Biomarker role of maternal soluble human leukocyte antigen G in pre-eclampsia: A meta-analysis

INTRODUCTION

Human leukocyte antigen-G (HLA-G) is a non-classical class I HLA molecule shown to regulate the immunomodulation of maternal immune cells to prevent fetal tissue destruction. Low levels of freely circulating maternal soluble HLA-G (sHLA-G) have been observed in pre-eclampsia, however, no pooled evidence exists. This meta-analysis aimed to generate pooled findings on the association of sHLA-G levels with pre-eclampsia and is the first study to perform a trimester-wise comparison of the levels of sHLA-G in preeclamptic cases and normal pregnant controls.

METHODS

The databases PubMed, Emba, Web of Science, and Google Scholar through May 31, 2023. Preeclamptic women were defined as cases and normal pregnancies as controls. Data on the level of sHLA-G in cases and controls was extracted and subjected to a meta-analysis using a random-effects model. The pooled effect was expressed in terms of standardized mean difference (SMD). Sensitivity analysis was performed to investigate the effect of the exclusion of each study on the pooled results. Publication bias was assessed statistically.

RESULTS

Nine studies with altogether 567 PE cases and 1132 normal pregnancy controls were included in the meta-analysis. The first and third trimester levels of sHLA-G in PE cases were significantly lower than that of normal pregnant controls: (SMD: -0.84 [-1.29; -0.38]; p = .003; I2 = 54%) and (SMD: -0.39 [-0.71; -0.06]; p = .02; I2 = 79%) respectively. Sensitivity analysis revealed significant fluctuations in the pooled findings when few studies were excluded, raising questions on the consistency of results among studies.

CONCLUSION

Although we found that first and third-trimester sHLA-G levels in pre-eclampsia are significantly lower, taking into consideration the inconsistent results from the sensitivity analysis, our findings advocate the demand for more studies with larger sample sizes to generate solid ground pooled evidence on the predictive role of sHLA-G in pre-eclampsia.

Herpes zoster vaccination and the risk of dementia: A systematic review and meta-analysis

INTRODUCTION

Previous studies have reported a decreased risk of dementia with herpes zoster vaccination. Given this background, this systematic review and meta-analysis aimed to investigate the association between herpes zoster vaccination and the risk of dementia.

METHODS

We searched five databases until November 2023 for case-control, cross-sectional, or cohort studies investigating the association of herpes zoster vaccination and dementia. Odds ratios and 95% confidence intervals (95% CIs) were pooled in the meta-analysis. Meta-regression, subgroup, and sensitivity analysis were also conducted.

RESULTS

We evaluated a total of five studies (one cross-sectional, one case-control, and four cohort studies) that included a total number of 103,615 patients who were vaccinated with herpes zoster vaccine. All the studies were of high quality, ranging from 7 to 9. Due to the high heterogeneity (I2 = 100%, p < .00001) observed in our study, a random effect model was used for the analysis. The pooled odds ratio was 0.84 (95% CI: 0.50, 1.43), p (overall effect) = .53), indicating that herpes zoster vaccination reduces the risk of dementia.

CONCLUSION

Herpes zoster vaccination is associated with a reduction of the risk of dementia. More epidemiological studies are needed to confirm the association.

Knowledge, attitude and practice towards Hepatitis B vaccination among medical undergraduate students of Maharajgunj Medical Campus in Nepal: a cross-sectional study

Background

The rate of Hepatitis B virus (HBV) infection among health professionals is about 2-10 times higher than that of the general population since, they are more prone for exposure to infected blood and body fluid and contaminated needles and syringes. The risk of accidental exposure among the medical students is even higher due to their non-experience, insufficient training and lack of preventive knowledge. The objective of this study is to assess knowledge, attitude, and practice of medical students towards Hepatitis B.

Methods

A cross-sectional study design was conducted among 206 medical undergraduate students from May 2022 to July 2022. A pretested self- administered questionnaire was used to collect data regarding knowledge, attitude, and practice towards Hepatitis B vaccination. Non-probability convenience sampling was used to collect data. Descriptive analysis was done by calculating frequency and percentages of categorical variables. χ2 test was used to determine the association between categorical independent variables and categorical dependent variables.

Results

Among 206 students, 93.7% of them had good knowledge and 98.5% had good attitude. The practice was low with only 35% having safe practices. Similarly, only 46.6% of medical students were completely vaccinated. 23.8% had done Hepatitis B testing. Students who had encountered Hepatitis B patients during their posting were 51.9%. There was significant association of sociodemographic variables with knowledge, attitude and practice towards Hepatitis B vaccination.

Conclusion

Although, the knowledge and attitude towards Hepatitis B vaccination is high, the practice levels are very low. This indicates need for immunizing medical students against Hepatitis B and reforming training curriculum more focusing on preventive practices against HBV.

Knowledge and attitude towards COVID-19 booster dose among healthcare professionals in Nepal: A cross-sectional study

Vaccination has become the most effective way to combat the coronavirus disease 2019 (COVID-19) pandemic. As there have been reports of a gradual decline in the protection it offers, many countries have decided to administer booster doses of the COVID-19 vaccine. In Nepal, booster doses have been introduced to frontline health workers as a priority group. Therefore, this study aims to assess the knowledge and attitude of health care professionals toward booster doses of COVID-19 vaccines in Nepal.

Methods

A cross-sectional study was conducted from December 2021 to January 2022 among health care professionals working at public health facilities in Nepal. Multivariable logistic regression was performed to identify predictors that correlate with knowledge and attitude toward COVID-19 booster dose. P value less than 0.05 was considered statistically significant.

Results

A total of 300 participants were included in the final analysis. Among the study participants, 68.0% and 78.6% had good knowledge and favorable attitude toward COVID-19 booster dose, respectively. Female health care workers and those who had received a single dose of COVID-19 vaccine had significantly lower odds of having good knowledge of COVID-19 booster dose. Similarly, participants with lower educational levels and those who had received a single dose of COVID-19 vaccination had an unfavorable attitude toward COVID-19 booster dose.

Conclusion

This study showed a satisfactory level of knowledge and attitude of health care professionals toward COVID-19 booster dose in Nepal. Health care professionals' positive attitude toward COVID-19 booster dose vaccine is key to the patient and community safety. Personalized education and risk communication can aid in improving overall awareness and attitudes toward COVID-19 booster dose in such populations.

Unbiased genetic screen identifies Caenorhabditis elegans genes conserved for nodavirus genome replication

All RNA viruses produce and use RNA-dependent RNA polymerases (RdRPs) for their genome replication. Efficient viral genome replication also requires host factors which often function as co-factors of viral RdRP. To identify host factors required for nodavirus genome replication, we carried out an unbiased genetic screen in Caenorhabditis elegans mutants defective in antiviral RNA interference. This genetic screen utilized a self-replicating GFP-tagged viral replicon, derived from flock house virus, as a reporter for the loss of viral genome replication. Upon completing the screen, 16 candidate alleles were isolated and assigned to 14 candidate genes through genetic complementation. Interestingly, 4 of the candidate genes were also found to be required for the genome replication of Orsay virus, a nodavirus that naturally infects C. elegans. Our unbiased genetic screen therefore has led to the identification of a set of worm genes conserved for nodavirus genome replication.

Antisynthetase syndrome and interstitial lung disease: A case report

Introduction

Myositis, Raynaud's phenomenon, fever, interstitial lung disease, mechanic's hands, and arthropathy are symptoms of Antisynthetase Syndrome (ASS), which is defined by the development of antibodies against t-ribonucleic acid (RNA) synthetase, particularly anti-Jo-1.

Case presentation

The case is about 29 years female with 1 month history of non-productive cough and dyspnea on exertion which was later diagnosed as ASS.

Discussion

The diagnosis of an inflammatory myopathy is based on clinical findings such as subacute development of symmetrical muscle weakness and signs such as laboratory investigations revealing skeletal muscle inflammation. Creatinine phosphokinase (CPK) is mainly used to demonstrate skeletal muscle involvement.

Conclusion

Interstitial lung disease is a frequent occurrence and is associated with a bad prognosis during the course of antisynthetase syndrome.

A case report on atypical spindle cell lipomatous tumor: A rare entity

Introduction

Atypical spindle cell lipomatous tumor (ASPLT), a separate entity for the group of benign/low grade adipocytic neoplasm that is characterized by adipocyte adequacy and the presence of lipoblast-like cells and spindle cells at varying degrees.

Case presentation

Here, we report a rare case of 60 years old male with atypical spindle cell lipomatous tumor in the anterior abdominal wall.

Discussion

Histopathology is the gold standard for establishing the diagnosis and grade of soft tissue tumor and consistent radiology-pathology correlation is essential to avoid any diagnostic pitfalls [1]. Ultrasound is preferred as an initial investigation for superficially located lesions.

Conclusion

ASPLT show a wide variety of microscopic features, and differential diagnosis is important and difficult. Recognition of morphologic clues and immunohistochemistry/molecular tests to confirm the diagnosis.

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Histopathology is the gold standard for establishing the diagnosis and grade of soft tissue tumor.

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Ultrasound is preferred as an initial investigation for superficially located lesions.

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Atypical spindle cell lipomatous tumor (ASPLT), a separate entity for the group of benign/low grade adipocytic neoplasm.

Visceral leishmaniasis in non‐endemic rural hilly region of Nepal: A case report

Visceral leishmaniasis is the most severe form of leishmaniasis, caused by the obligate intracellular protozoan parasites Leishmania donovani or L. infantum, transmitted by the bite of phlebotomine sand fly. Visceral leishmaniasis is a disease of lowlands and uncommon in highlands. We report a case of visceral leishmaniasis in 13‐year‐old female patient from a village of Arghakhanchi situated at an altitude of 1200 m.

Visceral leishmaniasis is endemic in lowland regions. However, high index of suspicion is needed in appropriate clinical setting even in high altitudes due to possible vector expansion to these areas.