ROS/RNS Balancing, Aerobic Fermentation Regulation and Cell Cycle Control - a Complex Early Trait ('CoV-MAC-TED') for Combating SARS-CoV-2-Induced Cell Reprogramming

In a perspective entitled 'From plant survival under severe stress to anti-viral human defense' we raised and justified the hypothesis that transcript level profiles of justified target genes established from in vitro somatic embryogenesis (SE) induction in plants as a reference compared to virus-induced profiles can identify differential virus signatures that link to harmful reprogramming. A standard profile of selected genes named 'ReprogVirus' was proposed for in vitro-scanning of early virus-induced reprogramming in critical primary infected cells/tissues as target trait. For data collection, the 'ReprogVirus platform' was initiated. This initiative aims to identify in a common effort across scientific boundaries critical virus footprints from diverse virus origins and variants as a basis for anti-viral strategy design. This approach is open for validation and extension. In the present study, we initiated validation by experimental transcriptome data available in public domain combined with advancing plant wet lab research. We compared plant-adapted transcriptomes according to 'RegroVirus' complemented by alternative oxidase (AOX) genes during de novo programming under SE-inducing conditions with in vitro corona virus-induced transcriptome profiles. This approach enabled identifying a major complex trait for early de novo programming during SARS-CoV-2 infection, called 'CoV-MAC-TED'. It consists of unbalanced ROS/RNS levels, which are connected to increased aerobic fermentation that links to alpha-tubulin-based cell restructuration and progression of cell cycle. We conclude that anti-viral/anti-SARS-CoV-2 strategies need to rigorously target 'CoV-MAC-TED' in primary infected nose and mouth cells through prophylactic and very early therapeutic strategies. We also discuss potential strategies in the view of the beneficial role of AOX for resilient behavior in plants. Furthermore, following the general observation that ROS/RNS equilibration/redox homeostasis is of utmost importance at the very beginning of viral infection, we highlight that 'de-stressing' disease and social handling should be seen as essential part of anti-viral/anti-SARS-CoV-2 strategies.

From Plant Survival Under Severe Stress to Anti-Viral Human Defense - A Perspective That Calls for Common Efforts

Reprogramming of primary virus-infected cells is the critical step that turns viral attacks harmful to humans by initiating super-spreading at cell, organism and population levels. To develop early anti-viral therapies and proactive administration, it is important to understand the very first steps of this process. Plant somatic embryogenesis (SE) is the earliest and most studied model for de novo programming upon severe stress that, in contrast to virus attacks, promotes individual cell and organism survival. We argued that transcript level profiles of target genes established from in vitro SE induction as reference compared to virus-induced profiles can identify differential virus traits that link to harmful reprogramming. To validate this hypothesis, we selected a standard set of genes named 'ReprogVirus'. This approach was recently applied and published. It resulted in identifying 'CoV-MAC-TED', a complex trait that is promising to support combating SARS-CoV-2-induced cell reprogramming in primary infected nose and mouth cells. In this perspective, we aim to explain the rationale of our scientific approach. We are highlighting relevant background knowledge on SE, emphasize the role of alternative oxidase in plant reprogramming and resilience as a learning tool for designing human virus-defense strategies and, present the list of selected genes. As an outlook, we announce wider data collection in a 'ReprogVirus Platform' to support anti-viral strategy design through common efforts.

Sparganosis mimicking a soft-tissue tumor: A diagnostic challenge

Human sparganosis is a rare but important food borne zoonosis and could be attributed to increased consumption of raw meat of fish, frogs, snakes etc. Sparganosis may involve varied organ systems but subcutaneous sparganosis remains the one of the commonly reported clinical condition. Rarity of this problem reinforces the necessity of sensitising the treating physicians of the differential possibility of this infection in patients with history of practice of consuming raw meat. Expansion of health communication and provision of safe food and water by the civic agencies can be a part of powerful preventive strategies.

The Changing Pattern of the Quantum of Biomedical Waste Generated from a Tertiary Care Hospital in Delhi

Background  As a consequence of growth and advancement in health care, production of health care waste has seen an exponential upward trend. Waste from individual health care facilities can vary based on the nature and scope of health care services they provide.

Objectives  To analyze the amount of biomedical waste generated by a tertiary care hospital.

Methods  Biomedical waste generated by the hospital from 2005 to 2019 was quantified and analyzed to calculate the total amount of incinerable waste, recyclable plastic waste, and sharp and glass waste. The amount of waste generated per bed per day and the compound annual growth rate (CAGR) were also calculated.

Results  The total amount of biomedical waste generated in 2005 was 65,658 kg, which has substantially increased to 374,712 kg in 2019, with a CAGR of 12.5%. The hospital was producing average biomedical waste of 0.179 kg/bed/day in 2005, which has increased four times in 2019 to reach 0.709 kg/bed/day. The overall estimated plastic waste was 31% of the total biomedical waste in 2005 and 53% in 2019.

Conclusion  The generation of biomedical waste is likely to see significant upward trends unless diligent deliberations are held between different stakeholders in regard to the reintroduction of reusable materials and waste reduction strategies.

Co-infection of COVID-19 and Tuberculosis in a Tertiary Care Hospital

Introduction: The burden of Tuberculosis (TB) has managed to remain an age old menace to our society, especially India. The potential impact of Corona Virus Disease-19 (COVID-19) on TB patients continues to be worrisome due to the disruption of the national program and its services. Aim: To compare the TB infection in COVID-19 vs non-COVID-19 patients. Materials and Methods: The study was undertaken at Department of Microbiology, ABVIMS, Dr. RML Hospital Delhi, India. The data was collected, retrospectively from 15thSeptember 2020 to 15th January 2021 from admitted 1094 non-COVID-19 and 150 COVID-19 patients, >18 years of age, either sex. Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) was done to diagnose COVID-19 and GeneXpert was used to detect Mycobacterium tuberculosis. The data entry was done in the Microsoft Excel spreadsheet and the final analysis was done with the use of Statistical Package for Social Sciences(SPSS) software version 21.0. Two by two contingency table was used for calculating the Odd’s ratio. Results: During the study period, 1094 samples were received from non-COVID-19 ward and 150 from COVID-19 ward. Out of 150 COVID-19 positive patients, 30 (20%) were also positive for Mycobacterium tuberculosis Complex (MTBC) and 120 (80%) were negative for MTBC. Out of 1094 COVID-19 negative patients, 98 (8.96%) were positive for MTBC and 996 (91.04%) were negative for MTBC. The Odd’s ratio/Risk Ratio (RR) of TB infection in COVID-19 infected patients was 3.08 {Confidence Interval (CI) 95%}. The mortality was 10% in the COVID-19 positive group. Conclusion: It was observed that the chances of contracting TBare thrice in COVID-19 patients and thus TB diagnosis should be equally emphasised and further strengthened in this ongoing pandemic.

Performance of Chip Based Real Time RT- PCR (TrueNat) and Conventional Real Time RT-PCR for Detection of SARS-CoV-2

Introduction: Coronavirus Disease-2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is ravaging the globe due to its rapid spread. Since providing fast results is of critical importance in a time of shortage of medical personnel and beds in isolation wards and to ensure timely treatment for patients, developing high quality rapid Point of Care (POC) diagnostics is essential. Aim: To compare the diagnostic performance of chip based real time Reverse Trancriptase Polymerase Chain Reaction (RT- PCR) (TrueNat) which has a shorter turnaround time compared to conventional real time RT-PCR in samples of suspected COVID-19 patients. Materials and Methods: The present cross-sectional observational study was carried out in a tertiary care hospital in New Delhi, India. Five hundred randomly selected Oropharyngeal (OP) swabs samples received from May-July 2020, were included in the study to compare the diagnostic performance of chip based real time RT- PCR (TrueNat) with conventional real time RT-PCR for diagnosis of SARS-CoV-2 infection. All statistical analysis was performed using STATA version 16.1 software (College station, Texas, USA). Results: The sensitivity of TrueNat test was 100% while the specificity was found to be 99.12% at 95% confidence intervals. The positive predictive value was 91.84% and the negative predictive value was 100%. Conclusion: The short turnaround time, good sensitivity and specificity makes TrueNat a reliable and affordable option to provide rapid results in cases requiring urgent interventions and to augment SARS-CoV-2 testing capacity at peripheral settings where sample load is less.

Diagnosis of pulmonary tuberculosis from gastric aspirate samples in nonexpectorating pediatric patients in a tertiary care hospital

Objectives

The aim of this study was to assess the utility of Xpert assay, Ziehl-Neelsen (ZN) staining, and Mycobacteria Growth Indicator Tube (MGIT™) culture for diagnosis of pediatric pulmonary tuberculosis from gastric aspirate (GA) samples and to compare Xpert assay and ZN staining with MGIT rapid liquid culture.

Materials and Methods

GA samples from 210 nonexpectorating children, aged between 6 months to 12 years, presenting to the pediatric out-patient department (OPD) with clinical suspicion of tuberculosis (TB) were collected. The samples were tested by GeneXpert, ZN staining, and MGIT liquid culture.

Results

GeneXpert is a more sensitive method for rapid and early diagnosis of pediatric TB when compared with microscopy.

Standardization and Classification of In vitro Biofilm Formation by Clinical Isolates of Staphylococcus aureus

BACKGROUND

Staphylococcus aureus is Gram-positive bacterium commonly associated with nosocomial infections. The development of biofilm exhibiting drug resistance especially in foreign body associated infections has enabled the bacterium to draw considerable attention. However, till date, consensus guidelines for in vitro biofilm quantitation and categorization criterion for the bacterial isolates based on biofilm-forming capacity are lacking. Therefore, it was intended to standardize in vitro biofilm formation by clinical isolates of S. aureus and then to classify them on the basis of their biofilm-forming capacity.

MATERIALS AND METHODS

A study was conducted for biofilm quantitation by tissue culture plate (TCP) assay employing 61 strains of S. aureus isolated from clinical samples during May 2015- December 2015 wherein several factors influencing the biofilm formation were optimized. Therefore, it was intended to propose a biofilm classification criteria based on the standard deviation multiples of the control differentiating them into non, low, medium, and high biofilm formers.

RESULTS

Brain-heart infusion broth was found to be more effective in biofilm formation compared to trypticase soy broth. Heat fixation was more effective than chemical fixation. Although, individually, glucose, sucrose, and sodium chloride (NaCl) had no significant effect on biofilm formation, a statistically significant increase in absorbance was observed after using the supplement mix consisting of 222.2 mM glucose, 116.9 mM sucrose, and 1000 mM NaCl (P= 0.037).

CONCLUSIONS

The present study puts forth a standardized in vitro TCP assay for biofilm biomass quantitation and categorization criteria for clinical isolates of S. aureus based on their biofilm-forming capacity. The proposed in vitro technique may be further evaluated for its usefulness in the management of persistent infections caused by the bacterium.

Fasciolopsiasis: Endemic focus of a neglected parasitic disease in Bihar

PURPOSE

To describe a newly discovered, previously unreported endemic focus of fasciolopsiasis in the Phulwaria village, under tehsil Sugauli, East Champaran, Bihar.

MATERIALS AND METHODS

A study was conducted at village Phulwaria, following diagnosis of fasciolopsiasis in three children from the village. A total of 120 individuals, including all the children and adults who gave history of recent passage of red fleshy masses in their stool, were included in the study. The cases of fasciolopsiasis were treated with Praziquantel 25 mg/kg, three doses a day. Risk factors for the transmission of the parasite in the village were also studied.

RESULTS

Questionnaire revealed majority of the population suffering from abdominal discomfort and passage of red fleshy masses in stool. These fleshy masses were identified as Fasciolopsis buski. One hundred and eighteen individuals were presumably considered as cases of the parasitic infection. After treatment with Praziquantel, all of them passed the parasite in their stool for the next 2-3 days. On investigating, it was observed that all the conditions required for effective continuation of the life cycle of the parasite were present in this village.

CONCLUSION

This study draws attention to a new endemic focus of fasciolopsiasis in Bihar, with a very high prevalence due to poverty, the lack of awareness about the parasite in villagers as well as ignorance among local medical practitioners. There is an urgent need for mass campaign around the region for its effective control.

Unusual presentation of intestinal myiasis due to Musca domestica: A report of two cases

Intestinal myiasis is an accidental phenomenon that occurs when fly eggs or larvae are ingested in food and passed into the faeces as larvae. It is usually transient and the patients are asymptomatic. In some cases, however, the passage of larvae may be associated with symptoms. The present case reports describe two such cases, one associated with persistent passage of maggots in stool and urticaria; and other associated with altered bowel habits and inflammatory changes in lower gastrointestinal tract. DOI: http://dx.doi.org/10.3126/ajms.v6i1.10803 Asian Journal of Medical Sciences Vol.6(1) 2015 124-126

Primary cerebral nocardiosis in a renal transplant recipient: a case report

Nocardial brain abscess is a rare central nervous system infection. A 50 year old renal transplant recipient developed a nocardial cerebral abscess. It manifested clinically with pyrexia of unknown origin, recurrent episodes of convulsions and a right sided hemiparesis. The purulent material was drained and sent to the Microbiology Laboratory for culture and sensitivity studies. Direct microscopy and culture confirmed the diagnosis of nocardial infection.