Rajesh Varma
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Effect of a third booster dose of COVID-19 mRNA vaccine in patients with haematological cancer after the initial two-dose vaccination - a single centre report
No full textNovel Coronavirus SARS-CoV-2 causing COVID-19 has been subject to intensive interest since its appearance in 2019, with the risk of severe course being significantly higher for adult patients with hematological malignancy. Results on a two-dose, standard vaccination regimen in patients with hematological cancer have identified risk populations with poor vaccination outcomes (Chronic lymphocytic leukemia, anti-CD20 treatment, etc.). Thus, a booster dose was anticipated with hopes of inducing an immune response in formerly non-respondent individuals. We have vaccinated 394 patients with hematological cancer with the third dose of the mRNA BNT 162b2 COMIRNATY vaccine. Our results show promise, especially for increasing protective antibody levels in patients who retain valid antibody titers. We also identify problematic populations such as chronic lymphocytic leukemia, which still represent a major challenge for prophylaxis and protection against a severe course of COVID-19. Our report brings more insight into vaccination results and behavior. Importantly, we have identified risk groups in which poor outcomes can be anticipated and what extensive preventive measures should be undertaken to avoid COVID-19 infection. </p
The nutrition and life-style of mothers from industrial and nonindustrial regions related to their economic situation
No full textAim: The study analyzed the nutrition and lifestyle of mothers related to air pollution in industrial and non-industrial regions, taking into account the economic situation of households.Methods: The respondents were a deliberate sample of mothers from two regions of the Czech Republic – districts of Ceske Budejovice (CB, N=376) and Karvina (KA, N=449). Selected districts were chosen for their difference in the air pollution, with CB being one of the least polluted and KA one of the most polluted regions/districts in the Czech Republic. Data were collected in maternity hospitals in the years 2019 and 2020.Results: The majority of respondents (98.5%) described their economic situation at least as average. They also consumed daily at least one hot meal. In Karvina mothers more often eat fish, poultry, legumes and also sweet meals and fried food than in Ceske Budejovice, where are more often consumed dairy products. Information about health risk are important for change of their habits.Conclusion: Most mothers in our study subjectively evaluated their economic situation as moderately good in both regions. Better economic situation was correlated with healthy nutrition, including higher consumption of fruits and vegetables, wholegrain bread, beef and fish and lower consumption of sweet drinks and produced meats. Notably the consumption of fruits and vegetables in the industrial region has risen in comparison with previous data, which is an improvement promising a better starting position for the new generation.</p
The occurrence and influencing factors of fatigue and sleep disturbance in maintenance hemodialysis patients
No full textObjective: To investigate the occurrence and influencing factors of fatigue and sleep disturbance in Maintenance Hemodialysis (MHD) patients. Methods: A total of 170 patients with end-stage renal disease who underwent MHD treatment in the hemodialysis room of Shaanxi Provincial Hospital of Traditional Chinese Medicine from October 2021 to March 2022 were selected as the research subjects. The basic information and laboratory indicators of the patients were collected by cross-sectional survey. The survey methods were evaluated by the revised Piper Fatigue Scale and the Pittsburgh Sleep Quality Rating Scale and the incidence and influencing factors of fatigue and sleep disturbance in MHD patients were analyzed. Results: Fatigue occurred in 135 cases, the incidence rate was 79.41%; sleep disturbance occurred in 124 cases and the incidence rate was 72.94%. After one-way analysis of variance, factors such as exercise, Albumin (ALB, serum Creatinine(CRE), Phosphorus(P) and Hemoglobin(HGB) in MHD patients can affect fatigue; while age, gender, exercise, primary disease, dialysis frequency, Phosphorus(P), Hemoglobin(HGB) and high-sensitivity C-Reactive Protein (hs-CRP) factors can affect sleep. A multiple linear regression model was constructed for the factors affecting fatigue (F = 81.110, p < 0.001), and it showed that 70.3% of fatigue (adjusted R2 = 0.703) was related to albumin (ALB), serum creatinine(CRE), and hemoglobin(HGB) (all p < 0.05); A multiple linear regression model was constructed based on the factors of 58% (F = 26.933, p < 0.001), which showed that 58% of sleep disorders (adjusted R2 = 0.580) were significantly related to age, gender, exercise or not, phosphorus(P), high-sensitivity C-reactive protein(hs-CRP) (all p < 0.05) related. Pearson correlation analysis was used to analyze sleep disturbance and fatigue in MHD patients and the results showed that there was a positive correlation between the two (r = 0.478, p < 0.001). Conclusion: The proportion of fatigue and sleep disturbance in MHD patients is relatively high, mainly mild to moderate and the two influence each other. Exercise intervention and nutritional support can effectively improve the occurrence of fatigue and sleep disturbance in MHD patients.</p
Characterization of enterotoxigenic Escherichia coli heat-labile toxin (LT) double mutant LTA72R/R192G as a Nontoxic and Effective Mucosal Adjuvant
No full textThe heat-labile enterotoxins of Escherichia coli (LT) protein were reported to be an ideal mucosal adjuvant for nasal or oral delivery with antigen. Because of its toxicity, the application of native LT protein was focused on the purification of subunit B (LTB) or reconstructing non-toxic LT mutants, such as LTK63, LTR72, LTG192, or LTK63/R72. In this study, we mutated nucleotides coding the rd63rd and nd72nd residues, as well as the nd72nd, and 192th amino acids, to explore whether the double mutant LTA72R/R192G had a good adjuvanticity the same as the single mutant LTS63K or LTA72R, which were known as the ideal mucosal adjuvants. LTA72R/R192G was harmless to the mice because of the reduction of the ADP- ribosylation activity and toxicity. Besides, it could significantly enhance the mucosal immune response against the NCDV or CSFV antigens. In conclusion, the nontoxicity LTA72R/R192G may potentially serve as an effective adjuvant for mucosal immunization. </p
Normal left pulmonary inferior lobe in abnormal systemic circulation arterial supply
No full textNormal left pulmonary inferior lobe in abnormal systemic circulation arterial supply without sequestration is a rare malformation of congenital lung vascular. Multi-Detector Computed Tomography (MDCT) and it’s Three-Dimensional (3D) reconstruction can display clearly the signs of the abnormal systemic circulation arterial supply to the lung lobe and the imaging changes of the left pulmonary inferior lobe associated with this disorder, it can provide detailed information for the clinician to make the treatment planning. </p
Secondary metabolites production combined with lead bioremediation by Halamphora sp. marine diatom microalgae and their physiological response
No full textThis study was designed to investigate the physiological and biochemical response of the diatom microalgae Halamphora sp. (SB1 MK575516.1) to the toxicity of lead (Pb) as well as its ability as phytoremediation. Four different concentrations of Pb (50, 100, 150, and 200 mg L-1) were applied for 10 days. Fatty acid profile, mineral composition, secondary metabolite contents, and physiological responses have been determined in Halamphora biomass. We found that this metal was mainly removed by bio adsorption on cell surfaces and that Halamphora sp. could acclimatize upon long-term exposure to Pb stress. A decrease in the cell’s number and size, polyunsaturated fatty acids as well as mineral content in Halamphora sp were observed under Pb stress. However, an increase in polyphenol, flavonoid, and carotenoid contents has been recorded at 100 mg Pb L-1, with stimulation of the antioxidant capacity as measured by DPPH and ABTS radical scavenging activities. An increase in MDA, proline, and H2O2 levels were also observed. On the other hand, the deleterious effect of Pb resulting from the cellular oxidative state can be alleviated by the enzymatic system such as Superoxide dismutase (SOD), Glutathione peroxidase (GPx), and catalase (CAT). The present study indicates the ability of Halamphora sp. to remove heavy metals from the aquatic environment and produce antioxidant biomolecules.</p
Molybdenum supplementation may increase sulfides in the human colon
No full textI have observed what seems to be a rare but novel symptom that has not been documented in the medical literature, in a subject that I have been studying. The observation was a worsening of flatus and stool odor in this subject, a few days after the subject started an unphysiologically high dose of dietary molybdenum.</p
Psychiatric co-morbidities and substance abuse are dominant factors in Predicting Emergency Department usage rates
No full textImportance: 1% of the United States population accounts for 20% of healthcare costs. What characterizes heavy users of the Emergency Department (UED) both demographically and clinically is an area of active research.Objective: Compare the proportion of nine common co-morbidities between heavy, moderate, and infrequent users then compare episodic and continuous heavy UED. Setting: A large metropolitan healthcare system.Participants: Heavy users were selected using a retrospective chart review of Barnes-Jewish Emergency Department records from 2010-2011. Emergency department usage for all unique patients seen in the time period specified was determined for two non-overlapping 365-day periods. Patients were stratified into 1 of 3 groups: Heavy users (> 10 visits for both periods), moderate users (5-9 visits for both periods), and infrequent users (1 visit in either the first or last period). There were 546 moderate users and 59,957 infrequent users matched 1:1 against 160 heavy users. These patients were matched for age, race, gender, and insurance. The 160 continuous heavy users were also compared to 388 patients who had > 10 visits in the first period, but not the second period, and 443 patients who had > 10 visits in the second period, but not the first. The proportion of subjects within each group was compared based on nine co-morbidities (substance abuse, mental illness, chronic pain, heart disease, lung disease, kidney disease, liver disease, cancer and stroke) using 95% confidence intervals.Results: Infrequent users had lower rates of all co-morbidities. Moderate users had similar rates of all co-morbidities to heavy users, except slightly higher CVA rates (13.7% v 10.6%; p = 0.49), lower rates for mental illness (33.3% v 43.1%; p = 0.08) and significantly lower rates for substance abuse (17% v 35%; p < 0.001). Only substance abuse demonstrated a significant difference between episodic and continuous heavy UED (35% v 23.5%; p = 0.002). Conclusion: Among nine common co-morbidities, only substance abuse rates were significantly higher among heavy users compared to matched moderate UED in our healthcare system. Infrequent users had lower rates of all co-morbidities. When comparing continuous and episodic heavy emergency department users, only substance abuse rates were significantly higher.</p
Distinct perivillious fibrin deposition and evidence of persisting positive SARS-CoV-2 PCR in placental tissue after COVID-19 Infection in the second trimester
No full textBackground: The effects of Coronavirus disease 2019 in women during the second trimester of pregnancy and the health of the fetus, remain very poorly explored. This report describes a case in which the normal development of pregnancy was complicated immediately after the patient had experienced COVID-19 at the 21st week of gestation. Specific conditions included critical blood flow in the fetal umbilical artery, fetal growth restriction and hydramnios in the 25th week of gestation. After informed consent, we decided just to wait and interrupted all examinations (CTG, Ultrasound) because of the high risk of severe adverse events at such an early premature birth. The patient finally delivered a healthy boy in the 39th week of gestation. Methods: We performed a histological examination of the placenta and analyzed the placenta for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through molecular and immunohistochemical assays and measured the fetal antibody response in the blood to this infection.Results: In the immunohistochemical examination with antibodies against SARS-CoV-2 a partial positivity in the villious throphoblastic epithel cells could be demonstrated. The PCR swab of the placenta which was obtained was positive for SARS-CoV-2 with a crossing threshold value of 22,8. The histological examination of the placenta showed a Massive Perivillous Fibrinoid Deposition (MPFD) with multiple focal placental infarctions in the intervillious space, intervillious thrombus, and a localized chorangiomatosis. Conclusion: According to many clinical and laboratory findings in this patient, the histopathological features and viral infection of the placenta suggest a prominent role for COVID-19 in this patient’s presentation. This is highlighted by the presence of levels of SARS-CoV-2 RNA. In this patient, an infection with Sars-CoV-2 might have caused the development of the MPFD. These findings suggest that COVID-19 may have contributed to placental dysfunction and fetal growth retardation. Also with a SARS-CoV-2 PCR test with a crossing threshold value of 22,8, it must be assumed that the placenta has been potentially infectious.</p
Awareness of smell exercise after smell dysfunction related to COVID-19 in Alahsaa, Saudi Arabia
No full textIntroduction: Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome. Globally, COVID-19 has infected more than 573 million people, with over 6.3 million deaths on July 27, 2022. The symptoms range from cold-like symptoms, cough, fever, shortness of breath, and sore throat; additionally, studies show that patients frequently have problems with smell and taste disorders (STD).Aim: We aim to estimate the prevalence of COVID-19-related anosmia, hyposmia, and parosmia in Alahssa, Saudi Arabia and establish the level of awareness of smell exercises.Patients and methods: This is a cross-sectional study conducted among adults aged 18–60 living in Alahssa, Saudi Arabia. An online questionnaire containing an informed consent form and a survey to collect demographic data, vaccination status, level of loss of smell and taste, and the level of awareness about smell exercises was distributed among all participants who agreed to participate in this study.Results: Five hundred twenty-four adults agreed to participate in this study. When we assessed their awareness of the smelling exercise, it was found that only 115 patients (21.9%) were aware. About 49 patients (61.3%) practiced the smelling exercise, and 55% reported improvements afterward.Conclusion: The prevalences of olfactory and gustatory dysfunction were found to be 54.6% and 52.5%, respectively. Awareness of olfactory training was moderately low among those infected with COVID-19, while 28% of the patients who had experienced olfactory disturbances were aware of this training. Active, collaborative research is essential for describing the natural history and effective therapy of chemosensory impairment in COVID-19.</p