The sensitivity and specificity of COVID-19 rapid anti-gene test in comparison to RT-PCR test as a gold standard test.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a modern infectious disease, first identified in December 2019 in Wuhan, China. The etiology is via severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in a pandemic manner. The study aimed to compare between RT-PCR and rapid anti-gene tests for COVID-19 with regard to sensitivity and specificity. METHODS: This is a cohort hospital-based study done during the period of July to September 2020. Both rapid anti-gene test kit (SARS-CoV-2) and RT-qPCR were used for the detection of COVID-19 in suspected cases. RESULTS: A total of 148 cases were tested using both the RT-qPCR and rapid test. Twenty-nine (19.6%) of these cases had positive results for RT-qPCR and 119 (80.4%) were negative, whereas 52 (35.1%) patients were positive to rapid anti-gene test and 96 (64.9%) of them negative. The sensitivity of the rapid test was 37.9%, the specificity was 65.5% and the accuracy was 64.44%. Rapid IgG test was positive in 47 (31.8) of cases. Although, rapid IgM test was positive in 18 (12.2%). The rapid IgG test was more sensitive than rapid IgM (Sensitivity 34.48% vs. 3.45%), but it was less specific than rapid IgM test (Specificity 68.91% vs. 85.71%). CONCLUSION: We cannot consider rapid anti-gene test alone as a diagnostic method for COVID-19. We should also conduct RT-PCR test and other investigations like imaging CT scan of chest to confirm the diagnosis. The rapid IgG test is more sensitive than rapid IgM, but it was less specific.

Isolation and characterization of blackish-brown BY2-melanin accumulated in cultured tobacco BY-2 cells.

The tobacco BY-2 cell line is one of the most utilized plant cell lines. After long-term culture, the cells turn brown to black, but the causal pigment is unknown. We successfully isolated a blackish-brown pigment from BY-2 cells cultured for 3 weeks. Morphological and spectroscopic analyses indicated that the pigment had similar features to a melanin-like substance reported previously. Furthermore, physicochemical analyses revealed that this pigment possessed most of the properties of melanin-like pigments. In addition, the high nitrogen content suggested that it differed from common plant melanins classified as allomelanins, suggesting a novel eumelanin-like pigment: "BY2-melanin". This is the first example showing that eumelanin-like pigments are produced in the cultures of plant cells for which the accumulation of melanin has not been reported. This tobacco BY-2 cell culture technique may represent a customizable and sustainable alternative to conventional melanin production platforms, with significant potential for industrial and pharmacological applications.

Psychometric properties of the Arabic version of Duke Activity Status Index in patients with chronic obstructive pulmonary disease.

PURPOSE: To translate and cross-culturally adapt the original Duke Activity Status Index (DASI) into the Arabic language and examine its psychometric properties in Arabic speaking patients with Chronic Obstructive Pulmonary Disease (COPD). MATERIALS AND METHODS: The DASI was translated into the Arabic language and tested on 70 Arabic patients with COPD. Patients with COPD completed also the Six-Minute Walk Test (6MWT) and Saint George Respiratory Questionnaire (SGRQ) on the first visit. On the second visit, the patients with COPD completed the Arabic version of DASI along with the global rating of change scale (GRC). The internal consistency, test-retest reliability and construct validity were examined. RESULTS: Seventy Arabic speaking patients with COPD (56 males), mean (SD) age was 63.2 (11.1) year, completed the study. The patients reported no difficulty in understanding and completing the scale. Three items were modified and adapted to the Arabic culture. The Cronbach's alpha was 0.87, and the ICC2,1 was 0.95. The Arabic version of DASI correlated with the 6MWT (r = 0.55), the total score of SGRQ (r = -0.64) and its activity domain (r = -0.67), all p < 0.001. CONCLUSION: The Arabic version of DASI is a simple, quick, reliable, and valid measure of functional capacity in Arabic speaking patients with COPD.Implications for practiceThe Arabic DASI can be used in all Arabic-speaking countries given that the scale was adapted to standard Arabic language.The Arabic DASI would yield similar scores with administrations over time in patients with unchanged condition and stable COPD.This questionnaire could be used for screening of functional capacity in COPD in primary care settings.

Exome Sequencing of a Clinical Population for Autosomal Dominant Polycystic Kidney Disease.

Importance: Most studies of autosomal dominant polycystic kidney disease (ADPKD) genetics have used kidney specialty cohorts, focusing on PKD1 and PKD2. These can lead to biased estimates of population prevalence of ADPKD-associated gene variants and their phenotypic expression. Objective: To determine the prevalence of ADPKD and contributions of PKD1, PKD2, and other genes related to cystic kidney disease in a large, unselected cohort. Design, Setting, and Participants: This retrospective observational study used an unselected health system-based cohort in central and northeast Pennsylvania with exome sequencing (enrolled from 2004 to 2020) and electronic health record data (up to October 2021). The genotype-first approach included the entire cohort and the phenotype-first approach focused on patients with ADPKD diagnosis codes, confirmed by chart and imaging review. Exposures: Loss-of-function (LOF) variants in PKD1, PKD2, and other genes associated with cystic kidney disease (ie, ALG8, ALG9, DNAJB11, GANAB, HNF1B, IFT140, SEC61B, PKHD1, PRKCSH, SEC63); likely pathogenic missense variants in PKD1 and PKD2. Main Outcomes and Measures: Genotype-first analysis: ADPKD diagnosis code (Q61.2, Q61.3, 753.13, 753.12); phenotype-first analysis: presence of a rare variant in PKD1, PKD2, or other genes associated with cystic kidney disease. Results: Of 174 172 patients (median age, 60 years; 60.6% female; 93% of European ancestry), 303 patients had ADPKD diagnosis codes, including 235 with sufficient chart review data for confirmation. In addition to PKD1 and PKD2, LOF variants in IFT140, GANAB, and HNF1B were associated with ADPKD diagnosis after correction for multiple comparisons. Among patients with LOF variants in PKD1, 66 of 68 (97%) had ADPKD; 43 of 43 patients (100%) with LOF variants in PKD2 had ADPKD. In contrast, only 24 of 77 patients (31.2%) with a PKD1 missense variant previously classified as "likely pathogenic" had ADPKD, suggesting misclassification or variable penetrance. Among patients with ADPKD diagnosis confirmed by chart review, 180 of 235 (76.6%) had a potential genetic cause, with the majority being rare variants in PKD1 (127 patients) or PKD2 (34 patients); 19 of 235 (8.1%) had variants in other genes associated with cystic kidney disease. Of these 235 patients with confirmed ADPKD, 150 (63.8%) had a family history of ADPKD. The yield for a genetic determinant of ADPKD was higher for those with a family history of ADPKD compared with those without family history (91.3% [137/150] vs 50.6% [43/85]; difference, 40.7% [95% CI, 29.2%-52.3%]; P < .001). Previously unreported PKD1, PKD2, and GANAB variants were identified with pedigree data suggesting pathogenicity, and several PKD1 missense variants previously reported as likely pathogenic appeared to be benign. Conclusions and Relevance: This study demonstrates substantial genetic and phenotypic variability in ADPKD among patients within a regional health system in the US.

Exercise Capacity Is Independent of Respiratory Muscle Strength in Patients with Chronic Heart Failure.

Background: Exercise intolerance in patients with chronic heart failure (CHF) is associated with a number of factors, including breathlessness and respiratory muscle weakness. However, many studies reported controversial results, and as yet there is no study on Arabic patients with CHF. This study aimed to examine the impact of breathlessness and respiratory muscle strength on exercise capacity in Arabic patients with CHF. Methods: This was a cross-sectional study, involving 42 stable adult male patients with CHF with a reduced ejection fraction and 42 controls who were free from cardiorespiratory and neuromuscular diseases. Patients with CHF and the controls underwent respiratory muscle strength tests and a six-minute walk test (6MWT), and the measurements were taken. Dyspnea was recorded using the modified Medical Research Council (mMRC) scale, along with the number of comorbidities. Results: Patients with CHF and controls were similar in age and sex. Patients with CHF had a greater number of comorbidities, a higher dyspnea score, a lower 6MWT score, and lower respiratory muscle strength (p < 0.001). Only 7% of patients with CHF had weak inspiratory muscle strength (<60% of that predicted) and 40% terminated the 6MWT due to dyspnea. The 6MWT was associated with mMRC (rs = −0.548, p < 0.001) but not with respiratory muscle strength (p > 0.05). Conclusions: Exercise intolerance in patients with CHF was associated with dyspnea and was independent of respiratory muscle strength.

Psychometric properties of the Arabic version of the anxiety inventory for respiratory disease in patients with COPD.

PURPOSE: The Anxiety Inventory for Respiratory Disease (AIR) is a reliable and valid scale for examining the anxiety in patients with COPD. This study aimed to cross-culturally adapt and translate the original AIR scale into the Arabic language and to examine its reliability and validity in Arab patients with COPD. MATERIAL AND METHODS: This was a validation study conducted on 70 Arabic patients with COPD. The AIR-A and the Hospital Anxiety and Depression Scale (HADS) were completed on the first assessment. After two weeks, 55 patients completed the AIR-A scale again. The reliability was assessed by Cronbach's α and intraclass correlation coefficients (ICC2,1). Exploratory factor analysis (EFA), and the confirmatory factor analysis (CFA) were used to measure the structural validity. The construct validity was also explored. RESULTS: The AIR-A questionnaire had a Cronbach's α of 0.91 and ICC2,1 of 0.86. The EFA revealed that the AIR-A was unidimensional. The CFA showed the single-factor model required minor modifications to reach the best fit. The AIR-A was correlated with the HADS- anxiety (r = 0.89, p < 0.001). CONCLUSION: The Arabic version of AIR scale is reliable, and valid for assessing the anxiety disorder in Arabic speaking patients with COPD worldwide.Implications for PracticeThe Arabic version of AIR will be useful for examining anxiety in Arabic speaking patients with COPD worldwide.The Arabic version of AIR will help clinicians to monitor the effect of interventions in Arabic speaking patients with COPD who suffer from anxiety.The Arabic version of AIR assess only the anxiety.

The immediate effect of thoracolumbar manipulation and diaphragmatic release on inspiratory muscle strength in healthy smokers: A randomized clinical trial.

BACKGROUND: Diaphragmatic release technique and thoracolumbar manipulation have been found effective in restoring normal diaphragmatic movement in healthy and diseased populations. Smoking has deleterious effects on human systems, including the musculoskeletal system. OBJECTIVE: The current study aimed to investigate the immediate effects of diaphragmatic release technique and thoracolumbar manipulation on diaphragm muscle strength in healthy smokers. METHODS: A double-blinded randomized clinical trial was conducted on 30 asymptomatic healthy smokers randomly assigned into two groups [intervention group (IG) and sham group (SG)] with 15 participants each. The IG received thoracolumbar manipulation and diaphragmatic release techniques, while the SG received no active treatment. The outcome measure was sniff nasal inspiratory pressure (SNIP). RESULTS: The IG showed a significant increase in the SNIP with a mean difference of 20.13 cmH2O (95% CI: 13.62-26.64; P< 0.001), while the SG had a reduction in the SNIP value -3.27 cmH2O (95% CI: -0.65 to -5.89; P= 0.02). Diaphragmatic release technique and thoracolumbar manipulation significantly improved SNIP values immediately after the intervention, with a between-group difference of 31.07 cmH2O (95% CI: 15.26-46.87; P< 0.001). CONCLUSIONS: Diaphragmatic release technique and thoracolumbar manipulation increased the diaphragm strength in healthy adult smokers, suggesting its potential utility in the management of participants with reduced respiratory muscle strength.

Effect of inspiratory muscle training on respiratory muscle strength and functional capacity in patients with type 2 diabetes mellitus: A randomized clinical trial.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is usually associated with respiratory manifestations including inspiratory muscle weakness which affects exercise capacity. The present study aimed to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and exercise capacity in patients with Type 2 diabetes mellitus (T2DM). METHODS: This was a randomized controlled trial in patients with type 2 diabetes mellitus with no previous cardiopulmonary or neuromuscular diseases. Patients had no back pain. Patients were randomized into interventional or placebo groups. Sniff nasal inspiratory pressure (SNIP), maximum inspiratory pressure (MIP), and six-minute walking test (6MWT) were measured at baseline and 8 weeks post incremental inspiratory muscle training. RESULTS: At baseline, interventional and placebo groups were similar in age, body mass index, sex inspiratory muscle strength, and exercise capacity. After 8 weeks of incremental inspiratory muscle training at 40% of MIP, the interventional group had a significant increase in the SNIP (mean difference: 18.5 ± 5.30 cm H2O vs 2.8 ± 4.8 cm H2O) and MIP (mean difference: 19.4 ± 4.3 Vs 5.4 ± 3.6 cm H2O) compared to the placebo group, respectively. The interventional group showed improvement in the 6MWT (mean difference: 70 ± 29 m vs 34 ± 24 m) compared to the placebo group, P < .05. CONCLUSION: Incremental inspiratory muscle training increased the diaphragm strength in patients with T2DM and improved exercise capacity.

The Effect of Spironolactone on the Incidence of Contrast-Induced Nephropathy in Patients Undergoing Cardiac Catheterization: Study Design and Rationale.

INTRODUCTION: Patients undergoing coronary catheterization are at high risk of developing contrast-induced nephropathy (CIN) acute kidney injury (AKI). Several approaches have been supposed to limit such an effect but with mixed results or non-practical methods. Spironolactone is supposed to be effective as a nephroprotective agent in animal studies. This study will try to measure the effect of spironolactone on the incidence of CIN-AKI in patients undergoing coronary catheterization (angiography angioplasty). METHODS: This study is a single-center, investigator-driven, double-blinded randomized controlled study in Iraq-Basra. More than 400 patients admitted for coronary angio unit in our center will be allocated in a 1:1 ratio to receive either spironolactone 200 mg single dose or placebo in addition to their usual premedication. PLANNED OUTCOMES: Primary end point will be CIN defined as more than 25% or 0.3 mg/dl elevation in serum creatinine (S.Cr.) from baseline during the first 2-3 days after the procedure. We hope to identify or answer an important question regarding CIN in such high-risk patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier, NCT03329443.

Preliminary study for non - invasive optical detection of squamous and basal cell carcinomas.

BACKGROUND: The early detection of skin cancer may highly increase the chances of its healing. One of the non-invasive methods of such detection based on the Oblique- Incidence Diffuse Reflectance (OIDR) measurements of the reflected diode laser light from the skin. In this research we designed and implemented the OIDR reflectometry measuring system with a 650 nm diode laser source to aid physicians in diagnosing both squamous cell carcinomas (SCC) and basal cell carcinomas(BCC). METHOD: The laser is delivered obliquely to the skin surface by an optical fiber fitted through a tube holder of CCD camera. The diffused reflected laser light from the skin is captured by the CCD camera and sent to a computer, which is supplied by a specially prepared Matlab program to analyze these images in order to decide in a time whether the lesion is malignant or benign. Fifty cases were diagnosed under supervision of the consultant section of The Governmental Specialized Marjan Teaching Hospital - MOH - Iraq. RESULT: The fifty diagnosed cases by this technique, the results were 90% accurate. CONCLUSION: The method of laser oblique-incidence diffuse reflectance (OIDR) combined with using the developed algorithms that have high classification rates may prove useful in the clinic as the process is fast, noninvasive and accurate.

Beneficial effects of clopidogrel on glycemic indices and oxidative stress in patients with type 2 diabetes.

Objective of present study is to evaluate the possible role of clopidogrel in improving glycemic indices and oxidative stress in patients with type 2 diabetes. This study was performed on 42 uncontrolled type 2 diabetic patients at the specialized center for Endocrinology and Diabetes, Al-Rasafa Directorate of Health, Baghdad. All of the patients were treated with (glibenclamide 5 mg at morning) and randomized into two groups: the first group includes 22 patients treated with clopidogrel tablets (75 mg/day) for 2 months; the second group includes 20 patients treated with a placebo formula (sodium bicarbonate 200 mg/day) for the same period. Treatment with clopidogrel produced significant improvement (P < 0.05) in fasting serum glucose (FSG), fasting serum insulin level, quantitative insulin sensitivity check index (QUICKI); and oxidative stress markers: serum malondialdehyde (MDA) and serum reduced glutathione (GSH) compared to their baseline levels. There was significant elevation (P < 0.05) in both FSG and fasting serum insulin and the MDA level with significant reduction (P < 0.05) in QUICKI of placebo group compared to their baseline levels. However, clopidogrel produced significant elevation (P < 0.05) in AST and ALT levels but placebo formula caused no significant alteration (P > 0.05) in the serum levels of these two enzymes. In conclusion the treatment with clopidogrel improved glycemic indices and reduced oxidative stress in patients with type 2 diabetes.

Perceptions of contradictory communication from parental figures by adults with borderline personality disorder: a preliminary study.

This study investigated a hypothesized correlation between contradictory responses from parental figures perceived in present-day interactions by adult subjects and the diagnosis of borderline personality disorder (BPD). One hundred subjects were given a questionnaire designed to assess the frequency of perceived parental response patterns divided into appropriate, conflicting, polarized, and neglectful categories. The BPD and a group subthreshold for the disorder endorsed significantly more conflicting and fewer appropriate responses for the first parental figure rated than did both patient control subjects and normal control subjects without BPD; a trend toward similar results was found for the second parental figure also. The frequency of polarized and neglectful responses was not significantly different among the groups. There was indirect evidence that BPD subjects did not engage in the defense mechanism of "splitting" when filling out the questionnaire. These results suggest that contradictory family communication patterns might be considered in models of ongoing reinforcement for dysfunctional BPD behavior.

Identification of sterol-independent regulatory elements in the human ATP-binding cassette transporter A1 promoter: role of Sp1/3, E-box binding factors, and an oncostatin M-responsive element.

The ATP-binding cassette transporter A1 (ABCA1) shows a differentiation-, cAMP-, and sterol-dependent up-regulation in human monocytes. As part of an ongoing study, we investigated the proximal promoter regions that are highly conserved between the human and murine ABCA1 genes. Using reporter gene assays, we show here that a TATA box 24 bp upstream of the transcription initiation site is essential for promoter activity in RAW 264.7 and HepG2 cells, whereas further enhancement of transcriptional activity is mediated by the -175 bp promoter region. Gel shift assays revealed in vitro binding of Sp1 to a -91 GnC motif as well as binding of Sp1 and Sp3 to a -157 GnC promoter region. In co-transfection experiments using Drosophila S2 cells, we demonstrate that Sp3 competes with Sp1 for binding to the -157 GnC motif and acts as a repressor. On the other hand, overexpression of Sp1 increased ABCA1 mRNA expression in HeLa cells and enhanced cellular cholesterol and phospholipid efflux in RAW 246.7 macrophages. We also show here that the conserved E-box at position -140 binds upstream stimulatory factors 1 and 2 and hepatic nuclear factor 1alpha and that mutagenesis of the E-box enhanced constitutive ABCA1 expression in RAW 264.7 cells, implying a role for this element in silencing ABCA1 expression. Besides the functional importance for basal gene expression, we have identified that the core promoter region (-175 to +224) is also responsible for the induction of ABCA1 by the cytokine oncostatin M, resulting in a rapid increase in ABCA1 mRNA levels in HepG2 cells. Interestingly, this oncostatin M-induced expression is not dependent on the currently known sequence motifs in the ABCA1 promoter. In conclusion, a functional complex of cis-elements within the proximal human ABCA1 promoter associated with the transcription factors Sp1/3, upstream stimulatory factors 1 and 2, and hepatic nuclear factor 1alpha has been characterized, which allows a subtle tissue-specific regulation of ABCA1 gene expression.