Comparison of different diagnostic modalities for isolation of Mycobacterium Tuberculosis among suspected tuberculous lymphadenitis patients

Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.

Glycogen synthase kinase-3 (GSK-3) a magic enzyme: it’s role in diabetes mellitus and glucose homeostasis, interactions with fluroquionlones. A mini-review

Diabetes mellitus (DM) is a non-communicable disease throughout the world in which there is persistently high blood glucose level from the normal range. The diabetes and insulin resistance are mainly responsible for the morbidities and mortalities of humans in the world. This disease is mainly regulated by various enzymes and hormones among which Glycogen synthase kinase-3 (GSK-3) is a principle enzyme and insulin is the key hormone regulating it. The GSK-3, that is the key enzyme is normally showing its actions by various mechanisms that include its phosphorylation, formation of protein complexes, and other cellular distribution and thus it control and directly affects cellular morphology, its growth, mobility and apoptosis of the cell. Disturbances in the action of GSK-3 enzyme may leads to various disease conditions that include insulin resistance leading to diabetes, neurological disease like Alzheimer’s disease and cancer. Fluoroquinolones are the most common class of drugs that shows dysglycemic effects via interacting with GSK-3 enzyme. Therefore, it is the need of the day to properly understand functions and mechanisms of GSK-3, especially its role in glucose homeostasis via effects on glycogen synthase.

Air-Liquid-Interface Differentiated Human Nose Epithelium: A Robust Primary Tissue Culture Model of SARS-CoV-2 Infection

The global urgency to uncover medical countermeasures to combat the COVID-19 pandemic caused by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has revealed an unmet need for robust tissue culture models that faithfully recapitulate key features of human tissues and disease. Infection of the nose is considered the dominant initial site for SARS-CoV-2 infection and models that replicate this entry portal offer the greatest potential for examining and demonstrating the effectiveness of countermeasures designed to prevent or manage this highly communicable disease. Here, we test an air–liquid-interface (ALI) differentiated human nasal epithelium (HNE) culture system as a model of authentic SARS-CoV-2 infection. Progenitor cells (basal cells) were isolated from nasal turbinate brushings, expanded under conditionally reprogrammed cell (CRC) culture conditions and differentiated at ALI. Differentiated cells were inoculated with different SARS-CoV-2 clinical isolates. Infectious virus release into apical washes was determined by TCID50, while infected cells were visualized by immunofluorescence and confocal microscopy. We demonstrate robust, reproducible SARS-CoV-2 infection of ALI-HNE established from different donors. Viral entry and release occurred from the apical surface, and infection was primarily observed in ciliated cells. In contrast to the ancestral clinical isolate, the Delta variant caused considerable cell damage. Successful establishment of ALI-HNE is donor dependent. ALI-HNE recapitulate key features of human SARS-CoV-2 infection of the nose and can serve as a pre-clinical model without the need for invasive collection of human respiratory tissue samples.

Association between county-level risk groups and COVID-19 outcomes in the United States: a socioecological study

Background Geographic heterogeneity in COVID-19 outcomes in the United States is well-documented and has been linked with factors at the county level, including sociodemographic and health factors. Whether an integrated measure of place-based risk can classify counties at high risk for COVID-19 outcomes is not known. Methods We conducted an ecological nationwide analysis of 2,701 US counties from 1/21/20 to 2/17/21. County-level characteristics across multiple domains, including demographic, socioeconomic, healthcare access, physical environment, and health factor prevalence were harmonized and linked from a variety of sources. We performed latent class analysis to identify distinct groups of counties based on multiple sociodemographic, health, and environmental domains and examined the association with COVID-19 cases and deaths per 100,000 population. Results Analysis of 25.9 million COVID-19 cases and 481,238 COVID-19 deaths revealed large between-county differences with widespread geographic dispersion, with the gap in cumulative cases and death rates between counties in the 90th and 10th percentile of 6,581 and 291 per 100,000, respectively. Counties from rural areas tended to cluster together compared with urban areas and were further stratified by social determinants of health factors that reflected high and low social vulnerability. Highest rates of cumulative COVID-19 cases (9,557 [2,520]) and deaths (210 [97]) per 100,000 occurred in the cluster comprised of rural disadvantaged counties. Conclusions County-level COVID-19 cases and deaths had substantial disparities with heterogeneous geographic spread across the US. The approach to county-level risk characterization used in this study has the potential to provide novel insights into communicable disease patterns and disparities at the local level.

Impact of Covid-19 Pandemic on Patients with Non-Communicable Disease: An Observational Cross-Sectional Study at AYUSH Set Ups of Krishna and Darjeeling District, India

Objective: To determine the impact of covid-19 in patients suffering from NCDs in terms of their knowledge, awareness, perception about COVID-19, use of AYUSH immune boosters, and management of chronic condition during the pandemic. Method: During the unlock down period (October 2020), a cross-sectional study was conducted in the Krishna and Darjeeling district of Andhra Pradesh and West Bengal, India. 499 individuals suffering from at least one chronic disease were interviewed using a structured questionnaire. Logistic regression was applied to investigate the relationship of socio-demographic characteristics with pandemic-related care challenges, Ayush Immune boosters(AIB). Principal Component Analysis was applied to minimize the dimensionality of factors related to covid care challenges. Results: 499 individuals were surveyed. 91% identified at least three correct covid appropriate behaviour. 92.2% considered the coronavirus to be a potential threat (mean±sd: 5.8±2.6). 44.7% and 55.3% lived with one and 2 or more chronic conditions respectively. Hypertension alone (27.4%) and diabetes with hypertension (33%) were leading presentations. Out of 499, participants, 88.8% had at least one form of AIB. 52% took Ars. alb with other AIB and 40% took Ars. alb. alone. Only 09 participants were infected from Covid-19. Conclusion: In the interest of a densely populated country like India, the inclusion of simple and safe AYUSH measures is realistic, ethical and cost-effective. Ayush interventions as Covid-19 prophylactic and treatment as well as Integrative care of chronic illnesses such as NCDs is suggested.

The needs, challenges, and burden experienced by informal caregivers in Uganda: a scoping review

Background The impact of informal caregiving is increasingly recognised as an important but often particularly neglected area of research in low and middle income countries. It is important to understand not only the effect of care on patient outcomes, but also the impact of caring on caregivers’ health and wellbeing. Methods Guided by the Arksey and O’Malley (Res Methodol 8:19–32, 2005) framework, this scoping review sought to collate and chart existing research on the needs, burdens and challenges experienced by caregivers in Uganda. Results The results of this review indicate that research focusing on the needs of caregivers for individuals with communicable disease, particularly HIV, has been well developed in Uganda, however, there is a lack of research on caregiving related to non-communicable diseases. Research has been dominated by small qualitative studies that are informative for understanding roles, burdens and contextually-specific aspects of care, but there is a need for larger studies that develop and test interventions designed to support the needs of caregivers. Conclusions Recurrent themes identified within this review, such as challenges in providing physical support and accessing treatment services, financial costs of care, psychological and mental health impacts and the experience of stigma, should help to inform well targeted and contextually-appropriate future research and interventions.

Deteksi dini faktor resiko kanker payudara pada wanita di wilayah kerja Puskesmas Batoh Banda Aceh

Background: Breast cancer is an abnormal growth of cells that form in breast tissue. In Aceh, breast cancer is the third most non-communicable disease with most breast cancer patients having a period of late treatment. The results of research on women in Lueng Bata District Banda Aceh City in 2015 found data that the majority of respondents had never had regular breast examinations. This can result in breast cancer being detected at an advanced stage where the therapy often cannot make the patient recover and end up in pain and death. To prevent the occurrence of these problems, health promotion is held about breast cancer and breast self-examination (BSE).Objectives: This study aims to increase women's knowledge and understanding of breast cancer and increase awareness for early detection and appropriate treatment.Methods: was carried out for 3 days from 12 to 14 September 2018 to the community in the work area of the Batoh Health Center in Banda Aceh. The method used is filling out questionnaires, lectures accompanied by questions and answers to explain risk factors, early signs of breast cancer, as well as demonstrations of breast self-examination.Results: From the evaluation of the results obtained from the community service activities, among others, is to increase awareness and understanding of the community, especially women about breast cancer and breast self-examination. It is thus expected to continue on a will that is applied in daily behavioral changes to prevent and routinely examine breast cancer in order to prevent complications and improve quality of life.Conclusion: There is an increase in knowledge and understanding of the meaning, risk factors, early signs and symptoms of breast cancer, and how to detect breast cancer early.