Complete Genome Assembly, Annotation and Comparative Analysis of Six Leishmaniinae Parasites

Leishmania is a widespread parasite that causes leishmaniasis, a serious but neglected tropical disease reported in nearly 100 countries. Leishmaniasis manifests itself in three main forms: visceral, cutaneous, and mucocutaneous. Leishmania is classified into four subgenera: Leishmania, Sauroleishmania, Viannia, and more recently, Mundinia, the latter of which accommodates the L. enriettii complex as well as other species from a variety of hosts and geographic locations. I detail here sequencing, assembly, and annotation of six Mundinia genomes, including those of the Asian species Leishmania (Mundinia) martiniquensis and L. (M.) orientalis, the American species L. (M.) enriettii and Porcisia hertigi (formerly L. hertigi), and two unnamed African species from Ghana and Namibia, namely L. (M.) sp. Ghana and L. (M.) sp. Namibia. To maintain chromosome structure while maximising the quality of short read sequencing, genomes were sequenced and assembled using both short and long reads platforms, specifically Illumina and Oxford Nanopore Technologies. They were then annotated using ab initio annotation in conjunction with publicly available proteins and transcripts. Each genome contains a complete set of 36 chromosomes and measures between 32.2-35.9 Mega-bases in length with an average N50 of 1,062,685 bases. Each assembly contained an average of 8,126 genes, mRNAs, exons, and protein coding regions. When compared to other Leishmania genomes, all were recognisably related to Mundinia species, except for Porcisia hertigi, which was found to be more closely related to Endotrypanum monterogeii, setting it as an outgroup. Phylogenomic analyses revealed that Mundinia genomes share a common ancestor with the other three Leishmania subgenera, which was estimated to have existed approximately 121 million years ago, during the early Cretaceous period. Selection pressure analysis showed that there are 36 positively selected proteins, four of which may be novel proteins. This work may pave the way for future research on Leishmania biology and evolution

Pathogenic and Non-Pathogenic Microbial Presence in Ventilator Associated Pneumonia Patients in Intensive Care Unit and Safety Protocols Under Surveillance of Healthcare Provider: A Research Study

Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection that is associated with longer stays in intensive care units (ICUs) and under mechanical ventilation for more than 48 hours. This article explores the prevalence and impact of VAP on mortality and morbidity, emphasizing the microbial associations involved in hospital-acquired infections. Various infections, including Lung infections, surgical site infections, sepsis, and urinary tract infections, are discussed, along with their associated microorganisms. Diagnostic criteria for VAP and related infections are outlined, highlighting the importance of microbiological testing for accurate diagnosis. The underlying factors for VAP acquisition in ICU patients are identified, and prompt antibiotic initiation is emphasized as a critical first-line defense against VAP. In this study, we have populated data from 100 ICU patients, among which 45 were suffering from VAP. It was found that female patients (57.40%) were more affected than male patients (30.43%). The decreasing PaO2 level was seen to be the early sign of infection. It was found that the time of ventilation was the major factor influencing the VAP. The most common organism causing infection in our study was found to be Staphylococcus Aureus (45.1%). The prognosis of early-onset VAP was 35.55% while compared to Late-onset VAP 64.44%. When compared to VAP and Non-VAP patients there was not very huge difference with 55% and 45% respectively. The other factor was age and position. Implementation of Prevention strategies, such as protective environments and HEPA filtration systems, is proposed to reduce VAP incidence. Proper diagnosis, treatment, and prevention are crucial to combatting VAP and enhancing patient outcomes in hospital settings

Preoperative Botulinum Toxin Injection for Complex Abdominal Wall Hernia Repair

Introduction: Due to their higher rates of morbidity and recurrence, complex abdominal wall hernias provide a difficult clinical dilemma. Botulinum toxin injection has been suggested as a feasible treatment option to ease patients' tense muscles and promote primary fascial closure. This study focus on how well preoperative botulinum toxin injections worked for patients with complicated abdominal wall hernias. Methodology: The patients in this retrospective study had complex abdominal wall hernias. Between January 2021 and December 2022, they had received preoperative botulinum toxin injections for those hernias. Age, gender, the extent of the transverse hernia defects both before and after the procedure, loss of domain, and muscle length, all were the study's variables. The data were analyzed using comparative analysis and paired t-tests. Results: The study involved 8 patients in all, with an average age of 53.38 ± 12.56 years. The mean fascial defect size before injection was 13.14 ± 4.58 cm, while the mean fascial defect size after injection was 11.84 ± 4.07 cm. Following the Botox injection, there was a statistically significant decrease in the size of the transverse hernia defect (p 0.001). The mean loss of domain before the surgery was 18.46 ± 11.96%, while the mean loss of domain after the 7.21%. Following the Botox injection, there was a statistically significant decrease in loss of domain (p 0.05). In 7 individuals, primary fascial closure was accomplished (87.5%). Both surgical and chemical components had no significant side effects. Conclusion: In individuals with complicated abdominal wall hernias, preoperative botulinum toxin injection is an efficient and secure method for lowering muscle tension and attaining primary fascial closure. it is challenging to make firm judgments on the effectiveness of preoperative Botox injection for complex abdominal wall hernia repair in the absence of a control group. The results of the current study need to be confirmed by larger studies with longer follow-up times and a control group

Chromosome-Scale Assembly of the Complete Genome Sequence of Porcisia hertigi, Isolate C119, Strain LV43

Porcisia hertigi is a parasitic kinetoplastid first isolated from porcupines (Coendou rothschildi) in central Panama in 1965. We present the complete genome sequence of P. hertigi, isolate C119, strain LV43, sequenced using combined short- and long-read technologies. This complete genome sequence will contribute to our knowledge of the parasitic genus Porcisia

Emergency of outpatient anaphylactic shock: Review article

Background: Anaphylaxis is a severe, potentially life-threatening allergic reaction triggered by substances such as food, medications, insect stings, or environmental factors. It presents a range of symptoms, including respiratory, cardiovascular, dermatological, and gastrointestinal manifestations, which can develop rapidly. Misdiagnosis is common, as symptoms overlap with conditions such as septic shock or asthma. The immediate administration of intramuscular epinephrine is critical for treatment, along with airway management, antihistamines, and glucocorticoids. Aim: This review aims to explore the outpatient management of anaphylactic shock, focusing on symptoms, treatment strategies, and emergency preparedness. The review emphasizes the importance of rapid intervention and staff training for successful management. Methods: Methods involve analyzing current literature on anaphylaxis, its clinical presentation, and emergency treatment protocols. Results: Results show that early epinephrine administration is crucial for improving outcomes, with delayed treatment contributing to increased fatality risks. Regular preparedness, such as maintaining an anaphylaxis cart and conducting staff drills, is vital for effective outpatient care. Conclusion: The conclusion underscores the necessity of equipping outpatient settings with proper protocols and emergency supplies to manage anaphylactic emergencies and the need for patient education on recognizing and managing future episodes

Chromosome-Scale Assembly of the Complete Genome Sequence of Leishmania (Mundinia) martiniquensis, Isolate LSCM1, Strain LV760

Leishmania (Mundinia) martiniquensis is a kinetoplastid parasite that was first isolated in 1995 on Martinique. We report the first complete genome for Leishmania martiniquensis from Asia, isolate LSCM1, strain LV760, which was sequenced using combined short-read and long-read technologies. This will facilitate greater understanding of the evolution of the geographically dispersed subgenus Mundinia

Chromosome-Scale Assembly of the Complete Genome Sequence of Leishmania (Mundinia) enriettii, Isolate CUR178, Strain LV763

Leishmania (Mundinia) enriettii is a parasitic kinetoplastid first isolated from a guinea pig in Brazil in 1946. We present the complete genome sequence of L. (M.) enriettii, isolate CUR178, strain LV763, sequenced using combined short-read and long-read technologies. This will facilitate a greater understanding of the genome diversity within L. (M.) enriettii

Chromosome-Scale Assembly of the Complete Genome Sequence of Leishmania (Mundinia) orientalis, Isolate LSCM4, Strain LV768

Leishmania (Mundinia) orientalis is a kinetoplastid parasite first isolated in 2014 in Thailand. We report the complete genome sequence of L. (M.) orientalis, sequenced using combined short-read and long-read technologies. This will facilitate greater understanding of this novel pathogen and its relationship to other members of the subgenus Mundinia

Chromosome-Scale Assembly of the Complete Genome Sequence of Leishmania (Mundinia) procaviensis Isolate 253, Strain LV425

Leishmania (Mundinia) procaviensis is a parasitic kinetoplastid that was first isolated from a rock hyrax in Namibia in 1975. We present the complete genome sequence of Leishmania (Mundinia) procaviensis isolate 253, strain LV425, sequenced using combined short- and long-read technologies. This genome will contribute to our understanding of hyraxes as a Leishmania reservoir

Chromosome-Scale Assembly of the Complete Genome Sequence of Leishmania (Mundinia) sp. Ghana, Isolate GH5, Strain LV757

Leishmania (Mundinia) sp. Ghana is a kinetoplastid parasite isolated in 2015 in Ghana. We report the complete genome sequence of L. (M.) sp. Ghana, sequenced using combined short-read and long-read technologies. This will facilitate greater understanding of this novel pathogen and its relationships within the subgenus Mundinia