The incidence of recurrent vulvovaginal candidiasis (RVVC) is extremely high. RVVC is likely to have a greater impact on patients. The aim of the study was to explore the risk factors of recurrent vulvovaginal candidiasis (RVVC) in the tropical coastal area. In this case-control study, a questionnaire survey was conducted in patients with VVC in the Sanya area from July 2014 to December 2016. The data included demographic characteristics, host factors, and behavioural characteristics. According to the maximum number of symptomatic episodes per year, the participants were classified into a non-recurrent VVC (NRVVC; < 4 episodes/year, including the current one) group or a RVVC group (≥ 4 episodes/year, including the current one). Crude odds ratios were calculated for potential risk factors and were adjusted using logistic regression. All vaginal secretions of patients with RVVC were cultured. Of the 728 cases of VVC, 69.0% (502/728) were NRVVC, and 31.0% (226/728) were RVVC. Previous antibiotic treatment (adjusted OR: 4.41, p < 0.01), repeat abortion (p < 0.05), and vaginal lavage (adjusted OR: 1.62, p < 0.05) were significantly associated with RVVC. A total of 230 yeasts isolates were obtained from 226 patients. C. albicans were the predominant Candida species (194 strains) in all patients of VVC. Our results demonstrate that in the tropical coastal area, a significant association was found between previous antibiotic treatment and incident RVVC. Host factors may be the most important factors in the occurrence of RVVC.
The RNA interference (RNAi) technique is a new modality for cancer therapy, and several candidates are being tested clinically. Nanotheranostics is a rapidly growing field combining disease diagnosis and therapy, which ultimately may add in the development of ‘personalized medicine’.
Technologies on theranostic nanomedicines has been discussed. We designed and developed bioresponsive and fluorescent hyaluronic acid-iodixanol nanogels (HAI-NGs) for targeted X-ray computed tomography (CT) imaging and chemotherapy of MCF-7 human breast tumors. HAI-NGs were obtained with a small size of ca. 90 nm, bright green fluorescence and high serum stability from hyaluronic acid-cystamine-tetrazole and reductively degradable polyiodixanol-methacrylate via nanoprecipitation and a photo-click crosslinking reaction. This chapter presents an over view of the current status of translating the RNAi cancer therapeutics in the clinic, a brief description of the biological barriers in drug delivery, and the roles of imaging in aspects of administration route, systemic circulation, and cellular barriers for the clinical translation of RNAi cancer therapeutics, and with partial content for discussing the safety concerns. Finally, we focus on imaging-guided delivery of RNAi therapeutics in preclinical development, including the basic principles of different imaging modalities, and their advantages and limitations for biological imaging. With growing number of RNAi therapeutics entering the clinic, various imaging methods will play an important role in facilitating the translation of RNAi cancer therapeutics from bench to bedside.
Introduction: Candidiasis is more frequent in human immunodeficiency virus (HIV)-infected patients and knowledge about the distribution and antifungal susceptibility of oral Candida species is important for effective management of candidiasis.
Material and Methods: An oral rinses sample collected from hundred HIV-infected patients with and without clinical evidence of oral candidiasis in this study at the Infectious Department/Tripoli Medical Center, Libya. Species identified by standard phenotypic and conventional methods and in vitro susceptibility testing of the yeast isolates to antifungals were performed using the Disc diffusion method protocol as recommended by the Clinical Laboratory Scientific Institute.
Results: Oral Candida colonization is detected in all patients with and without clinical syndromes, and Candida albicans were accounted for (74%), C. dubliniensis (11%) and C. glabrata (6%). A high proportion of Candida species (42%) showed decreased susceptibility to fluconazole. Among C., albicans more than 30% of isolate were resistant to most new azole antifungal including fluconazole, itraconazole, posoconazole and voriconazole.
Conclusions: A significant number of oral Candida species particular Candida albicans exhibiting decreased susceptibility to fluconazole were isolated from colonized HIV-infected individual, given the high incidence and severity of fungal infections in HIV-infected individuals. The results of this study reinforce the importance of antifungal susceptibility testing, which contributes to the therapeutic strategies and highlights the need for continuous surveillance of Candida colonization in this population.
Biomarkers have been used in the diagnosis of disease and other conditions for many decades. There are diverse ranges of analytical targets, including metabolites, nucleic acids and proteins were used as a biomarker. Clinical diagnoses already rely heavily on these for patient disease classification, management, and informing treatment and care pathways. For that there is always a need of rapid and point of care test. However, until fairly recently, studies of biomarker efficacy in a clinical setting were mainly limited to single or dual use, and the landscape was complex, confused, and often inconsistent. Few candidates emerged from this somewhat clouded picture: C-reactive protein, procalcitonin (PCT) for sepsis, ADA for mycobacterium tuberculosis and a Circulating miRNAs serve as molecular markers for diverse physiological and pathological conditions.
Purpose: The purpose of the study is to access the prevalence of accessory right inferior hepatic veins and their relevant significance in liver transplantation.
Materials and Methods: A retrospective study was done in which the CT of 82 potential liver transplant candidates between January 2012 and March 2013 were reviewed. The presence of the accessory right inferior hepatic vein was examined; the diameters of the accessory inferior hepatic veins and the distance between the point where they open into the inferior vena cava on the coronal plane and to the right hepatic vein-inferior vena cava junction was measured.
Results: Out of 82 patients, 42 (51%) had accessory right inferior hepatic veins. Right accessory inferior hepatic veins larger than 3 mm were detected in 23 (28%) patients. The distance of these veins to the right hepatic vein-inferior vena cava junction was more than 4 cm in 13 (15%) patients.
Conclusion: The precise preoperative knowledge of accessory right inferior hepatic veins is essential in living donor liver transplantation.
The authors describe the unusual case of subungual onychomycosis, due to fluconazole and itraconazole resistant Candida albicans after using the hybrid and acrylic lacquers and nail tips. The etiology of these atypical changes was supported by isolation of the fungus from the nail lesions, and its consistent identification by means of morphological and molecular diagnosis. In the presented case, topical treatment with ciclopirox 8% nail lacquer allow to fight the pathogenic fungus but did not restore the natural appearance of the nails.
Infectious bursal disease (IBD) considered as one of the major viral diseases threatening the poultry industry worldwide. The causative agent of the IBD is Infectious bursal disease virus (IBDV) which replicates in developing B lymphocytes in the bursa of Fabricius leading to its destruction and bursal inflammation. In this study, we investigated a technology to produce therapeutic recombinant antibodies against IBDV in bacteria by constructing a bacterial displayed recombinant scFv library from immunized chickens, followed by screening the scFv library by fluorescence activated cell sorting (FACS) with FITC-labeled VP2. Twelve VP2-binding scFv clones with unique sequences were obtained, with overall amino acid homology of 81.53%. The complementarity determining region (CDR) 3 in the heavy chain displayed the lowest homology, while the amino acid sequences in framework regions and CDR2 of both chains and CDR1 of the heavy chain are relatively conserved. Twelve VP2-binding scFv clones were expressed in E.coli and purified through denaturation and denaturation of inclusion bodies. Our ELISA results showed that all scFvs exhibited binding ability and specificity to VP2 and various IBDV strains. In addition, two scFvs showed significant neutralizing activity to IBDV (B-87 strain) as these scFvs inhibited cytopathic effect of chicken embryo fibroblast (DF1) caused by IBDV. In conclusion, our study provides a lead candidate for further development of therapeutic antibodies for IBDV infection.
Objectives: As the cancer patients are at higher risk of premature deaths due to candidemia. So, the present study aims to evaluate the predictors of candidemia along with its outcomes among hospitalized adults and pediatric cancer patients.
Methods: A retrospective study was conducted at a tertiary care cancer hospital in Lahore, Pakistan. The data was collected from the medical records of all the patients who were found positive for Candida species between 1st January 2017 and 31st June 2017. Data were analyzed by using Statistical Packages for Social Sciences (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) and Microsoft Excel (MS Office 2010).
Results: Overall, 135 patients were detected with candidemia. Based on blood culture test results, it was found that out of 100 cultures positive for any microorganism there were 2 cases of candidemia. Multivariate analysis revealed that hematological malignancies (AOR: 2.1), and shock (AOR: 9.1) were significantly associated with high risk of mortalities during the index hospitalization, while risk of mortality among cancer patients suffering from Candida albican infection (AOR: 0.47) and those who were administered with antifungal agent after sensitivity report of the fungal culture (AOR: 0.2) was significantly less. Also, there was no significant association of empiric therapy of antifungal agent with the risk of mortality before a positive culture found (p>0.05).
Conclusion: Although, no risk factor was found to be associated significantly with candidemia among cancer patients. But hematological malignancies, non-albican candidemia and shock were predictors of higher risk mortality during index hospitalization.
Objective: During aging, skin undergoes structural, cellular and molecular changes, which not only alter skin mechanical properties but also biological and physiological functions. Structurally the epidermis becomes thinner, the dermal epidermal junction flattens and the extra-cellular matrix component of the dermis is disorganized and degraded. The dermis is composed of two compartments: The Reticular dermis is the deepest and thickest part while the upper layer, the papillary dermis, which is much thinner and is in close contact with epidermis, plays an important role in the structure and function of the skin. We have recently shown that the papillary dermis was preferentially affected by skin aging because the activity of fibroblasts in this region was especially altered as a function of age. The purpose of this study was to investigate the capacity of a flax extract as anti-aging component.
Method: We investigated the capacity of a flax extract to stimulate or restore the activity of papillary fibroblasts from young and old donors in cultured monolayers and in reconstructed skin. Several biological markers of extracellular matrix homeostasis and mechanical properties were investigated.
Results: The tested flax extract seemed to improve parameters known to change with age: I/ In monolayers after treatment the number of aged fibroblasts increased II/ In reconstructed skin the flax extract appears to positively regulate some biological activities; particularly in aged fibroblasts where the deposition of laminin 5, fibrillin 1, procollagen I were increased in the dermis and the secretion of specific soluble factors like MMP1, MMP3 and KGF were regulated to levels similar to those observed in young fibroblasts III/ Mechanical properties were improved particularly for elastics parameters (R5, R2 and R7).
Conclusion: The flax extract is a promising anti-aging compound. The treatment of aged papillary fibroblasts resulted in a return to a younger-like profile for some of the studied parameters.
Chronic fatigue syndrome (CFS) is a poorly-understood respiratory condition that affects millions of individuals. Hyperbaric oxygen therapy (HBOT) is a treatment option being considered to address CFS as it is suggested to combat fatigue and increase oxygenation. HBOT provides two opportunities in advancing research of CFS: it may provide data on symptom amelioration and be utilized in the search for a biomarker. By either identifying biomarkers before using HBOT to compare epigenomes of patients before and after treatment or using HBOT to find epigenetic discrepancies between patients with and without treatment, matching epigenetic regulation with symptom amelioration may significantly advance the understanding of the etiology and treatment mechanism for CFS. EPAS1/HIF-2α is a leading candidate for an epigenetic biomarker as it responds differentially to hypoxic and normoxic conditions, which degrades more slowly in hypoxic conditions. Epigenetic regulation of EPAS1/HIF-2α in such differential conditions may be explored in HBOT experiments. In addition to HBOT as a promising treatment option for CFS symptoms, it may aid the identification of biomarkers in CFS. Further research into both outcomes is strongly encouraged.
The outbreak of new coronavirus acute respiratory disease (SARS-CoV-2) has been a major global challenge for the scientific community to save humanity. While, the unviability of the vaccine keeps most classes of society, especially African countries, suffer from the healthcare problem. Conventional medicine plants become the alternative method for the therapeutic because it contains valuable bioactive compounds. This brief review devoted the importance of medicinal plants such as Citrus, olive, garlic, ginger, green tea, woad, broad-leaf privet, Japanese torreya, and saffron crocus, by their antiviral effects (anti-SARS coronavirus, anti-HSV, and anti-HIV diseases) and their promising uses as probable boosters of the immune and anti-inflammatory response from SARS-CoV-2 infection. Based on scientific reports, bioactive compounds could inhibit 3-chymotrypsin-like cysteine protease and human protein ACE2, where these facts can be attractive to develop effective drugs.
Background: Laparoscopic sleeve gastrectomy (LSG) is becoming more popular in the treatment of obesity. LSG is safe with a low morbidity. The complications rarely result in morbidity and even mortality. Leaks are the major complication associated with LSG with a reported prevalence between 1.9% and 2.4%.
Objective: To compare surgical intervention and endoscopic stenting for treatment of gastric leakage after sleeve gastrectomy.
Patients and method: Our study included 30 patients presented with post sleeve leaks discovered by routine postoperative imaging or during the follow up period. Patients were recruited from October 6th university hospital during the period from August 2017 to August 2019. Patients were divided to the following groups: 1) Endoscopy group: This included 15 patients with post sleeve leakage undergoing endoscopic stent insertion. 2) Surgery group: which included 15 patients with post sleeve leak age undergoing surgical management. This division was random.
Results: Our study showed that Endoscopic stenting for management of post sleeve gastrectomy leakage is an effective method with lower morbidity and shorter post-operative hospital stay than surgical management. Some patients may be good candidates for early surgical intervention in type 1 leakage if managed early before dissemination of leakage and before tissues become friable. Complications of stents include stent migration (26%), stent related ulcer (13%) and stricture (13%). while the surgical intervention carries more complications (DVT, chest infection, wound infection and stricture) and longer postoperative hospital stay.
Conclusion: endoscopic management of post-sleeve gastrectomy leakage with stenting is recommended because it successfully manages the leaks and avoids invasive procedures with less risk, with shorter hospital stay and early return of function.
The nemesis: SARS-CoV-2 pandemic: Leaving in its wake millions of infections, accompanied by an immense magnitude of morbidity and multitude of mortality, and an unfathomable economic toll, the COVID-19 pandemic has led to a global calamity. An effective and safe COVID-19 vaccine is urgently needed to prevent the disease, thwart the complications and avert deaths resulting from unrestrained transmission of the infection.
The hubris: Vaccine development: While most of the platforms of vaccine candidates have focused on the spike (S) protein and its variants as the primary antigen of COVID-19 infection, various techniques involved include nucleic acid technologies (RNA and DNA), non-replicating viral vectors, peptides, recombinant proteins, live attenuated and inactivated viruses. There are novel vaccine technologies being developed using next-generation strategies for precision and flexibility for antigen manipulation relating to SARS-CoV-2 infection mechanisms.
The elpis: Updates and prospects: There were nine different technology platforms under research and development to create an effective vaccine against COVID 19. Although there are no licensed vaccines against COVID-19 yet, there are various potential vaccine candidates under development and advanced clinical trials. Out of them, one having undergone phase III clinical trials, has become available in some countries for use among the high-risk groups following emergency use authorization. Other COVID-19 vaccines may soon follow the suit.
Conclusion: Hopes and concerns: The hope of benefiting from the vaccine to the extent that it may be the only way to tide over and control the COVID-19 pandemic, is accompanied by the likely fear of adverse effects and opposition in public for COVID-19 vaccination, including the vaccine hesitancy. Further, there is concern among scientific circles that vaccine may have opposite of the desired effect by causing antibody-dependent disease enhancement.
Introduction: The incidence of STI-HIV/AIDS is on the rise, making adolescents a vulnerable group at risk.
Objective: To increase the knowledge and perception of risk about STI-HIV/AIDS, through Educational Intervention in students of the Polytechnic Institute ¨Hermanos Gómez¨ of the Municipality San José de las Lajas, Mayabeque Province.
Method: Quasi-experimental study, intervention at the ¨Hermanos Gómez Polytechnic Institute, of the Municipality of San José de la Lajas, through affective, participatory, animation and reflection techniques, the universe being made up of 17 students aged 16-17 years of specialty in Industrial Chemistry, during the period from December 2014 to November 2015. The variables used were: knowledge about STI-HIV/AIDS and perception of risk towards said diseases.
Results: after the intervention, an increase in the level of knowledge of the main STIs in the study was evident: Syphilis, Condylomas, HIV/AIDS, Gonorrhea, Trichomonas, Candida Albicans and Herpes simplex, which were adequately identified by 60%; 71% recognized the routes of sexual transmission, 60% the typical clinical manifestations, an increase in the levels of knowledge about the use of condoms to prevent STIs, and in the same way the perception of risk in an 83% after the intervention.
Conclusion: After the intervention, there was an increase in knowledge of STIs, transmission routes, clinical manifestations, condom use, and risk perception.
The day before yesterday, it was shameful for some politicians, especially President Trump, to label SARS-CoV2 virus as discriminatory “Chinese Virus”. Politicians should be more professional and graceful, and distance themselves from the independence of the academy if something remains unknown to them. Besides, there were two months for President Trump to prepare the Americans for this Virus [1]; unfortunately, could he have given more attention to his duty of anti-SARS-CoV2 action, despite spending time to defending against the impeachment of his presidency? Besides, in line with this idea, presidential candidate Hillary Clinton wrote: ”The president is turning to racist rhetoric to distract from his failures to take the coronavirus seriously early on, make tests widely available and adequately prepare the country for a period of crisis. Don’t fall for it. Don’t let your friends and family fall for it”.
The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is the most severe form of congenital malformation of the inner female reproductive tract. It is diagnosed as such when the uterus, the upper vagina and optionally the Fallopian tubes are absent. It accounts for approximately 1 in 5000 live-born females and has been classified in two subtypes: type 1 in the presence of isolated uterovaginal aplasia and type 2 when associated in various combinations with extragenital malformations of the kidneys, skeleton, heart and auditory system. Most cases of MRKH syndrome are sporadic, although a significant number of many familial cases have been reported to date. Despite numerous studies, the genetics of the syndrome remains largely unknown and appears to be heterogeneous: chromosomal abnormalities and some candidate gene variants appear to be associated with a few cases; others have been suggested but not yet confirmed. To date, mainly the GREB1L gene appears to be a serious candidate. Among the remaining hypotheses, the controversial contribution of partial duplications of the SHOX gene is still puzzling, as the deficiency of this gene is a major cause of skeletal adysplasia syndromes. We have attempted to resolve this controversy in a study of 60 MRKH cases. Our results tend to show that SHOX duplications can be the origin of a genetic mechanism responsible for MRKH syndrome.
Oral lichen planus (OLP) is an autoimmune chronic inflammatory disease. The potential risk of malignant transformation in OLP remains controversial. The aim of the present study was to review original clinical studies published in indexed databases, which assessed the potential risk cofactors which were implicated in the malignant transformation of oral lichen planus. We focused our search to include most of the studies that reported malignant transformation of oral lichen planus using different combinations of the following key indexing terms: oral lichen planus, malignant transformation, smoking, alcohol, chronic inflammation, candida, human papillomavirus (HPV), hepatitis C virus (HCV) and immunosuppression. The animal studies were excluded from our study. Despite a dearth of studies on this topic we have identified consumption of tobacco and/or alcohol, the presence of erosive and/or atrophic areas, infection with candida, HCV, HPV, and immunosuppression as significant cofactors. Patients with OLP with these risk co-factors are at risk of malignant transformation should, therefore be followed up for an extensive period or even for life.
Sara Rizwan Uppal, Aftab Ahmad Khan, Umar Saeed*, Zahra Zahid Piracha and Zuhaib Ali
Published on: 10th May, 2022
Despite the rising burden of fungal infections across the globe, the World Health Organization's efforts remained questionable in fungal infection-related projects. Most of the developing countries consequently lost focus on the need for assessment and establishment of national surveillance set up or advanced technology hubs against mycological infections. The current study aimed to the determination of the local burden of cutaneous fungal infections in 2019-2021. Among 497 suspected fungal cultures, 22.5% depicted fungal growth. Among males, the prevalence of dermatomycosis was 0.75 times higher than in females. Penicillium species followed by Epidermophyton and Candida species were common among subjects of < 30 years of age. The Aspergillus spp, Penicillium spp, mucormycosis agents, and Candida albicans infections were more common among subjects 30 to 60 years of age. Aspergillus species were more commonly observed among patients > 60 of age. 22.2% of the fungal infections were Penicillium species, 9% of the infections were Aspergillus species, followed by 4.4% of Epidermophyton, mucormycosis, Candida species, and Candida albicans respectively. There is an urgent need for the establishment of national policy for the prevention of fungal disease.
For over two years, COVID-19 pandemic has been a major global health concern and threat to human life. In the SARS-CoV2 macromolecules, the 3-chymotrypsin like protease (3CLpro or main protease) has been identified to be crucial and essential for viral survival, processing of the viral polyproteins and has been explored as a target in COVID-19 drug discovery. Although vaccines and other various inhibitors have been designed and launched, the emergence of the variant of this virus has put an unrelenting effort of researchers to this end. Also, the high cost of manufacturing these molecules coupled with the occurrence of drug resistance is a concern.Herein, Pefloxacin and its derivative for the first time were screened for their inhibitory activity against the SARS-CoV2 main protease through in silico analysis and their pharmacokinetic properties were evaluated. Interestingly, from the docking results, they both bind with high affinity at the active site of the protein. Moreover, they showed excellent pharmacokinetic and drug - likeness properties. Derivatization of Pefloxacin at the C7 position prevents its blood-brain barrier permeability. Overall, the dual antibacterial and potential antiviral activities of these two molecules make them promising drug candidates for COVID-19 management.
Atul R Rukadikar*, DK Mendiratta and Rafat Siddiqui
Published on: 29th August, 2022
One of the most severe threats to world health is the Candida species. Many non-Candida species are the major cause of vulvovaginal candidiasis (VVC). During the development of VVC, the host environment and Candida vaginal colonization are assumed to be out of balance, and this might be owing to physiological or non-physiological changes. Host-related and behavioral risks have been connected to VVC. Novel antifungal medications with particular molecular targets may be developed with the use of molecular tools in epidemiological research and the study of resistant Candida species. Using the Vitek-2 Antifungal Susceptibility System, this review will explain the many approaches used to identify and characterize Candida species isolated from vulvovaginal candidiasis patients.
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