Elevation in liver enzymes are associated with increased IL-2 and may predict severe outcomes of dengue virus infection in a Sri Lankan cohort [Poster Abstract]

This is an open access article under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)Background: A synergistic effect of host genetic factors, host immunity and the virulence of dengue viruses (DENV) contribute to the pathogenesis of DENV infections. In severe DENV infections, the hepatic transaminase AST level increases more than the hepatic transaminase ALT. IL-2 and TNF- are both elevated in DENV infection as a part of the body’s early response to infection. The objective was to assess the correlation between changes in IL-2 and TNF- levels with changes in liver enzymes in dengue patients with varying clinical severity. Methods & Materials: A total of 67 DENV infected patients (DF=24 and DHF=43) either confirmed by ELISA or RT-PCR from July 2011 to February 2012 from General Hospital Kandy were selected for the IL-2 and TNF- evaluation using a single analyte ELISArray (Qiagen, Germany). Clinical, haematological parameters and hepatic transaminases (AST and ALT) were recorded on admission. Five mL of blood was collected from DENV suspected patients on fever days 5 or less (onset of fever was considered as day 1). Results: Of the patients, 47.76% (n=32) showed AST: ALT >2. AST: ALT mean ±SD among DF was 1.64±0.74 U/L while it was 3.18± 4.50 U/L for DHF/DSS patients. No significant correlation was noted between AST: ALT and TNF- and also with IL-2. A significant positive linear correlation was observed between AST and IL-2 levels (r= 0.31 p = 0.01) and also between ALT and IL-2 levels (r= 0.27 p = 0.02). No significant correlation was noted between AST and TNF- and ALT and IL-2. Conclusion: Almost half of our study population showed AST: ALT>2 indicating acute changes in liver function and the potential for liver derangement due to DENV infection. There was a statistically significant positive correlation between the IL-2 with AST and ALT levels, although no correlation was noted between AST and ALT with TNF - . The positive correlations between elevations of AST and ALT with IL-2, and the association of higher levels of these factors in DHF/DSS compared with DF suggest that these measurements may be useful predictors for the progression of DENV infection to severe DF/DHF

Co-infections with multiple dengue virus serotypes in patients from 3 different Provinces of Sri Lanka, a dengue hyper endemic country [Poster Abstract]

This is an open access article under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0

Risk factors for acquiring varicella zoster virus (VZV) infection, and sero-prevalence of anti-VZV immunoglobulin G antibodies in adolescents from a tropical population

Introduction: Little is known about the sero-prevalence of anti-VZV antibodies among adolescents in the Kandy district of Sri Lanka although adulthood VZV infections are very common in this part of the country.Design: Socio-demographic data and blood samples were collected between November 2004 and April 2005 from a total of 271, 12- to 19-year-old, school students from urban, rural and estate communities. Sera were tested for anti-VZV IgG antibodies using a stranded enzyme-linked immunosorbent assay.Results: Sero-prevalence of anti-VZV antibodies among the adolescents was found to be 34%. Number of siblings (adolescents without siblings were non-immune; of those with 2 siblings - 27% were immune; of those with more than 2 siblings - 39% were immune) and areas of residence (urban, estate and rural) were significantly associated with the presence of anti-VZV IgG antibodies (p&lt;0.001).Conclusions: Sero-prevalence of anti-VZV IgG antibodies was low among adolescents in the Kandy district. Adolescents who lived in the urban areas had a significantly higher rate of anti-VZV IgG antibodies than those who lived in rural areas (p&lt;0.001). Adolescents who grow up without siblings are at risk of evading the childhood VZV infection and form a potential target group for adulthood chicken pox.DOI: http://dx.doi.org/10.4038/sljid.v4i1.5852 </p

Distribution of human metapneumovirus among children presenting with acute respiratory tract infection to a General Hospital in Sri Lanka

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Therapeutic antiviral effect of the nucleic acid polymer REP 2055 against persistent duck hepatitis B virus infection

Previous studies have demonstrated that nucleic acid polymers (NAPs) have both entry and post-entry inhibitory activity against duck hepatitis B virus (DHBV) infection. The inhibitory activity exhibited by NAPs prevented DHBV infection of primary duck hepatocytes in vitro and protected ducks from DHBV infection in vivo and did not result from direct activation of the immune response. In the current study treatment of primary human hepatocytes with NAP REP 2055 did not induce expression of the TNF, IL6, IL10, IFNA4 or IFNB1 genes, confirming the lack of direct immunostimulation by REP 2055. Ducks with persistent DHBV infection were treated with NAP 2055 to determine if the post-entry inhibitory activity exhibited by NAPs could provide a therapeutic effect against established DHBV infection in vivo. In all REP 2055-treated ducks, 28 days of treatment lead to initial rapid reductions in serum DHBsAg and DHBV DNA and increases in anti-DHBs antibodies. After treatment, 6/11 ducks experienced a sustained virologic response: DHBsAg and DHBV DNA remained at low or undetectable levels in the serum and no DHBsAg or DHBV core antigen positive hepatocytes and only trace amounts of DHBV total and covalently closed circular DNA (cccDNA) were detected in the liver at 9 or 16 weeks of follow-up. In the remaining 5/11 REP 2055-treated ducks, all markers of DHBV infection rapidly rebounded after treatment withdrawal: At 9 and 16 weeks of follow-up, levels of DHBsAg and DHBcAg and DHBV total and cccDNA in the liver had rebounded and matched levels observed in the control ducks treated with normal saline which remained persistently infected with DHBV. These data demonstrate that treatment with the NAP REP 2055 can lead to sustained control of persistent DHBV infection. These effects may be related to the unique ability of REP 2055 to block release of DHBsAg from infected hepatocytes.Faseeha Noordeen, Catherine A. Scougall, Arend Grosse, Qiao Qiao, Behzad B. Ajilian, Georget Reaiche-Miller, John Finnie, Melanie Werner, Ruth Broering, Joerg F. Schlaak, Andrew Vaillant, Allison R. Jilber

Assessment of angle velocity in girls with adolescent idiopathic scoliosis

<p>Abstract</p> <p>Background</p> <p>Although it has been demonstrated that the peak height velocity (PHV) is a predictive factor of progression in adolescent idiopathic scoliosis (AIS), little is known about the usefulness of angle progression in clinical practice. The purpose of this study was to establish a relationship between height and angle velocities, as well as to determine if peak angle velocity (PAV) occurs at the same time than PHV.</p> <p>Methods</p> <p>A retrospective study of a cohort of girls with idiopathic scoliotic curves greater than 10°. Data of 132 girls who participated in a previous retrospective study about growth in AIS were used to calculate height and angle velocities. Relationship between height and angle velocities was estimated by the use of a Linear Mixed Model.</p> <p>Results</p> <p>PHV and PAV take place simultaneously 1 year before menarche in progressive curves managed with a brace in AIS. Changes in angle velocity are influenced by changes in height growth velocity, in such a way that as from 6 months post-menarche, height growth velocity in this group of girls estimates curve progression velocity (β-coefficient -0.88, p = 0.04).</p> <p>Conclusion</p> <p>As from 6 months post-menarche, there is an inverse relationship between height velocity and curve progression in the group of AIS girls with progressive curves managed with a brace. Because height velocity is decreasing from 1 year before menarche, this finding corroborates that at the end of puberty, there is still a risk of progression in this group of girls despite bracing. The assessment of both height and angle velocity might be useful in clinical practice at the time of assessing brace effectiveness and how long bracing has to be indicated.</p

Antiviral activity of <em>Carica papaya</em> extract against experimental dengue virus 1 infection

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Histomorphological study of the spinal growth plates from the convex side and the concave side in adolescent idiopathic scoliosis

Asymmetrical growth of the vertebrae has been implicated as one possible etiologic factor in the pathogenesis of adolescent idiopathic scoliosis. The longitudinal vertebral growth derives from the endochondral ossification of the vertebral growth plate. In the present study, the growth plates from the convex and concave side of the vertebrae were characterized by the method of histology and immunohistochemistry to evaluate the growth activity, cell proliferation, and apoptosis. Normal zoned architectures were observed in the convex side of the growth plate and disorganized architectures in the concave side. The histological grades were significantly different between the convex and the concave side of the growth plate in the apex vertebrae (P < 0.05). The histological difference was also found significant statistically between end vertebrae and apex vertebrae in the concave side of vertebral growth plates (P < 0.05). The proliferative potential indexes and apoptosis indexes of chondrocytes in the proliferative and hypertrophic zone in the convex side were significantly higher than that in the concave side in the apex vertebral growth plate (P < 0.05). There was a significant difference of the proliferative potential index (proliferating cell nuclear antigen, PCNA index) between convex side and concave side at the upper end vertebra (P < 0.05). The difference of the proliferative potential index and apoptosis index were found significant statistically in the concave side of the vertebral growth plate between end vertebrae and apex vertebrae (P < 0.05). The same result was also found for the apoptosis index (terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate biotin nick end labeling assay, TUNEL index) in the convex side of vertebral growth plate between end vertebrae and apex vertebrae (P < 0.05). Some correlation were found between radiographic measurements and proliferation and apoptosis indexes. The difference in histological grades and cellular activity between the convex and concave side indicated that the bilateral growth plate of the vertebrae in AIS patients have different growth kinetics which may affect the curve progression

A Dutch guideline for the treatment of scoliosis in neuromuscular disorders

<p>Abstract</p> <p>Background</p> <p>Children with neuromuscular disorders with a progressive muscle weakness such as Duchenne Muscular Dystrophy and Spinal Muscular Atrophy frequently develop a progressive scoliosis. A severe scoliosis compromises respiratory function and makes sitting more difficult. Spinal surgery is considered the primary treatment option for correcting severe scoliosis in neuromuscular disorders. Surgery in this population requires a multidisciplinary approach, careful planning, dedicated surgical procedures, and specialized after care.</p> <p>Methods</p> <p>The guideline is based on scientific evidence and expert opinions. A multidisciplinary working group representing experts from all relevant specialties performed the research. A literature search was conducted to collect scientific evidence in answer to specific questions posed by the working group. Literature was classified according to the level of evidence.</p> <p>Results</p> <p>For most aspects of the treatment scientific evidence is scarce and only low level cohort studies were found. Nevertheless, a high degree of consensus was reached about the management of patients with scoliosis in neuromuscular disorders. This was translated into a set of recommendations, which are now officially accepted as a general guideline in the Netherlands.</p> <p>Conclusion</p> <p>In order to optimize the treatment for scoliosis in neuromuscular disorders a Dutch guideline has been composed. This evidence-based, multidisciplinary guideline addresses conservative treatment, the preoperative, perioperative, and postoperative care of scoliosis in neuromuscular disorders.</p