher proportion of CAM cases required supplemental oxygen compared to the controls; use of non-rebreather mask (NRBM) was associated as a protective factor against mucormycosis compared to face masks (aOR: 0.18, 95% CI 0.08, 0.41). Genomic sequencing of archived respiratory samples revealed similar occurrences of Delta and Delta derivates of SARS-CoV-2 infection in both cases and controls. CONCLUSIONS: Appropriate management of hyperglycemia, judicious use of steroids and use of NRBM during oxygen supplementation among COVID-19 patients have the potential to reduce the risk of occurrence of mucormycosis. Avoiding exposure to dusty environment would add to such prevention efforts.

Evaluation of role of interferon gamma release assays in the diagnosis of latent tuberculosis in human immunodeficiency virus-infected patients.

INTRODUCTION: Tuberculosis (TB) is the most common opportunistic infection in human immunodeficiency virus (HIV)-infected individuals. The risk of eventually developing active TB from latent TB infection (LTBI) is about 10% per year in HIV-positive patients in contrast to 10% lifetime risk in HIV-negative patients. Until recently, the tuberculin skin test (TST) was the only tool available for diagnosing LTBI. Interferon-gamma release assays (IGRAs) were recently developed and address many of the limitations of TST test, especially in immunocompromised state. AIMS AND OBJECTIVES: (1) To determine the prevalence of latent, active pulmonary, and multidrug-resistant (MDR)-TB among HIV-positive patients in and around Aligarh region; (2) sensitivity and specificity of TST and IGRAs for diagnosis of LTBI in HIV positive patients; and (3) to assess drug resistance and mutational patterns of the clinical isolates of MDR-TB in HIV-TB co-infection. MATERIALS AND METHODS: A cross-sectional study was done on all the patients attended the ICTC centre, JNMC, AMU Aligarh, seropositive for HIV, i.e. 469 (sample size) for the study period of 2 years from October 2015 to October 2017. All 469 HIV-positive patients were screened for latent and active pulmonary TB. Diagnosis of TB (active and latent) was made using clinical, radiological, and microbiological tests. TST and IGRA testing along with CD4 cell counts were also determined. Line probe assay was also done to assess drug resistance and mutational patterns of MDR-TB in HIV patients. RESULTS: In our study, prevalence of HIV infection was 5.04%. Sixty-seven (14.28%) patients were as active TB (HIV-TB co-infection), out of which only one patient (1.49%) was confirmed as MDR-TB, 117 (24.94%) were diagnosed as LTBI. It was also evaluated that IGRA has more sensitivity (75%) and specificity (76%) than TST with sensitivity of 71.7% and specificity 66%. CONCLUSION: As there is no gold standard test for latent TB, longitudinal follow-up is needed to interpret discordant test results. There is a need to interpret negative QFT results with caution and to test for latent TB at higher CD4 counts, if possible. Interferon gamma assays can become better tool for diagnosis of especially for latent TB. However, more research study required for establish their relevance, especially in immunocompromised states.

In silico proteolysis and analysis of bioactive peptides from sequences of fatty acid desaturase 3 (FAD3) of flaxseed protein.

Flaxseed (Linum usitatissimum), commonly known as linseed is an oilseed crop, emerging as an important and functional ingredient of food and has been paid more attention due to its nutritional value as well as beneficial effects. It is mainly rich in is α-linolenic acid (ALA, omega-3 fatty acid), fibres and lignans that have potential health benefits in reducing cardiovascular diseases, diabetes, osteoporosis, atherosclerosis, cancer, arthritis, neurological and autoimmune disorders. Due to its richness in omega-3 fatty acid, a group of enzymes known as fatty acid desaturases (FADs) mainly introduce double bonds into fatty acids' (FAs) hydrocarbon chains that produce unsaturated fatty acids. Fatty acid desaturase 3 (FAD3), the commonest microsomal enzyme of omega-3 fatty acid, synthesizes linolenic acid (C18:3) from linoleic acid located in endoplasmic reticulum (ER) facing towards the cytosol. The emerging field of bioinformatics and large number of databases of bioactive peptides, helps in providing time-saving and efficient method for identification of potential bioactivities of any protein. In this study, 10 unique sequences of FAD3 from flaxseed protein have been used for in silico proteolysis and releasing of various bioactive peptides using three plant proteases, namely ficin, papain and stem bromelain, that are evaluated with the help of BIOPEP database. Overall, 20 biological activities were identified from these proteins. The results showed that FAD3 protein is a potential source of peptides with angiotensin-I-converting enzyme (ACE) inhibitory and dipeptidyl peptidase-IV (DPP-IV) activities, and also various parameters such as ∑A, ∑B, AE, W, BE, V and DHt were also calculated. Furthermore, PeptideRanker have been used for screening of novel promising bioactive peptides. Various bioinformatics tools also used to study protein's physicochemical properties, peptide's score, toxicity, allergenicity aggregation, water solubility, and drug likeliness. The present work suggests that flaxseed protein can be a good source of bioactive peptides for the synthesis of good quality and quantity of oil, and in silico method helps in investigating and production of functional peptides.

Sustaining Protein Nutrition Through Plant-Based Foods.

Proteins are essential components of the human diet. Dietary proteins could be derived from animals and plants. Animal protein, although higher in demand, is generally considered less environmentally sustainable. Therefore, a gradual transition from animal- to plant-based protein food may be desirable to maintain environmental stability, ethical reasons, food affordability, greater food safety, fulfilling higher consumer demand, and combating of protein-energy malnutrition. Due to these reasons, plant-based proteins are steadily gaining popularity, and this upward trend is expected to continue for the next few decades. Plant proteins are a good source of many essential amino acids, vital macronutrients, and are sufficient to achieve complete protein nutrition. The main goal of this review is to provide an overview of plant-based protein that helps sustain a better life for humans and the nutritional quality of plant proteins. Therefore, the present review comprehensively explores the nutritional quality of the plant proteins, their cost-effective extraction and processing technologies, impacts on nutrition, different food wastes as an alternative source of plant protein, and their environmental impact. Furthermore, it focuses on the emerging technologies for improving plant proteins' bioavailability, digestibility, and organoleptic properties, and highlights the aforementioned technological challenges for future research work.

PlantPepDB: A manually curated plant peptide database.

Plants produce an array of peptides as part of their innate defense mechanism against pathogens. The potential use of these peptides for various therapeutic purposes is increasing per diem. In order to excel in this research, the community requires web repositories that provide reliable and accurate information about these phyto-peptides. This work is an attempt to bridge the gaps in plant-based peptide research. PlantPepDB is a manually curated database that consists of 3848 plant-derived peptides among which 2821 are experimentally validated at the protein level, 458 have experimental evidence at the transcript level, 530 are predicted and only 39 peptides are inferred from homology. Incorporation of physicochemical properties and tertiary structure into PlantPepDB will help the users to study the therapeutic potential of a peptide, thus, debuts as a powerful resource for therapeutic research. Different options like Simple, Advanced, PhysicoChem and AA composition search along with browsing utilities are provided in the database for the users to execute dynamic search and retrieve the desired data. Interestingly, many peptides that were considered to possess only a single property were found to exhibit multiple properties after careful curation and merging the duplicate data that was collected from published literature and already available databases. Overall, PlantPepDB is the first database comprising detailed analysis and comprehensive information of phyto-peptides from a broad functional range which will be useful for peptide-based applied research. PlantPepDB is freely available at http://www.nipgr.ac.in/PlantPepDB/.

Socio-Economic Implications Of A Younger Aged Female Predilection In Malignant Transformation Of Oral Sub Mucous Fibrosis.

BACKGROUND: This study was conducted to determine the age, gender and pattern of associated chewing habits among cases of oral squamous cell carcinoma (OSCC) presenting with, (OSMFCa) and without, (Ca-OSMF) pre-existing clinical oral submucous fibrosis in Karachi, Pakistan. METHODS: A cross sectional, multi centric study of (n=1009) cases with histologically confirmed oral squamous cell carcinoma seen at both public, private tertiary care hospitals and clinics over a period of eight years. A non-probability convenience sampling was used for selection of cases. Of these n=472 cases were reported as malignant transformation of clinical OSMF into OSCC: (OSMFCa) and n=537 were of OSCC without clinical evidence of OSMF: (Ca-OSMF). Qualitative analysis for gender and chewing patterns as well as chi square was performed for association. Age comparison between the OSMFCa and Ca-OSMF groups were performed by independent t test.. RESULTS: A total of n=1009 cases presenting with OSCC were examined. Of these 46.78% (n=472) cases were reported as OSMFCa and 53.22% (n=537) as Ca-OSMF. The comparison of age differences at presentation of OSMFCa and Ca- OSMF cases by independent t test was statistically significant (p<0.049). Both gender and chewing habits showed significant association with OSMFCa and Ca-OSMF. CONCLUSIONS: Common to both affected groups was consumption of betel quid, chewing tobacco and variants with males tending to move on to more complex combinations. An overall male trend was noted in OSCC, particularly in Ca- OSMF. However, proportion of females with OSMFCa was significantly higher than males. A significantly younger female affectation in this group has significant potential socio-economic consequences.

Profile of drug-resistant-conferring mutations among new and previously treated pulmonary tuberculosis cases from Aligarh region of Northern India.

Background: The prevalence of multidrug-resistant-tuberculosis (MDR-TB) among new and previously treated cases is increasing worldwide as well as in India. Rapid detection of MDR-TB allows the establishment of an effective treatment regimen; minimizes the risk of further resistance, and limits the spread of drug-resistant strains. Early diagnosis of MDR-TB is the need of the hour in high-TB burden countries like India, and GenotypeMTBDRplus is quite sensitive and specific in determining the molecular resistance in drugs such as rifampicin and isoniazid. Methods: The present study was done for molecular detection of rifampicin and isoniazid resistance and resistance patterns among MDR-TB suspects and comparison of resistance patterns among new and previously treated cases by GenoType® MTBDRplus Line Probe Assay. A total of 1268 sputum samples of MDR-TB suspects were subjected to fluorescent microscopy. Fluorescent microscopy positive samples were subjected to GenoType® MTBDRplus (HAIN Lifescience) assay. Results: MDR-TB was detected 11.02%, 20.03% in new and previously treated cases. Among MDR-TB patients S531 L was the most common mutation detected in rpoB gene; 71.43% in new, and 72.17% in previously treated cases. S315T1 was the most common mutation noted in katG gene; 100% in new and 81.74% in previously treated. While in hA gene, it was C15T (7.8%) among previously treated cases. Conclusion: MDR-TB has high prevalence in the western part of Uttar Pradesh, India. Previously treated cases have even more high rate of MDR-TB than new TB cases. The most dominant gene mutations associated with resistance to INH and RIF were observed in codon 315 of the katG gene and codon 531 of the rpoB gene. While comparing the mutation patterns by Genotype MTBDRplus assay, previously treated cases showed more diversity of mutations and had greater number of unknown mutations.

Comparing the profile of respiratory fungal pathogens amongst immunocompetent and immunocompromised hosts, their susceptibility pattern and correlation of various opportunistic respiratory fungal infections and their progression in relation to the CD4+T-cell counts.

INTRODUCTION: Invasive fungal infections are increasingly common in the nosocomial setting. MATERIALS AND METHODS: The patients were divided into two groups immunocompetent and immunocompromised that is, patients with significant neutropenia <500 neutrophils/µl for longer than 10 days. microscopy, culture, identification of isolates were done and some specilised tests on serum and BAL for antigen detection were performed. RESULTS: Majority of the patients were young adult males in this study. A higher prevalence of 26.7% was seen in immunocompromised patients. Amongst yeasts, Candida albicans was the predominant species followed by the National AIDS Control that is, Candida glabrata, Candida dubliniensis, Candida parapsilosis and Candida tropicalis in the same order. Amongst moulds, Aspergillus fumigatus was the most common species followed by Aspergillus flavus and Aspergillus niger. Mucor and Penicillium marneffei were seen in a lower prevalence. By Broth microdilution method, isolates of Candida spp. were most sensitive to caspofungin, amphotericin B, ketoconazole and fluconazole in the same order. Isolates of Aspergillus spp. were most sensitive to caspofungin, amphotericin B and itraconazole in the same order. By disc diffusion method, resistance to fluconazole was observed in 6.9% isolates of C. albicans. 50% of C. dubliniensis and 20% of C. glabrata showed resistance to fluconazole. A total mortality of 27.7% was observed during this study. This was distributed as 24.1%, 26.7%, 50%, 50%, 100% and 0% among by patients of candidiasis, aspergillosis, cryptococcosis, pneumocystosis, mucormycosis and penicilliosis. Fifteen per cent were lost to follow-up. CONCLUSION: Patterns of invasive fungal infections are changing in many ways. In the midst of these evolving trends, IFI of the respiratory tractcontinue to remain important causes of morbidity and mortality. Diagnostic tools can be adequately used only if the treating physician is aware of the propensity of patients to acquire a fungal infection. Thus, continuous awareness and education is crucial for successful management of patients. Judicious use of antifungal medications as prophylactic measures must be employed, particularly in the critically ill and patients of HIV.

A review on the antagonist Ebola: A prophylactic approach.

Ebola virus (EBOV), a member of Filoviridae virus family under the genus Ebolavirus, has emerged as a dangerous and potential threat to human health globally. It causes a severe and deadly hemorrhagic fever in humans and other mammals, called Ebola Virus Disease (EVD). In recent outbreaks of EVD, there has been loss of large numbers of individual's life. Therefore, EBOV has attracted researchers and increased interests in developing new models for virus evolution, and therapies. The EBOV interacts with the immune system of the host which led to understand how the virus functions and effects immune system behaviour. This article presents an exhaustive review on Ebola research which includes EVD illness, symptoms, transmission patterns, patho-physiology conditions, development of antiviral agents and vaccines, resilient health system, dynamics and mathematical model of EBOV, challenges and prospects for future studies.

Evaluation of genotype MTBDRplus line probe assay in detection of rifampicin and isoniazid resistance in comparison to solid culture drug susceptibility testing in a tertiary care centre of western Uttar Pradesh.

BACKGROUND: Isoniazid (INH) and rifampicin (Rif) are the key first-line antituberculosis drugs, and resistance to these drugs i.e., multi-drug-resistant tuberculosis (MDR-TB), is likely to result in treatment failure and poor clinical outcomes. India has the highest burden of TB and MDR-TB in the world, disproportionately high even for India's population. The GenoType® MTBDRplus molecular method allows rapid detection of Rif and INH resistance. AIM: The present study was done to compare the performance of line probe assay test (GenoType® MTBDRplus) with solid culture method for an early diagnosis of MDR-TB. METHODS: Totally 1503 sputum samples of MDR-TB suspects were subjected to fluorescent microscopy. Decontamination was done by N-acetyl-L-cysteine and sodium hydroxide method. Fluorescent microscopy-positive samples were subjected to GenoType® MTBDRplus (HAIN Lifescience) assay. Sixty-two random samples were compared with phenotypic drug susceptibility testing (DST) (1% proportion method) using solid culture method by Lowenstein-Jensen media. RESULTS: The sensitivity, specificity, positive predictive value and negative predictive value for detection of resistance to Rif were 94.74%, 95.35%, 90% and 97.62% and to INH were 92.00%, 91.89%, 88.46% and 94.44%, respectively, in comparison with the phenotypic DST. CONCLUSION: GenoType® MTBDRplus has good sensitivity and specificity in detecting MDR-TB cases with a significantly lesser turnaround time as compared to conventional DST method and simultaneous detection of Rif and INH resistance. This technique saves several weeks of time required for culture and DST.

High risk of malignant transformation of oral submucous fibrosis in Pakistani females: A potential national disaster.

OBJECTIVE: To determine the relationship of age, gender and other associated risk factors linked with malignant transformation of oral submucous fibrosis into oral squamous cell carcinoma. METHODS: This cross-sectional, multi-centre study was conducted at both public and private tertiary care hospitals and clinics of Karachi, Pakistan, from 2004 to 2012, and comprised patients with oral submucous fibrosis and/or oral squamous cell carcinoma. Out of the total sample, malignant transformations of oral submucous fibrosis to oral squamous cell carcinoma were included. Cases of oral squamous cell carcinoma without clinical evidence of pre-existing oral submucous fibrosis were excluded. Sample selection was based on non-probability convenience sampling. SPSS 18 was used for data analysis. RESULTS: Of the 1774 cases, 765(43.12%) were of oral submucous fibrosis alone, 472(26.60%) were reported as malignant transformation of oral submucous fibrosis into oral squamous cell carcinoma and 537(30.27%) were of oral squamous cell carcinoma without clinically visible oral submucous fibrosis. Of the malignant transformation cases,370(78.4%) involved women and 102(21.6%)men.Besides,5(1.1%)patients were aged below 25 years, 266(56.4%)were 26-50 years and 201(42.6%)were aged 51 years or above, with the mean age of 21.80±3.1, 34.02±2.1 and 40.28±13.1 years, respectively (p=0.001).Moreover, 228(48.3%)patients used betel quid with tobacco, 108(22.9%) consumed areca nut only, 55(11.7%) chewed betel quid without tobacco, 36(7.6%)used naswar, while 45(9.5%)had no chewing habits (p=0.001).. CONCLUSIONS: The risk of developing oral squamous cell carcinoma was high, especially women.

In Vitro Comparative Study of Two Different Bleaching Agents on Micro-hardness Dental Enamel.

OBJECTIVE: To evaluate the effect of home-use bleaching agent containing 16% Carbamide Peroxide (CP) and in-office bleaching agent containing 38% Hydrogen Peroxide (HP) on enamel micro-hardness. STUDY DESIGN: An in vitroexperimental study. PLACE AND DURATION OF STUDY: Department of Operative Dentistry and Science of Dental Materials at Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences and Material Engineering Department of NED University of Engineering and Technology, Karachi, from July to December 2014. METHODOLOGY: Atotal of 90 enamel slabs from 45 sound human 3rd molar were randomly divided into 3 groups. Each group contained 30 specimens (n=30). Group 1 was kept in artificial saliva at 37°C in incubator during the whole experiment. However, Groups 2 and 3 were treated with power whitening gel and tooth whitening pen respectively. After bleaching session, specimens were thoroughly rinsed with deionized water again for 10 seconds and then stored in artificial saliva at 37°C in incubator. Artificial saliva was changed after every 2 days. The Vickers hardness tester (Wolpert 402 MVD, Germany) was adjusted to a load of 0.1 kg (100 gm) and dwell time of 5 seconds. Three Vickers were performed on each specimen using a hardness tester according to the ISO 6507-3:1998 specification. Micro-hardness measurements were performed before and after bleaching at day 1, 7 and 14. RESULTS: In the control group, the baseline micro-hardness was 181.1 ±9.3 which was reduced after the storage on day 1, 7 and 14 (p = 0.104). In Group 2, baseline micro-hardness was 180.4 ±10.1 which was reduced to 179.79 ±10.0 units after day 1. Whereas, on day 7 and 14, the values of micro-hardness were 179.8 ±10 and 179.7 ±10.29, respectively (p=0.091). Furthermore, the baseline micro-hardness in Group 3 was 174.0 ±22.9 units which was reduced to 173 ±23 on day 1, 170 ±30 on day 7 and 173 ±23 on day 14 (p = 0.256). The statistically insignificant difference was found among micro-hardness values of different bleaching agents (p = 0.118). CONCLUSION: Bleaching with 38% Hydrogen Peroxide (HP) and 16% Carbamide Peroxide (CP) resulted in insignificant effect on surface micro-hardness of enamel.