Immune compromise in HIV-1/HTLV-1 coinfection with paradoxical resolution of CD4 lymphocytosis during antiretroviral therapy: a case report

Human immunodeficiency virus type-1 (HIV-1) and human T lymphotropic virus type-1 (HTLV-1) infections have complex effects on adaptive immunity, with specific tropism for, but contrasting effects on, CD4 T lymphocytes: depletion with HIV-1, proliferation with HTLV-1. Impaired T lymphocyte function occurs early in HIV-1 infection but opportunistic infections (OIs) rarely occur in the absence of CD4 lymphopenia. In the unusual case where a HIV-1 infected individual with a high CD4 count presents with recurrent OIs, a clinician is faced with the possibility of a second underlying comorbidity. We present a case of pseudo-adult T cell leukemia/lymphoma (ATLL) in HIV-1/HTLV-1 coinfection where the individual fulfilled Shimoyama criteria for chronic ATLL and had pulmonary Mycobacterium kansasii, despite a high CD4 lymphocyte count. However, there was no evidence of clonal T-cell proliferation by T-cell receptor gene rearrangement studies nor of monoclonal HTLV-1 integration by high-throughput sequencing. Mutually beneficial interplay between HIV-1 and HTLV-1, maintaining high level HIV-1 and HTLV-1 viremia and proliferation of poorly functional CD4 cells despite chronicity of infection is a postulated mechanism. Despite good microbiological response to antimycobacterial therapy, the patient remained systemically unwell with refractory anemia. Subsequent initiation of combined antiretroviral therapy led to paradoxical resolution of CD4 T lymphocytosis as well as HIV-1 viral suppression and decreased HTLV-1 proviral load. This is proposed to be the result of attenuation of immune activation post-HIV virological control. This case illustrates the importance of screening for HTLV-1 in HIV-1 patients with appropriate clinical presentation and epidemiological risk factors and explores mechanisms for the complex interactions on HIV-1/HTLV-1 adaptive immunity

DEVELOPMENT OF DESIGN PARAMETERS FOR AN INCLINED STEP-GRATE COMPOST VESSEL TO TREAT URBAN SOLID WASTES

There are several methods and systems of managing urban solid wastes. Aerobie systemsor managing wastes arc less expensive and the composition of wastes in most Sri Lankancities is conducive to compost making since the biodegradable component is high,The total quantity of organic matter generated in the urban centres if used as compost willstill not satisfy the demand for it. These basic problems could he solved by makingcompost [rom biodegradable urban wastes. facilitating the management of these wastes andalso providing organic matter for long awaited sustained and assured agriculturalproduction in Sri Lanka.The development of a feasible system or compost making was the challenge taken up by theDcpnruucnt or Agricultural Engineering. A series of studies were undertaken to determinesome of the major parameters to rcalise the concept of an inclined step-grate compostmakingvessel.The studies indicate that (l.'i% moisture content should be maintained for optimumconditions for compost making, The bulk density increases with time and It is inverselyproportional to mass, Within the first 20 days of degradation or mixed wastes. most of thevolatile solids react producing largely carbon dioxide and water, The generated heat fromthis reaction actuates the process or evaporating excess moisture. The reduction in massand increase in density can be expressed mathematically.A calculation or heat and mass balances was obtained for a 3-meter pile of wastes, Thesecalculations were based on data obtained from an Engineering Model. Several or the majorparameters such as the retention time. suction. heating and cooling system for moisturecontrol were developed to design a versatile bio-reactor to produce compost for treatingwastes aerobically.

Evaluation of total n, p, k and organic matter contents of soil amended with paddy husk charcoal coated urea and comparison of the yield of paddy.

Rice production in Sri Lanka has increased considerably during the last three decades as a result of cultivation of high yielding varieties, increase in the area of cultivation under irrigation and heavy use of plant nutrients. Most of the high yielding varieties which are extensively grown throughout the country require recommended levels of fertilizers in order to obtain their potential yields. Therefore, effective and efficient way of fertilizer application is important. Coated fertilizers are widely used to improve the efficiency of fertilizer application. However, the conventional coated fertilizers such as sulphur coated urea and urea super granules are not popular among the rice farmers in Sri Lanka owing to high cost of the coated fertilizers. One of the most sustainable solutions is application of paddy husk charcoal as a coating material to N fertilizer so as to gradually release nitrogenous compounds and making them available for plants. Objectives of this study were to evaluate total N, P K and organic matter of soil amended with paddy husk charcoal coated urea and to compare the yield of paddy production. A field experiment was carried out at Kalugamuwa farmer field in Yala 2010 and Maha 2010/2011. The field was divided into three blocks of equal size (30 m x 5 m) and each block was further subdivided into four plots (5 m x 5 m) and treatments were arranged in randomized complete block design. Treatments were application of (1) chemical fertilizer only, (2) urea coated charcoal only (1/3 of recommended urea) (3) chemical fertilizer and paddy straw compost (compost obtained from anaerobic digestion of paddy straw) and (4) paddy straw compost and urea coated charcoal only. The highest mean grain yield of 12.59kg/plot was obtained with the application of chemical fertilizer followed by charcoal coated urea with compost, chemical fertilizer and charcoal coated urea only for Yala season. Paddy husk charcoal coated urea can potentially be used as a slow releasing nitrogen fertilizer which reduces leaching losses of urea. In addition, coating is less costly and helps reducing the fertilizer cost (70% of urea cost) and contribute to mitigate atmospheric pollution as well as pollution of water bodies

Review on Photomicrography based Full Blood Count (FBC) Testing and Recent Advancements

With advancements in related sub-fields, research on photomicrography in life science is emerging and this is a review on its application towards human full blood count testing which is a primary test in medical practices. For a prolonged period of time, analysis of blood samples is the basis for bio medical observations of living creatures. Cell size, shape, constituents, count, ratios are few of the features identified using DIP based analysis and these features provide an overview of the state of human body which is important in identifying present medical conditions and indicating possible future complications. In addition, functionality of the immune system is observed using results of blood tests. In FBC tests, identification of different blood cell types and counting the number of cells of each type is required to obtain results. Literature discuss various techniques and methods and this article presents an insightful review on human blood cell morphology, photomicrography, digital image processing of photomicrographs, feature extraction and classification, and recent advances. Integration of emerging technologies such as microfluidics, micro-electromechanical systems, and artificial intelligence based image processing algorithms and classifiers with cell sensing have enabled exploration of novel research directions in blood testing applications.

Maternal and fetal outcomes in pregnant patients with lupus nephritis

Background: Pregnancy in a woman with lupus nephritis (LN) carries a high risk of maternal and fetal morbidity and mortality. This study aims to analyze the effect of LN on maternal and fetal outcomes and lupus activity.Methods: In a single-center, cross-sectional observational study at national hospital Kandy, 32 pregnancies in 23 women with biopsy-proven LN between 2007 and 2019 were analyzed retrospectively.Results: Mean age at pregnancy was 28.4 years (SD=4.8, range 19–38 years). In six women, LN developed during pregnancy, 17 patients were already diagnosed with LN when they became pregnant. A renal biopsy performed 4.6 (SD=3.8) years before pregnancy, showed diffuse LN in 18 (78.3%) and focal LN in 5 (21.7%) cases. At conception, most patients were in complete (43.8%) or partial (21.9%) remission. Therapeutic abortion was performed in 8 pregnancies (indications: renal flares in 5, pre-eclampsia in 3) at a mean period of amenorrhea (POA) of 16.8 weeks (range 8-28 weeks). Spontaneous fetal loss occurred in one pregnancy. Among 23 live births, there were four pre-term deliveries (0.05) between LN histological type, initial clinical presentation and treated hypertension with fetal outcome. No case of neonatal lupus or congenital heart block was noted. During pregnancy, there were five (15.6%) renal flares and two acute kidney injury cases; all were reversible. Eight patients (25%) developed PIHConclusions: Pregnancy induced hypertension is a more commonly encountered complication in pregnancies with lupus nephritis. The fetal outcome is unfavorable in pregnancies with renal flares.

A study of lipid profile and glycemic status in patients with chronic kidney disease of unknown etiology in Sri Lanka

Background: Dyslipidemia and impaired glucose tolerance are common complications of chronic kidney disease (CKD) and are responsible for increased cardiovascular risk. Studies on lipid profile and glycemic status in CKD of unknown origin (CKDu) are scarce. The objective of this study was to evaluate the lipid profile and glycemic status of the patients with CKDu and to aid in preventing morbidity and mortality.Methods: The descriptive, cross sectional study was conducted in a rural CKDu endemic area, Girandurukotte.  Data was collected from February 2018 to June 2019. For the diagnosis of CKDu, history and clinical features with supportive biochemical, renal biopsy and radiological evidence were taken as criteria. Blood samples were taken for serum creatinine, lipid profile and HbA1C. Already diagnosed patients with diabetes mellitus and dyslipidemia were excluded.Results: A total of 168 patients within the age range of 32-66 years (mean 50.3±7.7) were participated. There were 106 males (63%) 46.4% were farmers. Majority of the patients (65.5%) had normal body mass index (BMI) (mean 22.9 kg/m2, normal range 18.5-23.5%) followed by overweight (23.5-30 kg/m2) in 55 (32.7%) patients. The prevalence of dyslipidemia in CKDu was found to be 55.9%.  Majority of the abnormality was seen in the HDL group with 68 (40.5%) patients having low HDL cholesterol (mean 44.7 mg/dl, SD=12.3).  There was a significant rise in the serum triglyceride concentration (>150 mg/dl) in 53 (31.5%) (mean 152.4 mg/dl, SD=73.5) and total cholesterol (>200 mg/dl) in 30 (18%) patients (mean 182 mg/dl, SD=36.9). LDL cholesterol abnormality (>130 mg/dl) was seen in only 9 patients (mean 88.7 7658mg/dl, SD=25.4). From the total, 144 (85.7%) patients had abnormal HbA1C levels; 27 (16.1%) patients had HbA1C levels between 5.7% and 6.4% (pre-diabetes), and 117 (69.6%) patients had HbA1C level more than 6.5% (diabetes mellitus). There was no statistically significant association between HbA1C levels and BMI (p=0.29) or HbA1C and lipid abnormalities (p=0.32)Conclusions: The high prevalence of dyslipidemia, pre-diabetes and diabetes mellitus in patients with CKDu may accelerate the progression of chronic kidney disease and increase the risk of cardiovascular disease. Early detection, initiation of appropriate medication and early referral to the expertise will ameliorate morbidity and mortality.

Body composition in lupus nephritis patients

Background: The assessment of body fat distribution is an important evaluation in patients with lupus nephritis (LN), which does not practice routinely. The objectives of this study were to determine the body composition by using bioelectrical impedance analysis and to identify the effects of age, body mass index, disease activity, and corticosteroid therapy on body composition.Methods: This was a single-centered, cross-sectional, and observational study conducted at the nephrology unit, National Hospital Kandy, Sri Lanka. Seventy-nine patients with biopsy-proven LN have participated in the study.Results: There were 79 lupus nephritis patients enrolled in this study. The duration of LN ranged from 8 months to 32 years. The main non-renal clinical manifestations included skin lesions (59%), arthritis (54%), and oral ulcers (48%). The disease activity was low with a mean SLEDAI score of 1.01 (SD=2.3). The body fat (BF) percentage (p=0.002) and subcutaneous fat (SF) percentage (p<0.001) were significantly low in males compared to females. And, BF percentage was significantly low among patients with SLEDAI-2K 6 (p=0.03). Moreover, there were positive correlations found between SLE disease activity with the BMI (p=0.004), body fat percentage (p=0.001), and visceral fat percentage (p=0.001).Conclusions: Females are more prone to have a high mean value of body composition parameters than males in this study. There is a negative influence of the body composition parameters reported against the disease activity among LN patients in Sri Lanka.

Building local capacities in the operation and management of an integrated solid waste management programme; Experience of Ampara District, Eastern Sri Lanka

Open dumping and burning of wastes in the environmental sensitive areas were common practices in almost all the local authorities in Ampara district. It had become a big threat to public health, the beautiful natural environment and to the local economy. The Local Authorities of the District often faced severe difficulties in the management of solid waste in an environmentally, socially and economically feasible manner. The lack of technical and financial capacities to apply and practice the newly developed waste management guidelines and policies further aggravated this situation.Having identified the gravity  and the importance of this serious environmental issue, the Department of Assistant Commissioner of Local Government of Ampara District, with the financial assistance of the European Union and the technical assistance of the United Nations Office for Project Services (UNOPS), is currently implementing an Integrated Solid Waste Management Programme (ISWMP) in 12 local authorities of the District. This ISWMP is completely being operated with the full coordination of the District Office of the Central Environmental Authority, Ampara. The UNOPS, as part of its technical assistance, has constructed solid waste management facilities such as 7 engineered landfills, one Waste Transfer Station, 4 Recycling Centers, 5 compost yards, well developed collection systems  as well as provided with capability building/training assistance aiming to establish an effective and efficient solid waste management system for the District. These  facilities are now completed,  already in use and operational. With these facilities in place, and with the continued support from UNOPS in providing institutional and capacity building assistance to the LA officers and staff, haphazard dumping and littering of waste in certain areas of the LAs have now been stopped. Thus 45,000 urban households or 58% of the total urban population are benefitted under thisprogramme with a total collection of 137tonnes of wastes per day through this programme. Out of this 137tonnes of waste, 59 tonnes are collected from cluster systems involving five local authorities while the balance from the other non-clustered Local Authorities.The paper will also present the processes and methodologies to improve the landfill practices from the open dumping practices to controlled tipping and then to engineered landfills  among the implementing local authorities. It will also highlight interventions/strategies to ensure sustainability of the operation and their management through the introduction of a User Fee system/Service Charge which is currently being implemented in 04  Local Authorities. This collected User Fee covers about 80% of cost of collection of waste which would otherwise been spent through their normal budget.Key words: Integrated Solid Waste Management, Ampara, haphazard dumping, controlled tipping, engineered landfill

SNPs for Parentage Testing and Traceability in Globally Diverse Breeds of Sheep

DNA-based parentage determination accelerates genetic improvement in sheep by increasing pedigree accuracy. Single nucleotide polymorphism (SNP) markers can be used for determining parentage and to provide unique molecular identifiers for tracing sheep products to their source. However, the utility of a particular ‘‘parentage SNP’’ varies by breed depending on its minor allele frequency (MAF) and its sequence context. Our aims were to identify parentage SNPs with exceptional qualities for use in globally diverse breeds and to develop a subset for use in North American sheep. Starting with genotypes from 2,915 sheep and 74 breed groups provided by the International Sheep Genomics Consortium (ISGC), we analyzed 47,693 autosomal SNPs by multiple criteria and selected 163 with desirable properties for parentage testing. On average, each of the 163 SNPs was highly informative (MAF ≥ 0.3) in 48±5 breed groups. Nearby polymorphisms that could otherwise confound genetic testing were identified by whole genome and Sanger sequencing of 166 sheep from 54 breed groups. A genetic test with 109 of the 163 parentage SNPs was developed for matrix-assisted laser desorption/ionization– time-of-flight mass spectrometry. The scoring rates and accuracies for these 109 SNPs were greater than 99% in a panel of North American sheep. In a blinded set of 96 families (sire, dam, and non-identical twin lambs), each parent of every lamb was identified without using the other parent’s genotype. In 74 ISGC breed groups, the median estimates for probability of a coincidental match between two animals (PI), and the fraction of potential adults excluded from parentage (PE) were 1.1×10(−39) and 0.999987, respectively, for the 109 SNPs combined. The availability of a well-characterized set of 163 parentage SNPs facilitates the development of high-throughput genetic technologies for implementing accurate and economical parentage testing and traceability in many of the world’s sheep breeds