1 Mesenchymal Stem Cell Transplantation for COVID-19 , Attapon Cheepsattayakorn1*, Ruangrong Cheepsattayakorn2
In-vitro, Mesenchymal Stem Cell (MSC) populations with potentials of similar multi-lineage differentiation have been obtained from several Bone Marrow (BM) and non-bone marrow tissues, including umbilical cord, placenta, amniotic fluid, adipose tissue, and peripheral blood [1-10]. The clonogenic BM-human MSCs fraction ranges from 10 to 100 Colony-Forming Unit-Fibroblast (CFU-F) per 106 Marrow Mononuclear Cells (MNCs) [11]. BM-human MCSs are characterized by lacking CD11b, CD14, CD19, D34, CD45, CD79α, and Human Leukocyte Antigen (HLA)-DR expression; positive expression of surface antigens CD73, CD90, and CD105; multipotency (i.e., chondrogenic, osteogenic, and adipogenic); and their adherence to plastic [11]. By the year 2000, clinicians increasingly had become interested in intravenously applied MSC therapy [12]. A previous study demonstrated that both human and murine MCSs can induce immune suppression by attracting and killing auto reactive T cells via FasL, therefore stimulating Transforming Growth Factor-beta (TGF-β) production by macrophages and generation of regulatory T cells [13]. The dying T cells that is caused by the interaction involving the MSC-induced Monocyte Chemoattractant Protein-1 (MCP-1) secretion in turn activate macrophages to produce TGF-β, then stimulating regulatory T cells and promoting immune tolerance [14]. The capacity of MSCs for in-vivo differentiation and engraftment and by their efficacy in promoting wound healing highlighted its clinical relevance [15-21].
2 Chikungunya: A Neglected Tropical Disease , Rajeshwar Reddy Kasarla1*
Chikungunya, a mosquito-transmitted viral disease endemic to tropical regions is recurring in epidemic waves over the last 15 years, with outbreaks becoming increasingly severe, infecting over one million people annually and causing debilitating joint pain. The virus caused outbreaks throughout the world with an ability to spread to non-endemic areas. The Chikungunya Virus (CHIKV) was first described during an outbreak in 1952 on the Makonde plateau, in the Newala district, along the border, between Mozambique and Tanganyika, the mainland part of modern-day Tanzania in East Africa. It was subsequently introduced into Asia and caused several periodical outbreaks in various African and South-East Asian countries (India and Thailand) since the 1960s. Though chikungunya virus was first isolated in 1952, its biology, transmission, and mechanism of pathogenesis has been poorly understood, and deserves more attention [1].
3 The Spheroid Smarting- Glomus Tumour , Anubha Bajaj1*
Glomus tumour is benign, perivascular hamartoma arising from glomus apparatus or a mesenchymal neoplasm essentially comprised of modified smooth muscle cells, also termed as glomangioma, glomangiomyoma or glomangiomatosis. Glomus tumour can arise from bi- allelic inactivation of Neurofibromatosis type 1(NF1) and emerges in concurrence with NF1 gene. Also, decimation of neurofibromin within glomus cells activates the RAS-MAPK pathway. A gradually progressive, faintly tinged, bluish-red, subungual papule demonstrating a classic triad of symptoms as localized sensitivity, pain upon exposure to cold and intense pain with minor trauma is exhibited. Morphologically, a combination of glomus cells, smooth muscle cells and cogent vascular elements is discerned. Spheroid, punched out nuclei surrounded by minimal cytoplasm, an amphophilic to eosinophilic stroma and circumscribing branching, capillary sized vasculature is delineated.
4 Automatic Extraction of Epidemic-Related Sites in COVID-19 Media Reports of Webpages Based on Conditional Random Field Model , Kuiyun Huang1, Jinming Cao2, Bin Zhao1*
Background: Since the outbreak of the COVID-19 in Wuhan, China, in early December 2019, the Chinese government has formed a mode of information disclosure. More than 400 cities have announced specific location information for newly diagnosed cases of novel coronavirus pneumonia, including residential areas or places of stay. We have established a conditional random field model and a rule-dependent model based on Chinese geographical name elements. Taking Guangdong province as an example, the identification of named entities and the automatic extraction of epidemic-related sites are carried out. This method will help locate the spread of the epidemic, prevent and control the spread of the epidemic and gain more time for vaccine clinical trials. Methods: Based on the presentation form of the habitual place or place of stay of the diagnosed cases in the text of the web page, a conditional random field model is established, and a rule-dependent model is established according to the combination rule of the elements of the place words and the place name dictionary composed of provinces, cities and administrative regions. Findings: The results of the analysis based on the conditional random field model and the rule-dependent model show that the location of confirmed cases of new coronavirus pneumonia in Guangdong Province in mid-February is mainly concentrated in Guangzhou, Shenzhen, Zhuhai and Shantou cities. In Guangzhou, Futian district has more epidemic sites and Huangpu and Conghua district has fewer epidemic sites. Government officials in Guangzhou City should pay attention to Futian District. Interpretation: Governments at all levels in Guangzhou Province have intervened to control the epidemic through various means in mid-February. According to the results of the model analysis, we believe that the administrative regions with more diagnosed locations should focus on and take measures such as blockades and control of personnel flow to control the disease in those administrative regions to avoid affecting other adjacent administrative regions.
5 Coronavirus COVID-19 Detection, Symptoms, Spread and Prevention , Mamdouh I Nassar1*, Soha M Mohamed2, Samer M Ibrahim3
An ongoing outbreak of pneumonia associated with 2019 novel coronavirus (2019- nCoV) was reported in China. The epidemiological evidence has shown a potential transmission of the 2019-nCoV during the incubation period. It is unclear if the infectivity exists during the incubation period, although a person-to-person transmission has been reported in previous studies. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. This review provides a cautionary warning that COVID-19 may be shed through multiple routes.
6 Vitamin D Deficiency and Its Relation to Allergic Diseases: A Cross Sectional Study Among Allergic Patients from Jeddah City, Saudi Arabia , Amal A Abbas1,2*, Johara Wajeeh1, Hanan Wajeeh1, Asma Alghamdi1, Shahd Al Sharief1
Objective: In this cross-sectional study, we aimed to estimate the prevalence and trend of sensitization to common aeroallergens and food allergens among allergic patients and investigate the relationship between their atopic profile and vitamin D level. Methods: A total of 918 patients referred to King Fahd General Hospital Immunology Laboratory in Jeddah city; Kingdom of Saudi Arabia (KSA), with clinical manifestations or suspicion of respiratory and/or food allergies were included in the study. They underwent tests for total and allergen-specific serum IgE (sIgE). Vitamin D data was available for 222 sensitized patients. Results: Out of 918 patients, 383 cases exhibited positive sIgE to either one or more allergens (41.7%). Indoor allergens were the most common type of aeroallergens followed by grass pollens, molds and tree pollens. The most frequent indoor allergen panel was House Dust Mites (HDM) and cockroach panel. It included Dermatophagoides pteronyssinus and Dermatophagoides farina with (31.2 %) and (30.9%) prevalence respectively, then cockroach German (14.2%), followed by cat dander (9.3%) and dog dander (9.2%). The most prevalent grass pollen allergen was Bermuda grass (7.7%), while the commonest mold allergen was Candida albicans (7.1 %). The top food allergens were shrimp (16%), cod fish (8.3%) and peanut (6%) followed by milk (5.7%) and soybean (5.2%). The majority of the patients had vitamin D deficiency (74.7%) and (12.6 %) had vitamin D insufficiency. Patients with vitamin D deficiency are more liable to have allergic sensitization to different allergens, both food and aeroallergens among all grades than those with insufficient or sufficient levels, especially in high reactivity group (grade 6) in which 95% of patients had vitamin D deficiency. Conclusion: Sensitization to HDM, cockroach German and cat dander showed an increased prevalence amongst studied patients. The most frequent food allergens were shrimp and codfish. Vitamin D deficiency is significantly noticeable among allergic patients.
7 Immunogenetics and Immuno-epidemiological Parameters of COVID-19 , Attapon Cheepsattayakorn1*, Ruangrong Cheepsattayakorn2
As of February 15, 2020, 51,800 cases of COVID-19 disease, including more than 1,600 COVID-19 related deaths, had been laboratory-confirmed in mainland China, mainly in Hubei province. Additionally, 526 laboratory-confirmed cases have been reported across 25 other countries. Approximately, 15% of cases reported to the World Health Organization (WHO) are severe, 3% are critical, and 82% are mild clinical manifestations, whereas the estimated overall case fatality rate is approximately 2% but the figure outside of Hubei province is approximately 0.05% or less, not different from the fatality identified in the seasonal influenza. The mean age of COVID-19 patients is 52.4 years, whereas children and adolescents are the least likely group to be infected with the COVID-19, occurring in only 2 % of cases 19 years of age or younger. When the younger-age group get sick, they will get a mild form of COVID-19 without serious complications, with an average death rate of 0.2 %. Men constitute more than two-thirds of the reported COVID-19 cases (73 % vs. 27 %) and are more than 1.5 times more likely to die from COVID-19 (death rate : 2.8 % vs. 1.7 %). This sexual distinction of the anti-viral immunity between men and women is due to the genetic factors, hormonal factors, and environmental factors. The unanswered questions include the pathophysiology of pulmonary clinical infection, influenza and other viral co-infection, and the rate of bacterial complications. SARS-CoV-2 (COVID-19) infection has evolved to become a pandemic, in contrast to infections with SARS and MERS, whereas SARS-CoV-2 (COVID-19) has demonstrated having the similarities of genome sequence, receptor affinity, pathogenesis, and disease manifestation. In conclusion, although genomic evidence does not support the belief that COVID-19 is a laboratory construct, currently it is impossible to disprove or prove the theories of its origin. To identify the COVID-19 origin, obtaining virus sequences from immediate non-human animal sources would be the most definite method. In the absence of proper cure of COVID-19, it is necessary to identify the factors that may assist in assessment of the COVID-19 disease severity before rapid progression of the disease.
8 Mycobacterial Infection in Children at the Chu Hospital Du Mali: A Series of 12 Cases , Bréhima Traoré1*, Abou Coulibaly1, Bourama Kané2, Lassina G Timbiné1, Abdoul Karim Sangré1, Judicaël Ouedraogo1, Bourema Kouriba1
Introduction: Mycobacterial infections include infections with M. tuberculosis complex, M. leprae, and non-tuberculous mycobacteria. Mycobacteria can cause a wide variety of infection. Diagnosis of these infections is challenging especially in children because of low availability of clinical and laboratory services particularly in low-resource settings. Methods: We describe a retrospective case series of mycobacteria infections in children aged 0-15 years at the pediatric department of the Hospital du Mali between January and December 2017. The diagnosis was based on clinical assessment, microbiology (microscopy, culture, PCR); histopathology findings; and radiology evidences. Results: During the study period, 11354 children were seen in consultation among them 60 children had suspicion of Tuberculosis (TB). Mycobacteria infection was retained in 12 children. 66.7% were male and the average age was 8 years. Ten children (83.3%) were BCG vaccinated and 16.7% had history of TB contact. The most common symptoms were cough (83.3%), fever (75%), general state altered (75%) and dyspnea (50%). The locations were Lung (58.3%), miliary (16.7%), multifocal (8.3%), pericarditis (8.3%) and pleural (8.3%). The Tuberculin Skin Tests (TST) was negative in 58.3%. All children (100%) were seen more than a month after the onset of the symptoms. Other comorbidities were malaria (25%), severe malnutrition (25%), HIV (16.7%) and hypertension (16.7%). Conclusion: Combination of clinical, microbiological, histopathological and radiological examinations enabled us to better explore tuberculosis in children.
9 How Does Dexamethasone Work Against the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)? , Yusra Binte Sikandar1, Syed Abdullah Ibn Asaduzzaman1, Abrar Hamim Fayz1, Rashed Noor1*
The continuing COVID-19 pandemic instigated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led the scientists discover an array of candidate drugs and set up possible vaccine platforms under trial. However, till date no vaccines have been established to abate COVID-19 pandemic while a few drugs as the anti-virals or the immunomodulators have been proposed on the basis of patient trial success. One of them is remdesivir which is actually a broad spectrum anti-viral drug. Recently, the corticosteroid dexamethasone has evolved with a stunning property to cure the COVID-19 patients who have developed the Acute Respiratory Syndrome (ARDS), requiring ventilation. Several recent case studies have shown the efficacy of dexamethasone to treat the severe patients who were at the risk of death. Present review focused on the mechanism of action of dexamethasone with its specific immunological functions in course of curing the SARS-CoV-2 infection within a patient. A model regarding the mechanisms of dexamethasone action has been proposed as well.
10 SUBMIT MANUSCRIPT   Methicillin-Resistant Staphylococcus Aureus (MRSA): Prevalence and Antimicrobial Sensitivity Pattern among Outdoor and Indoor Patients Dhaka City Hospital, Bangladesh   , Md. Ashiqur Rahman1*
Methicillin-Resistant Staphylococcus Aureus (MRSA) is one of the significant pathogens with associated public-health concern in the world. This present study has been focused on the prevalence of MRSA and their antibiotic resistance of indoor and outdoor patients different age and gender in clinical history, Dr. Sirajul Islam medical college and hospital Dhaka, Bangladesh. We were performed during the period of January 2019 to July 2019. A total 964 samples which is outdoor 354 (36.72%) indoor 610 (63.27%). We were observation 5 days (BACTEC-9050 Machine) then inoculated selective onto Blood agar and MacConkey agar media and the culture plates were incubated at 37°C for 24 hrs. The S. aureus colonies showing golden yellow colour on Blood agar were primarily identified as S. aureus, which were then subjected for catalase and coagulase tests. The Methicillin-Resistant Staphylococcus Aureus (MRSA) could be detected only 42 (4.35%) into, males 18 (1.86%) and female 24 (2.48%) in total sample, on the other hand Staphylococci aureus. (MSSA) 50 (5.18%), Pseudomonas spp. 14 (1.45%), Klebsiella spp. 13 (1.34%), Salmonella spp. 27 (2.80%), E. coli 21 (2.17%), No MRSA, MSSA and other organisms are found 797 (82.67%), Standard antimicrobial disks representing multiple sixteen drug were, Sensitive-381 (56.69%), Resistance-284 (42.26%), as well as Intermediate-7 (1.04%) against antibiotics, Oxacillin, Vancomycin, Erythromycin, Co-trimoxazole, Ciprofloxacin, Gentamicin, Linezolid, Amoxicillin, Amoxyclave, Azithromycin, Imipenem, Meropenem, Netilmicin, Gatifloxacin, Cloxacillin, Sparfloxacin. In this review, we describe the current burden of MRSA infections in healthcare and community of Bangladesh. And settings across other country the main threats caused by recent changes in the epidemiology of MRSA. This data has important implication for quality of patients care antibiotic selection and infection control practices.
11 Is Diabetes Epidemic? - Symbiosis as Collective Consciousness , Maria Kuman1*
According to recent CDC data, in the US 10.5% of the population has diabetes, but another 21.4% are not diagnosed. This totals to 1/3 of the US population having diabetes in 2019 and the number steadily increases every year. The same is the situation in Canada – 1/3 of the Canadians had diabetes in 2019. A natural question arises: Is diabetes epidemic? And if it is, what is causing it? Diabetes is increased sugar level in the blood caused by decreased function of the pancreas. Normally, the pancreas produces enough insulin to degrade the sugar. So, there should be a factor that decreases the production of insulin in the pancreas, which leads to increased blood-sugar level. Studies done in Europe show that there is a parasite with the shape of a pumpkin seed, called pancreatic fluke, which inflicts the pancreas and decreases its function, thus causing high blood-sugar problem [1]. There are two alternatives:  putting the people with diabetes on insulin for life and seeing the number of diabetics grow every year or looking for alternative approaches. If pancreatic fluke causes the diabetes, the diabetes is going to have epidemic character. If so, in order to stop the growth of number of people with diabetes, these people should do parasite cleansing and help the pancreas restore its normal function or cure the diabetes with acupuncture.
12 The Juvenile Ribbons-Foetal Type Rhabdomyoma , Anubha Bajaj1*
Foetal rhabdomyoma is an exceptional, benign, heterologous, immature neoplasm demonstrating skeletal muscle differentiation. Foetal rhabdomyoma commonly emerges in infants and young children with a majority of neoplasms appearing beneath <3 years and a median age of disease emergence at 4 years. Majority of neoplasms are discerned within the head and neck or posterior auricular region. Rhabdomyoma is categorized as cardiac or extra-cardiac subtypes. The neoplasm can be discerned incidentally or appear as an asymptomatic tumour mass or represent as a painless nodule. Foetal rhadomyoma is pauci-cellular and comprised of primitive, spindle-shaped cells admixed with differentiated myoblasts depicting centroidal nuclei, prominent nucleoli and abundant, eosinophilic cytoplasm incorporated with cross striations.
13 Contact Dermatitis from Jamon Serrano , Gina Grimalt1, Enrico Valerio2, Mario Cutrone3, Ramon Grimalt1*
A 42-year-old man working as a specialized deboning butcher (deshuesador) in a “Jamon Serrano” factory in Spain presented with a professional hand contact dermatitis. We patch tested the patient with the rope that is used to hang the pig leg, with the grease covering the skin of the pork leg, with the grease covering the rope and with the grease in close contact to the ham itself. Patch test showed positive results at day 2 and 4 to the external grease and negative results to the rest. We path test 10 volunteers to exclude irritant contact dermatitis. One patient showed positive result to the grease, rope and grease covering the rope, rest of volunteers showed negative results. We patch tested the products used to cure the ham: rosed jam, marine salt H3, nitrificant 45 and curavi E-5 with negative results. We studied preservatives present on the different types of curing salt: E-310, E-250, E-331 and E-252. Accordingly, we also tested: sodium ascorbate 1% and 5%, sodium nitrite 10% trisodium citrate 10% and potassium nitrate at 10%, with negative results. The case was finally considered to be an irritant contact dermatitis from “serrano ham”.
14 Deforestation, Air Pollution and Brazilian COVID-19 Variant , Luisetto M1*, Naseer Almukthar2, Khaled Edbey3, Fiazza C4, Ahmed Yesvi Rafa5, Ghulam Rasool6, Latishev O Yurevich7
Aim of this work is to submit to the researcher the relationship whit climate condition, air pollution and deforestation in Manaus zone in Brazil and the rapid spread of so called Brazilian COVID-19 variant. Also other situation are analysed like South Africa variant. This topics of research make possible to better study the phenomena of new COVID-19 variant explosion and related effect on increase velocity in spread and in increased mortality rate in some region of the world. The ability of this variant to elude immune system need to seek also in environmental toxicology some response.
15 How Fungus Can Debilitate Your Immune System? , Raghavendra Rao MV1*, Abrar A Khan2, Srinivasa Rao D3, Dilip Mathai4, Mohammad Khaleel5, Mubasheer Ali6
ittle is known about the precise mechanism involved in immunity to fungal infections. Researchers discovered that fungal prostaglandins, deactivate immune cells, preventing them from destroying the infection. Fungi are known to make molecules similar to those of our own immune system. Scientists found that the fungus molecules weaken the immune system, which is essential in stopping infections. Opportunistic infections like Cryptococcus which normally pose no threat, but are potentially life-threatening in those with weakened immune systems. Scientists are now working to find the other ways these fungal molecules are affecting immune cells and how the immune cells are deactivated. Antibodies against fungi and yeasts may be found in the sera of many apparently normal people, as well as in those who have overt infections. In presence of clinical fungal infections e.g. due to Aspergillus fumigatus, the amount of antibody may be so great as to be readily demonstrable by precipitin tests. Although there is considerable evidence to implicate such antibodies in the pathogenic effects of pulmonary fungal infections, there is no evidence that they hinder their spread once infection is established. However, the very fact that patients with immunoglobulin deficiency diseases are so unduly prone to candida and monilia infections indicates that antibodies must play some part in protecting against initial or reinfection.
16 Psoriatic Manifestation on a Healed Herpes Zoster Lesion: A Case of Koebner Phenomenon Resistant to TNF-α Inhibitors , Capalbo Alessandro1, Gagliostro Nazareno1, Balampanos Charalampos Georgios1, Bushati Vilma2, Persechino Flavia3, Giordano Domenico4, Persechino Severino4*
Herpes Zoster (HZ) and psoriasis are common cutaneous diseases and in some patients psoriatic manifestations may appear over healed HZ lesions. This manifestation has been defined as Koebner Phenomenon (KP) or Wolf Isotopic Phenomenon (IP). We report a 35-year-old man with chronic moderate plaque psoriasis who developed KP at the areas of healed HZ. We noticed a lack of response to TNF alfa inhibitor treatment in the lesions previously affected by HZ. Therefore, we assume that other inflammatory mediators, in particular Substance P, can be related to the psoriatic manifestations over healed HZ lesions.
17 Morphea (Localized Scleroderma) in a COVID-19 patient: A Case Report , Capalbo Alessandro1, Gagliostro Nazareno1, Balampanos Charalampos Georgios1, Bushati Vilma2, Persechino Flavia3, Giordano Domenico4, Persechino Severino4*
Since the COVID-19 pandemic raised all over the world a year ago, many dermatological manifestations have been reported in COVID-19 patients including alopecia areata, erythematous rash, widespread urticaria and chickenpox-like vesicles and Chilblain-Like Acral Skin Lesions. This is the first case reported of morphea in a 62 years old Caucasian woman diagnosed during recovery from Sars-Cov-2 pneumonia in January 2021. She presented to our clinic in Saint’ Andrea hospital in Rome with multiple white sclerotic skin lesions with erythematous halo (lilac ring) all over the trunk. After blood tests, HRCT, serological tests and skin biopsy the only clinical reference was COVID-19 infection. Therefore, knowing that COVID-19 is related to immunological mechanisms we assume that both conditions are related. The pathways of connection between morphea and COVID-19 are still unknown that’s why further studies are needed.
18 Immuno-Multi-Therapy and Prophylaxis Efficacy against COVID-19 , Lungu P Anzwal1*, Kalumba A Kambote1, Tshinawej P Mukiny2, Sadiki P Wabula3, Moba C Iselenge3, Bangutulua V Mbezi3, Mokalu S Maope3, Jean-Paul J Gonzalez4, Balaka M Ekwalanga1
In the context of the current COVID-19 pandemic, strategies for finding effective therapies advocate the so-called “therapeutic repositioning” approach, i.e., the use of existing molecules on the pharmaceutical market, whose toxicity and therapeutic efficacy are known. The immunotherapy proposed in this study consisted to use four well-known components of validated therapeutic drugs, namely: interferon type 1 (IFNα), interferon type 2 (IFNγ), chloroquine (Chloroquine phosphate) and antioxidants (Vitamins A, C, E, trace elements and lycopene). Such non pathogen specific treatment was curative and preventive (i.e., prophylaxis), and expected to enhance the patient’s innate response. A selected cohort consisted of 122 patients tested positive by RT-PCR (SARS-CoV-2 infection). Among them, 89 patients were asymptomatic and 43 symptomatic (COVID-19). Due to the compassionate nature of this therapeutic approach, age, and gender were randomized. Four types of treatment were selected using a multi-therapy approach applied for a duration of five days. Among the medical team in charge of the protocol ten (10) were subjected for prophylactic purposes to a three-day tri-therapy treatment. A total of 132 participants received a multi-therapy treatment as curative treatment (122 patients) and as prevention (10 health workers). All participants were tested for RT-PCR before treatment, all patients tested positive while the health workers tested negative. After two weeks all participants tested negative by RT-PCR. Clinical follow-up showed a total and rapid recovery at the early stage of tri-immunotherapy while repeated RT-PCR testing for the participants with preventive treatment remained negative. Conclusion. Such multi-immunotherapy protocols against SARS-CoV-2 efficacy appear substantial for treatment and potentially efficient for health worker prevention. Due to our limited subject and the compassionate context, all multi-immunotherapy protocols would require a control study to evaluate their efficacy.
19 Lyme Disease-An Emerging Metazoonosis of Public Health Concern , Mahendra Pal1*
Recent decades witnessed the emergence of several zoonotic diseases, such as bird flu, Ebola disease, Nipah virus disease, severe acute respiratory syndrome, swine flu, COVID-19 and others [1]. The emergence of these zoonoses attracted the attention of national and international health authorities throughout the world. Emerging zoonoses caused by a variety of organisms like viruses, bacteria, fungi, Rickettsia, protozoa, and helminths, are significant causes of morbidity and mortality in humans as well as in animals. These diseases can occur in sporadic as well as epidemic form and are encountered in both sex, all age groups, in all seasons, in rural and urban settings, and in all climatic zones [1]. Several factors like rapid urbanization, industrialization, agricultural intensification, globalization of trade and travel, deforestation, natural disasters, social upheaval, construction of dam, and natural disasters etc. are driving the emergence of zoonotic diseases [1,2].
20 Some Opinions or Comments on the Five Important Papers Published Recently , Kuo-Chen Chou1*
It is my great honor and rare privilege to humbly share my opinions or comments for the five widely admirable recognized papers [1-5]. My humble opinions and comments are as follows: The door-opening policy is extremely important for a country to stimulate its development of science. In this sense, the science and technology for the door-opening countries are overwhelmingly advanced. It is also very important to follow the “5-steps rule” (Fig. 1), particularly in dealing with molecular biology or molecular biomedicine systems.
21 COVID-19 Vaccination in Patients with Pre-Solid-Organ Transplantation , Attapon Cheepsattayakorn1,2*, Ruangrong Cheepsattayakorn3, Porntep Siriwanarangsun1
Vaccine such as influenza vaccine, is administered in stable transplant recipients, although live attenuated virus vaccines are contraindicated, generally due to risk of disseminated infection [1,2]. Neither efficacy, safety, nor durability are well known in transplant recipients due to exclusion of them from recent COVID-19 vaccine trials [1,2]. Currently, there are no SARS-CoV-2 vaccine platforms using attenuated live virus approved in phase III trials. Nevertheless, if they are approved for use, concerns, including potential decrease in efficacy in immunocompromised patients, potential for vaccine-related allograft rejection, unknown durability of the immune response, and long-term safety data still exist. Due to experience with neither the influenza vaccine nor the adjuvant recombinant zoster vaccine having been related to allograft rejection, successful administration of influenza and adjuvanted recombinant zoster vaccines to stable transplant recipients, and unanticipated vaccine-related adverse events to the allograft having not borne out, the influenza and adjuvanted recombinant zoster vaccines are able to be extrapolated to COVID-19 vaccines [2,3]. In immunocompromised host, concerns for adenoviral vector vaccines are focused on a viral infection, but these concerns have no scientific evidence. Although newly approved adenoviral-vector use for vaccination, this vaccine platform has been used for decades for gene therapy for cancer and other rare diseases. Inactivated virus and protein subunit vaccine platforms that have been used in transplant recipients for other infections, such as human papilloma virus, pertussis, and hepatitis A and B, are currently under investigation for SARS-CoV-2 (COVID-19) infection in transplant recipients [2].
22 Outcome of Different Therapeutic Interventions in Mild COVID-19 Infection , Sayak Roy1*, Shambo Samrat Samajdar2, Santanu K Tripathi3, Shatavisa Mukherjee4, Kingshuk Bhattacharjee5
Background: Coronavirus disease 2019 (COVID-19) case and the death toll has reached milestones of over 12,28,22,505 and 27,09,041 respectively worldwide as of 22nd March 2021. Treatment regimens are cropping up daily and adding up to the dilemma of the treating physicians. Aims: This present study aimed to see the Clinical Response of Well-Being (CRWB) reporting time in mild COVID-19 infected patients after their treatment initiation in four different treatment arms. Methods: A total of 56 patients meeting the case definition of mild COVID-19 infection were included after the retrospective screening of the investigators’ electronic database. Patients were divided into four groups – Hydroxychloroquine (HCQ) taking group, patients on the combination of Doxycycline (DOX) + Ivermectin (IVR), Azithromycin (AZ) taking group and symptomatic treatment receiving group. Results: There was no difference in CRWB between the four groups (p-value 0.846). The group on symptomatic management arm showed significant correlation between CRP (p-value 0.01), LDH (p-value 0.001), and age (p-value 0.035) with CRWB. Significant correlation was also seen between blood levels of CRP (p-value 0.03), LDH (p-value 0.001) and D-dimer (p-value 0.04) with CRWB in the IVR+DOX group. Conclusion: No specific drug treatment is required to treat mild COVID-19 infection other than symptomatic management in patients with a low risk of progression.
23 Limited Temporary Effect of Several Social Relaxation Events on the COVID-19 Series: An Analysis Based on Primary Data , Fábio de Oliveira Martinez Alonso1, Bruno Duarte Sabino2, Marcia Soraya Carreteiro de Oliveira3, Fabiana Batalha Knackfuss4, Rafael Brandão Varella5*
The relaxation of restrictive measures imposed by the COVID-19 pandemic allowed a gradual resumption of human activities, although the influence of each measure on the COVID-19 series is not consensual. We analyzed the effects of sequential reopening events during COVID-19 pandemic based in 76,419 SARS-CoV-2 RT-PCR tests performed from April 2020 to January 2021 in Rio de Janeiro metropolitan area, Brazil. A statistically significant increase in cases after 3-4 weeks of reopening measures, followed by a drop for a similar period, indicated that such events resulted in temporary and non-cumulative effects. A second peak in November was preceded by measures of social relaxation of a high level of agglomeration in confined spaces, including an election campaign. Post-opening events provoked different impacts on cases, but showing limited temporary effect. It is possible that other factors, including the exhaustion of social distancing and the appearance of new SARS-CoV-2 strains may have also influenced this second wave.
24 Analysis of the Study of the Expression of Apoptosis Markers (CD95) and Intercellular Adhesion Markers (CD54) in Healthy Individuals and Patients Who Underwent COVID-19 When Using the Drug Mercureid , Sergey N Gusev1*, Velichko LN2, Bogdanova AV2, Khramenko NI2, Konovalova NV2
SARS-CoV-2, the pathogen, which is responsible for coronavirus disease 2019 (COVID-19), has caused unprecedented morbidity and mortality worldwide. Scientific and clinical evidence testifies about long-term COVID-19 effects that can affect many organ systems. Cellular damage, overproduction of proinflammatory cytokines and procoagulant abnormalities caused by SARS-CoV-2 infection may lead to these consequences. After suffering from COVID-19, a negative PCR test is only the beginning of a difficult path to full recovery. 61 % of patients will continue to have the signs of post-covid syndrome with the risk of developing serious COVID-19 health complications for a long time. Post-COVID syndrome is an underestimated large-scale problem that can lead to the collapse of the healthcare system in the nearest future. The treatment and prevention of post-covid syndrome require integrated rather than organ or disease specific approaches and there is an urgent need to conduct a special research to establish the risk factors. For this purpose, we studied the expression of markers of apoptosis (CD95) and intercellular adhesion (CD54) in healthy individuals and patients who underwent COVID-19, as well as the efficacy of the drug Mercureid for the treatment of post-covid syndrome. The expression level of the apoptosis marker CD95 in patients who underwent COVID-19 is 1.7-2.5 times higher than the norm and the intercellular adhesion marker CD54 is 2.9-4.4 times higher. This fact indicates a persistent high level of dysfunctional immune response in the short term after recovery. The severity of the expression of the intercellular adhesion molecule (ICAM-1, CD54) shows the involvement of the endothelium of the vascular wall in the inflammatory process as one of the mechanisms of the pathogenesis of post-covid syndrome. The use of Mercureid made it possible to reduce the overexpression of CD95 in 73.4 % of patients that led to the restoration of the number of CD4+/CD8+ T-cells, which are crucial in the restoration of functionally active antiviral and antitumor immunity of patients. Also, the use of Mercureid led to a normalization of ICAM-1 (CD54) levels in 75.8 % of patients. The pharmacological properties of the new targeted immunotherapy drug Mercureid provide new therapeutic opportunities for the physician to influence a number of therapeutic targets, such as CD95, ICAM-1 (CD54), to reduce the risk of post-COVID complications.
25 The Parochial Meddle-Endolymphatic Sac Tumour , Anubha Bajaj1*
Endolymphatic sac tumour is an exceptional, benign neoplasm arising from epithelium of endolymphatic duct or sac. Endolymphatic sac tumour is associated with von Hippel –Lindau disease in around 11% to 30% of subjects. The gradually progressive endolymphatic sac tumour manifests with acute or progressive deafness, tinnitus, episodic vertigo, otalgia, otorrhoea, disequilibrium, aural fullness, occipital headache, neurological deficits, facial paresis or hypoglossus muscle paralysis. The papillary neoplasm is layered with simple, cuboidal to columnar epithelial cells with minimal nuclear atypia, infrequent mitotic activity and absence of tumour necrosis. Endolymphatic sac tumour requires a segregation from neoplasms such as middle ear adenoma, middle ear carcinoma, choroid plexus papilloma, para-ganglioma, papillary ependymoma, metastatic renal cell carcinoma, metastatic thyroid papillary carcinoma, jugulotympanic paraganglioma, glomus jugulare tumour, enlarged vestibular aqueduct, petrous apicitis, cholesterol granuloma, meningioma or secondary metastasis within bone. Upon computerized tomography, erosion of petrous bone displays an infiltrative or “moth-eaten” configuration along with centric calcified spicules, intra-tumour and posterior rim calcification and intense, homogeneous enhancement of the tumefaction. Comprehensive surgical excision of the neoplasm is an optimal treatment strategy.
26 Explaining the Cancer Cure with Frequencies , Prof. Maria Kuman1*
I spent 40 years of my life investigating the human aura. First, I started photographic it – it can be photographed in high frequency electric field and it is called Kirlian photography. I found that positive emotions make the aura brighter, while negative emotions make the aura dimmer. I wanted to be able to measure the aura and have numbers how much brighter or dimmer. Since the aura is very weak field, 1,000 times weaker than the electromagnetic field of the material body, I had to develop and patent a super-sensitive equipment to be able to measure it. With my measurements, I found that positive emotions (joy, happiness) not only increase the brightness of the aura, they make the energy more balanced, and perfectly balanced energy means perfect health [1]. I found that negative emotions (anger, hatred, jealousy) not only decrease the brightness of the aura, they make the energy more unbalanced because the genetically inherited weak organ drops in energy maximum. This means that negative emotions (or just negative thinking) shift us a step farther to a disease of the genetically inherited weak organ [1].
27 The Pandemic, the Immunizations and the Mutating Viruses , Prof. Maria Kuman1*
The world famous virologist Luc Montagnier, who received the Nobel Prize in Medicine in 2008 for deciphering the DNA of the HIV causing AID’s disease, said in an interview in the French documentary “Hold-up” that one of the reasons to have so many new strengths of Coronavirus are the immunizations. Many people think that this is outrageous statement, but for me the authority of the famous virologist is too high to ignore or question his statement. Is the Coronavirus tired of being weakened and used in vaccines for immunizations and is trying to evolve to something different and more efficient? But we didn’t have such problem with other immunizations like TB and other vaccines. However, their usage was not so massive or maybe Coronavirus was specially designed to mutate?
28 A Multilayer Immune-Inflammatory Genetic Biomarkers in IRF5 Pathway as Contributors in Patient’s Outcome with COVID-19 , Leonardo V Barbosa1, Letícia R Dantas3, Marina C Deus3, André V Souza1, Eduardo M de Castro1, Andressa M dos Santos3, Andrea Moreno-Amaral2,3, Cristina P Baena3, Lucia Noronha3,4, Felipe F Tuon5, Cleber Machado-Souza1*
Background: Congenital Central Hypoventilation Syndrome (CCHS), is a condition characterized by ventilatory impairment that results in arterial hypoxemia. Studies revealed that the vast majority of patients with CCHS are free from any associated pulmonary, cardiac or brainstem pathologies. Material and Methods: F.R is a 20 -year-old- Austrian-girl presented in my consultation seeking advice for her unpleasant clinical history. In her early life, seizures were the first serious clinical presentation. Followed later on with hypertension, bouts of respiratory dysfunction and impairment of consciousness. In 2019 she underwent surgical intervention to remove a 2 cm hamartoma (posterior upper aspect of the right thigh). Few years later, another hamartoma on the ventral side of the tongue has been identified as well. Early on, she received the diagnosis of Mediterranean fever syndrome and the geneticist encountered homozygosity to the MEFV M694V mutation as the reason behind the constellation of the current unpleasant symptomatology. Later on a presumptive diagnosis of Ehlers-Danlos syndrome-hypermobile type has been suggested in other Medical Institutions. We proceeded with our documentation via clinical and radiological phenotypic characterizations. Results: Clinical examination showed growth above the 97th percentile (overgrowth) with no specific facial dysmorphic features. She manifested generalized ligamentous hyper laxity. Her ligamentous hyperlaxity was compatible with 6 points out of 9 in correlation with Beighton scoring test. On the bases of skeletal survey; lateral skull radiograph showed features of mastoid and temporal bone characterized with extensive-pneumatization. Axial CT scan shows bilateral hyper-pneumatization of the temporal bones, demonstrating expansion of aerial spaces with loss of the bony trabeculae and thinning of the mastoid bone. Mastoid cells appear to be in communication with a large intracranial epidural air cavity in the temporal and parietal regions. Reformatted CT scan of temporal bone, through coronal and axial images, at the level of the cavum tympani and the mastoid, showed a defect in the right tegmen appeared as cloudy/ opaque lesions around the cavum and the surrounding air cells. Contrast- enhanced computed CT angiography of the cervical and cerebral vasculature showed unusual malalignment and spiral twisting along several vascular segments resulted in the mal-development of basilar artery stenosis without atherosclerosis. The current patient manifested overgrowth syndromic entity with a constellation of osseous and vascular abnormalities resulted in a clinical course of congenital central hypoventilation syndrome. Conclusion: The etiology behind the extension of pneumatization has most likely occurred because of defective ossification of the occipito-mastoid synchondrosis . The reason behind the extension of pneumatization into the occipital and parietal bone is probably due to incomplete closure of the occipito-mastoid synchondrosis, lambdoid and sagittal sutures, which usually close in early adulthood and later, even at the age of thirties. In our patient, we postulate that the history of multiple hamartomas and abnormal vascular phenotype in conjunction with extensive hyper-pneumatization of the skull were the main etiology behind her unpleasant course of her devastating ailment regardless the genetic results. Our impression is neither Mediterranean fever syndrome nor Ehlers-Danlos syndrome seem compatible with her current constellation of osseous and vascular abnormalities. The overall clinical and imaging findings are highly likely in connection with either one of the different types of overgrowth syndromes or might be a novel syndromic association. We believe that congenital central hypoventilation is a symptom complex rather than a diagnostic entity.
29 A Rapidly Progressive Case of Skin and Soft Tissues Necrosis in a COVID-19 Positive Patient , Severino Persechino1*, Federica Rega1, Giulia Maretti1, Domenico Giordano1, Nazareno Gagliostro1, Alessandro Capalbo1, Flavia Persechino2
Sars-Cov2 infection can result in numerous and varied skin manifestations including vasculopathy, bullous lesions and rarely necrotic lesions. At present, the aetiopathogenetic mechanism is still unclear. We report a case of a 68-year-old patient with acute onset of bullous and necrotic lesions with rapid progression to osteomyelitis, suffering from mild Sars-Cov2 infection.
30 Viral Etiology in Acute Encephalitis Syndrome in North Indian Children , Arunkumar M1, Anju Aggarwal2*, Aaradhana Singh3, Rajeev Thakur4, NP Singh5, Prerna Batra6, Rajeev Malhotra7
Background and Objective: Acute Encephalitis Syndrome (AES) leads to significant mortality and morbidity in children. This study was undertaken to identify the viral causes of AES and its correlation with clinicodemographic profile. Methods: This cross-sectional study included 100 children aged 1 to 12 years presenting with fever of <14 days duration and a change in mental status (including symptoms such as confusion, disorientation, coma, or inability to talk) and/or new onset of seizures (excluding simple febrile seizures) [1]. Cerebrospinal Fluid (CSF) was collected aseptically by lumbar puncture for biochemical and cytological analysis, and for bacteriological culture. Multiplex PCR for the viruses HSV1, HSV2, Varicella zoster virus, Enterovirus, Mumps and Parecho virus was carried out. Serology for Japanese Encephalitis (JE) was done in blood and CSF by ELISA method. Dengue NS1 antigen and IgM ELISA was carried out in both blood and CSF samples. Serum IgM antibody for scrub typhus was done by ELISA method. Results: Out of 100 children viral cause was detected in 21 patients (Japanese encephalitis -16, Dengue – 4, Varicella zoster virus, Enterovirus and Mumps virus – 1 each). Serum IgM ELISA for scrub typhus was positive in 6 patients. Multiple viral etiology was seen in 2 patients. Mortality was significantly more in females (p=0.021), GCS <8 (p <0.001). Mortality was significantly more with higher CSF neutrophils and higher proteins (p<0.05). Interpretation and Conclusion: This study concludes that viral causes specially JE contributed in AES in North India. Hence viral pathogens including JE needs to be considered as one of major causative agents while treating patients of AES and further emphasis has to be given for JE vaccination in this region.
31 A Case of Fatal Disseminated Ascariasis: Clinico-Diagnostic Dilemma , Kaushik Stuti1, Duggal D Shalini2*, Gur R3, Sharma P4, Bharara T5, Verma J6
Ascaris lumbricoides is the most common soil transmitted helminth in India. Hepatobiliary and Pancreatic Ascariasis (HPA) is relatively an uncommon complication. We present a case of fatal HPA with genitourinary involvement. Morbidity and mortality can be minimized by keeping in mind the importance of basic investigations which can lead to a definite diagnosis in such cases for instituting timely treatment.
32 The Use of Oral Human Grade Ivermectin with Supplements Known as Immunomodulators for Treating Patients with COVID-19 Infections at Home , Godofreda R Vergeire-Dalmacion1*, Pedrosa Glenda2
Background: Several meta-analyses have shown low to moderate certainty for Ivermectin (IVM) to reduce all-cause mortality from COVID -19 infection by 68% and to prevent infection by about 86%. Objectives: The aim of our study is to determine the effects of oral IVM for treating mild to moderate COVID infections and the effects of demography, symptomatology, co-morbidities, IVM dose and combination or single immunomodulating supplements on clinical recovery Method: A cross-sectional design covering the period of April 2021 to June 2021 was used. The participants were clinicians in Metro Manila who prescribed IVM for home care treatment of their COVID-19 patients. Result: Out of 338 evaluable patients, 95.6% (323/338) showed full recovery at the end of the study, 0.59% (2/338) was still recovering, 2.36% (8/338) are long haulers and 1.47% (5/338) succumbed to the infection. Mild cases received IVM at 0.2 to 0.8 mg/kg body weight (kgbw) and 1.0 to 1.8 mg /kgbw for moderate cases for 5-7 days. The p-values of 0.022 for gender and 0.000 for co-morbidity showed that these factors can significantly affect the recovery of COVID-19 patients. Shortness of breath (p-value of 0.000), muscle pain (p-value =.002) and headache (p-value=0.011) have significant effects on recovery. Among the co-morbidities, hypertension (p-value=0.000), diabetes (p-value=.006), cardiovascular diseases (p-value=0.001) and obesity (p-value=0.014) have statistical significant effects on clinical outcomes. Using Kruskal Wallis H statistics, the intake of combination immunomodulators has significant effect on the recovery of COVID-19 patients (p-value of 0.027). Using Mann-Whitney statistics, Zinc alone showed statistically significant effect (p-value of 0.002) for recovering from COVID. Conclusion: IVM is effective for COVID infections provided it is given early and the dose is adjusted for severity and co-morbidities. The graduated dose regimen of IVM and the predilection of the virus to mutate will become a challenge for designing future randomized clinical trials.
33 Control Classification of Asthma in Children: Ensuring Compliance, Fehmida Najmuddin1, Keya Lahiri2, Pallavi Wadhawan3*
Introduction: Asthma is classified primarily based on the level of control rather than the severity of the underlying illness process, as per the new GINA (Global Initiative for Asthma) guideline. Objective: To study the control classification in children visiting Asthma Clinic To correlate the control classification with disease progression Material and Methods: A prospective, cross-sectional observational study was conducted at a tertiary care hospital from January 2013 to December 2021. The revised GINA guidelines were used to diagnose 50 patients aged 7 to 15 with bronchial Asthma for this study. Patients’ medical histories and PFT (Pulmonary Function Test) outcomes were noted in a pre-designed form. They were enrolled on their first visit and followed up periodically with a three-monthly interval each. Results: GINA guideline’s control classification aided in analysis of the significant differences in the distribution of progression (χ2 = 34.195, p =
34 Can Microbials Enhance Commercial Calves’ Gut Integrity, Immunity and Health?, Akbar Nikkhah1*, Masoud Alimirzaei2
Supplemental Microbials (SM) could offer commercial young dairy calves with healthy subjects to enhance gut microbial diversity and host health if calves are managed properly and optimally. The possible helpfulness of SM, however, must not be overstated and overemphasized. The major aim of this editorial was to address whether SM is practically workable in preventing digestive disorders namely diarrhoea. Another aim was to underline the possible efficacy of such products in enhancing calf health and immunity. Protecting newborn calves against infectious diseases and concurrently, improving their health and growth in early life is strictly related to herd economics and production sustainability. Diarrhoea is the most prevalent infectious disease, causing calf morbidity and mortality worldwide. Supplementing dairy calf diets (i.e., milk or starter) with potentially beneficial microorganisms such as bacteria and yeast has been attempted to improve the gut microbial ecosystem and optimize nutrient assimilation and immunity. However, infectious diarrhoea still remains a major problem in many dairy and beef farms around the globe. Since diarrhoea has a multi-factorial nature, it seems that the possible efficacy of SM depends on the environmental and management conditions in which the calves are raised. The rearing system (e.g., individual vs. group housing), diet, environmental microbial load and other management factors are involved in the incidence of diarrhoea. Therefore, using probiotic products may interact with such factors, thus influencing their effectiveness and likely causing inconsistencies concerning probiotics’ usefulness in commercial dairy farms.
35 Review on Cancer and the Immune System, Damtew Bekele1*
Cancer is a term for a large group of diseases caused by abnormal cells divide rapidly and spread to other tissue and organs. Under normal circumstances, so many cells multiply as long as the body is in need of them for the proper function daily. Healthy cells have a particular life cycle, reproducing and dying off in a way that is determined by the kind of cell. New cells replace old or damaged cells when they die. On the other hand, abnormal growth of cell or cancer disrupts this normal function. Cancer is one of the leading causes of death worldwide. It can migrate through the blood vessels or lymphatic system to different areas throughout the body. With regard to cancer diagnosis: one method is detection of a compromised immunological response of the patient toward his own tumor cells. And the second method is to use antisera, with which immunization of animals with human tumor extracts, for the detection of substances released into the blood by the tumor cells.
36 Night Meals to Pay Bills: An Immunological Innovation , Akbar Nikkhah1*
This objective of this policy opinion article was to address a perspective if chrono-eating can help prevent immunodeficiency diseases by optimizing circadian rhythms of nutrient assimilation and metabolism. In the modern era, eating timing, sequence, and frequency have been modified significantly. People tend to consume fast foods during later times of the circadian phase or almost 24-h period. Rising evidence indicates that eating at wrong times (i.e., evening and night) and inadequate physical activity would lead to suboptimal physiological rhythms of nutrient assimilation and metabolism. This trend is postulated to weaken immunity and cause obesity, diabetes, and other immunodeficiency and autoimmune diseases. These abnormalities are amongst the foremost metabolic disorders worldwide. Eating slowly releasing energy later in the evening and overnight may help optimize immunity. Therefore, chrono-eating is a mounting science that helps optimize circadian food consumption behavior to prevent, or at the very least, reduce immunodeficiency and associated metabolic disorders development.
37 COVID-19 Epidemics Monitored Through the Logarithmic Growth Rate and SIR Model , Tomokazu Konishi1*
The SIR model is often used to analyse and forecast an epidemic. In this model, the number of patients exponentially increases and decreases in the early and late phases; hence the logarithmic growth rate K is constant at the phases. However, in the case of COVID-19 epidemics, K never remains constant but increases and decreases linearly. Simulation showed that a situation in which smaller epidemics were repeated with short time intervals makes the changes in K; it also showed relationship between K to the mean infectious time τ and the basic reproduction number R0. Using this relationship, we analysed epidemic data from 279 countries and regions. The changes in K represented the state of the epidemics and were several weeks to a month ahead of the changes in the number of confirmed cases. If the negative peaks of K could not be reduced to 0.1, the number of patients remained high. To control the epidemic, it was important to observe K daily, not to allow K to remain positive continuously and to terminate a peak with a series of K-negative days. To accomplish this, it was necessary to shorten τ by finding and isolating a patient earlier.
38 A Survey of Methicillin-Resistance Staphylococcus aureus Isolated from Patients Hospitalized in the ICU, NICU and Surgical Departments of Tehran University of Medical Sciences Hospitals , Monireh Rahimkhani1*, Zahra Rajabi2
Background and Aim: Staphylococcus aureus is an important pathogen that causes various infections. The presence of some pathogenic factors in this bacterium helps the bacteria to survive in response to the immune system and antimicrobial treatments. Efforts to treat infections caused by these strains have resulted in resistance to most antibiotics, especially methicillin and vancomycin resistance, during recent years. Therefore, the consequences of infections caused by this bacterium can be serious. In this study we aimed to survey methicillin- resistance Staphylococcus aureus isolated from patients hospitalized in the ICU, NICU and surgical departments of Tehran University of Medical Sciences hospitals. Material and Method: 430 clinical samples of the patients were collected and identified as Staphylococcus aureus by phenotype and biotype tests. MRSA isolates were first screened by showing resistance to cefoxitin by disc diffusion method and finally confirmed by examining the mecA gene by PCR. The microbial resistance pattern of MRSA was also measured by disk diffusion method. Investigating the presence of a vancomycin resistance gene in isolated MRSA occurred by PCR. Results: Out of 430 clinical samples, 117 (27.20%) Staphylococcus aureus were isolated of which 42 (35.89%) were identified as MRSA. The most MRSA obtained from the ICU department with 25 cases (59.52%). The majority of patients infected with MRSA belonged to the age group of 40-65 years. The mecA gene was detected in all MRSA. The entire MRSA was 100% sensitive to vancomycin and linezolid, and 100% resistance to cloxacillin. Molecular detection of vanA gene in isolated MRSA showed 2 (4.76%) of them contained vanA gene. Conclusion: The high prevalence of MRSA and its antibiotic resistance pattern to vancomycin and other antibiotic families can lead to treatment failures, uncontrolled nosocomial infections, and mortality. Although the PCR-based detection method is superior to other conventional techniques, a combination of these methods can provide diagnostic accuracy.
39 Analysis of the Level of IgG to SARS-CoV-2 Virus and Molecular Markers of Activation of CD25, CD54 (ICAM-1) and CD95 Lymphocytes in the Patients Who were Not Ill with COVID-19, Recovered from COVID-19 and Who had Acute Respiratory Infections. The Results of the Correction of Impaired Immune Homeostasis Using the Multitarget Immunotherapy Drug Mercureid , Pasyechnikova NV1, Velichko LN1, Bogdanova AV1, Khramenko NI1, Konovalova NV1, Makarova MB1, Molodaya AL1, Borisova MI1, Kozorez IuV1, Gusev SN2*
Currently, the researchers have come across a paradox which consists in detecting protective IgG antibodies to SARS-CoV-2 virus only in a subset of patients who have recovered from COVID-19. The other patients, who were in contact with the infected people, have not contracted COVID-19 (there were no symptoms of this illness detected and PCR was negative). Nevertheless, these people have got IgG antibodies to SARS-CoV-2 virus too. It’s also worth pointing out that the presence of IgG to SARS-CoV-2 virus correlates with an altered immune response when infected with seasonal viral diseases; in particular, the ability to produce protective antibodies decreases. All these factors predetermine different clinical courses of the disease and the consequences of the patient’s post-COVID condition (post-COVID conditions / PCC). To examine the diverse immune responses of patients, including asymptomatic carriage, a study on 414 patients was conducted. The novelty of the research is the following. For the first time, not only the levels of protective IgG antibody titers to SARS-CoV-2 virus were determined, but also their correlations with lymphocyte activation markers CD25, CD54 (ICAM-1) and CD95 in three groups of patients, namely, people who did not have COVID-19, who recovered from COVID-19 and who had acute respiratory infections, were examined. The research is aimed at both scientific and practical purposes, including the search for new therapeutic options. The possibility of controlling the activation molecules of T-lymphocytes and editing their activity using the multitarget immunotherapy drug Mercureid was studied. The therapeutic efficacy of Mercureid usage was 75.6%.
40 Stop Eating Fast, Keep Staying Last , Akbar Nikkhah1*
This article addresses an important abnormal eating behavior or ‘speedy eating’ that can predispose human body to diabesity (diabetes and obesity) development and its associated complexities in the stressful modern times. Although, more research is required to enlighten the various clinical and psychological aspects of this phenomenon, public health programs must take new initiatives in educating people of different ages to manage stresses and slow down eating to help optimize endocrinology and metabolism and minimize diabesity risks. Efforts must be focused on edificating people how to overcome and manage their stresses first before ‘slow eating’ could be prioritized and practiced as a powerful lifestyle strategy. Meanwhile, stop eating fast, keep staying last!
41 Biofilm Formation, Virulence Factors and Antifungal Susceptibility of Candida spp. Isolated From the Oral Cavity of Diabetes Mellitus Patients , Jussevania Pereira Santos1, Natalia de Souza Botelho1, Ludmilla Gomes Pereira1, Célia Roman2, Katia Roberta Fávaro2, Alexandre Tadachi Morey3, Eliandro Reis Tavares1, Sueli Fumie Yamada-Ogatta1, Lucy Megumi Yamauchi1*
Background: Candida species colonize human microbiota and some conditions, such as immunosuppression or chronic illness, predispose the individual to fungal infections; among them, diabetes mellitus, a metabolic disorder frequently associated with higher rates of yeast infections. Material and Methods: The prevalence of Candida species in the oral cavity of patients with diabetes mellitus was evaluated and the carriage was compared between type 1 and type 2 diabetic groups. In addition, in vitro susceptibility to antifungals, biofilm formation, cell surface hydrophobicity, and the production of hydrolytic enzymes were tested. Results: The results demonstrated the presence of different Candida species in the oral cavity of diabetic patients; and, also showed that type 1 diabetic patients are more susceptible to Candida colonization. Almost all isolates produce virulence factors such as proteases, phospholipases, or form biofilm; and they are sensitive to fluconazole and nystatin. Conclusion: Colonization of Candida spp. oral isolates from type 1 and type 2 diabetic patients were similar; however, type 1 presented a higher colony-forming unit counting. Overall, Candida isolates from the oral cavity of diabetic patients are potential pathogens of candidiasis.
42 Inundate and Deluge-Hemophagocytic Lymphohistiocytosis , Anubha Bajaj1*
Hemophagocytic lymphohistiocytosis is a pathological syndrome constituted of defective Natural Killer (NK) cell or T cell function engendering unchecked secretions of cytokines and end organ damage on account of accompanying immune activation. Hemophagocytic lymphohistiocytosis is categorized into congenital, genetic or primary and acquired or secondary subtypes. Immune activation with consequent hyper-cytokinemia induces histiocytic infiltration within reticuloendothelial organs along with hemophagocytosis of erythrocytes, leukocytes, platelets and precursor cells. Untreated primary and secondary hemophagocytic lymphohistiocytosis is invariably associated with disease associated mortality. However, adoption of contemporary therapeutic protocols document 5 year survival rates of ~ 54%. Familial or primary hemophagocytic lymphohistiocytosis is a progressive, autosomal recessive condition characteristically occurring within young age. The disorder exemplifies decimated NK cell function and frequently detected mutations within perforin gene. Contingent to concordant genetic modifications, the autosomal recessive familial or primary hemophagocytic lymphohistiocytosis demonstrates cogent subtypes denominated as FHL1 to FHL5. Besides, familial hemophagocytic lymphohistiocytosis may be associated with primary immunodeficiency syndromes as Chédiak-Higashi syndrome, Griscelli syndrome type 2, Hermansky-Pudlak syndrome type 2 or X-linked lymphoproliferative disorder subtype 1 and subtype 2 [1,2].