Prevalence and Molecular Characterization of Giardia duodenalis Assemblage D of Dogs in Egypt, and Its Zoonotic Implication

Background, Methods: To elucidate the prevalence and molecular characterization of Giardia infection in dogs, a cross-sectional study was performed on stray and housed dogs from different localities of Egypt. Results: A total of 986 fecal specimens were collected from dogs. The overall infection rate was 8.5%. The diarrheic dogs revealed higher prevalence of 14.43% than asymptomatic animals. The infection was more prevalent in younger dogs ( < 6 months) (9.5%) compared to older animals. Higher prevalence of infection was observed during the cold winter months (11.24%). The community owned dogs (stray dogs in the street) showed (11.75%) higher prevalence rate than pet dogs in the household environment (5.59%). Moreover, it was found that dogs fed on undercooked meat, and offal's were showing higher prevalence of giardiasis than dogs fed on canned meat. On the other hand, dogs subjected to regular grooming and good hygienic practices had lesser prevalence rate of the infection compared to unclean neglected dogs. Conclusions: The sequencing and phylogenetic analysis of the amplicons of 18SrRNA gene of G. duodenalis revealed that; they were closer to assemblage D necessitating urgent attention due to their zoonotic importance.

Fasciitis by Lactococcus garvieae on an immunosuppressed patient by Diabetes Mellitus

Lactococcus garvieae, a gram-positive anaerobe facultative coccus, is a well-known pathogen in the aquaculture and cattle sector, being extremely rare for human beings. There are some case reports of infections caused by this microorganism, however, there are no fasciitis cases up to date. This is a case of a 24-year-old patient with uncontrolled diabetes mellitus and previous COVID-19 pneumonia without sequelae, admitted to the emergency room for a case compatible with fasciitis. Three cultures for L. garvieae were obtained from surgical debridement and microbiological studies were performed using automated VITEK-2 equipment. No posterior complications were documented. The patient went through a skin graft with a favorable response without evidence of clinical relapse.

Ex vivo Study of Antimalarial Activity of Canarium Odontophyllum Leaf Extracts Against Plasmodium Berghei NK65

Background: Malaria is a parasite that is transmitted to human through the bite of a female Anopheles mosquito. Every year human was exposed to the threat of malaria infection. This disease becomes more fatal as these parasites show resistance towards the drug available. Thus, searches for new antimalarial drug are crucial. This study was carried out to evaluate the antimalarial activity in Canarium odontophyllum leaf extracts (methanol, acetone and aqueous) against erythrocytes infected with Plasmodium berghei NK65 using Plasmodium Lactate Dehydrogenase (pLDH) Assay and SYBR green I fluorescence Assay. Method: Three types of solvents were used to extracts Canarium odontophyllum leaf according to increasing polarity index; acetone, methanol and aqueous. These extracts were made into eight-fold serial dilution; concentrations ranging from 0.00001μg / ml as the lowest concentration until 100 μg / ml as the highest concentration and further tested on Plasmodium berghei NK65 infected erythrocytes via ex-vivo. The IC50 (inhibition concentration) 50 readings were taken at the point of 5% parasitemia level and in the synchronization process. Both PLDH assay and SYBR green I fluorescence assay were being carried out simultaneously. Result: The One-way ANOVA showed that there is no significant difference between extracts at 5% parasitemia level, even so methanol was further tested on synchronization process as it showed the lowest reading of IC50 among the three extracts for PLDH assay and SYBR green I fluorescence assay respectively, (IC50 0.00045μg / ml, 0.002 μg / ml). For synchronization stages, the One-way ANOVA result showed there is no significant difference between stages of morphology. However, methanol extracts showed the most potent on schizont, (1.16x10-5 μg / ml ) and young trophozoite, (0.00195 μg / ml ) stages for each method respectively. Conclusions: All three extracts of Canarium odontophyllum leaf were effective on Plasmodium berghei NK65, however methanol showed most promising results and further research on the fractions were required for proper drug development. The Ministry of Higher Learning funded this project, Government of Malaysia, under the Fundamental Research Grant Scheme Code No. FRGS/2/2014/SG05/UKM/02/3.

Impact of three consecutive intravenous doses of tocilizumab in severe COVID-19 pneumonia: a retrospective cohort study

Background. Acute respiratory distress syndrome (ARDS) in severe COVID-19 pneumonia is mostly responsible for high mortality rate. Tocilizumab, an interleukin-6 (IL-6) inhibitors, down-regulates the progression of cytokine storm leading to ARDS. Objectives. The study aimed to assess the clinical outcomes of three consecutive intravenous doses of tocilizumab in patients with severe COVID-19 pneumonia. Methods. This retrospective observational study was conducted on severe COVID-19 pneumonia patients in a single-center who were treated with three intravenous dose of tocilizumab (8 mg/Kg of body weight, max 800 mg per dose × 3) along with intravenous dexamethasone. Three doses of tocilizumab-associated changes in respiratory function, clinical outcomes and mortality rate were analyzed. Results. Seventy-four patients (N) received intravenous tocilizumab therapy. After third intravenous dose of tocilizumab (48-72 h apart from the second dose), SpO2 (blood oxygen saturation) was increased and the requirement of supplemental oxygen (RSO) was decreased more than after the second dose [Median: 96.5% (IQR: 96-98%) and Median: 0 (IQR: 0-1 L), respectively versus Median: 92% (IQR: 91-92%) and Median: 6 L (IQR: 5-7.2 L, respectively] (P <0.05). SpO2 was normalized in 78.4% of patients (P=0.001) treated with three doses of tocilizumab. Further RSO and demand of invasive mechanical ventilation support were increased in 21.6% (58/74 patients) and 14.8% (11/74 patients) of patients, respectively with a 30-day mortality rate of 4% (3/74 patients). Tocilizumab therapy was well tolerated in all patients. Conclusions. An additional third intravenous dose of tocilizumab improved clinical outcomes and reduced mortality rate in patients with severe COVID-19 pneumonia.

Sensitivity and specificity of a rapid diagnostic test for chronic Chagas disease at a referral center in Brazil - can it be included as a standard serological diagnostic test in the clinical practice of a referral center?

Introduction: Chagas disease (CD) is a neglected tropical disease. In the chronic phase of CD, the diagnosis is essentially serologic. Conventional reactions are currently in use. More recently, the use of rapid diagnostic testing (RDT) is indicated when conventional techniques are not available. Objective: To evaluate the sensitivity and specificity of RDTs for chronic CD diagnosis. Methodology: Individuals under suspicion of CD were evaluated using ELISA, Chemiluminescence (ChLIA) and RDT tests. Results: The RDT showed 95.1% sensitivity and 96.7% specificity, respectively. Conclusion: The findings of the present study showed that RDT used in the diagnosis of CD at a referral center in Brazil were not able to detect all CD cases when compared to Elisa and ChLIA.

Description of human infestations by ticks in Panama and Costa Rica

Tick bites in humans are associated with the transmission of pathogens, anaphylactic shock, paralysis, and secondary infections. In this work we described six cases of tick bites in patients from Panama and Costa Rica. These bites were provoked for adults of Ornithodoros puertoricensis, Amblyomma cf. oblongoguttatum, Amblyomma ovale, and Ixodes cf. boliviensis, and a nymph of Amblyomma mixtum. The relationships of these species of ticks with the environment are explained. Among the reactions observed in the patients there are blisters, maculo-papular rash, granuloma, lymphadenopathy, and erythema migrans-like rash, but none referred symptoms compatible with an infectious disease. In the collected ticks a PCR battery was developed to rule out Borrelia, Rickettsia, Anaplasmataceae, and Coxiella diseases to the ticks from the cases 1, 2, 3 and 4, with negative results. Although no pathogen infections were evidenced, these finding indicate that the tick bites constitute a public health problem what goes unnoticed in many countries.

Evaluation of PORT/PSI and SOFA scores in predicting in-hospital mortality of patients with COVID-19

Introduction: There is limited information analyzing the utility of different prognostic scores in predicting in-hospital mortality among patients with COVID-19. This study aimed to evaluate the performance of PORT/PSI and SOFA scores in predicting the in-hospital mortality of patients with COVID-19. Material and methods: This was an observational, analytical, and retrospective study that included consecutive patients hospitalized for COVID-19 from April 1, 2020, to May 31, 2020. The study population was characterized, and ROC analysis was performed and used to calculate the area under the curve of PORT/PSI and SOFA scores as well as the sensitivity, specificity, and predictive values. Results: A total of 151 patients were included, with a median age of 52 years (IQR 45-64); 69.5% were men, with a median BMI of 29.3 kg/m2 (IQR 25.5-34.7). Of the total, 102 patients died during hospitalization (67.5%). The areas under the ROC curves for predicting in-hospital mortality were 0.74 (95% CI 0.67-0.81) for the SOFA score and 0.85 (95% CI 0.78-0.90) for the PORT/PSI score. When compared, the PORT/PSI score predicted mortality significantly better than the SOFA score (p: 0.01). Conclusions: The PORT/PSI score is a good tool to predict in-hospital mortality in patients with COVID-19.

Our Overall Current Knowledge of Covid 19: An Overview

The World Health Organization (WHO) declared COVID-19 as a public health epidemic emergency of international concern in March 2020. In just two years, this pandemic has invaded most countries and killed more than 4,800,000. The evolution of the number of cases and contaminations per day remains alarming. In May 2021, the bar of 400,000 new cases was crossed in India; this represents the highest daily number of cases recorded by a country in the history of the COVID-19 pandemic. In addition, new variants of the virus emerged in some countries. The international scientific and political community has organized itself and engaged in a race against time to find possible remedies. During this period, when people were forced to confine themselves to their homes, the way of life changed remarkably. From the declaration of the pandemic to the conception of the first vaccine, people are still in shock. This article is a short-review that explains in general what the COVID-19; the origin, biology and genetics as well as the mode of transmission and contamination of the coronavirus are discussed.

Well-Designed Studies are Needed to Assess Adverse Effects on Healthy Lung Function after Long-Term Face Masks Usage

Face coverings, especially cloth masks, were the critical personal protective equipment during the COVID-19 pandemic. The advantages of such masks were well understood and widely used across the world. With this idea in mind, we have reviewed the available data and literature to identify whether masks exert an untoward effect on lung function in otherwise healthy persons. Interestingly enough, we have found no well-designed studies to assess whether masks have an unintended negative consequence on healthy lung function. Moreover, we are also aware that there could exist a differential impact of facial coverings depending on the type of masks exposed to. In addition, there could also be some ethical challenges in order to implement these cohort studies. We are recommending the need for thorough evaluations of long term mask utilization.