Research Trends and Hotspots of Q Fever Research: A Bibliometric Analysis 1990-2019

Q fever is a worldwide distributed zoonosis caused by Coxiella burnetii, a Gram-negative bacterium. Despite existence of large amount of research data on the developments related to Q fever, no bibliometric analysis of this subject is available to our knowledge. Bibliometric studies are an essential resource to track scholarly trends and research output in a subject. This study is aimed at reporting a bibliometric analysis of publications related to Q fever (2,840 articles published in the period 1990-2019) retrieved from Science Citation Index Expanded, an online database of Clarivate Analytics Web of Science Core Collection. Data was retrieved using keywords “Q fever” or “Coxiella burnetii” in title, abstract, and author keywords to describe important research indicators such as the kind and language of articles, the most important publications, research journals and categories, authors, institutions, and the countries having the most significant contribution to this subject. Finally, the emerging areas in field of diagnosis, host range, and clinical presentation were identified. Word cluster analysis of research related to Q fever revealed that major focus of research has been on zoonosis, seroprevalence, laboratory diagnosis (mainly using ELISA and PCR), clinical manifestations (abortion and endocarditis), vectors (ticks), and hosts (sheep, goat, and cattle). This bibliometric study is intended to visualize the existing research landscape and future trends in Q fever to assist in future knowledge exchange and research collaborations.

Borrelia Ocular Infection: A Case Report and a Systematic Review of Published Cases

<b><i>Introduction:</i></b> Lyme borreliosis can cause many diverse manifestations, also ocular disease where the diagnosis of ocular borreliosis is challenging. The primary aim was to report on the evidence of <i>Borrelia spirochetes</i> in the ocular tissue in presumed ocular borreliosis. <b><i>Methods:</i></b> A systematic review of pathological eye conditions was performed where <i>Borrelia</i> has been suspected in relevant ocular tissue, together with a case report of diagnosed uveitis with polymerase chain reaction (PCR)-confirmed <i>Borrelia afzelii</i> in the vitreous. The evidence for clinical and laboratory diagnosis was evaluated systematically. As a secondary aim, the treatment of ocular <i>Borrelia</i> infection was also evaluated for confirmed cases. <b><i>Results:</i></b> Thirteen includable studies were found, and after the removal of case duplicates, eleven unique cases were extracted. Apart from the present case report, 4 other cases reported strong evidence for the detection of <i>B. spirochetes</i> in ocular tissue. Four cases presented reasonable evidence for assumed detected <i>Borrelia</i>, while three additional cases showed only weak diagnostic credibility that <i>Borrelia</i> was detected. <b><i>Conclusion:</i></b> This systematic review, including all reported cases and our case report, supports evidence of ocular infection of <i>Borrelia</i> species. Furthermore, in case of suspicion of infection and seronegativity, it is justified to look for <i>Borrelia</i> in eye tissue samples. In addition, microscopy without using PCR is not sufficient to confirm the diagnosis of borreliosis on ocular tissue. In the articles studied, there was no unambiguous recommendation of treatment.

Tuberculosis and Diabetes in India: Stakeholder Perspectives on Health System Challenges and Opportunities for Integrated Care

Background India has a dual burden of tuberculosis (TB) and diabetes mellitus (DM). Integrated care for TB/DM is still in the early phase in the country and can be considerably enhanced by understanding and addressing the challenges identified from stakeholders’ perspectives. This study explored the challenges and opportunities at individual, health system and policy level for integrated care of TB/DM comorbidities in India. Methods We used an outlier case study approach and conducted stakeholder interviews and focus group discussions with relevant program personnel including field staff and program managers of TB and DM control programs as well as officials of partners in Indian states, Kerala and Bihar. Results The integrated management requires strengthening the laboratory diagnosis and drug management components of the two individual programs for TB and DM. Focused training and sensitization of healthcare workers in public and private sector across all levels is essential. A district level management unit that coordinates the two vertical programs with a horizontal integration at the primary care level is the way forward. Substantial improvement in data infrastructure is essential to improve decision-making process. Conclusion Bi-directional screening and management of TB/DM comorbidities in India requires substantial investment in human resources, infrastructure, drug availability, and data infrastructure.

HIV-child with disseminated Talaromyces Marneffei (Penicillium marneffei) infection: a rare severe case report

Background Talaromyces Marneffei (Penicillium marneffei, T.marneffei) has been frequently reported in patients with adult acquired immunodeficiency syndrome. Still, cases of children with HIV combined with T.marneffei infection are very rare. This report describes the case of a HIV-child who is a girl from China. Her special clinical manifestations and laboratory diagnosis results can provide clinicians with the basis for diagnosis and treatment of T.marneffei related rare diseases. Case presntation We reported a single case of 7-year-old Chinese female patient who presented with fever, abdominal pain, multiple lymphadenopathy, hepatosplenomegaly, left lower extremity ecchymosis, and bloody stool. The patient received anti-inflammatory therapy; however, her symptoms did not improve. Consequently, she was diagnosed with T.marneffei and HIV infection; it was also confirmed that her mother did not undergo HIV blocking therapy during pregnancy. Yet, the child’s family refused all treatment, after which the child was discharged from the hospital. The patient died a few days later. Conclusion This case suggested that children with AIDS suffering from fever, lymphadenopathy and coagulation dysfunction, penicilliosis should be suspected. Clinicians should diagnose the disease early through laboratory and imaging results, which can help reduce the mortality, prolong the survival time and improve the quality of life of children.

Rapid diagnosis of Toxoplasma gondii using loop-mediated isothermal amplification assay in camels and small ruminants

Background This study was conducted to detect the presence of T. gondii in milk and blood samples using three different assays: enzyme-linked immunosorbent assay (ELISA), polymerase chain reaction (PCR), and loop-mediated isothermal amplification assay (LAMP). Whole blood, serum, and milk samples were collected from goats (n = 156), sheep (n = 261), and camels (n = 108) in different governorates in Egypt from December 2019 to February 2021 and screened by ELISA for anti-Toxoplasma IgG antibodies before DNA extraction. The target T. gondii DNA gene was detected and evaluated using the LAMP assay compared to PCR. Results T. gondii antibodies were found in milk and serum samples at the rates of (29.26%) and (36.58%) in camels, (34.18%) and (35.89%) in sheep, and (33.7%) and (36.36%) in goats, respectively. Similar to PCR, the percentages of LAMP tests for the detection of the T. gondii DNA gene in milk and blood samples of camels, sheep, and goats were (4.8, 14.63), (6.83, 7.69), and (7.79, 9.09), respectively. LAMP's sensitivity for detecting T. gondii in milk and blood samples, which was identical to that of PCR, was 100%. Conclusions The findings clearly demonstrated that there were no variations in T. gondii detection capabilities in milk and blood samples from various animals using both PCR and LAMP tests. It provides a quick, precise, and sensitive method of detecting T. gondii in a variety of samples that may be used both in the field and in laboratory diagnosis.

Possibilities of cytological diagnostics in gynecology. Human papillomavirus as an interdisciplinary problem

The article presents an analysis of current information on the etiology, pathogenesis, laboratory diagnosis of human papillomavirus. It is shown that at the current stage of development of laboratory diagnostics there is a reliable screening test — cytological examination of smears taken from the ecto- and endocervix. To diagnose HPV, a combination of microscopic (cytological studies) and molecular genetic (PCR) diagnostic methods is used.

Bacterial Causes and their Antimicrobial Susceptibility Testing among Urinary Tract Infection Patients in Tobruk Area, Libya

Urinary tract infections are very common among people of all ages, but the disease is more prevalent in women, so proper clinical and laboratory diagnosis, and the right treatment are very important to avoid complications and antimicrobial resistance. This study aimed to determine the bacterial causes and antibiotic susceptibility patterns of UTI patients. Recorded results of 6065 urine sample cultures and their antimicrobial susceptibility tests from the Department of Microbiology in Tobruk Medical Center, Tobruk City, were obtained from September 2016 to December 2018. The data was analyzed and discussed in compare with other studies. The study showed that a UTI is more common in females (78.8%) compared with male patients (21.2%). Gram-negative bacteria accounted for the majority of urinary pathogens (90%), where E. coli alone was (58.4%), klebsiellae (17.4%), Proteus (10.7%), while Pseudomonas species was the least common (3.3%) of the total. While the Gram-positive bacteria S. aureus constituted 9.6% of the total. The study was found statistically significant (P=0.000). The most effective antibiotics against all uropathogens were Imipenem and Amikacin, and less effective antibiotics were Ampicillin and Amoxicillin-clavulanic acid. This study concluded that the most common cause of UTI in Tobruk was Escherichia coli and the most effective antibiotics appear to be Imipenem and Amikacin.