Prevalence of Non-Albicans Candida Among the Patients Attending a Tertiary Care Hospital in Kathmandu, Nepal

The main objective of this study was to determine the prevalence of non-albicans Candida among the patients attending a tertiary care hospital in Kathmandu, Nepal. Candida spp. isolated from different clinical samples (sputum, urine, vaginal swab, blood, endotracheal (ET) secretion, pus) from 250 patients between the period of February 2013 and December 2015 were included in the study. Of those 250 patients, 20% were immunocompromised. Sabouraud dextrose agar was used for the isolation of Candida spp. and the identification was performed on the basis of colony morphology, Gram’s stain, India ink preparation, germ tube test, temperature tolerance test, characteristic color change in CHROMagar, chlamydospore production, sugar fermentation test and sugar assimilation test.Out of total 300 Candida spp., majority were isolated from sputum (43.33%) followed by urine (40%) and vaginal swab (6.67%). Of total 151 (50.33%) non-albicans Candida, the most common species isolated were C. tropicalis (62.25%) followed by C. glabrata (23.84%). High prevalence of non-albicans Candida among the patients attending a hospital in Kathmandu, Nepal was noted

Exploring the Impact of Micro-plastics on Soil Health and Ecosystem Dynamics: A Comprehensive Review

Microplastics, defined as particles measuring less than 5 mm, have emerged as widespread environmental pollutants, prompting concerns regarding their impact on soil ecosystems. This review investigates microplastics' presence, movement, and effects on soil health and ecosystem dynamics while highlighting their diverse sources, including industrial production and the breakdown of larger plastic materials. Despite their ubiquity, a significant gap exists in our understanding of the consequences of microplastics in terrestrial ecosystems, particularly within soils. The findings of this review article revealed that microplastics exert notable influences on soil properties, altering bulk density, aggregation, and water-holding capacity, which may have significant implications for soil biota and plant vitality. Furthermore, microplastics also carry toxic substances, complicating their environmental impact. The effects on soil microorganisms and soil-dwelling fauna, such as earthworms, underscore the intricate relationships within soil ecosystems. Additionally, microplastics can interact with other soil pollutants, potentially amplifying their adverse effects. The long-term impacts of microplastics on soil health remain uncertain, underscoring the imperative for sustained research endeavours. Challenges persist, including the absence of standardized methodologies for microplastic extraction and identification in soils, which hampers our ability to understand their presence and effects comprehensively. Furthermore, the lack of regulatory frameworks complicates managing and mitigating microplastic pollution. Future research should adopt a holistic approach, considering diverse microplastic types and applications. Both field and laboratory experiments are essential for accurately capturing the varied influences of microplastics. Efforts should concentrate on understanding the occurrence of microplastics, developing reliable detection methods, and exploring their interactions with other pollutants, especially in terrestrial ecosystems. In conclusion, mitigating microplastic pollution requires multifaceted strategies informed by ongoing research efforts and public awareness campaigns. We can effectively address the challenges posed by microplastic contamination in soil ecosystems through concerted action and comprehensive understanding

Cardiovascular Risk Factors in Subclinical Hypothyroidism: A Case Control Study in Nepalese Population

Objectives. To assess cardiovascular risk factors in Nepalese population with subclinical hypothyroidism as compared to age and sex matched controls. Materials and Methods. A case control study was conducted among 200 subjects (100 subclinical hypothyroid and 100 euthyroid) at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. Demographic and anthropometric variables including systolic and diastolic blood pressure (BP) were taken. Blood samples were assayed for serum free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and high sensitivity C reactive protein (hs-CRP). Results. Subclinical hypothyroid patients had significantly higher diastolic BP, total cholesterol, LDL cholesterol, and hs-CRP than controls. The odds ratio of having hypercholesterolemia (>200 mg/dL), low HDL cholesterol (<40 mg/dL), undesirable LDL-cholesterol (>100 mg/dL), high hs-CRP (>1 mg/L), and high diastolic BP (>80 mmHg) and being overweight (BMI ≥ 23 Kg/m2) in subclinical hypothyroidism was 2.29 (95% CI; 1.2–4.38, p=0.011), 1.73 (95% CI; 0.82–3.62, p=0.141), 3.04 (95% CI; 1.66–5.56, p<0.001), 2.02 (95% CI; 1.12–3.64, p=0.018), 3.35 (95% CI; 1.72–6.55, p<0.001), and 0.9 (95% CI; 0.48–1.67, p=0.753), respectively, as compared to controls. Conclusion. Subclinical hypothyroid patients are associated with higher risk for cardiovascular disease than euthyroid subjects

Diagnostic Accuracy of GeneXpert MTB/RIF Assay in Comparison to Conventional Drug Susceptibility Testing Method for the Diagnosis of Multidrug-Resistant Tuberculosis.

Xpert MTB/RIF assay is regarded as a great achievement of modern medicine for the rapid diagnosis of multidrug-resistant tuberculosis (MDR-TB). The main purpose of this study was to determine the performance of Xpert MTB/RIF assay compared to conventional drug susceptibility testing (DST) method for the diagnosis of MDR-TB. A comparative cross sectional study was carried out at German-Nepal Tuberculosis Project, Kathmandu, Nepal, from April 2014 to September 2014. A total of 88 culture positive clinical samples (83 pulmonary and 5 extra-pulmonary) received during the study period were analyzed for detection of multidrug-resistant tuberculosis by both GeneXpert MTB/RIF assay and conventional DST method. McNemar chi square test was used to compare the performance of Xpert with that of DST method. A p-value of less than 0.05 was considered as statistically significant. Of total 88 culture positive samples, one was reported as invalid while 2 were found to contain nontuberculous Mycobacteria (NTM). Among remaining 85 Mycobacterium tuberculosis culture positive samples, 69 were found to be MDR-TB positive by both methods. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of GeneXpert MTB/RIF assay were found to be 98.6%, 100%, 100% and 93.8% respectively. Statistically, there was no significant difference between the diagnostic performance of Xpert and conventional DST method for detection of MDR-TB. GeneXpert MTB/RIF assay was found to be highly sensitive, specific and comparable to gold standard conventional DST method for the diagnosis of MDR-TB

Therapeutic Targeting of Inflammation and Virus Simultaneously Ameliorates Influenza Pneumonia and Protects from Morbidity and Mortality

Influenza pneumonia is a severe complication caused by inflammation of the lungs following infection with seasonal and pandemic strains of influenza A virus (IAV), that can result in lung pathology, respiratory failure, and death. There is currently no treatment for severe disease and pneumonia caused by IAV. Antivirals are available but are only effective if treatment is initiated within 48 h of onset of symptoms. Influenza complications and mortality are often associated with high viral load and an excessive lung inflammatory cytokine response. Therefore, we simultaneously targeted the virus and inflammation. We used the antiviral oseltamivir and the anti-inflammatory drug etanercept to dampen TNF signaling after the onset of clinical signs to treat pneumonia in a mouse model of respiratory IAV infection. The combined treatment down-regulated the inflammatory cytokines TNF, IL-1β, IL-6, and IL-12p40, and the chemokines CCL2, CCL5, and CXCL10. Consequently, combined treatment with oseltamivir and a signal transducer and activator of transcription 3 (STAT3) inhibitor effectively reduced clinical disease and lung pathology. Combined treatment using etanercept or STAT3 inhibitor and oseltamivir dampened an overlapping set of cytokines. Thus, combined therapy targeting a specific cytokine or cytokine signaling pathway and an antiviral drug provide an effective treatment strategy for ameliorating IAV pneumonia. This approach might apply to treating pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Poxvirus-encoded TNF receptor homolog dampens inflammation and protects from uncontrolled lung pathology during respiratory infection

Ectromelia virus (ECTV) causes mousepox, a surrogate mouse model for smallpox caused by variola virus in humans. Both orthopoxviruses encode tumor necrosis factor receptor (TNFR) homologs or viral TNFR (vTNFR). These homologs are termed cytokine response modifier (Crm) proteins, containing a TNF-binding domain and a chemokine-binding domain called smallpox virus-encoded chemokine receptor (SECRET) domain. ECTV encodes one vTNFR known as CrmD. Infection of ECTV-resistant C57BL/6 mice with a CrmD deletion mutant virus resulted in uniform mortality due to excessive TNF secretion and dysregulated inflammatory cytokine production. CrmD dampened pathology, leukocyte recruitment, and inflammatory cytokine production in lungs including TNF, IL-6, IL-10, and IFN-γ. Blockade of TNF, IL-6, or IL-10R function with monoclonal antibodies reduced lung pathology and provided 60 to 100% protection from otherwise lethal infection. IFN-γ caused lung pathology only when both the TNF-binding and SECRET domains were absent. Presence of the SECRET domain alone induced significantly higher levels of IL-1β, IL-6, and IL-10, likely overcoming any protective effects that might have been afforded by anti–IFN-γ treatment. The use of TNF-deficient mice and those that express only membrane-associated but not secreted TNF revealed that CrmD is critically dependent on host TNF for its function. In vitro, recombinant Crm proteins from different orthopoxviruses bound to membrane-associated TNF and dampened inflammatory gene expression through reverse signaling. CrmD does not affect virus replication; however, it provides the host advantage by enabling survival. Host survival would facilitate virus spread, which would also provide an advantage to the virus.National Health and Medical Research Council of Australia to G.K. and G.C. (Grants 1007980 and 471426). The laboratory of A. Alcamí was funded by the Spanish Ministry of Science and Innovation and European Union (European Regional Development’s Funds

Performance of GeneXpert as compared to gold standard conventional drug susceptibility test.

<p>Performance of GeneXpert as compared to gold standard conventional drug susceptibility test.</p

Summary of anti-tubercular drug susceptibility test.

<p>Summary of anti-tubercular drug susceptibility test.</p