Vitamin D - An Elixir for Recurrent Upper Respiratory Tract Infection

AIM

The aim of this study was to assess and compare the level of serum vitamin-D in participants affected with recurrent upper respiratory tract infections and in healthy population and to know whether vitamin-D deficiency is factor contributing to recurrent upper respiratory tract infections (URTI).

Materials and Methods

A case control study was conducted on 52 subjects with recurrent URTI and 52 controls. Frequency and severity of infections in the previous 6 months were assessed and documented among the case group. Vitamin D level was assessed in all the participants among case and control group and statistical analysis was done.

Results

Mean serum vitamin D was 10.67 ± 3.58 ng/mL in the study group and 20.10 ± 7.73 ng/mL in the control group, the difference in value was statistically significant. None of the study group participants belonged to vitamin D sufficient group, and majority (98%) were in vitamin D deficient, except for 2% who were in insufficient group. In the control group, 10%,29%,61% were in sufficient, insufficient and deficient group respectively. Mean serum vitamin D was not significantly associated with severity and type of infection.

Conclusion

Significant number of participants in both study and control had serum vitamin D deficiency. This study also observed that a significant number of participants with recurrent URTI had serum vitamin D deficiency than the control group which suggest that hypovitaminosis D is a factor contributing to recurrent URTI.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-022-03220-z.

Trend in the use of neo-adjuvant chemotherapy for the management of muscle invasive bladder cancer at a major tertiary care hospital in Pakistan

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Background: Although the use of Neoadjuvant Chemotherapy (NAC) has now become the standard of care for Muscle Invasive Bladder Cancer (MIBC) in the world, most patients in lower- middle-income countries (LMIC), like Pakistan, are still undergoing upfront surgery despite being ideal candidates for chemotherapy. Multi-disciplinary tumor boards have been critical in the change of this trend in the developed world. We aimed to assess the trends in the use of NAC for patients with muscle invasive bladder cancer before undergoing definitive surgery. Methods: We included patients who underwent surgery for ≥ cT2 MIBC without distant metastasis between 2011 and 2015 at a tertiary care hospital in Karachi, Pakistan. We retrospectively assessed the trends in NAC compared to upfront surgery in these patients. Results: Among the 171 patients included in our study, only 4 (2.34%) received NAC, whereas the other 167 (97.67%) underwent upfront surgery without NAC. Out of the 90 patients who underwent surgery for MIBC between 2011 and 2013, none of them received NAC and underwent upfront surgery. Among the 81 patients with MIBC in 2014 and 2015, 4 patients received NAC before surgery whereas the other 77 underwent upfront surgery. Conclusions: The adoption of NAC for MIBC remains a challenge in lower- middle-income countries such as Pakistan. Introduction of a multidisciplinary tumor board in our hospital since 2014 has shown a slight change in this trend. Better communication between different departments remains the key in significantly changing the trend of a much desired standard of care.

Sorafenib-induced tumor lysis syndrome in a patient with metastatic hepatocellular carcinoma

Tumor lysis syndrome is a potentially lethal complication of chemotherapy, usually associated with aggressive hematologic malignancies. We describe the case of a young patient with metastatic hepatocellular cancer who developed rapid and fatal tumor lysis syndrome following initiation of sorafenib therapy. Although rare with sorafenib therapy for hepatocellular carcinoma, tumor lysis syndrome is serious complication. Patients with a high burden of disease at therapy initiation should have their metabolic parameters measured prior to starting therapy and closely followed for the first 1-2 weeks while being treated.

Redescription of Heterodera fici (Nematoda: Heteroderidae) with SEM Observations

Heterodera fici is redescribed and illustrated with comparative details and revised measurements and diagnostic characters of the females, males, cysts, and juveniles from Maryland and Pakistan. This species is in the "schachtii group" (cysts lemon shaped, with bullae, and ambifenestrate) but the fenestrae in some cysts, presumab!y young ones, are small and widely spaced, appearing bifenestrate. It is most closely related to H. schachtii, H. glycines, and H. cajani but differs from these species especially in having cysts with small, scattered bullae and weakly developed underbridge; and males with four small nipples on tail tip. Scanning electron microscopy (SEM) observations of the specimens are also presented. The relationship of this species to closely related forms is discussed.

Descriptions of Two New Species of Tylenchorhynchus Cobb, 1913 (Nematoda: Tylenchida), with Details on Morphology and Variation of T. claytoni

Two new species of plant parasitic nematodes (Tylenchorhynchus quaidi n. sp. and T. tritici n. sp.) from Pakistan are described and illustrated. Tylenchorhynchus quaidi n. sp., from soil around roots of potato (Solanum tuberosum) from an experimental field of NNRC, Karachi, Pakistan, is distinguishable from other species by its peculiar sunken dome-shaped head. Although similar to T. goffarti, it differs by head shape, areolation of lateral field, ratios a (23-28 vs. 29-37) and c (11-14 vs. 13-20), and a vagina that is half sclerotized and half unsclerotized. Tylenchorhynchus tritici n. sp., from soil around roots of wheat (Triticum aestivum) from Campbellpur, Pakistan, is similar to T. ventrosignatus and T. nordiensis. It differs from T. ventrosignatus by a continuous lip region, number of head annules (2-3 vs. 4), coarse body annulation, absence of a wave-like structure near the vulva, and by tail shape and number of tail annules (15-23 vs. 28-32). It differs from T. nordiensis by stylet length (12.4-14.6 vs. 11-13 mum), shape of stylet knobs, number of head annules (2-3 vs. 4), non-areolated lateral field in region of phasmids, and not fusing in posterior third of tail. Morphometrics of Tylenchorhynchus claytoni from soil around stunted maize (Zea mays L.), in Muscatine County, Iowa, and several other populations are given. Detailed morphometric data on T. claytoni based on topotypes collected from type locality and several other populations revealed that this species shows variations in the shape of tail in females, number of tail annules (and sometimes annules extending further back on the terminus, almost being an annulated terminus), position of phasmid, and shape of lip region. The subgenus Bitylenchus is proposed as a new synonym of Tylenchorhynchus and its species referred to the latter genus.

New Species of Cyst Nematode Heterodera pakistanensis (Nematoda: Heteroderidae) Attacking Wheat in Pakistan

Heterodera pakistanensis n. sp., described and illustrated from roots of common wheat (Triticum aestivum) from Sukkur, Sind, Pakistan, belongs to the goettingiana group. It is most closely related to H. cyperi Golden, Rau &Cobb, 1962, H. raskii Basnet & Jayaprakash, 1984, and H. mothi Khan &Husain, 1965. Second-stage juveniles (J2) can be distinguished from H. cyperi J2 by an areolated lateral field with four incisures and shorter stylet, whereas cysts are separated by a more elongated vulva slit and the conspicuous structure of the underbridge. It differs from H. raskii by having four areolated lateral lines in J2, smaller female lemon-shaped cyst, shorter fenestra length and width, conspicuous underbridge, and distinct anus with a high cuticular pattern 40-45 mum from posterior end. It also differs from H. mothi by the presence of four areolated lateral lines in J2 and absence of vulva denticles and bullae.

Criconemella anastomoides n. sp. (Nematoda: Criconematina) from Pakistan

Criconemella anastomoides, described and illustrated herein, is characterized by the presence of regular anastomosis on the body, two zig zag lateral lines, stylet knobs sloping posteriorly, short stylet, and short body length.

Description of Paktylenchus tuberosus gen. n., sp. n. (Nematoda: Tylenchinae)

Paktylenchus tuberosus gen.n., sp.n. is described and illustrated from soil around Solanum tuberosum from Kaghan Valley, Pakistan. Paktylenchus gen.n, can be distinguished from the most closely related genus, Agelenchus Andrassy, 1954, by the distinct longitudinal striae, three incisures in the lateral field, and absence of males. Paktylenchus tuberosus shows affinities to Coslenchus Siddiqi, 1978 but differs in having an oblique vagina-to-body axis and a prominent sunken vulva with vulval flaps. Four genera of the subfamily Tylenchinae are also discussed herein.

Three new species of the super family neotylenchoidea (nematoda: tylenchida) from pakistan

Three new species in the super family Neotylenchoidea collected in Pakistan during 1979-80 are described. New species Nothotylenchus gohleni is related to N. affinis Thorne, 1941 but is differentiated by its longer, more robust body with tine cuticular annules, a more posterior vulva, inconspicuous basal knobs of the stylet, and poorly developed metacorpal area. N. geraerti and N. tuberosus are also close to this undescribed species, hut they have a more developed metacorpal area and a larger post uterine sac. Boleodorus zaini n.sp. is distinguished by its excretory pore open at a level with the base of the posterior esophageal bulb and by six distinct lines in the lateral field. Paurodontella sohailai n.sp. is closely related to P. densa (Thorne, 1941) Hussain &Khan, 1967 and P. minuta Hussain &Khan, 1967 but differs from them by its larger body, shape of tail, and seven incisures in the lateral field.

Description of Quinisulcius solani n.sp. (Nematoda: Tylenchorhynchidae) with a Key to the Species and Data on Scutylenchus koreanus from Pakistan

A new species. Quinisulcius solani, is described and illustrated from specimens on Solanum tuberosum from Murree Hills, Pakistan. Q. solani n.sp. differs from its closest relative, Q. acutus (Allen, 1955) Siddiqi, 1971, by its spiral to open 'C' shaped body and stylet length of 19 mun, vs. 17 mum in Q. acutus. In Q. acutus the stylet knobs project anteriorly but slope posteriorly in Q. solani n.sp. Tail annules number 17 in Q. acutus but 38 in Q. solani n.sp.; also the phasmids in the former species are at mid-tail and in the latter are in anterior half of tail, at about 34%. Q. solani n.sp. is also closely related to Q. capitatus (Allen, 1955) Siddiqi, 1971 but differs in some characters. Head annules number eight and stylet length is 17 mum in Q. capitatus, but head annules are six and stylet length is 19 mum in Q. solani n.sp. In Q. capitatus T/ABW is 3 vs. 2.2 in Q. solani n.sp. Also, phasmids are located at mid-tail on Q. capitatus but at ahout one-third of the tail on Q. solani n.sp. A key to the 10 species of Quinisulcius is also presented. Scutylenchus koreanus (Choi &Geraert, 1971) Siddiqi, 1979 is recorded for the first time in Pakistan and morphometric data and illustrations given.