A bibliometric analysis of global research performance on tuberculosis (2011-2020): Time for a global approach to support high-burden countries

BACKGROUND:

Tuberculosis (TB) is a persistent public health issue requiring consistent global effort for its eradication and control. Research on the subject plays a vital role in combatting the disease, giving future directions, and meeting the sustainable development goals (SDGs). This study aimed to evaluate the global TB research trends and performance from 2011 to 2020.

MATERIALS AND METHODS:

All the data for TB-related research publications from 2011 to 2020 were extracted from the Web of Science database and a comprehensive analysis was performed on the R-bibliometrix package.

RESULTS:

An increasing number of publications with an annual growth rate of 6.32% and a plateau in production from 2015 to 2018 was observed. Of 145 countries, the United States of America (USA), China, India, the United Kingdom, and South Africa led and made up half of the global contribution. Out of 91,862 authors, Zhang Y was the most productive with 205 articles and Barry CE had the highest H-index of 45. Only seven of the top 20 authors were from high-burden countries. The University of Cape Town was the leading institutional affiliation, followed by Stellenbosch University and the London School of Hygiene and Tropical Medicine. The most frequent international collaboration was between the USA and South Africa, occurring on 1203 instances. Only five of the top 30 high-burden countries were present in the top 30 collaborations. PLOS ONE, disseminating 2271 articles, was the most productive out of 3500 sources.

CONCLUSION:

The past decade has seen a steady increase in global TB research. Prominent authors, affiliations, and countries showed collaborative trends, but publications were found to be mostly from developed, low-burden countries except China, India, and South Africa. To meet the goals set by the SDGs and the WHO End TB Strategy, high-burden countries need to explore feasible opportunities and global support to enhance their expected TB-related research contributions.

Performance of Zea mays L. cultivars in tannery polluted soils: Management of chromium phytotoxicity through the application of biochar and compost

Soil contamination with heavy metals caused by various industrial activities is a threatening global environmental issue of the current era. Chromium (Cr) is the most toxic heavy metal used in leather industry and disposal of untreated wastewater into natural water bodies leads to contamination of natural soil and water resources. We studied the combined effect of biochar and compost on improving the tolerance to Cr toxicity by enhancing the morpho-physiological and biochemical attributes of two maize cultivars (P-1543 and NK-8441) grown in tannery waste polluted soils. The results of this study reveal that Cr toxicity reduced the plant growth by affecting physiological and biochemical attributes. Here, compost and biochar application significantly increased the plant biomass (fresh and dry), height, photosynthesis, chlorophyll content, water relation, starch, and protein content over treatment set as control. However, significant decline in electrolyte leakage (EL), proline, lipid peroxidation, soluble sugars, and antioxidant enzymes (APX, GPX, GR, GST, GSH, SOD, and CAT) was observed by combined application of compost and biochar. Hexavalent chromium concentration was maximum decreased to 4.1 μg g^-1 in soil after post-harvesting of maize cultivar NK-8441, while in roots and shoots to 22.6 and 19.2 μg g^-1 of maize cultivar P-1543, respectively, by combined application of compost and biochar. Moreover, these both amendments in combination showed considerably better results than their sole application and cultivar P-1543 comparatively performed better than NK 8441, in both K and S soils. Correlation and principal component analysis (PCA) revealed mostly highly positive associations among all the studied morpho, physio, and biochemical attributes of maize plant with the few exceptions, particularly concentration of Cr(III) and Cr(VI) in soil. The present work concluded that combined use of biochar and compost has great potential to decrease Cr toxicity and improve plant growth in tannery polluted soils.

Knowledge, attitudes, and perceptions related to telemedicine among young doctors and nursing staff at the King Abdul-Aziz University Hospital Jeddah, KSA

Objective

To investigate the knowledge, perceptions, and attitude of young doctors and nurses at Kind Abdulaziz University Hospital (KAUH) Jeddah, KSA, regarding the effectiveness of telemedicine in dealing with the patients for either follow-up or continuous monitoring of chronic diseases.

Material and Methods

This prospective cross-sectional study was carried out on the young doctors and nursing staff at KAUH. An online questionnaire addressing all the required fields, i.e., background essential demography, perceptions, acceptance, and knowledge regarding telemedicine's utility, was sent to the targeted population of health care workers. Completed responses were analyzed statistically as per study objectives.

Results

The response rate in our study was 85%. A total of 335 participants responded to our questionnaire. One hundred seventy-one (51.1%) were doctors, whereas one hundred sixty-four (48.9%) were the nursing staff. Among doctors, 50 (29.4%) were recent graduates, whereas, in the nursing side, 77 (46.7%) were the senior nursing students. The knowledge and attitude of the young nursing staff were relatively better than the senior staff taking part in the study and the trends were found statistically significant.

Conclusion

Our study participants, being young, were enthusiastic, had good knowledge regarding the advantages and limitations of telemedicine in managing the selected groups of patients. Their perception and attitude were quite positive. This is an encouraging trend in the promotion of telemedicine as an established way of managing patients with special requirements in an effective way. The ongoing COVID-19 pandemic has highlighted the importance of telemedicine in emergencies to protect both patients and health care workers by reducing chronic patients' avoidable hospital visits.

Prevalence Rate and Molecular Characteristics of Oestrus ovis L. (Diptera, Oestridae) in Sheep and Goats from Riyadh, Saudi Arabia

Heads of sheep (n = 600) and goats (n = 800) slaughtered at Al-Aziziah Abattoir in Riyadh, Saudi Arabia, were inspected for the presence of O. ovis larvae (L). Heads were split along the longitudinal axes, and larvae (L1, L2, and L3) were gathered. The infestation rate was significantly higher in goats (44.5%; 356/800) than that in sheep (22.3%; 134/600). Out of the 151 collected larvae from sheep, 0% were L1, 1.3% were L2, and 98.7% were L3. Out of the total of 468 larvae from goats, 0% were L1, 1.2% were L2, and 98.8% were L3. The infestation rate was significantly higher in males than that in females. Myiasis-causing larvae collected from Riyadh, Saudi Arabia, were authenticated as O. ovis, according to morphological characteristics. Polymerase chain reaction (PCR) amplification of a partial fragment (600 bp) of the mitochondrial cytochrome c oxidase subunit I (mtCOI) gene further confirmed the species. Phylogenetic analysis based on the partial mtCOI gene sequence demonstrated that 23 unique sequences showed high similarity based on nucleotide pairs of O. ovis accessions retrieved from GenBank.

Tyramine Derivatives as Potent Therapeutics for Type 2 Diabetes: Synthesis and In Vitro Inhibition of α-Glucosidase Enzyme

Background:

Tyramine derivatives 3-16 were prepared and tested first time for their α- glucosidase (Sources: Saccharomyces cerevisiae) inhibitory activity by using an in vitro mechanismbased biochemical assay. All the compounds were found to be new, except compounds 3, 10-12 and 16.

Objective:

In continuation of our research to synthesize and identify potent inhibitors of α-glucosidase enzyme, we intended to synthesize new inhibitors of α-glucosidase enzyme with enhanced efficacy in order to provide the basis for the better treatment of the type-II diabetic.

Methods:

Tyramine (1) was allowed to react with a variety of aryl chlorides (2) to yield the corresponding amides. Synthesized compounds were then purified through normal phase column chromatography. Compounds 3-16 were then assessed for their α-glucosidase inhibitory activity in an in vitro biochemical assay. The cytotoxicity of compounds 3-16 was determined by using 3T3 mouse fibroblast cell lines.

Results:

Compounds 3-5, 8, 13, and 15-16 were found to be more active (IC50 = 103.1±0.46, 37.3±4.51, 56.7±4.2, 23.9±2.31, 43.6±2.88, 55.8±1.73, and 38.2±0.86 μM, respectively) than the acarbose, the standard inhibitor of α-glucosidase enzyme, (IC50= 840.0±1.73 μM). To determine the dissociation constants and mode of inhibition, the kinetic studies were also performed for compounds 4 and 8 (the most potent inhibitors). It was observed that compounds 4 and 8 possess noncompetitive properties as the inhibitors of α-glucosidase. All the compounds were found to be noncytotoxic, except 5 and 12 (IC50= 14.7± 0.24 and 6.6± 0.38 μM, respectively).

Conclusion:

The current study gives the facile synthesis and identification of potent inhibitors of α- glucosidase. The new inhibitors reported here may be investigated further for the designing and development of novel anti-diabetic agents.

Infection in neuro-muscular scoliosis deformity correction

Assess the outcome of a standardised protocol for the treatment of post-operative wound infection in patients undergoing deformity correction for neuro-muscular scoliosis (NMS). Retrospective review of 443 consecutive patients with a minimum 18 months' follow-up, following a primary posterior deformity correction for NMS. In patients who developed a wound complication, the patient demographic and comorbidities, causative pathogen, number of re-operations, length of stay (LOS), rate of cure, and complications were analysed. Forty-four patients (9.9%) developed a wound infection. Marginally more infections were mono-microbial (23) than poly-microbial (21). Coagulase negative staphylococcus and Staphylococcus aureus were the most commonly cultured pathogens. Seventeen patients were treated with antibiotics alone, while 27 patients also required surgical debridement. The average LOS for those treated with antibiotics alone was 12 days (range: 9-15 days), in contrast to those requiring debridement, which was 35 days (range: 35-70 days). All patients were cured from their infection and ultimately achieved fusion. Infection is common in NMS deformity correction. This is marginally more common as a mono-microbial than poly-microbial infection with most pathogens being staphylococcal in origin. Our defined treatment strategy resulted in a cure for all patients and capacity for all patients to achieve fusion.

Obesity paradox, obesity orthodox, and the metabolic syndrome: An approach to unity

Obesity and the accompanying metabolic syndrome are strongly associated with heightened morbidity and mortality in older adults. In our review of more than 20 epidemiologic studies of major infectious diseases, including leaders such as tuberculosis, community-acquired pneumonia, and sepsis, obesity was associated with better outcomes. A cause-and-effect relationship between over-nutrition and survival with infection is suggested by results of two preliminary studies of infections in mice, where high fat feeding for 8-10 weeks provided much better outcomes. The better outcomes of infections with obesity are reminiscent of many recent studies of "sterile" non-infectious medical and surgical conditions where outcomes for obese patients are better than for their thinner counterparts --- and given the tag "obesity paradox". Turning to the history of medicine and biological evolution, we hypothesize that the metabolic syndrome has very ancient origins and is part of a lifelong metabolic program. While part of that program (the metabolic syndrome) promotes morbidity and mortality with aging, it helps infants and children as well as adults in their fight against infections and recovery from injuries, key roles in the hundreds of centuries before the public health advances of the 20th century. We conclude with speculation on how understanding the biological elements that protect obese patients with infections or injuries might be applied advantageously to thin patients with the same medical challenges.

Determination of a safe INR for joint injections in patients taking warfarin

INTRODUCTION

With an increase in life expectancy in 'developed' countries, the number of elderly patients receiving joint injections for arthritis is increasing. There are legitimate concerns about an increased risk of thromboembolism if anticoagulation is stopped or reversed for such an injection. Despite being a common dilemma, the literature on this issue is scarce.

METHODS

We undertook 2,084 joint injections of the knee and shoulder in 1,714 patients between August 2008 and December 2013. Within this cohort, we noted 41 patients who were taking warfarin and followed them immediately after joint injection in the clinic or radiology department, looking carefully for complications. Then, we sought clinical follow-up, correspondence, and imaging evidence for 4 weeks, looking for complications from these joint injections. We recorded International Normalised Ratio (INR) values before injection.

RESULTS

No complications were associated with the procedure after any joint injection. The radiologists who undertook ultrasound-guided injections to shoulders re-scanned the joints looking for haemarthroses: they found none. A similar outcome was noted clinically after injections in the outpatient setting.

CONCLUSION

With a mean INR of 2.77 (range, 1.7-5.5) and a maximum INR within this group of 5.5, joint injections to the shoulder and knee can be undertaken safely in primary or secondary care settings despite the patient taking warfarin.

Deferral patterns of voluntary blood donors at the National Blood Transfusion Service, North East Zonal Centre, Maiduguri

Appropriate donor selection in an important step in ensuring safe supply of blood and blood products. In this study deferral patterns of voluntary non-renumerated blood donors were determined at the North-Eastern Zonal Centre of the National Blood Transfusion service. The study was conducted between April 2007 and April 2009, and it involved the administration of a structured questionnaire. A total of 4032 voluntary blood donors were recruited, seven hundred and thirteen (17.7%) were temporarily deferred. The commonest reasons for deferral were low haemoglobin, self-deferral, high blood pressure, low weight and high risk behaviour. Other reasons are use of certain medications, low blood pressure and failed venopuncture. Gender analysis showed that more females were deferred for low haemoglobin and more males were self-deferred. Following donor recall, 146 of the 173 donors temporarily deferred came back to donate. These consisted of 113 deferral due to low haemoglobin, 30 self-deferred and 3 induced in risky behaviour. Effective education or counseling, the old tradition of giving haematinics and good dietary advice to those with low haemaglobin values, improved the safety and availability of blood and blood products. Donors who are self-deferred and those involved in high risk bahviour should never be persuaded to donate blood. There is also the need for a review of operational guidelines with regards the uniform acceptable cutoff point of 12.5g/dl haemoglobin value for males and females.

Increased dietary oxalate does not increase urinary calcium oxalate saturation in hypercalciuric rats

BACKGROUND

Human calcium oxalate (CaOx) nephrolithiasis may occur if urine is supersaturated with respect to the solid-phase CaOx. In these patients, dietary oxalate is often restricted to reduce its absorption and subsequent excretion in an effort to lower supersaturation and to decrease stone formation. However, dietary oxalate also binds intestinal calcium which lowers calcium absorption and excretion. The effect of increasing dietary oxalate on urinary CaOx supersaturation is difficult to predict.

METHODS

To determine the effect of dietary oxalate intake on urinary supersaturation with respect to CaOx and brushite (CaHPO4), we fed 36th and 37th generation genetic hypercalciuric rats a normal Ca diet (1.2% Ca) alone or with sodium oxalate added at 0.5%, 1.0%, or 2.0% for a total of 18 weeks. We measured urinary ion excretion and calculated supersaturation with respect to the CaOx and CaHPO4 solid phases and determined the type of stones formed.

RESULTS

Increasing dietary oxalate from 0% to 2.0% significantly increased urinary oxalate and decreased urinary calcium excretion, the latter presumably due to increased dietary oxalate-binding intestinal calcium. Increasing dietary oxalate from 0% to 2.0% decreased CaOx supersaturation due to the decrease in urinary calcium offsetting the increase in urinary oxalate and the decreased CaHPO4 supersaturation. Each rat in each group formed stones. Scanning electron microscopy revealed discrete stones and not nephrocalcinosis. X-ray and electron diffraction and x-ray microanalysis revealed that the stones were composed of calcium and phosphate; there were no CaOx stones.

CONCLUSION

Thus, increasing dietary oxalate led to a decrease in CaOx and CaHPO4 supersaturation and did not alter the universal stone formation found in these rats, nor the type of stones formed. These results suggest the necessity for human studies aimed at determining the role, if any, of limiting oxalate intake to prevent recurrence of CaOx nephrolithiasis.