Performance Assessment of First-Generation AntiSARS-CoV-2 Serological Assays

The clinical and epidemiological use of SARS-CoV-2 antibody assays is under debate with urgent need to validate and verify the performance of SARS-CoV-2 serologic assays. We aim to assess the clinical and analytical performance of three commercial serological assays of SARS-CoV-2, comparing three anti-SARS-CoV-2-IgG ELISA and identifying the seroconversion and seroprevalence in our population. A cross sectional study conducted from April 2020 to July 2020 at National Institute of Blood disease and Bone Marrow Transplantation Karachi, Pakistan with sample size of 404, enrolled consecutively. Participants were categorized into four groups namely convalescent plasmadonors (CPDs n=239), health care professionals (HCPs n=44), healthy blood donors (HBDs n=70) and from community (n=51). We evaluated the performance of Elecsys anti-SARS-CoV-2 electrochemiluminescence (ECLIA) assay on Cobas-e411 by Roche, three qualitative anti-SARS-CoV-2-IgG enzyme linked imunosorbant assay (ELISA) by (Generic assays, Euroimmun & Omega diagnostics), one quantitative ELISA assay by AESKU Diagnostics and two immune chromatography(ICT) kits namely InstaTest by CORTEZ and TEST IT by TURKLAB. From total 404 subjects, 322 (83.5%) were males. Mean age was 36.79{+/-}11.95 years. Among 239 in CPDs group, 202(84.5%) showed positive antibodies by ECLIA. The qualitative anti-SARS-CoV-2 IgG ELISA was positive in 174 (72.8%) and quantitative IgG in 180(75.3%) with mean titer of 56.7 {+/-}39.7 U/ml. Sensitivity and specificity of ECLIA were 97.44& 99%, ELISA by Generic assays were 67.85% and 89.9%; Euroimmun had 90.38% and 94.9%; Omega Diagnostics 96.4% and 95% and the AESKULISA 93.75% and 100% respectively. Seroconversion was found to be 53.8% and 77.77% within 7 -8 days and 12 to 14 days post onset of symptoms respectively. ICT had more specificity but less sensitivity. Seroprevalence was found to be 84.5%, 40.9% and 21.4% in CPDs, HCPs and HBDs respectively. The Roche ECLIA, qualitative ELISA by Omega Diagnostics & Euroimmun showed higher sensitivity as well as higher specificity. Quantitative ELISA has higher specificity and relatively high sensitivity. Significant numbers of COVID patients do not have detectable antibodies by all assays.

Impact of Emergency Medical Services Activation of the Cardiac Catheterization Laboratory and a 24-Hour/Day In-Hospital Interventional Cardiology Team on Treatment Times (Door to Balloon and Medical Contact to Balloon) for ST-Elevation Myocardial Infarction.

The incremental benefit of emergency medical services (EMS) activation of the cardiac catheterization laboratory (CCL) for ST-elevation myocardial infarction (STEMI) in the setting of an established in-house interventional team (IHIT) is uncertain. We evaluated the impact of EMS activation on door-to-balloon (D2B) time and first medical contact-to-balloon (FMC2B) time for STEMI when coupled with a 24-hour/day IHIT. All patients presenting with STEMI to Loyola University Medical Center had demographic, procedural, and outcome data consecutively entered in a STEMI Data Registry. From 223 consecutive patients presenting between April 2009 and December 2015, a retrospective analysis was performed on 190 patients. Patients were divided into 2 groups depending on CCL activation mode (EMS activation or emergency department activation) and STEMI treatment process times were compared. The primary end point was D2B process times. The secondary end point was FMC2B process times in a subgroup analysis of EMS-transported patients. D2B times were shorter (37 ± 14 minutes vs 57 ± 27 minutes, p < 0.001) with EMS activation. Subgroup analysis of EMS-transported patients demonstrated shorter FMC2B times with EMS activation (52 ± 17 minutes vs 67 ± 32 minutes, p = 0.002). EMS activation was the only predictor of D2B ≤60 minutes in multivariable analysis of EMS-transported patients (odds ratio 9.4; 95% confidence interval 2.1 to 43.0; p = 0.04). In conclusion, EMS activation of the CCL in STEMI was associated with significant improvements in already excellent D2B and FMC2B times even in the setting of a 24-hour/day IHIT.

Application of attenuated total reflectance Fourier transform infrared spectroscopy for determination of cefixime in oral pharmaceutical formulations.

A quick and reliable analytical method for the quantitative assessment of cefixime in orally administered pharmaceutical formulations is developed by using diamond cell attenuated total reflectance (ATR) Fourier transform infrared (FT-IR) spectroscopy as an easy procedure for quality control laboratories. The standards for calibration were prepared in aqueous medium ranging from 350 to 6000mg/kg. The calibration model was developed based on partial least square (PLS) using finger print region of FT-IR spectrum in the range from 1485 to 887cm(-1). Excellent coefficient of determination (R(2)) was achieved as high as 0.99976 with root mean square error of 44.8 for calibration. The application of diamond cell (smart accessory) ATR FT-IR proves a reliable determination of cefixime in pharmaceutical formulations to assess the quality of the final product.

Kefir and health: a contemporary perspective.

Kefir and its related products are renowned nutraceutical dairy products produced through fermentation of yeasts and bacteria naturally present in grains of kefir. The nutritional attributes of this self-carbonated beverage are due to presence of vital nutrients such as carbohydrates, proteins, minerals, vitamins, and some nutraceutical components. Antimicrobial activity, better gut health, anticarcinogenic activity, control on serum glucose and cholesterol, control on lactose intolerance and better immune system can be achieved through its regular consumption. Moreover, on the one side kefir is good dietetic beverage, and of particular interest of athletes, and on the other side the whole kefir is good for feeding small babies and pre-schoolers for good tolerance against disease and quick weight gain. Lots of works have been done on kefir from a health point of view. This study summarizes all the data that have been compiled to date. The purpose of this review is to gather information about microbiological, chemical, nutritional, and therapeutic aspects of kefir and kefir-like products to provide justification for its consumption. This review leads us to conclude that kefir begins a new dawn of food for the mankind.

2-(N-Phenyl-methane-sulfonamido)-ethyl 1H-pyrrole-2-carboxyl-ate.

In the title compound, C(14)H(16)N(2)O(4)S, the eth-oxy-carbonyl group is nearly planar, with an r.m.s. deviation of 0.0067 Å, and is almost coplanar with the pyrrole ring [dihedral angle = 5.81 (15)°], whereas it is inclined at a dihedral angle of 61.90 (13)° to the phenyl ring. The dihedral angle between the pyrrole and phenyl rings is 56.15 (13)°. In the crystal, centrosymmetrically related mol-ecules are linked into dimers by pairs of N-H⋯O hydrogen bonds, forming rings of R(2) (2)(10) graph-set motif. The dimers are further connected by weak inter-molecular C-H⋯O hydrogen bonds and C-H⋯π inter-actions, forming layers parallel to the bc plane.

Thrombolysis for saddle pulmonary embolism and 3-chamber thrombus.

Currently, the only widely accepted indication for thrombolysis in cases of pulmonary embolism is hemodynamic instability. However, the presence of a right-heart thrombus along with pulmonary embolism is a poor prognostic indicator, and the use of thrombolytic agents should also be considered in this circumstance. Furthermore, despite a risk of distal embolization, thrombolytic therapy may be implemented if the intracardiac thrombus also straddles a patent foramen ovale. Herein, we present the case of a 92-year-old woman who presented at our institution after a syncopal event and multiple recent episodes of amaurosis fugax. Transthoracic echocardiography revealed a mobile right-heart thrombus that extended through a patent foramen ovale into the left atrium. Computed tomography of the chest showed a saddle pulmonary embolus. We used thrombolytic therapy to treat the patient, and imaging showed complete resolution of the thrombus and the embolism 2 days later.

3-Phenyl-1H-pyrrolo[2,1-c][1,4]oxazin-1-one.

The mol-ecule of the title compound, C(13)H(9)NO(2), is slightly twisted with a dihedral angle of 4.85 (9)° between the nine-membered ring system and the phenyl ring. The nine non-H atoms of the 1H-pyrrolo[2,1-c][1,4]oxazin-1-one system are coplanar [r.m.s. deviation = 0.0122 (2) Å]. In the crystal, weak inter-molecular C-H⋯O inter-actions link mol-ecules into chains along [10]. The crystal studied was an inversion twin with a 0.48624 (9):0.51376 (9) domain ratio.

3-Methyl-1H-pyrrolo[2,1-c][1,4]oxazin-1-one.

In the title mol-ecule, C(8)H(7)NO(2), all the non-H atoms lie essentially in the same plane (r.m.s. deviation = 0.019 Å) In the crystal structure, weak inter-molecular C-H⋯O inter-actions link mol-ecules into chains along [100]. In addition, there are π-π stacking inter-actions between mol-ecules related by the c-glide plane, with alternating centroid-centroid distances of 3.434 (2) and 3.639 (2) Å.

N-[2-(3-Methyl-1-oxo-1,2-dihydro-pyrrolo-[1,2-a]pyrazin-2-yl)eth-yl]methane-sulfonamide.

In the title compound, C(11)H(15)N(3)O(3)S, the dihedral angle between the five- and six-membered rings is 1.13 (18)°. The ethyl-methane-sulfonamide group is in a (+)synclinal conformation. In the crystal, inter-molecular N-H⋯O and C-H⋯O hydrogen-bond inter-actions link mol-ecules into zigzag ribbons parallel to the b axis. The ribbons are further connected by C-H⋯π inter-actions.