Morpho-molecular investigation of ectoparasitic infestation of companion animals in Sylhet city, Bangladesh.

Ticks (Ixodida) and Fleas (Siphonaptera) are considered among the most important arthropod of public health concern due to their ability to transmit vector-borne pathogens to humans. By sharing a common environment, vector-borne diseases constituted major setbacks to the development of a pet population in Bangladesh. This study aimed to determine companion animal-associated ticks and fleas based on morpho-molecular approaches. Between December 2021 and May 2022, 74 animals (62 cats and 12 dogs) were examined, of which 17 (27.4%) cats and 9 (75.0%) dogs had ectoparasitic infestations, with 35.1% overall prevalence. Morphometrical examination showed the ectoparasites in these animals were Ctenocephalides spp. (flea) and Riphicephalus spp. (tick). Genetic analysis using the mitochondrial markers i.e. Cytochrome c oxidase subunit 1 (cox1) revealed the presence of two flea species i.e., Ctenocephalides canis, Ctenocephalides felis, and one tick species Rhipicephalus sanguineus. Interviews of animal owners indicate that 35.14% of them had no concern about ectoparasitic infestation or ectoparasites-borne diseases. Our results indicated that fleas and ticks were the most common ectoparasites in companion animals of this area. The zoonotic nature of some ectoparasites can be regarded as a public health alert. The findings will assist epidemiologists and policymakers in offering customized guidance for upcoming monitoring and preventive tactics in this area.

Faunal diversity of ticks in animals and environment in eastern Bangladesh.

Tick and tick-borne diseases cause significant impediments to livestock health and production; however, information on the tick fauna is significantly limited in Bangladesh. This study was aimed to investigate tick fauna in Sylhet sub-district of Bangladesh targeting animal hosts and environment. A total 1427 ticks were collected by using blunt forceps, hand picking and dragging techniques from host body and environment during October 2018 to March 2019. Identification was made using morpho-taxonomical keys. Eight species from three separate genera of tick, namely Rhipicephalus(≈Boophilus) microplus, Rhipicephalus decoloratus, R. annulatus, R. sanguineus, Haemaphysalis intermedia, H. bispinosa, H. leachi, and Amblyomma variegatum were identified. Rhipicephalus spp. was dominant in the hosts whereas, Haemaphysalis spp. was the most prevalent in the environment. This study for the first-time enlisted ticks in two different ecological settings in Sylhet, Bangladesh. Further investigations should be made to evaluate the burden and control the associated socio-economic risk.

The Global case-fatality rate of COVID-19 has been declining disproportionately between top vaccinated countries and the rest of the world

Globally 58.83% human population received at least one dose of the COVID-19 vaccines as of 5 January 2021. COVID-19 vaccination rollout is progressing at varied rates globally and data on the impact of mass vaccination on infection and case-fatality rates require definition. We compared the global reported cumulative case-fatality rate (rCFR) between top-20 countries with COVID-19 vaccination rates (>125 doses/100 people) and the rest of the world, before and after commencement of vaccination programmes. We considered the 28th day of receiving the first vaccine in the world as a cut-off to compare the pre-vaccine period (Jan 1, 2020 - Jan 5, 2021) and the post-vaccine period (Jan 6, 2021-Jan 5, 2022). We used a Generalized linear mixed model (GLMM) with a beta distribution to investigate the association between the CFR and potential predictors of each country and reported the relative risk (RR) of each variable. The mean rCFR of COVID-19 in the top-20 countries with vaccination rates was 1.83 (95% CI: 1.24-2.43) on 5 Jan 2021 and 1.18 (95% CI: 0.73-1.62) on 5 Jan 2022. The CFR for the rest of the world on 5 Jan 2021 was 2.32 (95% CI: 1.86-2.79) and 2.20 (95% CI: 1.86-2.55) on 5 January 2022. In Sub-Saharan Africa, the CFR remained roughly unchanged at 1.97 (95% CI: 1.59-2.35) on 5 Jan 2021 and 1.98 (95% CI:1.58-2.37) on 5 Jan 2022. The GLMM showed vaccination (/100 population) (RR:0.37) and Stringency Index (RR:0.88) were strong protective factors for the countrys COVID-19 CFR indicating that both vaccination and lockdown measures help in the reduction of COVID-19 CFR. The rCFR of COVID-19 continues to decline, although at a disproportionate rate between top vaccinated countries and the rest of the world. Vaccine equity and faster roll-out across the world is critically important in reducing COVID-19 transmission and CFR. Key Questions What is already knownO_LIVaccination can reduce the case-fatality rate of COVID-19. Globally, the COVID-19 vaccination rollout is progressing at varied rates. C_LI What are the new findingsO_LIIn the top-20 countries with vaccination, >200 doses of vaccines are given per 100 people on 5th Jan 2022, In the rest of the word, the figure is 105, and in Sub-Saharan Africa (SSA) only 15.72 C_LIO_LIAfter the introduction of COVID-19 vaccination the reported case-fatality rate (rCFR) of COVID-19 has reduced by 35% in the top-20 countries with vaccination, 8% in the rest of the world roughly unchanged in SSA. C_LIO_LIThe doses of COVID-19 vaccines (/100 people) and rCFR has a negative correlation on 5 Jan 2022 (r=-0.296, p<0.001). C_LIO_LIThe COVID-19 vaccination and Stringency Index are strong protective factors for the countrys COVID-19 rCFR indicating that both vaccination and lockdown measures help in reduction of COVID-19 rCFR. C_LI What do the new findings implyO_LIThe disproportionate case-fatality rate of COVID-19 between top vaccinated countries and the rest of the world demand fast and equitable vaccine rollout globally to reduce COVID-19 transmission and CFR C_LI

Kidney protective potential of lactoferrin: pharmacological insights and therapeutic advances

Kidney disease is becoming a global public health issue. Acute kidney injury (AKI) and chronic kidney disease (CKD) have serious adverse health outcomes.However, there is no effective therapy to treat these diseases. Lactoferrin (LF), a multi-functional glycoprotein, is protective against various pathophysiological conditions in various disease models. LF shows protective effects against AKI and CKD.LF reduces markers related to inflammation, oxidative stress, apoptosis, and kidney fibrosis, and induces autophagy and mitochondrial biogenesis in the kidney. Although there are no clinical trials of LF to treat kidney disease, several clinical trials and studies on LF-based drug development are ongoing. In this review, we discussed the possible kidney protective mechanisms of LF, as well as the pharmacological and therapeutic advances. The evidence suggests that LF may become a potent pharmacological agent to treat kidney diseases.

Transition in Learning Approach for Undergraduate Medical Students of Bangladesh in Covid 19 Pandemic: A Situation Analysis

BackgroundThe outbreak of Covid-19 pandemic has fundamentally transformed the landscape of medical education system upside down worldwide. This unanticipated transition without any pre build infrastructure has made this altered prospect more challenging in Bangladesh. Though many countries across the world utilize Web Based Learning (WBL), but medical students of Bangladesh are mostly unfamiliar and unaccustomed with this newly imposed online learning avenue. Therefore, this study has evaluated the familiarity, usage, attitude of students towards online class and figured out the barriers witnessed by students in Bangladesh prospect. MethodsThis cross sectional, questionnaire based study was conducted in medical colleges across Bangladesh. A questionnaire linked to google form were distributed to undergraduate medical students all over Bangladesh through different social platforms. The answered questionnaires were automatically stored in Google drive in a specific email ID. ResultsA total of 1708 students participated. Among the respondents 45.1% were satisfied with online class. Though most students (45.8%) think online class is not effective like traditional lectures but 47.4% agrees to the point that online class should have complementary role in medical education. One of the strong attitude of medical students revealed that, most of them undoubtedly in unison (49.5% disagree, 30.3% strongly disagree) with that online class can never replace traditional class. 77.2% students responded that web based learning is interactive. 54.9% students pointed out interrupted internet connections with low speed during class which is a barrier to WBL. 83.2% of the respondents complained about facing audio visual problem in class which is attributed to poor network connectivity. Most students (74.8%) found online classes costly and 53.8% needed technical supports for online class. ConclusionThis study finding can suggest a potential reform for online class in Bangladesh. Addressing the obstacles and expectations can execute a fruitful web based learning in Bangladesh.

Adverse effects of COVID-19 vaccination: machine learning and statistical approach to identify and classify incidences of morbidity and post-vaccination reactogenicity

Good vaccine safety and reliability are essential to prevent infectious disease spread. A small but significant number of apparent adverse reactions to the new COVID-19 vaccines have been reported. Here, we aim to identify possible common causes for such adverse reactions with a view to enabling strategies that reduce patient risk by using patient data to classify and characterise patients those at risk of such reactions. We examined patient medical histories and data documenting post-vaccination effects and outcomes. The data analyses were conducted by different statistical approaches followed by a set of machine learning classification algorithms. In most cases, similar features were significantly associated with poor patient reactions. These included patient prior illnesses, admission to hospitals and SARS-CoV-2 reinfection. The analyses indicated that patient age, gender, allergic history, taking other medications, type-2 diabetes, hypertension and heart disease are the most significant pre-existing factors associated with risk of poor outcome and long duration of hospital treatments, pyrexia, headache, dyspnoea, chills, fatigue, various kind of pain and dizziness are the most significant clinical predictors. The machine learning classifiers using medical history were also able to predict patients most likely to have complication-free vaccination with an accuracy score above 85%. Our study identifies profiles of individuals that may need extra monitoring and care (e.g., vaccination at a location with access to comprehensive clinical support) to reduce negative outcomes through classification approaches. Important classifiers achieving these reactions notably included allergic susceptibility and incidence of heart disease or type-2 diabetes.

The prevalence of olfactory dysfunction and its associated factors in patients with COVID-19 infection

ObjectiveTo determine the prevalence of olfactory dysfunctions, mainly, anosmia and to identify its associated factors in patients with COVID-19 infection. Study designA hospital-based prospective observational cohort study SettingA COVID dedicated hospital, Square Hospitals Ltd., Dhaka, Bangladesh. MethodsWe collected patients information including laboratory-confirmed COVID-19 test results. We used Pearson Chi-square test and logistic regression model to assess the associations between demographic and clinical characteristics and olfactory outcomes. ResultsOut of 600 COVID-19 positive patients, 38.7% were diagnosed with olfactory dysfunction. Our analyses showed that patients age, smoking status, cough, dyspnea, sore throat, asthenia, and nausea or vomiting were significantly associated with the anosmia. We observed the risk of developing anosmia was greater in younger patients than in older patients, and this risk decreased as age increased [odds ratio (OR) range for different age groups: 1.26 to 1.08]. Smoking patients were 1.73 times more likely to experience anosmia than non-smoking patients [OR=1.73, 95% confidence interval (CI) = 1.01-2.98]. In addition, patients complained asthenia had a significantly double risk of developing the anosmia [OR = 1.96, CI = 1.23-3.06]. ConclusionsOur study shows that about 39% of patients diagnosed with olfactory dysfunction. Patients age, smoking status, and asthenia are significantly positively associated with the anosmia. Since anosmia can be a significant marker for the diagnosis of COVID-19, we suggest regular screening of olfactory dysfunction in patients with early symptoms of COVID-19, particularly younger patients, smoker, and complained asthenia.

Estimation of novel coronavirus (covid-19) reproduction number and case fatality rate: a systematic review and meta-analysis

Understanding the transmission dynamics and the severity of the novel coronavirus disease 2019 (COVID-19) informs public health interventions, surveillance, and planning. Two important parameters, the basic reproduction number (R0) and case fatality rate (CFR) of COVID-19, help in this understanding process. The objective of this study was to estimate the R0 and CFR of COVID-19 and assess whether the parameters vary in different regions of the world. We carried out a systematic review to retrieve the published estimates of the R0 and the CFR in articles from international databases between 1st January and 31st August 2020. Random-effect models and Forest plots were implemented to evaluate the mean effect size of the R0 and the CFR. Furthermore, the R0 and CFR of the studies were quantified based on geographic location, the tests/thousand population, and the median population age of the countries where studies were conducted. The I2 statistic and the Cochrans Q test were applied to assess statistical heterogeneity among the selected studies. Forty-five studies involving R0 and thirty-four studies involving CFR were included. The pooled estimation of the R0 was 2.69 (95% CI: 2.40, 2.98), and that of the CFR was 2.67 (2.25, 3.13). The CFR in different regions of the world varied significantly, from 2.51 (2.12, 2.95) in Asia to 7.11 (6.38, 7.91) in Africa. We observed higher mean CFR values for the countries with lower tests (3.15 vs. 2.16) and greater median population age (3.13 vs. 2.27). However, the R0 did not vary significantly in different regions of the world. An R0 of 2.69 and CFR of 2.67 indicate the severity of the COVID-19. Although R0 and CFR may vary over time, space, and demographics, we recommend considering these figures in control and prevention measures.

Prevalence and correlation of symptoms and comorbidities in COVID-19 patients: A systematic review and meta-analysis

BackgroundThe COVID-19 affected millions of people, and the patients present a constellation of symptoms and comorbidities. We aimed to chronicle the prevalence and correlations of symptoms and comorbidities, and associated covariates among the patients. MethodsWe performed a systematic review and meta-analysis [PROSPERO registration: CRD42020182677]. Databases [PubMed, SCOPUS, EMBASE, WHO, Semantic Scholar, and COVID-19 Primer] were searched for clinical studies published in English from January 1 to April 20, 2020. The pooled prevalence of symptoms and comorbidities were identified using the random effect model, and sub-groups analysis of patients age and locations were investigated. A multivariable factor analysis was also performed to show the correlation among symptoms, comorbidities and age of the COVID-19 patients. FindingsTwenty-nine articles [China (24); Outside of China (5)], with 4,884 COVID-19 patients were included in this systematic review. The meta-analysis investigated 33 symptoms, where fever [84%], cough/dry cough [61%], and fatigue/weakness [42%] were found frequent. Out of 43 comorbidities investigated, acute respiratory distress syndrome (ARDS) [61%] was a common condition, followed by hypertension [23%] and diabetes [12%]. According to the patients age, the prevalence of symptoms like fatigue/weakness, dyspnea/shortness of breath, and anorexia were highly prevalent in older adults [[≥]50 years] than younger adults [[≤]50 years]. Diabetes, hypertension, coronary heart disease, and COPD/lung disease were more prevalent comorbidities in older adults than younger adults. The patients from outside of China had significantly higher prevalence [p< 0.005] of diarrhea, fatigue, nausea, sore throat, and dyspnea, and the prevalent comorbidities in that region were diabetes, hypertension, coronary heart disease, and ARDS. The multivariable factor analysis showed positive association between a group of symptoms and comorbidities, and with the patients age. InterpretationEpitomizing the correlation of symptoms of COVID-19 with comorbidities and patients age would help clinicians effectively manage the patients. Summary boxO_TEXTBOXO_LSTWhat is already known?C_LSTO_LIThere is scarce evidence on the prevalence of all symptoms and comorbidities in COVID-19 infected older adults and patients from outside of China. C_LIO_LIPreviously published review studies excluded a wide range of symptoms and comorbidities from their analysis due to limited time-frame. C_LIO_LIStudy on the correlation of symptoms and comorbidity with age of the COVID-19 patients are not yet to be explored. C_LI O_LSTWhat are the new findings?C_LSTO_LIWe investigated all the reported symptoms [33] and comorbidity [43] where fever [84%], cough/dry cough [61%], fatigue/weakness [42%] and dyspnea/shortness of breath [ symptoms, and ARDS [61%], followed by hypertension [23%] and frequent comorbidity. C_LIO_LIKey findings, the fatigue/weakness, dyspnea/shortness of breath and anorexia were comparatively higher in older adults than younger adults, and the patients from outside of China had a higher prevalence diarrhoea, fatigue, nausea, sore throat, dyspnea, diabetes, hypertension, coronary heart disease and ARDS. C_LIO_LIKey findings, the symptoms comprising fever, dyspnea/shortness of breath, nausea, vomiting, abdominal pain, dizziness, anorexia and pharyngalgia; and the comorbidities including diabetes, hypertension, coronary heart disease, COPD/lung disease and ARDS were positively correlated with the COVID-19 patients age. C_LI O_LSTWhat do the new findings imply?C_LSTO_LIThese findings according to patients age and geographical variations may help the health care providers and policy makers. C_LIO_LIThis pioneering efforts in estimating the prevalence and correlations of all frequent symptoms and comorbidities will help the clinicians and disease practitioners like WHO to implement patient-centered interventions. C_LI C_TEXTBOX

Fyn Kinase: A Potential Therapeutic Target in Acute Kidney Injury

Acute kidney injury (AKI) is a common disease with a complex pathophysiology which significantly contributes to the development of chronic kidney disease and end stage kidney failure. Preventing AKI can consequently reduce mortality, morbidity, and healthcare burden. However, there are no effective drugs in use for either prevention or treatment of AKI. Developing therapeutic agents with pleiotropic effects covering multiple pathophysiological pathways are likely to be more effective in attenuating AKI. Fyn, a nonreceptor tyrosine kinase, has been acknowledged to integrate multiple injurious stimuli in the kidney. Limited studies have shown increased Fyn transcription level and activation under experimental AKI. Activated Fyn kinase propagates various downstream signaling pathways associated to the progression of AKI, such as oxidative stress, inflammation, endoplasmic reticulum stress, as well as autophagy dysfunction. The versatility of Fyn kinase in mediating various pathophysiological pathways suggests that its inhibition can be a potential strategy in attenuating AKI.

Carbon monoxide releasing molecule-2 protects mice against acute kidney injury through inhibition of ER stress

Acute kidney injury (AKI), which is defined as a rapid decline of renal function, becomes common and recently recognized to be closely intertwined with chronic kidney diseases. Current treatment for AKI is largely supportive, and endoplasmic reticulum (ER) stress has emerged as a novel mediator of AKI. Since carbon monoxide attenuates ER stress, the objective of the present study aimed to determine the protective effect of carbon monoxide releasing molecule-2 (CORM2) on AKI associated with ER stress. Kidney injury was induced after LPS (15 mg/kg) treatment at 12 to 24 h in C57BL/6J mice. Pretreatment of CORM2 (30 mg/kg) effectively prevented LPS-induced oxidative stress and inflammation during AKI in mice. CORM2 treatment also effectively inhibited LPS-induced ER stress in AKI mice. In order to confirm effect of CO on the pathophysiological role of tubular epithelial cells in AKI, we used mProx24 cells. Pretreatment of CORM2 attenuated LPS-induced ER stress, oxidative stress, and inflammation in mProx24 cells. These data suggest that CO therapy may prevent ER stress-mediated AKI.