Seropositivity of hepatitis B viral infection among liver disorder patients, voluntary blood donors and hospital personnel

Background: HBV is highly infectious when compared with HIV even minute traces of infected blood as little as 0.0001 ml can transmit infection. Several of the routine therapeutic, diagnostic, prophylactic invasive procedures are capable of spreading HBV infection. Objectives of the study were to study the prevalence of hepatitis B surface antigen in voluntary blood donors, health care workers (medical and paramedical personnel) and patients with liver disordersMethods: Present study was hospital based cross sectional study carried out among 75 subjects during a period of one year. These 75 subjects consisted of 25 patients with liver disorder, 25 health care workers and 25 voluntary blood donors. All of these were selected randomly. After obtaining informed consent, detailed history and examination was carried out. The blood samples were collected and sent for detection of HBsAg by ELISA. Data was entered and analyzed using proportions.Results: Maximum subjects 40 (53.3%) belonged to the age group of 21-30 years overall as well as among the voluntary blood donors i.e. 60%. Among voluntary blood donors, 96% were males. 60% belonged to urban areas. Among rural subjects, maximum (53.3%) were having liver disorders. Only 28% were illiterate. Liver disorder was more common among illiterates i.e. it was 76.2%. Overall only 24% were having high risk behavior and all of them were heterosexuals. 76% were not having any high risk behavior. Liver disorder was more common (66.7%) among heterosexual high risk behavior subjects compared to only 22.8% with no high risk behavior. Seropositivity was found highest among patients with liver disorder (64%) followed by among health care workers (12%). No one was seropositive among voluntary blood donors. Overall the seropositivity was 25.4%.Conclusions: Patients with liver disorders especially chronic hepatitis were mostly seropositive. Among health care workers, being a doctor was an important risk factor for acquiring hepatitis B infection. Hence all health care workers should be immunized for hepatitis B.

Correlation between prostate specific antigen and prostate volume with disease symptom severity assessed by international prostate symptom score

Background: Benign prostatic hyperplasia (BPH) is clinically defined as prostate adenoma, resulting in bladder outlet obstruction (BOO), which may eventually harm the bladder and even kidneys. For differential diagnosis of male LUTS, uroflowmetry can be used together with non-invasive ultrasound to ascertain the flow rate and IPP. PSA is also an important indicator for differential diagnosis. International prostate symptoms score (IPSS) is used to assess the severity of the symptoms for clinical BPH. There is also a recommendation to consider the quality of life (QoL) index, where a QoL score of ≥3 is considered as worrisome. Methods: This was a retro-prospective study based on secondary and primary data collection and analysis, pertaining to BPH patients who visited the study site previously as well as those who are coming for regular follow-up since 2019. Patient enrolment was done at a teaching hospital Shree Krishna Hospital affiliated to the Pramukh Swami Medical College, Bhaikaka University, Karamsad. About 100 patients presenting with lower urinary tract symptoms (LUTS) and histo-pathologically proven cases of BPH were enrolled to pursue research objectives. All patients were followed up to a period of 3-months after initiating the treatment and disease severity through IPSS and quality of life upon completion of treatment were also assessed. Results: PSA is also an important indicator for differential diagnosis, which is generally less than 1 μg/l in patients in absence of clinically confirmed BPH. In our study, mean prostate volume was reported to be 43.46±19.35 cc. A positive correlation was observed between prostate volume and serum PSA with disease severity. Conclusions: Our study evaluated the IPSS to predict the disease severity and correlated it with quality of life, prostate volume and serum PSA. Our findings were in line with currently available evidences, and suggested that QoL, prostate volume and serum PSA are better predictors of disease severity, IPSS

Insights into HLA-Restricted T Cell Responses in a Novel Mouse Model of Dengue Virus Infection Point toward New Implications for Vaccine Design

The frequency of dengue virus (DENV) infection has increased dramatically in the last few decades, and the lack of a vaccine has led to significant morbidity and mortality worldwide. To date, a convenient murine system to study human T cell responses to DENV has not been available. Mice transgenic for human leukocyte antigens (HLA) are widely used to model human immune responses and it has been shown that mouse-passaged DENV is able to replicate to significant levels in IFN-α/βR−/− mice. To cover a wide range of HLA phenotypes, we backcrossed IFN-α/βR−/− mice with HLA A*0201, A*0101, A*1101, B*0702 and DRB1*0101 transgenic mice. A DENV proteome-wide screen identified a total of 42 epitopes across all HLA-transgenic IFN-α/βR−/− strains tested. In contrast only 8 of these elicited responses in the corresponding IFN-α/βR+/+ mice. We were able to identify T cell epitopes from 9 out of the 10 DENV proteins. However, the majority of responses were derived from the highly conserved nonstructural proteins NS3 and NS5. The relevance of this model is further demonstrated by the fact that most of the epitopes identified in our murine system are also recognized by PBMC from DENV exposed human donors, and a dominance of HLA B*0702 restricted responses has been detected in both systems. Our results provide new insights into HLA-restricted T cell responses against DENV, and we herein describe a novel murine model, which allows the investigation of T cell-mediated immune mechanisms relevant to vaccine design

Evidence-based clinical advice for nutrition and dietary weight loss strategies for the management of NAFLD and NASH

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide and affects approximately one third of adults in the United States. The disease is becoming a global epidemic as a result of the rising rates of obesity and metabolic disease. Emerging data suggest weight loss of ≥10% overall body weight is beneficial in resolving steatosis and reversing fibrosis. Prospective trials comparing various diets are limited by lack of sufficient power as well as pre- and post-treatment histopathology, and therefore no specific diet is recommended at this time. In this narrative review we examine the pathophysiology behind specific macronutrient components that can either promote or reverse NAFLD to help inform more specific dietary recommendations. Overall, the data supports reducing saturated fat, refined carbohydrates, and red and processed meats in the diet, and increasing the consumption of plant-based foods. Diets that incorporate these recommendations include plant-based diets such as the Dietary Approaches to Stop Hypertension, Mediterranean, vegetarian, and vegan diets

Arthrobacter Strains from Industrial Polluted Soil and its Oxidative Potential of Choline Oxidase Gene

Betaine is a trimethylglycine, serves as osmoregulator to prevent dehydration and plasmolysis under adverse hyperosmotic environments. Choline oxidase gene from Arthrobacter sp. catalyzes two step oxidation reaction of choline to betaine followed by betaine accumulation in cells which in turn help them to survive and thrive in harsh environmental condition. To identify potential choline oxidase gene source, a gram stain positive, rod shaped, catalase and oxidase positive, motile, aerobic bacterial strains designated as HYJE003 and HYJE005 was isolated based on the colony morphology, biochemical and molecular characterization from the industrially polluted soil samples of Hyderabad, India. Optimum growth of the isolated strains was observed at 32°C on nutrient agar media and was found that both the strains were capable of utilizing variety of sugars as carbon source. The 16S rRNA gene sequence analysis revealed that strain HYJE003 was closely related to Arthrobacter globiformis with pairwise sequence similarities of 99.85%, 99.63%, 98.76% and 98.12% respectively. The strain HYJE005 was closely related to Arthrobacter phenanthrenivorans with pairwise sequence similarities of 99.93%, 99.47%, 99.25% and 98.11% respectively. Choline oxidase gene potential of the isolates was studied by feeding the cultures with choline chloride and converted betaine was assessed by the formation of betaine reineckate. Findings revealed that the isolated strain Arthrobacter globiformis-HYJE003 has four times higher conversion rate of choline chloride to betaine than the strain Arthrobacter phenanthrenivorans HYJE005

Hypercholesterolemia After COVID-19: Time to Include Lipoprotein X Among the Differential Diagnoses

Background: Lipoprotein X (LpX) is an abnormal lipoprotein composed of phospholipids, free cholesterol, and albumin. Its overaccumulation is an infrequent cause of hyperlipidemia, which oftentimes presents in patients with cholestatic liver disease. The aim is to present the first 2 cases of patients with post-COVID cholangiopathy and LpX overaccumulation. Case Report: We present 2 female patients (ie, a 34-year-old [patient 1] and a 56-year-old [patient 2]), who had complicated courses of COVID-19, requiring prolonged mechanical ventilation (>4 weeks). One month after discharge, patient 1 presented with abdominal pain. Patient 2 had gangrenous cholecystitis and later developed recurrent elevation of alkaline phosphatase and bilirubin. Both patients were diagnosed with cholestatic liver disease. During outpatient follow-up both patients were found to have elevated plasma low-density lipoprotein cholesterol (LDL-C) in routine lipid panels (723 mg/dL and 1389 mg/dL, respectively). Both patients underwent various treatments for elevated LDL-C before referral to endocrinology. Patients were diagnosed with LpX overaccumulation from post-COVID-19 cholangiopathy. In both patients, LDL-C fluctuations seen in routine lipid panels (affected by LpX levels) were tightly correlated with changes in alkaline phosphate and bilirubin. Discussion: Our patients represent the first report of LpX overaccumulation in patients with post-COVID-19 cholangiopathy. Whether LpX accumulation is only the result of liver dysfunction, or COVID-19 infection plays a direct role in elevated LpX levels is still unknown. Conclusion: In patients with complicated courses of COVID-19, LpX overaccumulation should be considered when a routine lipid panel shows significant LDL-C elevations. Awareness among health care providers regarding LpX is important to avoid unnecessary workup and treatment