Saliva as a promising biofluid for SARS-CoV-2 detection during the early stages of infection / La saliva como biofluido promisorio para la detección del SARS-CoV-2 durante las primeras etapas de la infección

Abstract Background: Diagnostic testing for coronavirus disease (COVID)-19 is performed using nasopharyngeal swabs. This type of sampling is uncomfortable for the patient, dangerous for health workers, and its high demand has led to a global shortage of swabs. One of the alternative specimens is saliva. However, the optimal conditions for the test have not been established. Methods: Reverse transcription-polymerase chain reaction was used to detect the viral genome in saliva samples kept at room temperature, in the fridge or frozen for 2 days. In addition, the influence of brushing teeth and feeding on the detection of the virus in saliva was addressed. Finally, the efficiency of saliva in revealing the presence of the virus during the hospitalization period was determined in children. Results: The viral genome was consistently detected regardless of the storage conditions of saliva samples. Brushing teeth and feeding did not influence the sensitivity of the test. In hospitalized children, positive results were obtained only during the early days. Conclusions: These results support the idea of the use of saliva as an alternative specimen for diagnostic testing for COVID-19. The viral genome is stable and endures perturbations in the oral cavity. However, clearance of the virus from the mouth during the infection may limit the use of the test only to the early stages of the disease.

Resumen Introducción: El diagnóstico de COVID-19 (enfermedad por coronavirus 2019) se realiza con un hisopado nasofaríngeo. El procedimiento de toma de muestra es molesto para el paciente y peligroso para el personal de salud, y la alta demanda de análisis ha conducido a la escasez de hisopos. Una alternativa es el uso de saliva, pero las condiciones óptimas para realizar el estudio no han sido establecidas. Métodos: Se usó la reacción en cadena de la polimerasa con transcriptasa reversa para detectar el genoma viral en muestras de saliva mantenidas a temperatura ambiente, en refrigeración o congeladas. Además, se evaluó la influencia del aseo bucal y de la ingesta de alimento en la detección del virus. Finalmente, se determinó el desempeño de la saliva para reportar la presencia del virus durante el periodo de hospitalización en niños. Resultados: El genoma viral fue estable durante 2 días a las diferentes temperaturas ensayadas. El aseo bucal y la ingesta de alimento no influyeron en la detección del virus. En los niños hospitalizados solo se obtuvieron resultados positivos durante los primeros días. Conclusiones: Los resultados coinciden con la idea del uso de la saliva como biofluido alternativo para el diagnóstico de COVID-19. El genoma viral es estable y no se ve afectado por perturbaciones en la cavidad oral; sin embargo, la dinámica de la infección puede provocar que el ensayo solo sea útil durante las primeras etapas de la enfermedad.

A study on occupational stressors among civil police officers of a subdivision of Thrissur district

Background: Occupational stress among police officers is an extensive but neglected issue due to number of negative consequences on an individual as well as the police department. Policing is a highly demanding work environment, with constant threat to life, uncertainty at work, encounters, political pressure, exposure to violence, and death. Objectives: The objective of the study was to identify the occupation-related stressors faced by civil police officers in a subdivision in Thrissur. Materials and Methods: A cross-sectional study was conducted among civil police officers in Irinjalakuda subdivision, Kerala, from January 2017 to October 2018. The study population consisted of all civil police officers from the subdivision. Data were collected using a pre-tested structured questionnaire, which included sociodemographic variables and self-reported physical morbidities. Occupational stressors were measured using operational and organizational police stress Questionnaire. The data obtained was coded, entered in Microsoft Excel sheet and analyzed using the statistical software, Statistical Package for Social Sciences (SPSS version-23). Results: Nearly three-fourths of the participants were males and the mean age of the participants was 39.94 ± 7.067 years. Eight operational stressors were found to have a median value above four, while a median of five organizational stressors was found to be above four. “Fatigue” and “friends/family feel the stigma associated with job” were the most commonly quoted operational stressors while “staff shortages” and “bureaucratic red tape” were the most commonly quoted organizational stressors. Conclusion: Modifications such as sharing work and allotting fixed duty hours should be done to avoid stress and its adverse effects. Stress management training can be given at regular intervals to improve competency and enhance coping skills.

Liquid biopsy: emergence of a new era in personalized cancer care

The most successful treatment for cancer involves identifying druggable, biological markers for targeted therapy. In the clinical setting, surgical removal of tumors is the only procedure for identifying such targetable molecules. Shed from tumor cells, these markers are also present in circulating blood, albeit in very negligible amounts. Liquid biopsy is a procedure performed on a blood sample to look for such circulating cancer markers cells or pieces of nucleic acid from the tumor. The procedure shows promise in revolutionizing personalized cancer treatments. Here we briefly review the technique, characterization, and its utilization in clinics

Caudal regression syndrome.

A case of caudal regression syndrome was reported in 20 wks foetus during routine foetal autopsy at GMCH, Chandigarh. The external examination showed 2 vessels in umbilicus. There was anteroposterior lengthening of skull. The anal opening was absent. The lower limbs were fused in thigh region with a small appendages attached to this on left side which also terminated in foot. The right foot had 5 toes and left foot had 3 toes. No external genitalia were seen. On internal examination, the gut was opening in a dilated cloaca like blind chamber. Kidneys were absent on both sides.X ray examination revealed small sacrum, femur, tibia in both the legs. Fibula was absent bilaterally. Caudal dysgenesis syndrome and caudal regression syndrome are broad terms that refer to a constellation of caudal congenital anomalies affecting caudal spine and spinal cord, hind gut, urogenital system, and the lower limbs. The etiology, incidence, causative factors of this case will be discussed in light of available literature

Manejo conservador laparoscópico de un embarazo ectópico intersticial no roto: Reporte de caso, descripción de la técnica quirúrgica y revisión de la literatura / Conservative laparoscopic management of an unruptured interstitial ectopic pregnancy: A case report, surgical technique and review of literature

El embarazo ectópico es la implantación del embrión fuera de la cavidad endometrial. La localización más frecuente es en la trompa de Falopio en su porción ampular. La localización en la porción intersticial representa el sitio menos probable de implantación de un embarazo ectópico tubario. El diagnóstico y tratamiento oportuno previo a su ruptura son de importancia significativa, debido a que tiene una alta morbimortalidad materna en caso de presentarse la ruptura. El diagnóstico se realiza mediante sospecha clínica y la ayuda del ultrasonido, de preferencia endovaginal, y los niveles séricos de hCG. El tratamiento puede ser a base de metotrexate solamente, cirugía radical (cornuectomía e incluso histerectomía) y manejo conservador (cornuostomía) por laparotomía o laparoscopia. El objetivo del estudio es presentar el caso de una paciente con diagnóstico de embarazo ectópico intersticial no roto a la que se realizó cirugía laparoscópica conservadora, describir la técnica quirúrgica y revisión de la literatura.

Ectopic pregnancy is the embryo implantation outside the endometrial cavity. The most common location is the ampular region of Fallopian tube. The interstitial ectopic pregnancy represents the least probable site of implantation for a tubal ectopic pregnancy. The diagnosis and treatment, prior to rupture are important because its high morbidity and mortality when rupture occurs. Diagnosis is done by clinical suspicion, ultrasound and hCG blood levels. Treatment options are medical (metotrexate), radical surgery (cornuectomy or hysterectomy), and conservative management (cornuostomy) either by laparotomy or laparoscopy. The aim of this study is to report the case of a woman with an unruptured interstitial ectopic pregnancy who was managed by laparoscopic conservative management, describe the surgical technique and review of the literature.

Medical education in India: Time to make some changes.

India is in need of well-trained doctors. We highlight and analyse some of the problems affecting medical education in India and their possible solutions. The medical education system can be reviewed under four heads: selection of students, medical training, evaluation, and the development and accreditation of faculty. In India, students enter medical colleges without receiving sufficient orientation about the profession. If students were given some exposure to various professions in the final years of school, it would help address this issue. Medical students are selected on the basis of pre-medical tests consisting of multiple-choice questions, the validity of which is being questioned increasingly. There is no coordination between the scheduling of lectures on various diseases and their management and the clinical exposure of the students. Active involvement in treatment is limited to the final year, called internship, which is hampered by preparation for postgraduate entrance examinations. Efforts should be made to provide hands-on experience at an earlier time in the course. A systematic and reliable programme for evaluation is a must. There is a need for a shift in the focus of evaluation, which should assess the application of knowledge rather than the ability to recall facts. The replacement of the traditional long-/short-case examinations with more valid and reliable instruments for the assessment of clinical skills should be considered. ‘Vision 2015’, a document developed by the Medical Council of India, contains many notable recommendations for the improvement of the current system. If these are implemented effectively, the impact of improvement in Indian medical education will be felt globally.

An age structured model for obesity prevalence dynamics in populations

Objective. Modeling the correlation of the development of obesity in a population with age and time and predict the dynamics of the correlation of the development of obesity in a population with age and time under different scenarios in Valencia (Spain). Materials and methods. An age structured mathematical model is used to describe the future dynamics of obesity prevalence for different ages in human population with excess weight. Simulation of the model with parameters estimated using the Health Survey of the Region of Valencia 2000 (4.319 interviews) and Health Survey of the Region of Valencia 2005 (4.012 interviews). The model considers only overweight and obese populations since these subpopulations are the most relevant on obesity health concern. Results. The model allows predicting and studying the prevalence of obesity for each age. Results showed an increasing trend of obesity in the following years in well accordance with the trend observed in several countries. Conclusions. Based on the numerical simulations it is possible to conclude that the age structured mathematical model is suitable to forecast the obesity epidemic in each age group in different countries. Additionally, this type of models may be applied to study other characteristics of other populations such animal populations.

Efecto citotóxico de las semillas de Annona cherimola en cultivos de cáncer de cérvix, mama y leucemia mieloide crónica / Cytotoxic activity of seeds of Annona cherimola in cell cultures of cervical and breast cancer and chronic myeloid leukemia

Introducción: Diversos productos naturales del género Annona han sido utilizados en el tratamiento del cáncer. Annona cherimola posee diversos compuestos puros de sus semillas y tallos que han demostrado actividad antitumoral frente a células de carcinoma nasofaríngeo. Objetivo: Determinar el efecto citotóxico del extracto etanólico de Annona cherimola en las líneas celulares MCF-7 (adenocarcinoma de mama humano), ME-180 (carcinoma epidermoide de cervix), K562 (leucemia mieloide crónica) y 3T3 (fibroblastos normales de ratón). Materiales y métodos: Las líneas MCF-7, ME-180, K562 y 3T3, fueron expuestas a cuatro concentraciones del extracto etanólico de Annona cherimola (0,125, 0,031, 0,008, 0,002 mg/mL). Asimismo, a diferentes concentraciones de 5-fluorouracilo (0,01563, 0,00391, 0,00098, 0,00024 mg/mL) y Cisplatino (0,00250, 0,00063, 0,00016, 0,00004 mg/mL) como controles positivos. Se hallaron los porcentajes de crecimiento en 48 horas. Luego se determinó la concentración inhibitoria de crecimiento 50 (CI50) mediante correlación lineal, Asimismo se obtuvieron los coeficientes de determinación r2 utilizando Microsoft Office Excel 2007. Finalmente, se precisó el Índice de Selectividad de cada muestra. Resultados: Los CI50 en μg/mL del extracto etanólico de semillas de Annona cherimola fueron 9,4(r2 = 0,96) para MCF-7; 6,6(r2 = 0,99)para ME-180; 2,2(r2 = 0,96) para K562 y 29,5(r2 = 0,98) para 3T3. Los CI50 de 5-fluorouracilo fueron 3,4 (r2 = 0,95) para MCF-7; 3,8 (r2 = 0,96) para K562 y 0,2 (r2 = 0,98) para 3T3 y los CI50 del Cisplatino fueron 12,1 (r2 =0,96) para MCF-7; 0,1 (r2 = 0,96) para K562 y 0,3 (r2 = 0,99) para 3T3. La relación dosis respuesta del extracto para la línea normal 3T3 fue de -0,98 (p menor que 0,05) y para una línea tumoral K562 fue de -0,98 (p menor que 0,05). Los índices de selectividad del extracto fueron de 2,17, 6,07 y 2,39 para las líneas MCF-7, K562 y ME-180 respectivamente. Contrariamente, el 5-FU y Cisplatino, solo alcanzaron...

Introduction: Diverse natural products of the Annona sort have been used in the treatment of the cancer. Annona Cherimola has diverse pure compounds of its seeds and stems that have demonstrated to antitumor like activity front to cells of nasofaríngeo carcinoma. Objective: To determine the cytotoxic effect of the extract of Annonacherimola in the cell lines MCF-7 (adenocarcinoma of human breast), ME-180(carcinoma epidermoide of cervix), K562 (chronic myeloidleukemia) and 3T3 (normal fibroblasts of mouse). Materials and methods: The lines MCF-7, ME-180, K 562 and 3T3, were exposed to four concentrations of the etanolic extract of Annona cherimola (0,125, 0,031, 0,008, 0,002 mg/mL), also to different concentrations of 5-fluorouracilo (0,01563, 0,00391, 0,00098, 0,00024mg/mL) and Cisplatino (0,00250, 0,00063, 0,00016, 0,00004 mg/mL) like positive controls. We found the growth percentages in 48 hours. Then, the inhibiting concentration of growth 50 (CI50) was determined through linear correlation, also we obtained the determination coefficients r2 using Microsoft Office Excel 2007. Finally the Selectivity Index of each samplewas determined. Results: The CI50 in μg/mL of the extract of Annona cherimola were 9,4(r2 = 0,96) for MCF-7; 6,6(r2 = 0,99) for ME-180; 2,2 (r2 = 0,96) for K562 and 29,5(r2 = 0,98) for 3T3. The CI50 of 5-fluorouracilowere 3,4 (r2 = 0,95) for MCF-7; 3,8(r2 = 0,96) for K562 and 0,2 (r2 = 0,98)for 3T3 and the CI50 of Cisplatino were 12,1(r2 = 0,96) for MCF-7; 0,1(r2 = 0,96) for K562 and 0,3(r2 = 0,99) for 3T3. The relation dose answer of the extract for the normal line 3T3 was -0,98 (p less than 0,05) and for the line K562 was -0,98 (p less than 0,05). The Selectivity Index of the extract was of 2,17, 6,07 and 2,39 for the lines MCF-7, K562 and ME-180 respectively; contrary, the 5-FU and Cisplatino, only reached values of 0,07 and 0,06; 0,02 and 2,25 for the lines MCF-7 and K562 respectively...

Actividad citotóxica del extracto etanólico de gnaphalium spicatum keto keto en cultivos de líneas celulares tumorales humanas / Cytotoxic activity of an ethanolic extract of gnaphalium spicatum keto keto on human tumor cell lines

Objetivos. Evaluar la actividad citotóxica de extractos etanólicos de raíces, tallos, hojas y flores de Gnaphalium spicatum sobre algunas líneas celulares tumorales humanas. Materiales y métodos. Las líneas celulares HT-29, H-460, MCF-7, M-14, PC-3, DU-145, K-562, y 3T3, fueron expuestas a cuatro concentraciones de extractos etanólicos de raíces, tallos, hojas y flores de Gnaphalim spicatum, asimismo, a diferentes concentraciones de cisplatino, que se usó como control positivo. Se halló los porcentajes de crecimiento en 48 horas. Luego se determinó la concentración inhibitoria 50 (CI50) mediante análisis de regresión lineal, el índice de selectividad de cada muestra y finalmente, la relación dosis-respuesta entre las concentraciones de los extractos y cisplatino, con los porcentajes de crecimiento. Resultados. El extracto etanólico de las raíces de Gnaphalium spicatum mostró mayor actividad citotóxica en la líneas celulares MCF-7 yK-562. Los CI50 en ¦Ìg/mL fueron de 98 (r= -0,98 p menor que 0,01) y 46 (r= -0,97 p menor que 0,01), respectivamente. Asimismo, su citotoxicidad en la l¨ªnea celular 3T3 fue de 215 (r= 0,97 p menor que 0,01). Los CI50 del cisplatino en ¦Ìg/mL fueron de 2 (r=-0,96 p menor que 0,01), 7,7 (r=-0,98 p menor que 0,01) y 3 (r=-0,97p menor que 0,01), para MCF-7, K-562 y 3T3, respectivamente. Los índices de selectividad del extracto de raíces y cisplatino fueron 2,2 y 0,3 para MCF-7, y 4,7 y 1,5 para K-562, respectivamente. Los extractos de tallos, hojas y flores obtuvieron CI50 mayor que a 0,250 mg/mL en todas la líneas celulares evaluadas. Conclusiones. Los extractos etanólicos de tallos, hojas y flores de Gnaphalium spicatum no mostraron actividadcitotóxica en este bioensayo. Los extractos de raíces mostraron citotoxicidad en las todas las líneas celulares tumorales, excepto en M-14. Además fueron menos citotóxicos en relación al cisplatino en la línea celular 3T3.

Objectives. To evaluate the cytotoxic activity ethanolic extracts of roots, stems, leaves and flowers of Gnaphalium spicatum in somehuman tumor cell lines. Material and methods. The following cell lines: HT-29, H-460, MCF-7, M-14, PC-3, DU-145, K-562, and 3T3, were exposed to four different concentrations of ethanolic extracts from roots, stems, leaves and flowers of Gnaphalium spicatum, and also to different concentrations of cisplatin, which was used as a positive control. Percentage growth was assessed after 48 hours. The minimalinhibitory concentration for 50 per cent of the cells (IC50) was determined using linear regression analysis; also, the selectivity index for each sample and the dose-response relationship between the extract concentrations and cisplatin, as well as growth percentages were determined. Results. The ethanolic extract of Gnaphalium spicatum roots showed its highest cytotoxic activity in MCF-7 and K-562 cell lines. IC50 values, expressed in ¦Ìg/mL, were 98 (r=-0.98; p <0.01) and 46 (r= -0.97; p minor that 0.01), respectively. Cytotoxicity against the 3T3 cellline was 215 (r= 0.97; p minor that 0.01). IC50 values for cisplatin were 2 (r= -0.96 p minor that 0.01), 7.7 (r= -0.98; p minor that 0.01), and 3 (r= -0.97; p minor that 0.01), for theMCF7, K562 and 3T3 cell lines, respectively. The selectivity index of the ethanolic extract from Gnaphalium spicatum roots and cisplatinwere 2.2 and 0.03 for the MCF-7 cell line, and 4,7 and 1.5 for the K-562 cell line, respectively. Extracts from stems, leaves and flowers of Gnapahlium spicatum acheived IC50 levels major that 0.250 mg/mL in every cell lines tested. Conclusions. The ethanolic extracts of stems, leaves and flowers of Gnaphalium spicatum did not show cytotoxic activity in this bioassay. The extract from roots showed cytotoxicity in all tumor cell lines, except in M-14. Furthermore, it was less cytotoxic than cisplatin in 3T3 cell line.

Neurosciences - A neurosurgeon's perspective.

The advancements in the field of science in the past fifty years have highlighted the need to integrate all fields of human endeavours and have emphasised interdependency of various disciplines. The separation of humanities, therefore, from neurosciences is a preposterous practical joke on all thinking men. With the human genome project on the anvil, biotechnology is making significant headway holding out promise for organ regeneration. Macro evolution is over, but micro-evolution continues in the brain. Neural Darwinism thus, continues to evolve as long as individual remains conscious and has memory. In the milieu of widely varying internal physiological mechanisms and external stimuli, an alternative theory to preprogrammed directionalism is proposed by three mechanisms namely developmental variation and selection, experiential selections and reentrant signalling. Reentrant signalling reorients and correlates the external inputs leading to psychic development preceding the development of consciousness. The cholinergic and aminergic neuro-modelling systems are well suited to serve as value systems. The main achievement of consciousness is to bring together the many categorizations involved in perceptions into a SCENE. Another part of evolution involved capacity of reentrant signalling to be guided by a value system where it is provided with a lot of choices. With 10(13) neurons and 10(16) connections, freedom of choice may manifest into a 'Buddha' or a 'Hitler'. As part of the evolutionary process, it was interesting how capacity to categorize the need to worship by referring to environment outside evolved into a search within our minds. As the next stage of evolution, neuroscience may, thus, serve as the next gateway to understanding the mind and soul.

Changes in phospholipids and acetylcholinesterase during early phase of injury to spinal cord--an experimental study in rats.

Injury to spinal cord was produced in rats by the clip compression technique by placing the aneurysm clip extradurally for 30 seconds. The traumatised spinal segment and the adjoining upper segment were used for biochemical estimations. Motor function of the injured rats was evaluated using the inclined plane. Phospholipid phosphorus values were significantly decreased in the injured spinal segment at 24 hrs. AchE activity was also decreased in the traumatised segment one week after injury. Dexamethasone and verapamil reversed the changes in AchE activity at the end of one week. At the one week assessment period, aneurysm clipped rats showed a decrease in the maximum angle in the inclined plane. Dexamethasone and verapamil treated rats showed improvement in the neurologic function, neurologic recovery was better in the dexamethasone treated group.

Evaluation of drug effects on spinal cord injury--an experimental study in monkeys.

Contusion injury is produced experimentally in anaesthetised monkeys by weight drop method. A group of animals having laminectomy alone served as sham controls. Drugs were administered 30 min after injury initially. Naloxone and nifedipine were administered as single dose administration immediately after injury. Dipyridamole and DMSO were administered daily for a period of 1 week. Acetylcholinesterase (AchE) was estimated in 2 spinal tissue segments, S1-at the site of injury and S2-the segment above the site of injury, at the end of 1 week after sacrificing the animals. Contusion injury produced significant decrease in specific activity of AchE in the traumatised segment of the experimental animals. The non-traumatised adjacent segment did not show any significant change. Nifedipine, naloxone and DMSO produced a decrease in AchE activity in S1 and S2 segments. Monkeys developed paraplegia after contusion injury. A score 2+ was observed after 1 week as compared to the score of 4+ of sham controls. Single dose administration of naloxone seemed to reverse the motor deficit by getting a score of 3+; other drugs did not produce any beneficial effect on motor deficit.

Brain abscess and congenital heart disease.

One hundred and thirty-three cases of brain abscess over a period of 20 years (1967-1986) were reviewed and 25 (18.7%) of these were associated with congenital heart disease (CHD). Headache was the predominant clinical feature and anaerobic streptococci were the commonest pathogen isolated. Craniotomy and excision of the abscess and burrhole aspiration were the mainstay of treatment together with appropriate antibiotic therapy. The importance of early diagnosis and treatment had been highlighted and the relative merits of the two methods of treatment were discussed.

Change in acetylcholinesterase during early phase of experimental spinal cord trauma in primates.

Specific activity of acetylcholinesterase has been shown to be decreased following experimental spinal cord trauma (200 gcm) in primates. The decrease in activity was evident at 8, 24, 48 hr and 1 week after injury to the traumatized segments of spinal cord.

Posterior fossa abscesses. A review of 33 cases.

Thirty three cases of posterior fossa abscesses seen over a period of 20 years are reviewed. 84.8% of these were secondary to otogenic disease. Two abscesses were due to tuberculosis and one due to actinomycotic infection. The overall mortality was 12.1%. Total excision of the abscess with appropriate antibiotic therapy was associated with an operative mortality of 3.4%.

Changes in noradrenaline and histamine in monkey spinal cords traumatised by weight drop, compression and subsequent decompression.

Levels of noradrenaline (NA) and histamine (H) in the spinal cord of monkeys at 8, 24 and 48 hr following 200 g/cm contusion injury, 50 g of compression injury at 8 hr and decompression for 16 and 40 hr following 8 hr of compression were studied in the traumatised and in an adjacent non-traumatised segment. The NA level doubled in the traumatised and non-traumatised segments at 8 hr contusion injury followed by a slow decline to control values at 24 and 48 hr of contusion injury. There was no change in NA content of the spinal cord segments at 8 hr of compression injury. Decompression for 16 hr following 8 hr of compression increased NA content of the traumatised segment. H levels decreased in the traumatised and non-traumatised segments at 24 and 48 hr of contusion injury. Compression for 8 hr elevated H in the traumatised and non-traumatised segments. On decompression H level was further increased in the traumatised segment.