Utilization of dental care services among adult Indian population: A meta-analysis of evidence from 2011–2022

Background: This study aimed to generate a pooled national estimate on dental health care services utilization by the adult population in India from any public or private facility in an effort to highlight the demand and usage for oral health care. Methods: In this meta-analysis, PubMed, ScienceDirect, DOAJ, and Google Scholar were searched using a search strategy that combined MeSH headings and keywords (e.g., "Oral Health", "Dental Health Services", utilization, India, etc.) for articles on dental utilization among Indian adults, published between January 2011 and June 2022. Study quality was assessed using the NIH Quality assessment tool, and a random-effects inverse-variance method was used for pulling utilization proportions. Meta-regression and sub-group analyses were conducted to identify the sources of heterogeneity. Heterogeneity is reported as I2 . To examine publication bias, the funnel plot, egger’s test, and trim-and-fill analysis were performed. Results: From 4012 identified articles, 21 were eligible for inclusion. The pooled dental care utilization amongst Indian adults were found to be 23.96% (confidence interval [CI]: 16.81%– 31.11%, P<0.001, I2=98.93%), and the highest estimate was in South Zone (30.02%, CI: 19.14–40.90, P<0.01, I2=98.63%). Visual inspection of the funnel plot revealed the presence of publication bias (egger’s P value 0.02). A mild decrease in utilization estimate was noted through trim and fill analysis (adjusted estimate 17.65%, CI: 8.97–26.33, P=0.03). No significant subgroup effect was found for the variables study zone and conduction years (P value: 0.09 & 0.34 respectively). Conclusion: Future studies should be undertaken to focus on the demand and supply of oral health care services since an evidential gap has been identified due to the uneven distribution of studies available from various regions of India. The heterogeneity can be attributed to the diverse socioeconomic, literacy, and inherent health system performance status

Syndemic effect of COVID-19 outbreak on HIV care delivery around the globe: A systematic review using narrative synthesis

Background: The burden of the COVID-19 pandemic on healthcare systems worldwide has been compromising the progress made in the fight against HIV. This paper aims to determine how the COVID-19 pandemic has impacted HIV comprehensive care service delivery globally as well as to consolidate the evidence and recommendations that may be useful in averting future crisis. Methods: This review adheres to PRISMA guidelines. PubMed, DOAJ, Science Direct and other sources like Google Scholar and citations from included studies were searched methodically to locate studies evaluating the effects of COVID on services for HIV care. The NIH and JBI quality assessment tools were used for the quality assessment of individual studies. Results: In the present review 31 eligible studies were included and the impact on HIV care cascade were summarised under six themes: Lab services, Treatment and allied services, Counselling services, Outreach services, Psycho-social impact and Implementation of sustainable strategies. The studies also presented many innovative alternatives which were lucidly highlighted in the present article. Conclusion: Current evidence depicts multiple factors are responsible for the interruption of HIV care service delivery during the pandemic, especially in low resources settings. The prospective, alternative solutions that have been used to circumvent the threat have also been addressed in this review, in addition to the negative aspects that have been observed. Transition with new innovative, sustainable care paradigms may prove to be the building blocks in removing HIV-AIDS as a public health threat. Registration: Open Science Framework (DOI: 10.17605/OSF.IO/74GHM)

Assessing Acanthamoeba cytotoxicity: comparison of common cell viability assays

BackgroundIn vitro models for studying interactions between Acanthamoeba and host cells are crucial for understanding the pathomechanism of Acanthamoeba and assessing differences between strains and cell types. The virulence of Acanthamoeba strains is usually assessed and monitored by using cell cytotoxicity assays. The aim of the present study was to evaluate and compare the most widely used cytotoxicity assays for their suitability to assess Acanthamoeba cytopathogenicity.MethodsThe viability of human corneal epithelial cells (HCECs) after co-culture with Acanthamoeba was evaluated in phase contrast microscopy.ResultsIt was shown that Acanthamoeba is unable to considerably reduce the tetrazolium salt and the NanoLuc® Luciferase prosubstrate to formazan and the luciferase substrate, respectively. This incapacity helped to generate a cell density-dependent signal allowing to accurately quantify Acanthamoeba cytotoxicity. The lactate dehydrogenase (LDH) assay led to an underestimation of the cytotoxic effect of Acanthamoeba on HCECs since their co-incubation negatively affected the lactate dehydrogenase activity.DiscussionOur findings demonstrate that cell-based assays using the aqueous soluble tetrazolium-formazan, and the NanoLuc® Luciferase prosubstrate products, in contrast to LDH, are excellent markers to monitor the interaction of Acanthamoeba with human cell lines and to determine and quantify effectively the cytotoxic effect induced by the amoebae. Furthermore, our data indicate that protease activity may have an impact on the outcome and thus the reliability of these tests

Implementation status of airborne infection control measures in primary and secondary public health facilities, Puducherry: A mixed-methods study

Background: Poor ventilation in healthcare settings is a concern for airborne infections, particularly in light of the potential for coronavirus disease 2019 (COVID-19) transmission. This study aimed to assess the implementation status of airborne infection control (AIC) measures in primary and secondary public healthcare facilities (HCFs) and to explore the facilitating factors and barriers in the implementation of AIC measures. Methods: A mixed-methods approach was adopted, which includes a cross-sectional descriptive study using a checklist to collect data on the implementation of AIC measures in 22 primary and two secondary public HCFs in Puducherry, South India, between October 2020 and February 2021. Further, key informant interviews (KIIs) were conducted among medical officers (MOs). The qualitative data were manually analyzed, and transcripts created from handwritten notes and audio recordings were deductively evaluated. Results: Of the twenty-four health facilities visited, 54.2% had infection control (IC) committees. Annual IC training was held for housekeeping staff, MOs, nurses, and laboratory technicians in 23 (95.8%), 21 (87.5%), 20 (83.4%), and 14 (58.4%) facilities, respectively. Respiratory symptomatic patients were counseled on cough etiquettes in 22 (91.6%) facilities. Adequate cross-ventilation was present in outpatient departments in 16 (66.6%) institutions. N95 masks and face shields were provided in 21 (87.5%) facilities. Training through the KAYAKALP program and the presence of a separate sputum collection area were facilitators of IC, while lack of patient adherence and delays in fund release were found as barriers. Conclusion: Overall, the AIC measures were well-implemented, but improvements are needed in infrastructure development for patient segregation in outpatient departments and dedicated AIC training for all healthcare personnel

Molecular characterization of Histomonas meleagridis exoproteome with emphasis on protease secretion and parasite-bacteria interaction.

The exoproteome of parasitic protists constitutes extracellular proteins that play a fundamental role in host-parasite interactions. Lytic factors, especially secreted proteases, are capable of modulating tissue invasion, thereby aggravating host susceptibility. Despite the important role of exoproteins during infection, the exoproteomic data on Histomonas meleagridis are non-existent. The present study employed traditional 1D-in-gel-zymography (1D-IGZ) and micro-LC-ESI-MS/MS (shotgun proteomics), to investigate H. meleagridis exoproteomes, obtained from a clonal virulent and an attenuated strain. Both strains were maintained as mono-eukaryotic monoxenic cultures with Escherichia coli. We demonstrated active in vitro secretion kinetics of proteases by both parasite strains, with a widespread proteolytic activity ranging from 17 kDa to 120 kDa. Based on protease inhibitor susceptibility assay, the majority of proteases present in both exoproteomes belonged to the family of cysteine proteases and showed stronger activity in the exoproteome of a virulent H. meleagridis. Shotgun proteomics, aided by customized database search, identified 176 proteins including actin, potential moonlighting glycolytic enzymes, lytic molecules such as pore-forming proteins (PFPs) and proteases like cathepsin-L like cysteine protease. To quantify the exoproteomic differences between the virulent and the attenuated H. meleagridis cultures, a sequential window acquisition of all theoretical spectra mass spectrometric (SWATH-MS) approach was applied. Surprisingly, results showed most of the exoproteomic differences to be of bacterial origin, especially targeting metabolism and locomotion. By deciphering such molecular signatures, novel insights into a complex in vitro protozoan- bacteria relationship were elucidated