Seroprevalence of Newcastle disease virus and avian influenza virus in poultry and captive wild birds in poultry-dense regions of Pakistan.

Newcastle disease virus (NDV) and avian influenza virus (AIV) are causing contagious diseases in chickens and wild birds worldwide; however, there is a paucity of information on the current status of seropositivity of Newcastle and avian influenza diseases in chickens and wild birds of Pakistan. Therefore, the present study aimed to investigate the serological evidence of both diseases in commercial poultry (broiler, layer chickens), backyard poultry, and captive wild birds in poultry­dense regions of Punjab, Pakistan. Enzyme­linked immunosorbent (ELISA) and haemagglutination inhibition (HI) assays were performed for the determination of antibodies against NDV and AIV and their genotyping and subtyping, respectively. Overall, 47.5% and 67.4% seroprevalence of NDV and AIV, respectively, was observed in both poultry and wild birds. Based on bird's category, layer chickens had the highest seroprevalence of NDV (60.8%, 95% CI: 52.95­68.22, OR: 0.71) followed by backyard poultry (56.8%, 95% CI: 47.92­65.32, OR: 0.82), broilers (52.7%, 95% CI: 46.84­58.64), pigeons (41.3%, 95% CI: 30.53­52.81, OR: 1.59), peafowls (26.1%, 95% CI: 11.09­48.69, OR: 3.16), ducks (23.8%, 95% CI: 12.59­39.8, OR: 3.57), turkeys (16.7%, 95% CI: 4.41­42.27, OR: 5.58), parrots (14.3%, 95% CI: 2.52­43.85, OR: 6.70) and quails (2.3%, 95% CI: 0.2­13.51, OR: 4.8). Comparatively, backyard chickens had the highest seroprevalence of AIV (78.8%, 95% CI: 70.64­85.22, OR: 0.63) followed by ducks (73.8%, 95% CI: 57.68­85.6, OR: 0.83), layers (73.5%, 95% CI: 65.98­79.89, OR: 0.84), pigeons (72.5%, 95% CI: 61.2­81.61, OR: 0.89), broilers (70.1%, 95% CI: 64.44­75.29), turkeys (55.5%, 95% CI: 31.35­77.6, OR: 1.87), peafowls (47.8%, 95% CI: 27.42­68.9, OR: 2.56) and parrots (42.8%, 95% CI: 18.8­70.3, OR: 3.1). Overall, 40.1%, 34.2%, 31.3%, and 25.1% sera were positive for H9 AIV, G­VII NDV, H7 AIV, and G­VI NDV, respectively. The current study revealed a widespread exposure to NDV and AIV in poultry and captive wild birds. Therefore, it is crucial to include captive wild birds in NDV and AIV surveillance programs to further strengthen disease control measures, particularly in endemic regions.

A Rare Case of Salmonella Gastroenteritis Presenting as Aspiration Pneumonia With Pleural Empyema in an Immunocompetent Patient.

Non-typhoidal salmonella (NTS) can cause infections ranging from self-limited chronic carriers to gastroenteritis, bacteremia, and extraintestinal infections. Pulmonary involvement, particularly empyema, is quite rare and generally found in immunosuppressed individuals. We present a case of salmonellosis in an immunocompetent patient with rare pulmonary complications of empyema. The patient, with no underlying immunocompromised illness, presented with a one-day history of worsening generalized weakness, fever, shortness of breath, and productive cough after having gastroenteritis symptoms of five days duration, which stopped two days prior to admission. On further investigation, imaging revealed right lower lobe pneumonia with empyema. The patient was managed with intravenous antibiotics and chest tube placement with good clinical response. Pleural fluid analysis showed exudative fluid and grew Salmonella enteritidis with negative blood and sputum cultures. The patient, in stable condition, was discharged on four weeks of amoxicillin/clavulanic acid after consulting the infectious disease specialist for presumed aspiration pneumonia complicated with empyema in the setting of multiple episodes of vomiting due to gastroenteritis. The lung is an atypical site for salmonellosis. Pulmonary infections in immunocompetent hosts are rare in the medical literature. Early recognition and timely management of pulmonary complications can lead to better outcomes.

Energy Prediction and Optimization for Smart Homes with Weather Metric-Weight Coefficients.

Home appliances are considered to account for a large portion of smart homes' energy consumption. This is due to the abundant use of IoT devices. Various home appliances, such as heaters, dishwashers, and vacuum cleaners, are used every day. It is thought that proper control of these home appliances can reduce significant amounts of energy use. For this purpose, optimization techniques focusing mainly on energy reduction are used. Current optimization techniques somewhat reduce energy use but overlook user convenience, which was the main goal of introducing home appliances. Therefore, there is a need for an optimization method that effectively addresses the trade-off between energy saving and user convenience. Current optimization techniques should include weather metrics other than temperature and humidity to effectively optimize the energy cost of controlling the desired indoor setting of a smart home for the user. This research work involves an optimization technique that addresses the trade-off between energy saving and user convenience, including the use of air pressure, dew point, and wind speed. To test the optimization, a hybrid approach utilizing GWO and PSO was modeled. This work involved enabling proactive energy optimization using appliance energy prediction. An LSTM model was designed to test the appliances' energy predictions. Through predictions and optimized control, smart home appliances could be proactively and effectively controlled. First, we evaluated the RMSE score of the predictive model and found that the proposed model results in low RMSE values. Second, we conducted several simulations and found the proposed optimization results to provide energy cost savings used in appliance control to regulate the desired indoor setting of the smart home. Energy cost reduction goals using the optimization strategies were evaluated for seasonal and monthly patterns of data for result verification. Hence, the proposed work is considered a better candidate solution for proactively optimizing the energy of smart homes.

Efficacy of single dose dermatological 0.1% Tacrolimus Ointment in the treatment of vernal keratoconjunctivitis.

Objectives: To assess the safety of dermatological 0.1% tacrolimus ointment when used topically and its efficacy in the treatment of vernal keratoconvinctivtis. METHODS: The quasi-experimental, multi-centre study was conducted at the Gujranwala Medical College/District Headquarters Teaching Hospital, Gujranwala, and the Gomal Medial College/Mufti Mehmood Teaching Hospital, Dera Ismail Khan, Pakistan, from July 2019 to March 2020, and comprised patients of severe vernal keratoconvinctivtis. Symptoms and clinical signs were graded on a pre-devised scale. Patients were given small amount of tacrolimus 0.1% ointment applied to the inferior conjunctival fornix before going to bed. The duration of treatment was 3 months and the patients were followed up for up to 6 months. Data was analysed using SPSS 20. RESULTS: Of the 50 patients, 30(60%) were males and 20(40%) were females. The overall mean age was 10.64±3.199 years. Mean symptom score and clinical signs score gradually reduced on each follow-up (p<0.05). Mild recurrence was noted in 12(24%) patients who were managed with lubricants and anti-histamine topical drops. No complication was noted. CONCLUSIONS: Tacrolimus 0.1% was found to be effective and safe in the treatment of severe refractory vernal keratoconvinctivtis even when given once a day. Clinical Trial Registration: Chinese Clinical Trial Registry Id: ChiCTR2000031929 link: www.chictr.org.cn/hvshowproject.aspx?id=28053.

Detection and molecular characterization of picobirnaviruses in the wild birds: Identification of a novel picobirnavirus possessing yeast mitochondrial genetic code.

Picobirnaviruses (PBVs) are bi-segmented dsRNA viruses that have been detected in various animal species including vertebrates and invertebrates. In this study, 17 complete or incomplete PBV segment-2 and one unsegmented PBV-like virus sequence were identified in fecal samples from different bird species using viral metagenomic approach. The bird PBV and PBV-like virus retained the conservative motifs that are conserved in dsRNA2 of common PBVs. The RdRp of these 17 PBVs shared the highest Amino acid (aa) identity of 45.90%∼94.19% with previous animal and human PBVs, while the RdRp of the unsegment PBV-like virus shared the highest aa sequence identity of 31.93% with one chicken PBV (GenBank No. MW837829). The unsegmented PBV-like virus unexpectedly used the yeast mitochondrial genetic code (transl_table=3) for all ORFs translation. In addition, the prokaryotic RBS sequence was not only detected upstream to ORF2 at position 360AGGAGG365 of this unsegmented PBV-like virus, but also found upstream to ORF of bird PBV dsRNA2. The presence of the prokaryotic ribosomal binding site in the bird PBV genomes, and the finding of one novel unsegmented PBV-like virus using the yeast mitochondrial genetic code for translation supported recent speculations that PBVs may actually infect prokaryotic or fungal host cells. This study enhanced our understanding of PBVs and provided data support for exploring the real host of PBVs.

Development, Biological Characterization, and Immunological Evaluation of Virosome Vaccine against Newcastle Disease in Pakistan.

Newcastle disease (ND) is a highly fatal, infectious, viral disease, and despite immunization with live and inactivated vaccines, the disease is still endemic, causing heavy morbidity and mortality leading to huge economic losses to the poultry industry in Pakistan. Therefore, the present study was aimed for the first time in the country at using novel virosomal technology to develop the ND vaccine using an indigenous highly virulent strain of the virus. ND virosome was prepared using Triton X-100, and SM2 Bio-Beads were used to remove the detergent and reconstitute the viral membrane into virosome. Confirmation was done by transmission electron microscopy and protein analysis by SDS-PAGE. In vitro cell adhesion property was observed by incorporating green fluorescent protein (GFP), producing plasmid into virosome and in vitro cell culture assay. Sterility, safety, and stability of the vaccine were tested before in vivo evaluation of immunogenicity and challenge protection study in commercial broiler. The virosome vaccine was administered (30 µg/bird) at days 7 and 14 through the intranasal route in comparison with commercially available live and inactivated ND vaccines. Results revealed significantly high (p < 0.05) and clinically protective hemagglutination inhibition (HI) antibody titers at 7, 14, 21, and 28 days postimmunization with the virosome vaccine in comparison to the negative control. The GMTs were comparable to live and inactivated vaccines with nonsignificant (p > 0.05) differences throughout the experiment. Antibody levels increased in all vaccinated groups gradually from the 7th day and were maximum at 28th-day postvaccination. In the virosome-administered group, GMT was 83.18 and 77.62 at 21st and 28th-days postvaccination, respectively. Challenge revealed 100%, 90%, and 80% protection in virosome, live, and inactivated vaccinated groups, respectively. Under given experimental conditions, we can conclude that ND virosome vaccine prepared from the indigenous virus was found to be safe and immunogenic.

A comparative phylogenomic analysis of SARS-CoV-2 strains reported from non-human mammalian species and environmental samples.

Coronaviruses (CoVs) infect a wide range of domestic and wild mammals. These viruses have a potential and tendency to cross-species barriers and infect humans. Novel human coronavirus 2019-nCoV (hCoV-19) emerged from Wuhan, China, and has caused a global pandemic. Genomic features of SARS-CoV-2 may attribute inter-species transmission and adaptation to a novel host, and therefore is imperative to explicate the evolutionary dynamics of the viral genome and its propensity for differential host selection. We conducted an in silico analysis of all the coding gene sequences of SARS-CoV-2 strains (n = 39) originating from a range of non-human mammalian species, including pangolin, bat, dog, cat, tiger, mink, mouse, and the environmental samples such as wastewater, air and surface samples from the door handle and seafood market. Compared to the reference SARS-CoV-2 strain (MN908947; Wuhan-Hu-1), phylogenetic and comparative residue analysis revealed the circulation of three variants, including hCoV-19 virus from humans and two hCoV-19-related precursors from bats and pangolins. A lack of obvious differences as well as a maximum genetic homology among dog-, cat-, tiger-, mink-, mouse-, bat- and pangolin-derived SARS-CoV-2 sequences suggested a likely evolution of these strains from a common ancestor. Several residue substitutions were observed in the receptor-binding domain (RBD) of the spike protein, concluding a promiscuous nature of the virus for host species where genomic alternations may be required for the adaptation to novel host/s. However, such speculation needs in vitro investigations to unleash the influence of substitutions towards species-jump and disease pathogenesis.

The Impact of Appendectomy in Clostridium difficile Infection and Length of Hospital Stay.

Introduction We aim to investigate Clostridium difficile infection (CDI) recurrence, severity, complications, and length of hospital stay in patients with and without prior history of appendectomy who were admitted to the hospital with CDI. Method We analyzed retrospective data for 862 patients, 18 years and older, with C. difficile inpatients diagnosed between January 1, 2017 and December 31, 2018 and sorted into two groups, with or without prior appendicectomy, to look for outcomes such as recurrence, hospital stay, complications, and related death in each group and use statistical analysis for comparison. Result There were 862 patients admitted with CDI, of which 122 (14.2%) had a prior history of appendectomy and 740 (85.8%) did not. Patients with an appendectomy prior were older (median age of 75 vs. 69, p = 0.0033) and had a higher proportion of females (68.9% vs. 53.6%, p = 0.0017). C. difficile recurrence in prior appendicectomy group vs. no appendectomy group was 12.3% and 9.3%, respectively, but no statistical difference was noted (p = 0.28). Also, there was no statistical difference in complications like ileus, colectomy, and mortality related to CDI in both groups. However, patients with appendectomies had significantly shorter hospital stays during C. difficile admission compared to patients without appendectomies (median of six days vs. seven days, p = 0.0014). Conclusion Our study shows that there is no statistical difference in the recurrence, severity, and complications of CDI in the presence or absence of the appendix but remarkably noted that people with prior appendicectomy had a shorter hospital stay.

Unique Case of Gastroenteritis Presenting as Pneumatosis Intestinalis With Emphysematous Gastritis and Portal Vein Gas: Do Not Take Gastroenteritis Lightly.

Pneumatosis intestinalis (PI) consists of multiple, thin, gas-filled cysts in the wall of the gastrointestinal (GI) tract. It is an uncommon entity that can involve any gastrointestinal site from the stomach to the rectum. Isolated stomach involvement is rare. PI can represent a broad spectrum of diseases with variable prognoses. We present the case of a patient who was admitted with gastroenteritis-like symptoms. He remained hemodynamically stable, and on further imaging with contrast-enhanced computed tomography of the abdomen and pelvis, air was found in the portal vein and gastric wall, with minimal thickening of the proximal small bowel concerning for emphysematous gastroenteritis. Further workup results were negative, including blood cultures, stool studies, Clostridium difficile toxins, and lactic acid levels. The patient was managed nonoperatively and recovered without serious complications. Our case is unique in terms of the presence of air in the portal vein, which would otherwise suggest the possible spread of infection across the bowel wall.

Over-the-Counter Drug Causing Acute Pancreatitis.

Acute pancreatitis is caused by alcohol, gall stone disease, drugs, trauma, infections, and metabolic causes such as hypercalcemia and hyperlipidemia. Hypercalcemia-induced acute pancreatitis has been well documented but only rarely occurs due to over-the-counter calcium carbonate. In this article, we present a case of over-the-counter calcium carbonate-induced acute pancreatitis.

Isolated Thrombosis of the Superior Mesenteric Vein.

Most cases of pancreatitis are mild and self-limited. On the other hand, a few patients with pancreatitis may develop vascular complications. Splenic vein thrombosis is the most common vascular complication of acute pancreatitis. Isolated superior mesenteric vein thrombosis is rare and can lead to gut ischemia and necrosis if not timely diagnosed and managed. We report the case of a 40-year-old patient who presented to the hospital with abdominal pain due to acute pancreatitis, leading to superior mesenteric vein thrombosis, which was timely diagnosed and treated with a good outcome.

Amiodarone-Induced Acute Liver Injury.

Amiodarone is a lipophilic structure with a half-life of 25-100 days. Long-term oral amiodarone is associated with photosensitivity, thyroid dysfunction, and pulmonary and hepatic toxicity. Intravenous amiodarone can lead to sweating, heating sensation, nausea, phlebitis at the injection site, and rarely acute hepatitis. This is a compelling case of a 60-year-old male who developed acute liver injury 24-36 h after starting amiodarone. All the possible causes of acute liver injury were ruled out, and his liver enzymes improved after discontinuing amiodarone.

Splenic injuries secondary to colonoscopy: Rare but serious complication.

BACKGROUND: Colonoscopy is a safe and routine diagnostic and therapeutic procedure for evaluation of large bowel diseases. Most common procedure related complications include bleeding and perforation but rarely a splenic Injury. AIM: To investigate the reason for colonoscopy, presentation of patient with spleen injury, types of injury, diagnosis, management and outcomes of patients. METHODS: A structured search on four databases was done and 45 articles with 68 patients were selected. The reason for colonoscopy, presentation of patient with spleen injury, types of injury, diagnosis, management and outcomes of patients were identified and analyzed using SPSS. RESULTS: The mean age of the patients was 62.7 years with 64% females. Twenty two percent had a complete splenic rupture with colonoscopy while 63% had subcapsular hematoma, spleen laceration and spleen avulsion. The most common reason for colonoscopy was screening (46%) followed by diagnostic colonoscopy (28%). Eighty seven percent of patients presented with abdominal pain. Patients with spleen rupture mostly required splenectomy (47%), while minor spleen hematomas and lacerations were managed conservatively (38%). Six percent of the patients were managed with proximal splenic artery splenic embolization and 4% were managed with laparoscopic repair. The overall mortality was 10% while 77% had complete recovery. The reason of colonoscopy against presentation specifically, abdominal pain showed no statistical significance P = 0.69. The indication of colonoscopy had no significant impact on incidence of splenic injury (P = 0.89). Majority of the patients (47%) were managed with splenectomy while the rest were managed conservatively (P = 0.04). This association was moderately strong at a cramer's V test (0.34). The Fisher exact test showed a higher mortality with spleen rupture (P = 0.028). CONCLUSION: Spleen rupture due to colonoscopy is a significant concern and is associated with high mortality. The management of the patients can be individualized based on clinical presentation.

Famotidine induced hypomagnesemia leading to hypocalcemia.

Fifty-five-year-old female with a past medical history of gastroesophageal reflux disease was admitted to hospital due to increased confusion, and muscle cramps for last 15 days. She was taking famotidine 20 mg twice a day for the last 2 years. She was alert and oriented to person and place only. She had dry skin, positive Chvostek's and Trousseau's sign. Blood work showed 141 mmol/L of sodium, 0.7 mg/dl of creatinine, 5.7 mg/dl of calcium, 0.55 mg/dl of magnesium, low PTH but normal parathyroid related peptide PTHrP, vitamin D (25) and vitamin D (1.25). She was discharged home on electrolyte supplements. She was readmitted with very low calcium and magnesium. Extensive workup including 24 h of urine calcium and magnesium was unimpressive. She was treated with IV therapy and discharged to follow up with nephrology in the clinic, and famotidine was discontinued on second discharge. Her calcium and magnesium levels remained normal, and in a few weeks later, oral electrolyte supplements were discontinued.

Significance of Testing Anti-HBcIgM Antibodies for the Screening of Hepatitis B in the Donor Blood.

BACKGROUND: The purpose to perform this study was to screen blood donors for possible occult HBV by checking the seroprevalence of the hepatitis B antibodies in blood donors. It was a Cross-sectional study conducted at Blood Bank of Lahore General Hospital Lahore from April to June 2015 (3-months). METHODS: In this prospective study, 180 healthy blood donors, presenting to the blood bank of Lahore General Hospital were selected. Their detailed demographic data and blood samples were collected. HBsAg testing was done by ELISA and further HBc IgM testing was also done by ELISA. Those testing positive for HBc IgM were further evaluated by real-time PCR to detect HBV DNA. RESULTS: Mean duration of the life span was 26.51 years with a range of 18-61 years. Sex distribution show 93.9% (n=169) males and 6.1% (n=11) females. HBsAg was positive in 3.3% (n=6) while their HBc IgM was negative and HBc IGM was positive in 2.2% (n=4) of the healthy donors in whom HBsAg was found negative by ICT method. further qualitative HBV DNA by rt-PCR was done on those positive with anti HBc IgM and no patient had HBV DNA detected from their blood. CONCLUSION: Without routine screening of the sera for the HBc Antibody, the low-level HBV viraemia may not be detected as the nonappearance of the surface antigen in the blood of apparently healthy donors do not ensure the absence of circulating virus in the blood of these donors.

Corrigendum: Impact of Salicylic Acid and PGPR on the Drought Tolerance and Phytoremediation Potential of Helianthus annus.

[This corrects the article DOI: 10.3389/fmicb.2018.02507.].

Trends and Patterns of Primary Hepatic Carcinoma in Saudi Arabia.

BACKGROUND: Primary hepatic carcinoma (PHC) is the 4th most common malignancy among males at King Faisal Specialist Hospital and Research center (KFSH & RC) and in Saudi Arabia. There has been a steady increase in the number of PHC cases since 1975 at KFSH & RC and the burden of hepatic carcinomas is growing in Saudi Arabia. The aim of this study is to explore the changing trends and patterns of PHCs at KFSH & RC and conduct a comparative analysis with local, regional and global trends. MATERIALS AND METHODS: Cancer incidence data was obtained from the King Faisal Specialist Hospital and Research Center Tumor Registry program as per the American College of Surgeons standards. Clinico-epidemiological data of 1174 liver cancer patients from KFSH & RC during 2000 to 2014 and Saudi Cancer Registry (SCR) between 2001-2015 with total of 5,796 cases was reviewed. Trends, patterns of occurrence and other prognostic factors of interest were sub-stratified by gender, age, stage, and grade. RESULTS: Temporal trends indicated a rising incidence of PHC from 2001 to 2014 in Saudi Arabia; from 323 cases in 2001 to 376 cases in 2015 as per SCR. A total of 2,779 new cases of PHC were seen at KFSH & RC between 1975 and 2014; the rate of PHC increased from 60 cases in 2004 to 80 cases in 2014. Majority of liver cancers were hepatocellular carcinomas (79.3%) followed by cholangiocarcinoma (11%), and hepatoblastoma (4.7%) with significantly higher incidence among males with a male to female ratio of 2:1 (p <0.01). The highest incidence by age was at 6th and 7th decade of life. Majority of patients were diagnosed in localized stage (44.6%) and had a past medical history (28.2%) of hepatitis (p < 0.001). The most common treatment for liver cancer at KFSH & RC was surgery (26.7%) followed by transplant (9.5%). CONCLUSION: Despite improvement in preventive measures, incidence rates of PHC has increased during the last decade with marked regional variation. Etiology of this escalating trend is multifactorial; predominantly, chronic infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV), heavy alcohol consumption, obesity, diabetes, and tobacco smoking. This exponential increase may also be due to early detection and diagnosis due to expanding health care delivery in the Kingdom. Further studies are indicated to comprehend the rising trends at the molecular and genetic levels.

Potential for heat production by retrofitting abandoned gas wells into geothermal wells.

Using abandoned gas wells as geothermal resources for energy production is an effective way to extract geothermal energy from geological formations. These abandoned wells have the potential to significantly contribute in the rising global demand for energy without requiring the land disruption resulting from deep drilling or digging, processes necessary for energy extraction from geological formations via more traditional methods. In this paper, a method to extract geothermal energy from abandoned gas wells is proposed. The method offers an efficient, economical, and environmentally-conscious way to generate electricity. A mathematical model of a thermal and hydraulic coupling process is constructed, and a 3D numerical model is generated to study the process of geothermal energy extraction by retrofitting an abandoned gas reservoir into a geothermal reservoir. Using the model, heat extraction and fluid flow are analyzed over a period of 50 years. The heat production, electricity generation, and thermal recovery over the lifetime of the reservoir indicate that a commercially viable geothermal dual well system can produce geothermal energy effectively. Dual-well systems contain at least one injection well and one production well. They are composed of a two-way flow system in which the fluid flows into the reservoir via an injection well and returns from the production well having absorbed thermal energy from the surrounding rocks. Sensitivity analysis of the main parameters controlling the average outlet temperature of the fluid from the sedimentary geothermal system reveals that abandoned gas wells are a suitable source of geothermal energy. This energy can be harvested via a method whose use of reservoir fluids differs from that of the traditional method of closed-loop circulation via a borehole heat exchanger. Here, it is demonstrated that abandoned oil and gas fields can be repurposed to be geothermal energy sources that provide low-cost electricity and are economically sustainable.