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Background: Influenza activity was reported to be below the seasonal levels during the Coronavirus disease?2019 (COVID?19) pandemic globally. However, during the severe acute respiratory syndrome corona virus?2 outbreak, the routine real?time surveillance of influenza?like illness and acute respiratory infection was adversely affected due to the changes in priorities, economic constraints, repurposing of hospitals for COVID care, and closure of outpatient services. Methods: A systematic review and meta-analysis were carried out to assess the pooled proportion of symptomatic cases tested for influenza virus before the current pandemic in 2019 and during the pandemic in 2020/21. An electronic search of PubMed/MEDLINE, Scopus, and Google Scholar was carried out for the articles reporting the impact of the COVID?19 pandemic on influenza surveillance among humans using search terms. The study was designed based on Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and the meta-analysis was performed to synthesize the pooled proportion of patients sampled for influenza with 95% confidence interval (CI). Results: The nine qualified studies from the WHO European region, Canada, Japan, Germany, Italy, Spain, South Africa, and the United States were pooled by random?effects meta?analysis. The overall pooled proportion of symptomatic cases sampled for influenza surveillance before and during the pandemic was 2.38% (95% CI 2.08%–2.67%) and 4.18% (95% CI 3.8%–4.52%), respectively. However, the pooled proportion of samples tested for influenza before the pandemic was 0.69% (95% CI 0.45%–0.92%) and during the pandemic was 0.48% (95% CI 0.28%–0.68%) when studies from Canada were excluded. Conclusion: The meta-analysis concludes that globally there was a decline in influenza surveillance during the COVID?19 pandemic except in Canada.
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The coronavirus disease 2019 (COVID‑19) pandemic has changed the epidemiology of respiratory syncytial virus (RSV) infection which accounts for most bronchiolitis and viral pneumonias in infants. This systematic review and meta‑analysis aimed to quantitatively assess the effect of the COVID‑19 pandemic on RSV‑associated bronchiolitis among hospitalized infants. The study protocol was registered in the PROSPERO database (CRD42022314000) and was designed based on Preferred Reporting Items for Systematic Reviews and Meta‑analyses guidelines updated in May 2020. The meta‑analysis component was modified appropriately to synthesize the pooled proportion of infants having RSV‑associated bronchiolitis before the COVID‑19 pandemic in 2019 and during the pandemic with 95% confidence interval (CI). We identified and screened 189 articles and systematically reviewed 50 full texts. Eight qualified studies from Europe and China, including 109,186 symptomatic cases of bronchiolitis before the pandemic in 2019 and 61,982 cases in 2020–2021 were pooled by random‑effects meta‑analysis. The quantitative analysis included laboratory‑confirmed RSV infection in 7691 infants with bronchiolitis reported before the pandemic in 2019. Meanwhile, during the pandemic, 4964 bronchiolitis cases were associated with RSV infection. The pooled proportion of RSV‑associated bronchiolitis cases before the pandemic in 2019 was 16.74% (95% CI 11.73, 22.43%, 95% prediction interval 0.032, 34.16). The pooled proportion of confirmed RSV cases during the pandemic in 2020/2021 was 19.20% (95% CI 12.01, 27.59%, 95% prediction interval 0.046, 42.35). There was an increase in RSV activity after the relaxation of stringent public health measures during the COVID‑19 pandemic.
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Background: Newer drug research worldwide is now focusing on medicinal plants for ensuring health and vitality due to the seemingly safer side effect profile and abundance of plants in nature, compared to synthetic drugs. Antioxidants are vital in preventing free radical induced tissue damage. The purpose of the present study is to evaluate the antioxidant activity of the methanolic extract of the leaves of Carica papaya using 1,1-diphenyl-2-picrylhydrazine (DPPH). Phytochemical tests proved the presence of bioactive ingredients in the extract.Methods: DPPH free radical assay, one of the most accurate methods for evaluating antioxidant activity, was used to evaluate the antioxidant activity of methanolic extract of leaves of C. papaya.Results: The methanolic leaf extract of C. papaya showed antioxidant property with free radical scavenging activity increasing with increase in concentration. The IC50 value of methanolic extract was 213.68 礸m/ml. Ascorbic acid was used as control.Conclusions: Oxidative stress has been linked to heart disease, cancer, immune deficiency. Antioxidants as suggested from various studies may reduce the risk of such diseases. The utility of C. papaya in the treatment of heart disease, cancer and immune deficiency will have to be proved by detailed evaluation of its pharmacological properties.
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OBJECTIVE@#The causal association of human papillomavirus (HPV) in uterine cervical cancer was well established and this oncogenic virus was reported to be a biomarker for overall recurrence and central pelvic recurrence. The objective of the present systematic review and meta-analysis was to assess the role of HPV DNA testing in early detection of recurrence among cervical cancer survivors after radiotherapy.@*METHODS@#We performed a systematic review and meta-analysis by means of searching electronic databases for published articles between January 1984 and June 2018, on the basis of standard systematic review guidelines prescribed by major agencies namely Cochrane Collaboration (https://www.cochrane.org) and Campbell Collaboration (https://www.campbellcollaboration.org). The meta-analysis component was further modified appropriately for the synthesis of sensitivity and specificity results.@*RESULTS@#A total of 1,055 cervical cancer cases who had received pelvic radiation with or without chemotherapy from ten cohort studies were evaluated. The overall pooled sensitivity and specificity of HPV DNA testing was 0.84 (95% confidence interval [CI]= 0.66–0.94) and 0.35 (95% CI=0.20–0.54) respectively. The positive likelihood ratio was 1.3 (95% CI=1.0–1.7) and the negative likelihood ratio was 0.45 (95% CI=0.18–1.10) with an estimated diagnostic odds ratio of 3 (95% CI=1–9).@*CONCLUSION@#The screening for HPV DNA testing during follow-up facilitates early detection of recurrence after radiotherapy.
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OBJECTIVE: The causal association of human papillomavirus (HPV) in uterine cervical cancer was well established and this oncogenic virus was reported to be a biomarker for overall recurrence and central pelvic recurrence. The objective of the present systematic review and meta-analysis was to assess the role of HPV DNA testing in early detection of recurrence among cervical cancer survivors after radiotherapy.METHODS: We performed a systematic review and meta-analysis by means of searching electronic databases for published articles between January 1984 and June 2018, on the basis of standard systematic review guidelines prescribed by major agencies namely Cochrane Collaboration (https://www.cochrane.org) and Campbell Collaboration (https://www.campbellcollaboration.org). The meta-analysis component was further modified appropriately for the synthesis of sensitivity and specificity results.RESULTS: A total of 1,055 cervical cancer cases who had received pelvic radiation with or without chemotherapy from ten cohort studies were evaluated. The overall pooled sensitivity and specificity of HPV DNA testing was 0.84 (95% confidence interval [CI]= 0.66–0.94) and 0.35 (95% CI=0.20–0.54) respectively. The positive likelihood ratio was 1.3 (95% CI=1.0–1.7) and the negative likelihood ratio was 0.45 (95% CI=0.18–1.10) with an estimated diagnostic odds ratio of 3 (95% CI=1–9).CONCLUSION: The screening for HPV DNA testing during follow-up facilitates early detection of recurrence after radiotherapy.
Subject(s)
Female , Humans , Cervix Uteri , Cohort Studies , Cooperative Behavior , DNA , Drug Therapy , Follow-Up Studies , Human Papillomavirus DNA Tests , Mass Screening , Odds Ratio , Oncogenic Viruses , Radiotherapy , Recurrence , Sensitivity and Specificity , Survivors , Uterine Cervical NeoplasmsABSTRACT
Purpose: The major cause of chronic hepatitis is infections with hepatitis B virus and hepatitis C virus (HCV) globally. However, there exists sparse epidemiological data regarding the prevalence of HCV infection from India. Methodology: We carried out a cross-sectional study to estimate the prevalence of anti-HCV antibody among acute febrile illness cases aged between 1 and 65 years in Idar Taluk, Sabarkantha district, Gujarat state located in West India. A total of 702 serum samples collected from the study area during the year 2017, were screened for anti-hepatitis C IgG by enzyme-linked immunosorbent assay. The serum samples screened positive were then subjected to molecular testing for confirmation. Results: Among the 702 study participants screened, 16 cases were reported to be anti-HCV IgG positive with an estimated seroprevalence rate of 2.3% (95% confidence interval: 1.4%–3.7%). Out of the 16 cases, two samples were confirmed positive by molecular testing indicating active infection. When analysed phylogenetically, one strain was genotyped as HCV1b genotype, and the other one was clustered along with HCV3a genotype. Both the patients with hepatitis C infection were observed to be having a probable 1-year survival rate of 100% and a 2-year survival rate of 85% when the Child-Turcotte-Pugh classification was applied. Conclusion: The estimated seroprevalence of hepatitis C in Idar Taluk, Sabarkantha district, west India was 2.3%. HCV genotypes 1b and 3a were observed to be circulating in the study area.
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Background & objectives: Dengue virus infection is endemic in India with all the four serotypes of dengue virus in circulation. This study was aimed to determine the geographic distribution of the primary and secondary dengue cases in India. Methods: A multicentre cross-sectional study was conducted at Department of Health Research / Indian Council of Medical Research (DHR)/(ICMR) viral research and diagnostic laboratories (VRDLs) and selected ICMR institutes located in India. Only laboratory-confirmed dengue cases with date of onset of illness less than or equal to seven days were included between September and October 2017. Dengue NS1 antigen ELISA and anti-dengue IgM capture ELISA were used to diagnose dengue cases while anti-dengue IgG capture ELISA was used for identifying the secondary dengue cases. Results: Of the 1372 dengue cases, 897 (65%) were classified as primary dengue and 475 (35%) as secondary dengue cases. However, the proportion varied widely geographically, with Theni, Tamil Nadu; Tirupati, Andhra Pradesh and Udupi-Manipal, Karnataka reporting more than 65 per cent secondary dengue cases while Srinagar, Jammu and Kashmir reporting as low as 10 per cent of the same. The median age of primary dengue cases was 25 yr [interquartile range (IQR 17-35] while that of secondary dengue cases was 23 yr (IQR 13.5-34). Secondary dengue was around 50 per cent among the children belonging to the age group 6-10 yr while it ranged between 20-43 per cent among other age groups. Interpretation & conclusions: Our findings showed a wide geographical variation in the distribution of primary and secondary dengue cases in India. It would prove beneficial to include primary and secondary dengue differentiation protocol in the national dengue surveillance programme.
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Background: Cassia fistula Linn is a plant which is widely grown in India and is used for medicinal purposes. The study was carried out with an objective to demonstrate the antimicrobial activity of leaves of Cassia fistula Linn. The aim of the study is to assess antibacterial and antifungal activity of methanolic leaf extract of Cassia fistula Linn against selected clinical isolates.Methods: The antimicrobial activity of methanolic extract of Cassia fistula was evaluated using agar well diffusion method and to zone of inhibition of extract was determined. Clinical isolates of Staphyloccocus aureus, MRSA, Pseudomonas aeruginosa, E. coli and Proteus were screened.Results: The methanolic extracts exhibited antibacterial activity against Staphylococcus aureus. The extract was not active against E. coli, Proteus, MRSA, Pseudomonas aeruginosa. The extract also failed to demonstrate antifungal activity against Candida albicans and Aspergillus niger.Conclusions: The global emergence of multidrug resistant bacterial strains is increasing, limiting the effectiveness of current drugs and treatment failure of infections. A novel approach to the prevention of antibiotic resistance of pathogenic species is the use of new compounds that are not based on existing synthetic antimicrobial agents.
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Background: The use of medicinal plants for maintaining good health is getting attention worldwide. Antioxidants play an important role to protect damage caused by oxidative stress. In the present study methanolic extracts of Cassia fistula was determined using DPPH for its antioxidant activity. Phytochemical investigation confirmed the presence of bioactive ingredients in the extract.Methods: The antioxidant activity of methanolic extract of Cassia fistula was evaluated using DPPH free radical assay. DPPH (1,1-diphenyl-2-picrylhydrazyine) free radical analysis is one of the accurate and frequently employed method for evaluating antioxidant activity.Results: The methanolic extracts showed increase in radical scavenging activity as concentration increases. The IC50 values were calculated for the methanolic extract. Ascorbic acid was used as control. Cassia fistula exhibited IC 50 of 79.42µg/ml.Conclusions: Scientific evidence suggests that antioxidants reduce the risk for chronic diseases including cancer and heart disease and infectious diseases. Further evaluation of pharmacological activities of Cassia fistula may prove useful in treatment of cancer and heart diseases.
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Squamous papilloma is the most common benign oral epithelial lesion, and it is well known to be associated with human papilloma virus 6 and 11. Here, we report a case of squamous papilloma associated with human papilloma viruses (HPV)‑32 in a 4‑year‑old boy who presented with a verrucous lesion on the lower lip. HPV‑32 is often associated with a rare benign condition focal epithelial hyperplasia (FEH). A limited number of lesions and the absence of characteristic histology ruled out FEH in our patient. To the best of our knowledge, the association of oral squamous papilloma with HPV‑32 is hitherto unreported.
Subject(s)
Humans , Fever , Myalgia , Headache , Cough , Dyspnea , Respiratory Insufficiency , Renal InsufficiencyABSTRACT
Objective: To investigate the hepatoprotective activity of methanolic extract of leaves ofErythroxylum monogynum Methods: Methanolic extract of leaves of E. monogynum was given in doses of 100 mg/kg, 200 mg/kg and 400 mg/kg for 7 d and toxicity was induced by paracetamol (2 mg/kg) on Day 8. Silymarin (50 mg/kg) was used as reference standard. After 24 h of toxicity induction blood samples were collected from retro-orbital plexsus and analyzed for serum parameters like serum glutamic pyruvic transaminase, serum glutamic oxaloacetate transaminse, alkaline phosphatase and total bilirubin. Livers isolated were studied for histopathological changes. (E. monogynum) on paracetamol induced toxicity. Results: Phytochemical analysis of methanolic extract of E. monogynum leaves showed the presence of carbohydrates, flavonoids, phenols and saponins. Prior administration of this extract restored the elevated levels serum markers as compared to toxic group which is also confirmed by the histopathological changes observed.Conclusions:The present study showed that methanolic extract of leaves of E. monogynum possess hepatoprotective action against paracetamol induced hepatotoxicity.
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A 45-year-old man, on carbamazepine for the past 3 months, was referred as a case of atypical measles. On examination, he had high-grade fever, generalized itchy rash, cough, vomiting and jaundice. A provisional diagnosis of drug hypersensitivity syndrome to carbamazepine was made with a differential diagnosis of viral exanthema with systemic complications. Laboratory investigations revealed leukocytosis with eosnophilia and elevated liver enzymes. Real-time multiplex polymerase chain reaction (PCR) on throat swab and blood was suggestive of human herpesvirus-6 (HHV-6). Measles was ruled out by PCR and serology. The diagnosis of drug-induced hypersensitivity syndrome (DIHS) was confirmed, which could explain all the features manifested by the patient. HHV-6 infects almost all humans by age 2 years. It infects and replicates in CD4 T lymphocytes and establishes latency in human peripheral blood monocytes or macrophages and early bone marrow progenitors. In DIHS, allergic reaction to the causative drug stimulates T cells, which leads to reactivation of the herpesvirus genome. DIHS is treated by withdrawal of the culprit drug and administration of systemic steroids. Our patient responded well to steroids and HHV-6 was negative on repeat real-time multiplex PCR at the end of treatment.
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Thioredoxin reductase 1 [TXNRD1] and thioredoxin interacting protein [TXNIP] also known as thioredoxin binding protein 2 or vitamin D3-upregulated protein 1 are key players in oxidative stress control. Thioredoxin [TRX] is one of the major components of the thiol reducing system and plays multiple roles in cellular processes. Computational analyses of TXNRD1, TXNIP and TRX expressions have not been analyzed in relation to prognosis of breast cancer. High expression of TXNRD1 and low expression of TXNIP are associated with worst prognosis in breast cancer. Using bioinformatics applications we studied sequence analysis, molecular modeling, template and fold recognition, docking and scoring of thioredoxin as a target. The resultant model obtained was validated based on the templates from I-TASSER server and binding site residues were predicted. The predicted model was used for Threading and Fold recognition and was optimized using GROMACS. The generated model was validated using programs such as Procheck, Ramachandran plot, verify-3d and Errat value from Saves server, and the results show that the model is reliable. Next we obtained small molecules from pubchem and chembank which are databases for selecting suitable ligands for our modeled target. These molecules were screened for docking, using GOLD and scoring was obtained using Chemscore as a scoring function. This study predicted the ligand interaction of four molecules with the minimized protein modeled structure and the best ligand with top scores from about 500 molecules screened. These were 3-hydroxy-2,3-diphenylbutanoic acid, 4-amino-3-pentadecylphenol, 3-[hydroxyimino]-2,4-diphenylbutanenitrile and 2-ethyl-1,2-diphenylbutyl carbamate, which are proposed as possible hit molecules for the drug discovery and development process
Subject(s)
Breast Neoplasms , Thioredoxin Reductase 2 , Thioredoxin Reductase 1 , Drug Therapy , Antineoplastic Agents , Carrier ProteinsABSTRACT
Presence of microfilaria in the thyroid gland is a rare finding. Filariasis is a common public health problem in the Indian sub-continent. Most of the cases of microfilaria in thyroid gland reported in the literature are associated with goiter and thyroid neoplasms. Here, we present a rare case that showed microfilaria on fine needle aspiration cytology of solitary thyroid nodule.
Subject(s)
Adult , Animals , Biopsy, Fine-Needle , Female , Filariasis/diagnosis , Humans , Microfilariae/isolation & purification , Thyroid Gland/pathology , Thyroid Nodule/parasitologyABSTRACT
We are reporting a rare case of primary mucocutaneous histoplasmosis. A 47-year-old male with a part-time job of rearing pigeons presented with a non-healing oral ulcer with no associated systemic symptoms. Differential diagnosis of oral ulcerative lichen planus, squamous cell carcinoma and mucocutaneous leishmaniasis was considered. Histopathology showed multiple organisms with a peripheral halo, stained strongly with Gomori methenamine silver stain.
Subject(s)
Antifungal Agents/therapeutic use , Histoplasmosis/complications , Humans , Male , Middle Aged , Oral Ulcer/microbiologyABSTRACT
A 36-year-old young male with multiple heterosexual contacts presented with bilateral inguinal bubo and the classical "sign of groove". A diagnosis of lymphogranuloma venereum (LGV) was made and a three-week course of doxycycline was given. Lack of response prompted us to investigate further. A biopsy of the bubo was consistent with non-Hodgkin's lymphoma (NHL). Immunohistochemistry of the lymph node done at the Regional Cancer Center (RCC), Trivandrum, confirmed the diagnosis as NHL of diffuse large B-cell type. The second patient, a 32-year-old male with two unprotected heterosexual contacts presented with a left-sided inguinal bubo of six weeks duration. An empirical course of doxycycline was given even though investigations did not reveal any STI. Lack of response prompted us to do a lymph node biopsy, which was consistent with NHL, which later with immunohistochemistry was confirmed as NHL, diffuse large cell type. We are reporting here that the "sign of groove" is not specific for LGV as thought earlier, but can occur in NHL also.
Subject(s)
Adult , Groin , Humans , Lymph Nodes/pathology , Lymphatic Diseases/diagnosis , Lymphoma, B-Cell/diagnosis , Lymphoma, Large B-Cell, Diffuse/diagnosis , MaleABSTRACT
A 14-month-old boy presented with generalised vesicular eruption involving the face, trunk and extremities accompanied by high grade fever. He had associated redness and purulent discharge from both eyes. Examination revealed erosions on the tongue, soft palate and genitalia with haemorrhagic crusts on the lips and nasal orifices. All laboratory investigations were within normal limits except leucocytosis. Chest x-ray showed left middle zone pneumonitis. Treatment was by paracetamol, antibiotics and oral acyclovir. Desquamation started from the eighth day. Our purpose in reporting this case is to highlight the fact that varicella can be atypical with distal involvement and can present as SJS-TEN overlap syndrome.