E-vape and E-Cigarettes-Associated Lung Injury (EVALI) in the COVID-19 Pandemic: A Diagnostic Dilemma and Therapeutic Challenge.

E-vape and e-cigarettes-associated lung injury (EVALI) is a diagnostic dilemma and even more obscure during the coronavirus disease 2019 (COVID-19) pandemic. A rise was seen in EVALI cases at the beginning of the COVID-19 pandemic. Still, the non-specific presentation, or the overlapping symptoms of COVID-19 and EVALI, can negate the possible diagnosis of EVALI because of a clinician's predisposition toward infectious etiologies, and it becomes even more challenging during a viral pandemic. The patient's social history remains the key distinctive point in diagnosing EVALI. Systemic steroids are generally used along with supportive care to treat patients with EVALI. This case report demonstrates the dilemma in diagnosing EVALI in a 19-year-old female during the COVID-19 pandemic.

A prospective clinical study on the use of reverse transcription-polymerase chain reaction for the early diagnosis of Dengue fever.

Laboratory testing for dengue virus is used to confirm the diagnosis of dengue virus infection and to differentiate dengue from other febrile tropical illnesses. There are few data on the clinical use of reverse transcription-polymerase chain reaction (RT-PCR) for diagnosis of dengue virus infection. We prospectively evaluated 121 consecutive patients with possible dengue who had samples submitted for RT-PCR, IgM serology, and virus culture. Results were compared with the final discharge diagnosis. Semi-nested RT-PCR was performed using genus- and serotype-specific NS3 consensus primers. Results of 112 patients were available for the final analysis. The RT-PCR was positive in 40 of 62 patients with dengue. Patients who were RT-PCR-positive alone showed a mean of 4.4 days to RT-PCR positivity compared with 5.9 days in patients who were RT-PCR-negative and IgM serology-positive (P = 0.03, Mann-Whitney U-test). The sensitivity, specificity, negative predictive value, and positive predictive value were 70, 100, 84, and 100%, respectively, for samples analyzed within 5 days of illness onset. The RT-PCR also provided epidemiological data regarding the prevailing dengue virus serotypes: 25 with Den-2, eight with Den-3, and seven with Den-1 infection. We propose an algorithm of dengue testing that uses RT-PCR within 5 days of illness onset, whereas IgM capture enzyme-linked immunosorbent assay is preferred for those presenting later.

Tertiary interactions between helices h13 and h44 in 16S RNA contribute to the fidelity of translation.

The A-minor interaction, formed between single-stranded adenosines and the minor groove of a receptor helix, is among the most common motifs found in rRNA. Among the A-minors found in 16S rRNA are a set of interactions between adenosines at positions 1433, 1434 and 1468 in helix 44 (h44) and their receptors in the nucleotide 320-340 region of helix 13 (h13). These interactions have been implicated in the maintenance of translational accuracy, because base substitutions at the adjacent C1469 increase miscoding errors. We have tested their functional significance through mutagenesis of h13 and h44. Mutations at the h44 A residues, or the A-minor receptors in h13, increase a variety of translational errors and a subset of the mutants show decreased association between 30S and 50S ribosomal subunits. These results are consistent with the involvement of h13-h44 interactions in the alignment and packing of these helices in the 30S subunit and the importance of this helical alignment for tRNA selection and subunit-subunit interaction.