Proteinuria in early detection of human leptospirosis

Background: Leptospirosis is an infectious disease caused by spirochetes bacteria Leptospira spp. and is reported from all over the world. As the clinical signs and symptoms of Leptospirosis often are nonspecific and the disease is early mistaken for other major infectious febrile illness, laboratory test to confirm the clinical diagnosis thus is essential for optimal treatment and patient management.Methods: Serum and urine samples were collected from patients clinically suspected cases of Leptospirosis. Preparations of urine concentrate by precipitation and centrifugation.Results: It was interesting to note that immunoglobulins are present in the urine protein concentrate of patients with Leptospirosis on the day of admission in the hospital, with urine albumin reports either positive or negative. By ELISA test it was noted that antibodies present in urine and serum were of both IgM and IgG class against the Leptospiral antigens from three pathogenic serovars and one non-pathogenicserovars. In the immunospot test which was done and compared with standard ELISA test for serum antibodies using same antigen showed that antibodies present in urine protein concentrate, which was collected on the day of admission when patients come with suspecting symptoms of Leptospirosis.Conclusions: Proteinuria is the most frequent abnormality noted in all patients at some stage of illness. This is the first report on the presence of immunoglobulins in urine samples, which were found to be of IgM and IgG classes. These findings are of significant diagnostic potential as a simple immune-spot test can be done for detecting anti-leptospiral antibodies in urine samples of suspected cases. The present attempt was aimed at developing an immunospot test, a simple and rapid diagnostic test to detect Leptospirosis using urine samples of clinically suspected patients of the infection at the earliest. It was found to be in good correlation with standard ELISA method which is being used to detect serum antibodies in Leptospira infected patients using the same antigen

Abnormal M1/M2 macrophage phenotype profiles in the small airway wall and lumen in smokers and chronic obstructive pulmonary disease (COPD)

© 2017 The Author(s). We explore potential dysregulation of macrophage phenotypes in COPD pathogenesis through integrated study of human small airway tissue, bronchoalveolar lavage (BAL) and an experimental murine model of COPD. We evaluated human airway tissue and BAL from healthy controls, normal lung function smokers (NLFS), and COPD subjects. Both small airways and BAL cells were immunohistochemically stained with anti-CD68 for total macrophages and with anti-CD163 for M2, and anti-iNOS for M1 macrophages. Multiplex ELISA measured BAL cytokines. Comparable cigarette smoke-induced experimental COPD mouse model was assessed for relevant mRNA profiles. We found an increase in pro-inflammatory M1s in the small airways of NLFS and COPD compared to controls with a reciprocal decrease in M2 macrophages, which remained unchanged among pathological groups. However, luminal macrophages showed a dominant M2 phenotype in both NLFS and COPD subjects. BAL cytokine skewed towards an M2 profile with increase in CCL22, IL-4, IL-13, and IL-10 in both NLFS and COPDs. The mouse-model of COPD showed similar increase in mRNA for M2 markers. Our finding suggests abnormal macrophage switching in both mucosal and luminal areas of COPD patients, that strongly associated with cytokine balance. There may be potential for beneficial therapeutic cytokine manipulation of macrophage phenotypes in COPD

Acute fatty liver of pregnancy: an update on mechanisms

Acute fatty liver of pregnancy (AFLP), characterized by hepatic microvesicular steatosis, is a sudden catastrophic illness occurring almost exclusively in the third trimester of pregnancy. Defective fatty acid oxidation in the fetus has been shown to be associated with this disease. Since the placenta has the same genetic makeup as the fetus and as AFLP patients generally recover following delivery, we hypothesized that the placenta might be involved in pathogenesis of this disease. In an animal model of hepatic microvesicular steatosis (using sodium valproate), we found that microvesicular steatosis results in mitochondrial structural alterations and oxidative stress in subcellular organelles of the liver. In placentas from patients with AFLP, we observed placental mitochondrial dysfunction and oxidative stress in subcellular organelles. In addition, defective placental fatty acid oxidation results in accumulation of toxic mediators such as arachidonic acid. Escape of these mediators into the maternal circulation might affect the maternal liver resulting in microvesicular steatosis

Effect of solarized potting mixture on growth of black pepper (Piper nigrum L.) rooted cuttings in the nursery

Solarized potting mixture in combination with nutrients and biocontrol agents was evaluatedfor production of vigorous disease free rooted cuttings of black pepper. Plants raised insolarized potting mixture had better growth than plants raised in nonsolarized pottingmixture (soil, sand, and farm yard manure 2:1:1proportion). Among the various treatments,plants raised in solarized potting mixture with recommended nutrients (urea,superphosphate, potash and magnesium sulphate 4:3:2:1)  showed significant increase innumber of leaves(5.3), length of roots (20cm), leaf area (177cm2), nutrient contents andbiomass (3.7g pl-1). The results indicated the superiority of solarized potting mixture forreducing the incidence of diseases besides yielding vigorous planting material. Cost ofproduction of rooted cuttings with biocontrol agents was found to be cheaper in the case ofrooted black pepper cuttings raised in solarized potting mixture. Bio control agents or biofertilizers can be mixed with solarized potting mixture. &nbsp

Decreasing Physical Activity Levels across Religious Sikh Male South Asian Migrant Population in Kent, UK: A Public Health Concern

Physical activity (PA) plays a crucial role in reducing the risk of non-communicable diseases (NCDs). We investigated intergenerational physical activity level (PAL) among first and second generation Sikh Punjabi male subjects (n = 137), recruited from two Sikh temples in Medway, UK. Employing a crosssectional survey PA was quantified using the validated Global PA Questionnaire (GPAQ). Data were analysed using SPSS 20 and Epi Info software. Ninety-one per cent of the subjects were classified as overweight. Mean PAL range was sedentary to low levels of PA (1.45–1.60). Comparisons between first and second generation Punjabi male subjects showed that the two groups are equally culpable in not engaging in work-related or recreational PA, but for the second generation this is significantly lower. Low PAL is a contributory factor to increased risk and prevalence of NCDs among this population and a public health concern. Efforts to increase PA in this group should continue

Assessment of myofascial pain syndrome among married female healthcare workers: a cross sectional comparative study in a tertiary care centre

Background: Myofascial pain syndrome (MPS) is common among females between ages 20-40 years. Psychosomatic and mechanical reasons are attributed as causative factors. Female health care workers (FHW) in hospitals with rapid patient turn over are vulnerable to develop MPS. Our aim was to ascertain the prevalence of MPS in married FHW working in various departments of the hospital and its association with poor sleep and work stress. Methods: We selected married FHWs in 20-50 years age group and divided them into two groups, medical and paramedical (those involved directly and indirectly with patient care respectively). MPS was diagnosed after detailed personal interview and clinical examination. Sleep duration was divided into less than 5 hours and more than 5hours. Presence of work-related stress and other medical parameters were also recorded. Results: A total of 150 medical and 150 paramedical FHWs were included in the study. Overall prevalence of MPS among FHWs was 42%, of which, medical group was 32% and paramedical was 52%. The paramedical group showed significantly higher prevalence of MPS (p: 0.02). Sleep was less than 5 hours in 29.3% of medical FHW and 13.3% of paramedical. This difference didn’t show any association to MPS (p=0.8). 38% FHW perceived excessive work stress, 40% were paramedical and 36% were medical. This didn’t correlate with prevalence of MPS (p=0.2) among them. Conclusions: Paramedical FHW experienced more MPS than medical and it was more of mechanical type and not due to work stress or sleep deprivation

Advances in Basic and Translational Research as Part of the Center for the Study of Complex Malaria in India.

The Center for the Study of Complex Malaria in India (CSCMi) is one of 10 International Centers of Excellence in Malaria Research funded by the National Institutes of Health since 2010. The Center combines innovative research with capacity building and technology transfer to undertake studies with clinical and translational impact that will move malaria control in India toward the ultimate goal of malaria elimination/eradication. A key element of each research site in the four states of India (Tamil Nadu, Gujarat, Odisha, and Meghalaya) has been undertaking community- and clinic-based epidemiology projects to characterize the burden of malaria in the region. Demographic and clinical data and samples collected during these studies have been used in downstream projects on, for example, the widespread use of mosquito repellants, the population genomics of Plasmodium vivax, and the serological responses to P. vivax and Plasmodium falciparum antigens that reflect past or present exposure. A focus has been studying the pathogenesis of severe malaria caused by P. falciparum through magnetic resonance imaging of cerebral malaria patients. Here we provide a snapshot of some of the basic and applied research the CSCMi has undertaken over the past 12 years and indicate the further research and/or clinical and translational impact these studies have had

Prevalence and factors associated with parental concerns about development detected by the Parents' Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks in a birth cohort

Objectives: Early identification of developmental vulnerability is vital. This study aimed to estimate the prevalence of moderate or high developmental risk on the Parents' Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks; identify associated risk factors; and examine documentation of the PEDS at well-child checks. Design, participants: A prospective birth cohort of 2025 children with 50% of those approached agreeing to participate. Demographic data were obtained via questionnaires and linked electronic medical records. Telephone interviews were conducted with parents to collect PEDS data. Primary and secondary outcomes: Multiple logistic regression analyses identified risk factors for moderate or high developmental risk on the PEDS. A Cumulative Risk Index examined the impact of multiple risk factors on developmental risk and documentation of the PEDS at the well-child checks. Results: Of the original cohort, 792 (39%) had 6-month, 649 (32%) had 12-month and 565 (28%) had 18-month PEDS data. Parental concerns indicating moderate or high developmental risk on the PEDS were 27% (95% CI 24 to 30) at 6 months, 27% (95% CI 24 to 30) at 12 months and 33% (95% CI 29 to 37) at 18 months. Factors associated with moderate or high developmental risk were perinatal risk (OR 12 months: 1.7 (95% CI 1.1 to 2.7)); maternal Middle Eastern or Asian nationality (OR 6 months: 1.6 (95% CI 1.1 to 2.4)), (OR 12 months: 1.7 (95% CI 1.1 to 2.7)); and household disadvantage (OR 6 months: 1.5 (95% CI 1.0 to 2.2). As the number of risk factors increased the odds increased for high or moderate developmental risk and no documentation of the PEDS at well-child checks. Conclusions: Children with multiple risk factors are more likely to have parental concerns indicating

Multi-country evaluation of the durability of pyrethroid plus piperonyl-butoxide insecticide-treated nets: study protocol

BACKGROUND: Mass distributions of long-lasting insecticidal nets (LLINs) have contributed to large reductions in the malaria burden. However, this success is in jeopardy due in part to the increasing pyrethroid-resistant mosquito population as well as low LLINs coverage in various areas because the lifespan of LLINs is often shorter than the interval between replenishment campaigns. New insecticide-treated nets (ITNs) containing pyrethroid and piperonyl-butoxide (PBO) have shown a greater reduction in the incidence of malaria than pyrethroid LLINs in areas with pyrethroid-resistant mosquitoes. However, the durability (attrition, bio-efficacy, physical integrity and chemical retainment) of pyrethroid-PBO ITNs under operational settings has not been fully characterized. This study will measure the durability of pyrethroid-PBO ITNs to assess whether they meet the World Health Organization (WHO) three years of operational performance criteria required to be categorized as "long-lasting". METHODS: A prospective household randomized controlled trial will be conducted simultaneously in Tanzania, India and Cote d'Ivoire to estimate the field durability of three pyrethroid-PBO ITNs (Veeralin(R), Tsara(R) Boost, and Olyset(R) Plus) compared to a pyrethroid LLIN: MAGNet(R). Durability monitoring will be conducted up to 36 months post-distribution and median survival in months will be calculated. The proportion of ITNs: (1) lost (attrition), (2) physical integrity, (3) resistance to damage score, (4) meeting WHO bio-efficacy (>/= 95% knockdown after 1 h or >/= 80% mortality after 24 h for WHO cone bioassay, or >/= 90% blood-feeding inhibition or >/= 80% mortality after 24 h for WHO Tunnel tests) criteria against laboratory-reared resistant and susceptible mosquitoes, and insecticidal persistence over time will be estimated. The non-inferiority of Veeralin(R) and Tsara(R) Boost to the first-in-class, Olyset(R) Plus will additionally be assessed for mortality, and the equivalence of 20 times washed ITNs compared to field aged ITNs will be assessed for mortality and blood-feeding inhibition endpoints in the Ifakara Ambient Chamber Test, Tanzania. CONCLUSION: This will be the first large-scale prospective household randomized controlled trial of pyrethroid-PBO ITNs in three different countries in East Africa, West Africa and South Asia, simultaneously. The study will generate information on the replenishment intervals for PBO nets