A Retrospective Study of Covid-19 Patients: A Real-Life Experience in a Secondary Care Hospital, Jashore, Bangladesh.

Covid-19 was first detected on 8th March of 2020 in Bangladesh after the global pandemic being started. As a new virus and disease there are scarcity of data of SARS-CoV-2 and Covid-19 respectively in our country. Aim of this study is to assess the demographic characteristics, clinical profiles, underlying co-morbid conditions, treatment pattern and outcome of the SARS-CoV-2 positive patients in Jashore, Bangladesh. This retrospective study recruited 208 RT-PCR positive Covid-19 patients from 1st April 2020 to 15th May 2020 who appeared at Flu corner centre, 250 Bedded General Hospital, Jashore, Bangladesh. Data was collected online through telephone, mobile and email due to the high contagious property of Covid-19. Out of total 208 Covid-19 patients, the mean age of the participants was 37.0±15.0 years with a male and female ratio of 2.06:1. Underlying comorbidities were documented in 36.5% of total Covid-19 patents of which hypertension in 16.3%, diabetes in 14.4%, respiratory diseases in 8.7% and pre-existing coronary arterial diseases in 6.3% patients. Though 17.8% Covid-19 patients were asymptomatic, the most common symptoms were fever (68.8%), cough (30.8%), myalgia (30.8%), sore throat (22.1%), vertigo (21.6%), respiratory distress (20.7%), anorexia (17.8%), nasal congestion (16.3%), nausea or vomiting (13.9%) and diarrhoea (13.0%). Whereas, the symptomatic patients were classified as flu-like illness (77.9%), mild to moderate pneumonia (2.4%) and severe pneumonia (1.9%). Many patients (19.2%) recovered spontaneously and 22.1% patients cured by the only simple symptomatic treatment. The most commonly received antibiotics were Azithromycin and Doxycycline. Home stay management was demonstrated in 73.1% patients, whereas, 26.0% patients required general ward admission and only 0.9% patients required referral for the HDU or ICU management with an average duration of hospital stay of 16±6 days. A high satisfactory outcome was found as evident by complete recovery in 98.08% of Covid-19 patients, complications (0.48%) and fatality (1.44%) even in this secondary care center. Therefore, we can conclude that the disease was well managed with highly satisfactory outcomes even in the low resource health care setting in the early stage of Covid-19 pandemic era. Hence, the early case detection, identification of the high-risk groups and proper management may mitigate to develop complications and fatalities of Covid-19.

The inflammatory stimulus of a natural latex biomembrane improves healing in mice

The aim of the present study was to compare healing obtained with biomembranes with the natural healing process (sham) using biochemical and immunohistological assays. C57BL/6 mice were divided into 4 groups of 15 mice each and received different subcutaneous implants: natural latex biomembrane (NLB), denatured latex (DL), expanded polytetrafluorethylene (ePTFE), or sham. On the 2nd, 7th, and 14th days post-treatment, 5 mice per group were sacrificed and biopsied for the following measurements: oxidative stress based on malondialdehyde (MDA), myeloperoxidase (MPO) and hydrogen peroxide by the method of ferrous oxidation-xylenol orange (FOX), as well as glutathione and total proteins; histological evaluation to enumerate inflammatory cells, fibroblasts, blood vessels, and collagen, and immunohistochemical staining for inducible nitric oxide synthase, interleukin-1β, vascular endothelial growth factor (VEGF), and transforming growth factor-β1 (TGF-β1). On day 2 post-treatment, NLB stimulated a dense inflammatory infiltrate mainly consisting of polymorphonuclear cells, as indicated by increased MPO (P < 0.05), but oxidative stress due to MDA was not observed until the 7th day (P < 0.05). The number of blood vessels was greater in NLB (P < 0.05) and DL (P < 0.05) mice compared to sham animals on day 14. NLB induced fibroplasia by day 14 (P < 0.05) with low expression of TGF-β1 and collagenesis. Thus, NLB significantly induced the inflammatory phase of healing mediated by oxidative stress, which appeared to influence the subsequent phases such as angiogenesis (with low expression of VEGF) and fibroplasia (independent of TGF-β1) without influencing collagenesis.

Presence of Wolbachia endosymbionts in microfilariae of Wuchereria bancrofti (Spirurida: Onchocercidae) from different geographical regions in India

In view of the recent discovery of rickettsial endosymbionts, Wolbachia in lymphatic filarial parasites, Wuchereria bancrofti and Brugia malayi and subsequently of their vital role in the survival and development of the latter, antibiotics such as tetracycline are being suggested for the treatment of lymphatic filariasis, by way of eliminating the endosymbiont. But, it is essential to assess their presence in parasites from areas endemic for lymphatic filariasis before such a new control tool is employed. In the present communication, we report the detection of Wolbachia endosymbionts in microfilariae of W. bancrofti parasites collected from geographically distant locations of India, such as Pondicherry (Union Territory), Calicut (Kerala), Jagadalpur (Madhya Pradesh), Thirukoilur (TamilNadu), Chinnanergunam (TamilNadu), Rajahmundry (Andhra Pradesh), and Varanasi (Uttar Pradesh), using Wolbachia specific 16S rDNA polymerase chain reaction.

Sero-diagnosis of tuberculosis with A60 antigen enzyme-linked immunosorbent assay: failure in HIV-infected individuals in Ghana

In order to assess the diagnostic usefulness of the A60 (ANDA Biological; Strassbourg; France) sero-diagnostic enzyme-linked immunosorbent assay (ELISA) kit for tuberculosis in Africa; sera of 53 pulmonary smear-positive tuberculosis (TB) patients; 30 apparently healthy control subjects and 6 AIDS suspects were sampled in Agogo Hospital in the forest area of Ghana. These sera were analyzed for antibodies to HIV-1 and HIV-2; and IgG-antibodies to the A60 BCG-antigen; while the non-HIV individuals were tested for total IgG levels. One healthy control subject; all of 6 AIDS suspects and 7 of the TB patients has HIV infections. In the non-HIV TB group; the sensitivity and specifity of the A60 ELISA was 78 per cent and 86 per cent; respectively; which was much poorer than expected from published reports about the A60 test. The A60 test failed; completely however; to discriminate between TB and non-TB in the HIV-positive group. In the non-HIV groups; total IgG levels were significantly higher in TB patients than in controls. It seems that the usefulness of the A60 ELISA test to diagnose tuberculosis is very limited in this high-incidence area; and that it seems to be of no value in patients infected with HIV

Evaluation of the integrated pest and vector management (IPVM) project in Sri Lanka : mission report, July 2006

An evaluation mission was organized by the WHO South-East Asia Regional Office on the effectiveness, sustainability and replicability of the project to assist in the implementation of the World Health Organization's new strategy on integrated vector management (IVM). integrated pest and vector management (IPVM) builds upon the successful experience in Integrated Pest Management (IPM), which is based on the practical, field-based education imposed to groups of rice farmers during weekly sessions at the Farmer Field Schools (FFS). Farmers learn the skills of observation-based crop management to grow better crops in healthier environments and reduce dependence on the use of insecticides. The wetland rice environment, while providing food and fodder also supports the breeding of the vectors of human diseases. The IPVM project with support from FAO and UNEP was initiated in Sri Lanka in 2002 has been unique in connecting vector management with agricultural activities, involving farming communities in observation-based decision-making on vector management. The mission team observed that farmers will able to analyse their agricultural and pen-domestic environments and make sound decisions on the management of not only vectors in a sustained manner, but also pests and crops. The IPVM-FFS alumni reported a sharp drop in insecticide use which was attributable to training. Vector management activities are being practised following the FFS training, including small-scale local rearing of fish, clearing of coconut shells and containers, covering water containers at regular time intervals, and group action on household and village sanitation, and preventive measures such as bed net use. The mission found that convergence between activities of the health and agriculture sectors has come a long way, producing effective cross-sector learning and a joint process of curriculum development.

Sero-Diagnosis of tuberculosis with A-60 Antigen ELISA: Failure in HIV-Infected individuals in Ghana

It is concluded that the A60 ELISA test to diagnose fails in patients infected with HIV

Monoclonal ELISA to detect active tuberculosis

Serological tests have not lived up to expectations; despite enormous efforts over the last decade. Results differ not only according to the antigen used; but also according to the population tested. We have found that the A60 antigen IgG ELISA test; reported to give good results; failed in patients co-infected with HIV

The use of subcellular components of BCG for studying host-Mycobacterium interaction in relation to leprosy

Mycobacterium bovis-BCG was sonified and centrifuged at 90,000g for 2h to obtain pellet (P90) and supernatant (S90), and bacilli broken by chilled X-press were fractionated into cell wall (CW), plasma membrane and cytosol. Rabbits were immunized with P90, S90 and whole sonified-broken BCG. The antigenic make-up of these antisera. These analysed by cross-immunoelectrophoresis using the antisera. These subcellular preparations were also used for detecting circulating antibodies in the sera of 45 leprosy patients by Ouchterlony´s technique and immunoelectrophoresis. Although there were many antigenic determinants common to more than one fraction, some components were found in only one fraction. Furthermore, different leprosy patients showed different patterns of antibody response to the antigens in the different fractions. In addition, these fractions were also used to assess cell-mediated immunity in mice sensitized with lyophilized whole BCG as well as with irradiated Mycobacterium. it was found that BCG, intraperitoneally injected, engedered different specifically antigen-sensitized populations of lymphocytes in the spleen and lymph node. Moreover, a certain degree of antigenic cross-reactivity was observed between BCG and M. leprae, possibly at the T-cell level. In vitro experiments suggested that the CW stimulated B cells, indicating a mitogenic ctivity leading to polyclonal activation. Finally, in vitro priming experiments established that these subcellular fractions could sensitize human peripheral lymphocytes, and upon secondary culture all primed cells were able to respond to homologous preparations but not always to heterologous preparations, thus offering a means to distinguish antigens of interest from those antigenically less complicated fractions at the T-cell level.