An Evaluation of the Sensitivity and Specificity of Three COVID-19 Rapid Immunochromatographic Test Kits Compared to Real-Time Reverse Transcriptase-Polymerase Chain Reaction (rRT-PCR) Among Clinical Samples.

Background and objective The coronavirus disease 2019 (COVID-19) pandemic has imposed a significant burden on healthcare systems worldwide. This highlights the need for simple, rapid, and affordable diagnostic tests that can serve as alternatives to the existing costly and demanding polymerase chain reaction (PCR) assay, especially in resource-limited countries like Ghana. In light of this, we aimed to assess the diagnostic efficacy of three COVID-19 rapid immunochromatographic antigen test kits vs. real-time reverse transcriptase-PCR (rRT-PCR). Methods This study evaluated the sensitivity and specificity of three COVID-19 rapid immunochromatographic antigen test kits: DG Rapid, SD Rapid, and SS Rapid. They were compared with the gold standard RT-PCR for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid antigen in 75 randomly selected archived nasopharyngeal samples. Results Of the 75 samples tested, 38 (50.7%) were positive and 37 (49.3%) were negative for SARS-CoV-2 RNA by rRT-PCR assay. No false positives were recorded. On the other hand, the DG Rapid kit detected 30 (78.9%) true positives and eight (21.1%) false negatives. SD Rapid kit detected 28 (73.7%) true positives and 10 (26.3%) false negatives, while the SS Rapid kit detected 19 (50.0%) true positives and 19 (50.0%) false negatives. While the specificity of each test kit was 100% (95% CI), the sensitivity of the DG Rapid, SD Rapid, and SS Rapid kits was 79%, 74%, and 50% (95% CI), respectively. Higher sensitivities were recorded among samples with cycle threshold (Ct) values <29.99 for each kit. Also, the DG Rapid kit demonstrated 79% excellent agreement with rRT-PCR, while the SD Rapid and SS Rapid kits demonstrated good agreement with rRT-PCR with 73% and 50% Cohen's kappa values, respectively. Conclusions Based on our findings, DG Rapid and SD Rapid kits are reliable alternatives to rRT-PCR for the detection of SARS-CoV-2 infection, especially in resource-limited settings like Ghana.

Comparison of two iron supplementation methods on Hemoglobin level and Menstrual Bleeding in Tabriz students.

BACKGROUND: Iron deficiency anemia is a global health problem, and approximately 50% of anemia is caused by iron deficiency. According to studies, iron supplementation in young females improves iron status by increasing concentration of hemoglobin. To compare of prescribing two methods of iron supplementation administered either on a weekly basis or during menstruation, on hemoglobin level and menstrual blood¸ this double blind Randomized clinical trial study was carried out among female students in Tabriz, Iran. MATERIALS AND METHODS: In this double-blind randomized clinical trial, 150 female students allocated randomly in two groups. (75 students took an iron tablet weekly and 75 students took an iron tablet for first four days during their menstruation cycle for 16 weeks). Before and after intervention, the level of hemoglobin was measured and Higham chart was completed by participants in each group. Chi-square, independent t-Test, paired t-Test and ANCOVA were used for data analysis. RESULTS: There was no significant difference between two groups in terms of demographic characteristics, hemoglobin level and amount of menstrual bleeding before and after intervention (p>0.05). Taking iron supplement increased significantly the level of hemoglobin in each group (p<0.001). However, there was no significant difference in amount of menstrual bleeding (p>0.05) when comparing the data before and after intervention in each group. CONCLUSION: The two iron supplementation methods (menstrual bleeding period and weekly) have similar results on Hemoglobin level and menstrual bleeding.

4-epi-Pimaric acid: a phytomolecule as a potent antibacterial and anti-biofilm agent for oral cavity pathogens.

The present study focused on the antibacterial and biofilm inhibitory potential of 4-epi-pimaric acid isolated from aerial parts (stem and leaves) of Aralia cachemirica L. (Araliaceae) against oral cavity pathogens. 4-epi-Pimaric acid exhibited minimum inhibitory concentration (MIC) in the range of 4-16 µg/ml and minimum bactericidal concentration (MBC) two- to four-folds higher than MIC. There was significant inhibition in the biofilm formation by Streptococcus mutans on the saliva coated surface (P < 0.05), and confocal microscopy revealed that 4-epi-pimaric acid inhibited the clumping and attachment of S. mutans. At 8 × MIC concentration, it significantly prevented the pH drop and reduced S. mutans biofilms (P < 0.05). Increased propidium iodide staining and leakage of 260- and 280-nm absorbing material by 4-epi-pimaric acid treated cells of S. mutans suggested that it probably causes disruption of the cytoplasmic membrane structure. It also exhibited significant suppression of TNF-α expression in human neutrophils, suggestive of its anti-inflammatory activity. Furthermore, the compound was found to be significantly safe (IC(50) >100 µg/ml) in the MTT assay on AML-12 cell lines. In conclusion, 4-epi-pimaric acid showed promising antibacterial, anti-biofilm and anti-inflammatory potency and this compound can be exploited for therapeutic application in oral microbial infections.

Intestinal parasites isolated in a large teaching hospital, Italy, 1 May 2006 to 31 December 2008.

Intestinal parasites account for the majority of parasitic diseases, particularly in endemic areas. Most are transmitted via contaminated food. Because of increased immigration and travel, enteric parasitoses are now distributed worldwide. Between May 2006 and December 2008, we examined stool specimens from 5,351 patients (4,695 Italians, 656 non-Italians) for ova and parasites using microscopy, culture techniques, and molecular methods. Stools from 594 patients (11.1%) were contaminated and for all patients samples combined, a total of 700 intestinal parasites were counted. Ninety of the 594 infected patients had more than one parasite in their stools. Parasites causing intestinal disease occurred in 8.8% of patients. The prevalence was over twice as high among non-Italians (26.8% vs 8.9% in Italians, p<0.001) and higher in males (13.0% vs 9.5% in females, p=0.003). Most isolates were pathogenic protozoa, including in decreasing order of frequency: Blastocystis hominis, Giardia intestinalis, Entamoeba histolytica, and Cyclospora cayetanensis. The latter two species tended to be more common in Italians, although not at significant level (3.6% (15/418) vs 1.7% (3/176) in non-Italians, OR: 2.15; 95%CI: 0.60­11.70, p=0.22). Helminthes were found in 28 patients, mainly non-Italians (5.7% (10/176) vs 4.3% (18/418), OR: 1.34; 95%CI: 0.54­3.13, p=0.47). Ascaris lumbricoides and Hymenolepis nana were the most common. Strongyloides stercoralis, Enterobius vermicularis, Taenia spp. and Trichuris trichiura were also found. Intestinal parasites are a serious problem in developing countries, but should not be underestimated in industrialised countries.

Short term outcome of patients with hematochezia and normal initial colonoscopic findings: do they really need further screening?

BACKGROUND: In a significant number of the patients with hematochezia, colonoscopy turns out to be normal and therefore is unable to determine the cause of bleeding. This study investigates outcomes and possible necessity for further work up in cases of hematochezia with normal colonoscopy. METHODS: Ninety-seven patients with normal colonoscopy were followed for at least one year from the time of colonoscopy by regular visits and phone calls. Mortality and recurrent bleeding were recorded as primary end points. Those with recurrent or continued hematochezia were invited for a new visit and further work up. RESULTS: Among the ninety seven patients, nine cases (9.3%) were lost at follow ups, 10 experienced rebleeding (10.3 %), and the remaining 78 (80.4 %) were apparently healthy and had no further complaints. There were two mortalities during the follow up, one due to gastric cancer and the other due to cerebrovascular accident. CONCLUSION: It is unusual for the cases of hematochezia with a normal initial colonoscopy to have recurrent bleeding as a result of a significant missed lesion in the colon.

Anti-histaminic, anti-inflammatory and bronchorelaxant activities of 2, 7-dimethyl-3-nitro-4H pyrido [1,2-a] pyrimidine-4-one.

An immunopharmacological profile of 2, 7-dimethyl-3-nitro-4H pyrido [1,2-a] pyrimidine-4-one (P-I) has been investigated using in vitro and in vivo models representing various features of Type I allergy. P-I prevented compound 48/80-mediated histamine release from rat peritoneal mast cells. A promising anti-inflammatory activity of P-I was evident in active paw anaphylaxis (mice) and carragenan-induced paw edema (rat). P-I inhibited eosonophil accumulation and eosinophil peroxidase activity in bronchoalveolar lavage fluid from ovalbumin challenged balb/c mice: in these animals blood levels of IL-5, and CD4+ T cells also remained attenuated. A promising bronchorelaxant effect of P-I was observed in histamine-contracted guinea pig tracheal chain via its antagonism to H1 receptor. These findings were compared with some known compounds (ketotifen, cetirizine and promethazine). The anti-histaminic, anti-inflammatory and bronchorelaxant activities of P-I has been discussed in context with its potential profile as an anti-allergic and anti-asthmatic agent.

Inhibition of early and late phase allergic reactions by Euphorbia hirta L.

A 95% ethanol extract from whole aerial parts of Euphorbia hirta (EH A001) showed antihistaminic, antiinflammatory and immunosuppressive properties in various animal models. EH A001 inhibited rat peritoneal mast cell degranulation triggered by compound 48/80. It significantly inhibited dextran-induced rat paw edema. EH A001 prevented eosinophil accumulation and eosinophil peroxidase activity and reduced the protein content in bronchoalveolar lavage fluid (BALF) in a 'mild' model of asthma. Moreover, the CD4/CD8 ratio in peripheral blood was suppressed. EH A001 attenuated the release of interleukin-4 (IL-4) and augmented interferon-gamma (IFN-gamma) in ovalbumin-sensitized mouse splenocytes. The results were compared with the effects of known compounds, ketotifen, cetirizine and cyclophosphamide. These findings demonstrated that Euphorbia hirta possessed significant activity to prevent early and late phase allergic reactions.

Anti-inflammatory activity of 'TAF' an active fraction from the plant Barleria prionitis Linn.

'TAF' fraction from the methanol-water extract of Barleria prionitis Linn. was evaluated for anti-inflammatory and anti-arthritic activities against different acute and chronic animal test models. It exhibited significant anti-inflammatory activity against different inflammagens like carrageenan, histamine and dextran. The anti-inflammatory activity in adrenalectomised rats was maintained showing that the effect of fraction 'TAF' is not activated by the pituitary-adrenal axis. Significant anti-arthritic activity was observed in adjuvant-induced polyarthritis test in rats. 'TAF' also showed inhibition of vascular permeability and leucocytes migration in vivo into the site of inflammatory insult.Ibuprofen (Cadilla India Ltd., Mumbai) was used as a standard reference drug. The oral (p.o.) LD(50) was more than 3000mg/kg, with no signs of abnormalities or any mortality observed for 15 days after single-dose drug administration. The intraperitoneal (i.p.) LD(50) was found to be 2530mg/kg (+/-87mg/kg S.E.) [Proceedings of Society of Experimental Biological Medicine 57 (1944) 261].

Anti-inflammatory activity of the hydrosoluble fraction of Euphorbia royleana latex.

The hydrosoluble fraction of Euphorbia royleana latex (AER), administered by gavage at doses of 50-200 mg/kg, showed dose-dependent anti-inflammatory and anti-arthritic effects in different acute and chronic test models in rats and mice. It reduced the exudate volume and the migration of leukocytes and showed a poor inhibitory effect on the granuloma formation induced by cotton pellets, while it had a low ulcerogenic score. The oral LD(50) was more than 1500 mg/kg in both rats and mice.

Anti-inflammatory and anti-arthritic activities of silymarin acting through inhibition of 5-lipoxygenase.

Silymarin, a mixture of flavonolignans, comprised mainly of three isomers, silybin, silydianin and silychristin isolated from the fruits of Silybum marianum, is currently in therapeutic use as a hepatoprotective agent. Silymarin on evaluation exhibited significant antiinflammatory and antiarthritic activities in the papaya latex induced model of inflammation and mycobacterial adjuvant induced arthritis in rats. Results of the study indicate its action through inhibition of 5-lipoxygenase for antiinflammatory and antiarthritic activities.

Anti-inflammatory actions of boswellic acids.

Boswellic acids (BA) demonstrated dose-related anti-inflammatory activity (AIA) in acute tests of carrageenan-, histamine- and dextran-induced edema in rats and mice. It elicited inhibitory action on vascular permeability in mice induced by acetic acid. Marked AIA was observed in chronic models of adjuvant-induced polyarthritis and formaldehyde arthritis in rats and bovine serum albumin-induced arthritis in rabbits. It produced significant protective effects in sodium urate gouty arthritis in dogs. BA reduced exudate volume and inhibited leucocyte migration in carrageenan-induced pleurisy in rats. It did not affect the parturition period in pregnant rats or castor oil-induced diarrhea in rats. It failed to exhibit any analgesic or ulcerogenic effects. BA elicited antipyretic activity in rats and rabbits. LD(50) of BA was found to be greater than 2 g/kg in rats and mice when administered orally or intraperitoneally.

Toxicity and safety evaluation of boswellic acids.

The acute, sub-acute and chronic toxicity studies on boswellic acids (BAs) were carried out on mice, rats and monkeys. BAs did not cause any mortality in rats and mice when administered orally and intraperitoneally in doses up to 2 g/kg. Daily oral administration of BAs in three doses (low and very high) to rats and monkeys revealed no significant changes in general behaviour, or clinical, haematological, biochemical and pathological data. BAs, therefore, can be regarded as safe for clinical studies.

Actions of some flavonoids on specific and non-specific immune mechanisms.

The immunomodulatory activity of some flavonoids on antigen specific humoral and cell mediated immune responses and complement-mediated hemolysis has been investigated and compared with that of levamisole. Flavanone, 6-methoxyflavanone, 7-methoxyflavanone and bavachinin enhanced the sheep erythrocyte (SRBC), induced primary and secondary humoral immune responses in mice, and 6-hydroxyflavanone, 7-hydroxyflavanone and rutin inhibited primary response. Levamisole slighly stimulated the primary and suppressed the secondary response. All the flavonoids tested decreased the manifestation of SRBC induced delayed type hypersensitivity reaction and showed no effect on classical or alternative pathway dependent hemolysis. The studies revealed the significant immunomodulatory potential of these flavonoids, methoxy derivatives having immunostimulatory activity and hydroxy derivatives immunosuppressive properties.

2-(2,3-dimethylchromon-6-yl) propanoic acid (OVS-103): a potent anti-inflammatory agent.

The compound OVS-103 showed dose-dependent anti-inflammatory and anti-arthritic effects in different acute and chronic test models in rats and mice. It produced inhibition of the exudate volume and the migration of leucocytes in the carrageenan induced pleurisy test in rats. OVS-103 showed poor inhibitory effect on granuloma formation induced by cotton pellet and had no anti-pyretic and analgesic property. ALD50 in both rats and mice was more than 2000 mg/kg, p.o. and 1500 mg/kg, i.p.

Anti-inflammatory properties of 3-methylpyrazolin-5-(4 H)-one-4-[3'-methoxy-4' (2'',3'',4'',6''-tetra-O-acetyl-beta-D-glycopyranosyl]benzylidene (compound IIIA).

Oral treatment of compound IIIA exhibited dose related inhibitory action in acute tests of carrageenan, histamine and dextran-induced oedema in rats. Marked inhibitory action of the compound was found when it was administered intraperitoneally in animals. It displayed prominent anti-arthritic activity in chronic tests of adjuvant and formaldehyde-induced arthritis in rats. It prevented the arthritis associated rise in total leucocyte count and erythrocyte sedimentation rate. It also lowered the levels of exudate volume and migration of leucocytes in carrageenan induced pleurisy in rats. It did not exhibit any analgesic, antipyretic or ulcerogenic effect. No mortality was recorded up to 2 g/kg in mice on oral or intraperitoneal treatment over a period of 72 hr.

Anti-inflammatory activity of oleanolic acid in rats and mice.

Oleanolic acid displayed anti-inflammatory activity in carrageenan and dextran-induced oedema in rats. It elicited marked anti-arthritic action in adjuvant-induced polyarthritis in rats and mice and in formaldehyde-induced arthritis in rats. Oleanolic acid checked the inflammation-induced increased serum transaminase levels. It reduced exudate volume and inhibited leucocyte infiltration in carrageenan-induced pleurisy in rats. It is devoid of any analgesic, antipyretic or ulcerogenic action. Oleanolic acid did not affect the parturition time in pregnant rats or castor oil-induced diarrhoea in rats. Oral LD50 was found to be greater than 2 g kg-1 in mice and rats.

Hypotensive action of a Coscinium fenestratum stem extract.

A 50% ethanol extract of Coscinium fenestratum stem material (AECF) has been found to possess hypotensive action in anaesthetised dogs, rats and guinea pigs in a dose-related pattern. The fall in blood pressure was not modified by alpha and beta adrenergic blockers, cholinergic and histaminergic antagonists or by ganglion blocking agents. The effect was more pronounced in spinal-transected animals. AECF non-specifically inhibited the pressor responses to epinephrine, norepinephrine, DMPP and depressor responses to acetylcholine and histamine. AECF failed to exhibit any hypotension when administered via cannula into the lateral cerebral ventricle. Given orally to mice, AECF did not exhibit grossly observable central nervous effects up to doses of 800 mg/kg. The oral LD50 was estimated to be 1200 mg/kg in mice.

Anti-arthritic activity of boswellic acids in bovine serum albumin (BSA)-induced arthritis.

The effect of boswellic acids on bovine serum albumin (BSA)-induced arthritis in rabbits was studied. Oral administration of boswellic acids (25, 50 and 100 mg/kg/day) significantly reduced the population of leucocytes in a BSA-injected knee and changed the electrophoretic pattern of the synovial fluid proteins. The local injection of boswellic acids (5, 10 and 20 mg) into the knee 15 min prior to BSA challenge also significantly reduced the infiltration of leucocytes into the knee joint, reduced the infiltration of leucocytes into the pleural cavity and inhibited the migration of PMN in vitro. The leucocyte-inhibitory activity of boswellic acids was not due to its cytotoxic effect. The boswellic acids did not show any detergent or surfactant properties.