Investigating the Anti-inflammatory Effect of Quinoline Derivative: N1-(5-methyl-5H-indolo[2,3-b]quinolin-11-yl)benzene-1,4-diamine Hydrochloride Loaded Soluble Starch Nanoparticles Against Methotrexate-induced Inflammation in Experimental Model.

BACKGROUND: It is necessary to develop advanced therapies utilizing natural ingredients with anti-inflammatory qualities in order to lessen the negative effects of chemotherapeutics. RESULTS: The bioactive N1-(5-methyl-5H-indolo[2,3-b]quinolin-11-yl)benzene-1,4-diamine hydrochloride (NIQBD) was synthesized. After that, soluble starch nanoparticles (StNPs) was used as a carrier for the synthesized NIQBD with different concentrations (50 mg, 100 mg, and 200 mg). The obtained StNPs loaded with different concentrations of NIQBD were coded as StNPs-1, StNPs-2, and StNPs-3. It was observed that, StNPs-1, StNPs-2, and StNPs-3 exhibited an average size of 246, 300, and 328 nm, respectively. Additionally, they also formed with homogeneity particles as depicted from polydispersity index values (PDI). The PDI values of StNPs-1, StNPs-2, and StNPs-3 are 0.298, 0.177, and 0.262, respectively. In vivo investigation of the potential properties of the different concentrations of StNPs loaded with NIQBD against MTX-induced inflammation in the lung and liver showed a statistically substantial increase in levels of reduced glutathione (GSH) accompanied by a significant decrease in levels of oxidants such as malondialdehyde (MDA), nitric oxide (NO), advanced oxidation protein product (AOPP), matrix metalloproteinase 9/Gelatinase B (MMP-9), and levels of inflammatory mediators including interleukin 1-beta (IL-1ß), nuclear factor kappa-B (NF-κB) in both lung and liver tissues, and a significant decrease in levels of plasma homocysteine (Hcy) compared to the MTX-induced inflammation group. The highly significant results were obtained by treatment with a concentration of 200 mg/mL. Histopathological examination supported these results, where treatment showed minimal inflammatory infiltration and congestion in lung tissue, a mildly congested central vein, and mild activation of Kupffer cells in liver tissues. CONCLUSION: Combining the treatment of MTX with natural antioxidant supplements may help reducing the associated oxidation and inflammation.

Cryptolepine Analog Exhibits Antitumor Activity against Ehrlich Ascites Carcinoma Cells in Mice via Targeting Cell Growth, Oxidative Stress, and PTEN/Akt/mTOR Signaling Pathway.

BACKGROUND: The efficacy of chemotherapy continues to be limited due to associated toxicity and chemoresistance. Thus, synthesizing and investigating novel agents for cancer treatment that could potentially eliminate such limitations is imperative. OBJECTIVE: The current study aims to explore the anticancer potency of cryptolepine (CPE) analog on Ehrlich ascites carcinoma cells (EACs) in mice. METHODS: The effect of a CPE analog on EAC cell viability and ascites volume, as well as malonaldehyde, total antioxidant capacity, and catalase, were estimated. The concentration of caspase-8 and mTOR in EACs was also measured, and the expression levels of PTEN and Akt were determined. RESULTS: Results revealed that CPE analog exerts a cytotoxic effect on EAC cell viability and reduces the ascites volume. Moreover, this analog induces oxidative stress in EACs by increasing the level of malonaldehyde and decreasing the level of total antioxidant capacity and catalase activity. It also induces apoptosis by elevating the concentration of caspase-8 in EACs. Furthermore, it decreases the concentration of mTOR in EACs. Moreover, it upregulates the expression of PTEN and downregulates the expression of Akt in EACs. CONCLUSION: Our findings showed the anticancer activity of CPE analog against EACs in mice mediated by regulation of the PTEN/Akt/mTOR signaling pathway.

Influence of high porous sponges for improving the interfacial evaporation from hemispherical solar distillers.

The present study aims to improve the palatable water production from the hemispherical cover solar distiller (HSD). To augment the palatable water produced from the hemispherical cover, a black sponge was utilized as a porous medium using different thicknesses, which augments the interfacial evaporation through the capillary effect of the water through the sponge. The rate of condensation of the hemispherical cover depends on the higher interaction of air from the ambient through wind velocity as the exposure area of the hemispherical cover is relatively higher as compared to the other traditional distillers. The rate of evaporation from the distillers depends on the interfacial materials used in the distillation unit, and this is achieved by using a highly porous black sponge to attain a higher evaporation rate. The thickness of the black porous sponge was optimized (1 to 4 cm), which was the operating parameter for better interfacial evaporation through the sponge, and the same has been compared to the conventional HSD without a porous sponge medium. Results showed a significant improvement in the evaporation rate using a porous medium as the palatable water produced from the HSD was improved by 72.29% using 3 cm as sponge thickness inside compared to the conventional HSD without the porous medium. The cumulative palatable water produced from the HSD using 3 cm as sponge thickness was found as 7150 mL/m2, whereas the conventional HSD without sponge, it was found as 4150 mL/m2. Moreover, using a porous sponge layer as an interfacial evaporation medium, the exergy and energy efficiencies were improved by about 512.87 and 70.53%, respectively. Similarly, with the influence of a porous sponge as an interfacial evaporation medium, the distilled water cost decreased by 41.67% more than the conventional HSD.

Cytotoxic Potential of Novel Quinoline Derivative: 11-(1,4-Bisaminopropylpiperazinyl)5-methyl-5H-indolo[2,3-b]quinoline against Different Cancer Cell Lines via Activation and Deactivation of the Expression of Some Proteins.

The current study evaluated the cytotoxic activity of 11-(1,4-bisaminopropylpiperazinyl)5-methyl-5H-indolo[2,3-b]quinoline (BAPPN), a novel derivative of 5-methyl-5H-indolo[2,3-b]quinoline, against hepatocellular carcinoma (HepG2), colon carcinoma (HCT-116), breast (MCF-7), and lung (A549) cancer cell lines and the possible molecular mechanism through which it exerts its cytotoxic activity. BAPPN was synthesized and characterized with FT-IR and NMR spectroscopy. The binding affinity scores of BAPPN for caspase-3 PDB: 7JL7 was -7.836, with an RMSD of 1.483° A. In silico screening of ADME properties indicated that BAPPN showed promising oral bioavailability records in addition to their high gastrointestinal absorption and blood-brain barrier penetrability. BAPPN induced cytotoxicity, with IC50 values of 3.3, 23, 3.1, and 9.96 µg/mL against cancer cells HepG2, HCT-116, MCF-7, and A549, respectively. In addition, it induced cell injury and morphological changes in ultracellular structure, including cellular delayed activity, vanishing of membrane blebbing, microvilli, cytoplasmic condensation, and shrunken nucleus with more condensed chromatin autophagosomes. Furthermore, BAPPN significantly increased the protein expression of caspase-3 and tumor suppressor protein (P53). However, it significantly reduced the secretion of vascular endothelial growth factor (VEGF) protein into the medium and decreased the protein expression of proliferation cellular nuclear antigen (PCNA) and Ki67 in HepG2, HCT-116, MCF-7, and A549 cells. This study indicates that BAPPN has cytotoxic action against liver, colon, breast, and lung cancer cell lines via the up-regulation of apoptotic proteins, caspase-3 and P53, and the downregulation of proliferative proteins, VEGF, PCNA, and Ki67.

Impact of Synthesized Indoloquinoline Analog to Isolates from Cryptolepis sanguinolenta on Tumor Growth Inhibition and Hepatotoxicity in Ehrlich Solid Tumor-Bearing Female Mice.

The study evaluated the antitumor efficacy of APAN, "synthesized indoloquinoline analog derived from the parent neocryptolepine isolated from the roots of Cryptolepis sanguinolenta", versus the chemotherapeutic drug etoposide (ETO) in Ehrlich solid tumor (EST)-bearing female mice as well as its protective effect against etoposide-triggered hepatic disorders. APAN showed an ameliorative activity against Ehrlich solid tumor and hepatic toxicity, and the greatest improvement was found in the combined treatment of APAN with ETO. The results indicated that EST altered the levels of tumor markers (AFP, CEA, and anti-dsDNA) and liver biomarker function (ALT, AST, ALP, ALB, and T. protein). Furthermore, EST elevated CD68 and anti-survivin proteins immuno-expressions in the solid tumor and liver tissue. Molecular docking studies were demonstrated to investigate their affinity for both TNF-α and topoisomerase II as target proteins, as etoposide is based on the inhibition of topoisomerase II, and TNF-α is quite highly expressed in the solid tumor and liver tissues of EST-bearing animals, which prompted the authors' interest to explore APAN affinity to its binding site. Treatment of mice bearing EST with APAN and ETO nearly regularized serum levels of the altered parameters and ameliorated the impact of EST on the tissue structure of the liver better than that by treatment with each of them separately.

Molluscicidal and Larvicidal Potency of N-Heterocylic Analogs against Biomophalaria alexandrina Snails and Schistosoma mansoni Larval Stages.

This work describes the synthesis of quinoline-based N--heterocyclic arenes and their biological evaluation as molluscicides against adult Biomophalaria alexandrina snails as well as larvicides against Schistosoma mansoni larvae (miracidia and cercariae). Molecular docking studies were demonstrated to investigate their affinity for cysteine protease protein as an interesting target for antiparasitics. Compound AEAN showed the best docking results followed by APAN in comparison to the co-crystallized ligand D1R reflected by their binding affinities and RMSD values. The egg production, hatchability of B. alexandrina snails and ultrastructural topography of S. mansoni cercariae using SEM were assessed. Biological evaluations (hatchability and egg-laying capacity) revealed that the quinoline hydrochloride salt CAAQ was the most effective compound against adult B. alexandrina snails, whereas the indolo-quinoline derivative APAN had the most efficiency against miracidia, and the acridinyl derivative AEAA was the most effective against cercariae and caused 100% mortality. CAAQ and AEAA were found to modulate the biological responses of B. alexandrina snails with/without S. mansoni infection and larval stages that will affect S. mansoni infection. AEAA caused deleterious morphological effects on cercariae. CAAQ caused inhibition in the number of eggs/snail/week and reduced reproductive rate to 43.8% in all the experimental groups. CAAQ and AEAA can be recommended as an effective molluscicide of plant origin for the control program of schistosomiasis.

Design and cytotoxic evaluation via apoptotic and antiproliferative activity for novel 11(4-aminophenylamino)neocryptolepine on hepatocellular and colorectal cancer cells.

The current study evaluated the cytotoxic activity of 11(4-Aminophenylamino)neocryptolepine (APAN), a novel derivative of neocryptolepine, on hepatocellular (HepG2) and colon (HCT-116) carcinoma cell lines as well as, the possible molecular mechanism through which it exerts its cytotoxic activity. The APAN was synthesized and characterized based on their spectral analyses. Scanning for anticancer target of APAN by Swiss software indicated that APAN had highest affinity for protein tyrosine kinase 6 enzyme. Furthermore, Super pred software indicated that APAN can be indicated in hepatic and colorectal cells with 92%. Molecular docking studies indicated that the binding affinity scores of APAN for protein PDB code: 6CZ4 of tyrosine kinase 6 recorded of - 6.6084 and RMSD value of 0.8891°A, while that for protein PDB: 7JL7 of caspase 3 was - 6.1712 and RMSD of 0.8490°A. Treatment of HepG2 and HCT-116 cells with APAN induced cytotoxicity with IC50 of 2.6 and 1.82 µg/mL respectively. In addition, it induced injury and serious morphological changes in cells including, disappearance of microvilli, membrane blebbing, cytoplasmic condensation, and shrunken nucleus with more condensed chromatin. Moreover, APAN significantly increased protein expression of annexin V (apoptotic marker). Furthermore, APAN significantly increased protein expression of caspase 3 and P53. However, it significantly reduced secretion of VEGF protein into the medium and decreased protein expression of PCNA and Ki67 in HepG2 and HCT-116 cells. This study indicated that APAN had cytotoxic activity against HepG2 and HCT-116 cells via increasing the expression of apoptotic proteins and reducing the expression of proliferative proteins.

Hemispherical Solar Distiller Performance Utilizing Hybrid Storage Media, Paraffin Wax with Nanoparticles: An Experimental Study.

The traditional method of obtaining fresh water for drinking is by burning fossil fuels, emitting greenhouse gases into the atmosphere. However, renewable energy is gaining more traction since it is available free of cost for producing fresh water. In this study, Al2O3 nanoparticles were distributed in a phase change material (paraffin wax) that had been fixed at a hemispherical distiller water basin. Three scenarios with three hemispherical distillers were examined. A conventional hemispherical distiller (CHD), a conventional hemispherical distiller with paraffin wax as a phase change material (CHD-PCM), and a conventional hemispherical distiller with PCM partially filled with Al2O3 nanoparticles (CHD-N-PCM) were tested under the same climatic conditions. The experimental results showed that CHD gave a daily yield of 4.85 L/m2/day, while CHD-PCM increased the yield to up to 6.2 L/m2/day with a 27.84% daily yield enhancement. The addition of Al2O3 nanoparticles to paraffin wax CHD-N-PCM improved hemispherical distillate yield up to 8.3 L/m2/day with a 71.13% increase over CHD yield.

Synthesis, Biocidal and Antibiofilm Activities of New Isatin-Quinoline Conjugates against Multidrug-Resistant Bacterial Pathogens along with Their In Silico Screening.

Isatin-quinoline conjugates 10a-f and 11a-f were assembled by the reaction of N-(bromobutyl) isatin derivatives 3a, b with aminoquinolines 6a-c and their corresponding hydrazinyl 9a-c in good yields. The structures of the resulting conjugates were established by spectroscopic tools and showed data consistent with the proposed structures. In vitro antibacterial activity against different bacterial strains was evaluated. All tested conjugates showed significant biocidal activity with lower MIC than the first line drugs chloramphenicol and ampicillin. Conjugates 10a, 10b and 10f displayed the most potent activity against all clinical isolates. The antibiofilm activity for all tested conjugates was screened against the reference drug vancomycin using the MRSA strain. The results revealed that all conjugates had an inhibitory activity against biofilm formation and conjugate. Conjugate 11a showed 83.60% inhibition at 10 mg/mL. In addition, TEM studies were used to prove the mechanism of antibacterial action of conjugates 10a and 11a against (MRSA). Modeling procedures were performed on 10a-f and 11a-f and interestingly the results were nearly consistent with the biological activities. In addition, in silico pharmacokinetic evaluation was performed and revealed that the synthesized compounds 10a-f and 11a-f were considered drug-like molecules with promising bioavailability and high GI absorption. The results confirmed that the title compounds caused the disruption of bacterial cell membranes and could be used as potential leads for the further development and optimization of antibacterial agents.

Mechanisms of Luminescence in Lanthanide Complexes: A Crucial Role of Metal-Ligand Covalency.

A current understanding of the luminescence of lanthanide complexes is based on the phenomenological Judd-Ofelt (JO) theory. However, the mechanisms of electric-dipole transitions lying at its basis were never subjected to a rigorous analysis. Here, we investigate the contributions to the electric-dipole transitions in the Er3+ 4S3/2 → 4I15/2 band of an erbium trensal complex using state-of-the-art ab initio calculations. We find that the conventional JO mechanism based on the electrostatic crystal field yields only a quarter of the integral intensity of this band. Accordingly, three quarters of it is contributed by covalent binding of erbium and ligand orbitals via three major mechanisms, the 4f ligand and ligand-ligand electric-dipole transitions and covalent enhancement of the hybridization of 4f and even empty orbitals of erbium. We expect that these findings will inspire the design of efficient rare-earth luminescent materials.

Synthesis, Nanoformulations, and In Vitro Anticancer Activity of N-Substituted Side Chain Neocryptolepine Scaffolds.

The naturally occurring neocryptolepine (5-Methylindolo [2,3-b]quinoline) and its analogs exhibited prominent anticancer and antimalarial activity. However, the main problem of this class of compounds is their poor aqueous solubility, hampering their bioavailability and preventing their clinical development. To overcome the problem of insolubility and to improve the physicochemical and the pharmacological properties of 5-Methylindolo [2,3-b]quinoline compounds, this work was designed to encapsulate such efficient medical compounds into mesoporous silica oxide nanoemulsion (SiO2NPs). Thus, in this study, SiO2NPs was loaded with three different concentrations (0.2 g, 0.3, and 0.6 g) of 7b (denoted as NPA). The findings illustrated that the nanoparticles were formed with a spherical shape and exhibited small size (less than 500 nm) using a high concentration of the synthesized chemical compound (NPA, 0.6 g) and good stabilization against agglomeration (more than -30 mv). In addition, NPA-loaded SiO2NPs had no phase separation as observed by our naked eyes even after 30 days. The findings also revealed that the fabricated SiO2NPs could sustain the release of NPA at two different pH levels, 4.5 and 7.4. Additionally, the cell viability of the produced nanoemulsion system loaded with different concentrations of NPA was greater than SiO2NPs without loading, affirming that NPA had a positive impact on increasing the safety and cell viability of the whole nanoemulsion. Based on these obtained promising data, it can be considered that the prepared NPA-loaded SiO2NPs seem to have the potential for use as an effective anticancer drug nanosystem.

Experimental and Molecular Docking Studies of Cyclic Diphenyl Phosphonates as DNA Gyrase Inhibitors for Fluoroquinolone-Resistant Pathogens.

DNA gyrase and topoisomerase IV are proven to be validated targets in the design of novel antibacterial drugs. In this study, we report the antibacterial evaluation and molecular docking studies of previously synthesized two series of cyclic diphenylphosphonates (1a-e and 2a-e) as DNA gyrase inhibitors. The synthesized compounds were screened for their activity (antibacterial and DNA gyrase inhibition) against ciprofloxacin-resistant E.coli and Klebsiella pneumoniae clinical isolates having mutations (deletion and substitution) in QRDR region of DNA gyrase. The target compound (2a) that exhibited the most potent activity against ciprofloxacin Gram-negative clinical isolates was selected to screen its inhibitory activity against DNA gyrase displayed IC50 of 12.03 µM. In addition, a docking study was performed with inhibitor (2a), to illustrate its binding mode in the active site of DNA gyrase and the results were compatible with the observed inhibitory potency. Furthermore, the docking study revealed that the binding of inhibitor (2a) to DNA gyrase is mediated and modulated by divalent Mg2+ at good binding energy (-9.08 Kcal/mol). Moreover, structure-activity relationships (SARs) demonstrated that the combination of hydrazinyl moiety in conjunction with the cyclic diphenylphosphonate based scaffold resulted in an optimized molecule that inhibited the bacterial DNA gyrase by its detectable effect in vitro on gyrase-catalyzed DNA supercoiling activity.

Towards understanding the magnetism of Os(IV) complexes: an ab initio insight.

The magnetism of a recently synthesized trans-[OsIVCl4(κN1-Hind)2] complex (5d4-system), where Hind = 2H-indazole, was studied experimentally and theoretically. Relativistic CASSCF/CASPT2 calculations for this and model [OsIVCl6]2- complexes were employed to understand the nature of the low-lying multiplets. It is found that despite strong metal-ligand covalency they are basically characterized by the total angular pseudo-momentum J̃ originating from the spin-orbit coupling of the ground-state spin S = 1 with the orbital pseudo-momentum L̃ = 1 of the OsIV ion. The strong spin-orbit interaction also preserves the dominant J̃ = 0 character of the non-magnetic ground state in the trans-[OsIVCl4(κN1-Hind)2] complex despite significant deviation of the ligand environment of OsIV from octahedral symmetry. At the same time the spin-orbit admixture of all multiplets arising from the t2g4 strong-field electronic configuration is indispensable for the correct description of magnetic properties of OsIV complexes. Moreover, based on ab initio calculations, we argue that the charge-transfer states play an important role in the magnetism of the present and probably other 5d complexes, a situation never encountered for 3d and 4f compounds.

Ameliorative effects of 9-diaminoacridine derivative against Ehrlich ascites carcinoma-induced hepatorenal injury in mice.

Ehrlich ascites carcinoma induces hepatorenal injuries while acridine derivatives have antioxidant, anticancer, and anti-inflammatory. Thus, this study evaluated the protective potential of a newly synthesized the 9-diaminoacridine derivative (9-DAAD), N1-(acridin-9-yl) propane-1, 3-diamine hydrochloride, against Ehrlich ascites carcinoma (EAC) induced hepatorenal injury in female mice. Forty female mice were allocated into 4 groups. Group I was injected with 0.1% DMSO subcutaneously and kept a control. Group II received 9-DAAD (30 mg/kg bw/2 days) subcutaneously for 2 weeks. Group III was injected interaperitonealy with 2.5 × 106 cells of EAC/20 g bw. Group IV was injected with EAC as the third group and administered with 9-DAAD as the second group for 2 weeks after induction of EAC. EAC significantly elevated total leukocytes and platelets counts; activities of serum AST, ALT, and ALP; serum levels of alpha-fetoprotein; carcinoembryonic antigen; urea and creatinine; and expression of vascular endothelial growth factor protein in hepatic and renal tissues. Meanwhile it decreased red blood cells count, hemoglobin concentration and hematocrit value. At the same time, it significantly reduced serum levels of total protein and albumin and altered hepatic and renal tissues structures. Also, EAC decreased apoptosis and DNA synthesis in hepatic and renal cells. However, treatment of EAC-bearing mice with 9-DAAD improved liver and kidney structures, functions and modulated EAC altered parameters, as well as it reduced hepatic and renal cells proliferation and DNA synthesis. This study indicated that 9-DAAD had a potential ameliorative effect against EAC-induced hepatorenal injury.

Frequency of Gallbladder Stones Among Patients Underwent Abdominal Ultrasound in a Tertiary Hospital in Sana’a City, Yemen

@#Introduction: The Gallbladder stone (GBS) disease is most commonly asymptomatic that may lead to several complications such as ascending cholangitis and obstructive jaundice. In this study the frequency of gallbladder stones among patients referred for abdominal ultrasound at the University of Science and Technology hospital (USTH), Sana’a – Yemen, have been estimated during the period between January and June 2013. Methods: This study is a record-based and conducted at the radiology department in USTH, on cases underwent abdominal ultrasound during the period from January – June 2013. Information were collected from abdominal ultrasonography reports. Results: In this study 4935 patients’ records are included. Of them, 2541 were males and 2394 were females. The frequency of patients with GBS was 5.53%. Multiple stones were observed in 3.57% of patients and 4.34% patients had large stones with size ≥ 5 mm. Females had significantly higher frequency of GBS (8.0%: 191/2394) than males (3.2%: 82/2541) (P < 0.001). It was found that, no significant difference between males and females in harboring small stones (< 5mm) (P = 0.251). However, significantly higher frequency of large GBS (≥ 5 mm) was found among females compared to males (P < 0.001). The frequencies of GBS, small size of GBS and large size of GBS have significantly increased with increasing age (P < 0.001). Conclusion: In this study it was found that females had significantly higher frequency of GBS than males. No significant difference between males and females in harboring small stones. There was a significantly higher frequency of large GBS was found among females compared to males. The frequencies of GBS, small size of GBS and large size of GBS have significantly increased with increasing age.

Use of community health workers to manage and prevent noncommunicable diseases: policy options based on the findings of the COACH study

The Asia Pacific Observatory on Health Systems and Policies is a collaborative partnership which supports and promotes evidence-based health policy making in the Asia Pacific Region. Based in WHO’s Regional Office for South-East Asia, it brings together governments, international agencies, foundations, civil society and the research community with the aim of linking systematic and scientific analysis of health systems in the Asia Pacific Region with the decision-makers who shape policy and practice.

Intra-Cavitary Masses: Rare Presentation of a Common Illness in SAARC Nation.

Cardiovascular tuberculosis (TB) is a relatively uncommon manifestation of Mycobacterium tuberculosis infection. TB can affect all three layers of the heart; endocardial tuberculoma is the rarest form. Endocardial tuberculoma, when it occurs, can easily be confused with other common causes of intracardiac mass lesions, especially in echocardiography. Timely diagnosis and appropriate treatment is essential, as only this can lessen the associated morbidity and mortality. Here, a case of cardiovascular TB has been described in a middle-aged woman from the SAARC nation; the woman presented with simultaneous pericardial constriction and multichamber endocardial tuberculoma. Combined pharmacological and surgical approach was successful.

Pattern of Viral Infections among Infants and Children Admitted to the Paediatric Intensive Care Unit at Sultan Qaboos University Hospital, Oman.

OBJECTIVES: The aim of this study was to describe the pattern of viral infections in infants and children admitted to the Paediatric Intensive Care Unit (PICU) at Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. METHODS: A retrospective review of patient records was carried out on all patients admitted to the PICU between January 2011 and December 2012. In order to detect viruses, polymerase chain reaction (PCR) technology was used to detect viruses in nasopharyngeal aspirates, tracheal aspirates, plasma, stool and urine samples. All infants and children below 13 years old, who were admitted to the PICU at SQUH during the study period and with confirmed viral infections, were included in the study. RESULTS: A total of 373 infants and children were admitted to the PICU during the study period. Viruses were detected in 34 patients. The most frequently detected viruses were cytomegalovirus (CMV) in 29.4%; this virus was noted predominantly in immuncompromised patients (80%, P = 0.023) and was associated with increased mortality (50%, P = 0.031) and prolonged PICU stay (70%, P = 0.045). Fatalities before discharge were recorded in 23.5% of the patients. The most frequent risk factors for viral infections were an age of <12 months old (47.1%), assisted ventilation/intubation (52.9%) and a prolonged PICU stay (55.9%). CONCLUSION: The results of this study found that CMV was the most common viral infection among infants and children admitted to the PICU in SQUH. CMV was also the leading cause of mortality.

Factors associated with acceptability of circumcision among male drug users in western China: a cross-sectional study.

This study is aimed to investigate whether male circumcision (MC) is feasible among IDUs in China. 1304 drug users who attended methadone maintenance therapy clinics in Guangxi, Chongqing and Xinjiang were selected for participation by using convenience sampling, and completed a self-administered questionnaire. The factors associated with the acceptability of MC were examined via multiple logistic regression models. 45.2% (589/1304) of the participants reported an acceptance of MC. Many of the participants who were initially not willing to accept MC (715/1304) had changed their mind when they were informed that MC would reduce the risk of HIV and STDs (43.4%; 310/715), that MC is associated with few surgery-related complications (23.1%; 165/715), that the surgical procedure could be arranged free of charge (20.1%, 144/715). In the multivariate analysis, higher acceptability of MC was associated with knowledge of the hazards of phimosis (OR=2.22), the presence of phimosis (OR=14.87), and knowledge that MC can prevent AIDS and STDs (OR=1.49); while lower acceptability was associated with residing in Chongqing province (OR=0.41) and an educational level of junior (OR=0.64) and senior high (OR=0.63) school. The MC policy targeting IDUs in China should take into account these factors associated with MC acceptability.

Use of bronchoalveolar lavage enzyme-linked immunospot for diagnosis of smear-negative pulmonary tuberculosis.

OBJECTIVE: To compare the diagnostic validity of blood enzyme-linked immunospot assay (ELISpot), broncho-alveolar lavage (BAL) ELISpot and the tuberculin skin test (TST) in patients with pulmonary smear-negative tuberculosis (TB) in a country with high TB prevalence. DESIGN: In a prospective, hospital-based study, 107 patients with suspected TB were tested simultaneously using blood and BAL ELISpot and TST. RESULTS: Of 102 patients with active pulmonary TB, 36 (35.3%) were diagnosed with TB, while 66/102 (64.7%) had a non-TB diagnosis. The sensitivity and specificity for ELISpot on mononuclear cells from BAL fluid was respectively 94.4% (95%CI 81.9-98.5) and 78.1% (95%CI 66.6-86.5). The specificity of BAL ELISpot was significantly higher than that of blood ELISpot (P = 0.011). Compared with blood ELISpot and TST, BAL ELISpot was not significantly influenced by previous history of TB (OR 2.05, P > 0.05) or household contact with a patient with active TB (OR 2.41, P > 0.05). CONCLUSION: ELISpot on BAL appears to be a more rapid and sensitive supplementary test than on blood for the diagnosis of active TB patients with a negative sputum smear in a developing country setting with high TB prevalence and access to bronchoscopy and ELISpot assay. However, the test's utility was limited by its moderate specificity.