Mitigating the impact of COVID-19 on tuberculosis and HIV services: A cross-sectional survey of 669 health professionals in 64 low and middle-income countries.

OBJECTIVE: The experiences of frontline healthcare professionals are essential in identifying strategies to mitigate the disruption to healthcare services caused by the COVID-19 pandemic. METHODS: We conducted a cross-sectional study of TB and HIV professionals in low and middle-income countries (LMIC). Between May 12 and August 6, 2020, we collected qualitative and quantitative data using an online survey in 11 languages. We used descriptive statistics and thematic analysis to analyse responses. FINDINGS: 669 respondents from 64 countries completed the survey. Over 40% stated that it was either impossible or much harder for TB and HIV patients to reach healthcare facilities since COVID-19. The most common barriers reported to affect patients were: fear of getting infected with SARS-CoV-2, transport disruptions and movement restrictions. 37% and 28% of responses about TB and HIV stated that healthcare provider access to facilities was also severely impacted. Strategies to address reduced transport needs and costs-including proactive coordination between the health and transport sector and cards that facilitate lower cost or easier travel-were presented in qualitative responses. Access to non-medical support for patients, such as food supplementation or counselling, was severely disrupted according to 36% and 31% of HIV and TB respondents respectively; qualitative data suggested that the need for such services was exacerbated. CONCLUSION: Patients and healthcare providers across numerous LMIC faced substantial challenges in accessing healthcare facilities, and non-medical support for patients was particularly impacted. Synthesising recommendations of frontline professionals should be prioritised for informing policymakers and healthcare service delivery organisations

Pulmonary Tuberculosis and Drug Resistance in Dhaka Central Jail, the Largest Prison in Bangladesh

There are limited data on TB among prison inmates in Bangladesh. The aim of the study was to determine the prevalence of pulmonary tuberculosis (TB), its drug resistance and risk factors in Dhaka Central Jail, the largest prison in Bangladesh.Cross sectional survey with, active screening of a total number of 11,001 inmates over a period of 2 years. Sputum samples from TB suspects were taken for acid- fast bacilli (AFB) microscopy, culture and drug susceptibility testing. (5.37, 4.02–7.16).The study results revealed a very high prevalence of TB in the prison population in Dhaka Central Jail. Entry examinations and active symptom screening among inmates are important to control TB transmission inside the prison. Identifying undiagnosed smear-negative TB cases remains a challenge to combat this deadly disease in this difficult setting

Biosynthesis of precious metabolites in callus cultures of Eclipta alba

International audienceEclipta alba (False daisy) is an important medicinal plant with well-known antihepatotoxic activity. However, no previous in vitro studies are available for its callus culture for increased production of antioxidant secondary metabolites. Herein, we maintained a competent protocol for callus culture of E. alba using stem and leaf explants grown on MS medium containing various concentrations of thidiazuron, 6-benzylaminopurine (BAP) either alone or in association with α-naphthalene acetic acid (NAA). Among all the applied plant growth regulators, BAP along with NAA resulted in maximal dry biomass of 18.0 and 13.8 g/l for stem and leaf explants, respectively. Furthermore, the highest production of phenolics (375.7 mg/l for stem-associated callus and 298 mg/l for leaf-associated callus) and flavonoids (62.0 and 52.3 mg/l for stem- and leaf-associated callus, respectively) were found to be present in optimized callus culture. Antioxidant activity was also elucidated for both stem and leaf derived calli. The highest antioxidant activities (~ 93.5%) were witnessed for stem and leaf associated calli at set concentrations of 3.0 mg/l BAP + 1.0 mg/l NAA and 4.0 mg/l BAP, respectively. High-performance liquid chromatography analyses revealed optimum accumulation of coumarin (1.98 mg/g DW) and wedelolactone (49.63 mg/g DW) in leaf associated callus and desmethylwedelolactone (69.96 mg/g DW), β-amyrin (0.8179 mg/g DW) and eclalbatin (0.3202 mg/g DW) in stem associated callus at optimized concentration

UV-C mediated accumulation of pharmacologically significant phytochemicals under light regimes in in vitro culture of Fagonia indica (L.)

Abstract Fagonia indica (L.) is an important medicinal plant with multitude of therapeutic potentials. Such application has been attributed to the presence of various pharmacological important phytochemicals. However, the inadequate biosynthesis of such metabolites in intact plants has hampered scalable production. Thus, herein, we have established an in vitro based elicitation strategy to enhance such metabolites in callus culture of F. indica. Cultures were exposed to various doses of UV radiation (UV-C) and grown in different photoperiod regimes and their impact was evaluated on biomass accumulation, biosynthesis of phytochemicals along antioxidant expression. Cultures grown under photoperiod (16L/8D h) after exposure to UV-C (5.4 kJ/m2) accumulated optimal biomass (438.3 g/L FW; 16.4 g/L DW), phenolics contents (TPC: 11.8 μgGAE/mg) and flavonoids contents (TFC: 4.05 μgQE/mg). Similarly, HPLC quantification revealed that total production (6.967 μg/mg DW) of phytochemicals wherein kaempferol (1.377 μg/mg DW), apigenin (1.057 μg/mg DW), myricetin (1.022 μg/mg DW) and isorhamnetin (1.022 μg/mg DW) were recorded highly accumulated compounds in cultures at UV-C (5.4 kJ/m2) dose than other UV-C radiations and light regimes.. The antioxidants activities examined as DPPH (92.8%), FRAP (182.3 µM TEAC) and ABTS (489.1 µM TEAC) were also recorded highly expressed by cultures under photoperiod after treatment with UV-C dose 5.4 kJ/m2. Moreover, same cultures also expressed maximum % inhibition towards phospholipase A2 (sPLA2: 35.8%), lipoxygenase (15-LOX: 43.3%) and cyclooxygenases (COX-1: 55.3% and COX-2: 39.9%) with 1.0-, 1.3-, 1.3- and 2.8-fold increased levels as compared with control, respectively. Hence, findings suggest that light and UV can synergistically improve the metabolism of F. indica and could be used to produce such valuable metabolites on commercial scale

Lights triggered differential accumulation of antioxidant and antidiabetic secondary metabolites in callus culture of Eclipta alba L

Eclipta alba L., also known as false daisy, is well known and commercially attractive plant with excellent hepatotoxic and antidiabetic activities. Light is considered a key modulator in plant morphogenesis and survival by regulating important physiological cascades. Current study was carried out to investigate growth and developmental aspects of E. alba under differential effect of multispectral lights. In vitro derived callus culture of E. alba was exposed to multispectral monochromatic lights under controlled aseptic conditions. Maximum dry weight was recorded in culture grown under red light (11.2 g/L) whereas negative effect was observed under exposure of yellow light on callus growth (4.87 g/L). Furthermore, red light significantly enhanced phenolics and flavonoids content (TPC: 57.8 mg/g, TFC: 11.1 mg/g) in callus cultures compared to rest of lights. HPLC analysis further confirmed highest accumulation of four major compounds i.e. coumarin (1.26 mg/g), eclalbatin (5.00 mg/g), wedelolactone (32.54 mg/g) and demethylwedelolactone (23.67 mg/g) and two minor compounds (β-amyrin: 0.38 mg/g, luteolin: 0.39 mg/g) in red light treated culture whereas stigmasterol was found optimum (0.22 mg/g) under blue light. In vitro based biological activities including antioxidant, antidiabetic and lipase inhibitory assays showed optimum values in cultures exposed to red light, suggesting crucial role of these phytochemicals in the enhancement of the therapeutic potential of E. alba. These results clearly revealed that the use of multispectral lights in in vitro cultures could be an effective strategy for enhanced production of phytochemicals

Effects of Biogenic Zinc Oxide Nanoparticles on Growth and Oxidative Stress Response in Flax Seedlings vs. In Vitro Cultures: A Comparative Analysis

International audienc

Enhancement in the production of phenolic compounds from Fagonia indica callus cultures via Fusarium oxysporum triggered elicitation

Fagonia indica Burm.f. (1768) is a medicinally important plant showing diverse pharmaceutical benefits. It is renowned for its ability to biosynthesize several anticancer and anti-inflammatory metabolites. For the eco-friendly and sustainable synthesis of phytochemicals and plant biomass, a biotechnological technique, “elicitation,” is a highly effective method in various in vitro cultures. The present study includes using various concentrations of Fusarium oxysporum Schlecht. as an elicitor in callus cultures of Fagonia indica. The main goal was to achieve enhancement in biomass production and secondary metabolism. The findings demonstrated that maximum biomass production (FW: 167.42 ± 3.99 g per 100 mL; DW: 12.53 ± 1.04 g per 100 mL) was observed at 50 mg L−1 of Fusarium oxysporum as compared to the control. Secondary metabolites showed immense production (phenolic content (9.68 ± 0.23 µg mg−1); flavonoid content (2.814808 ± 0.11 µg mg−1)) in callus cultures treated with 10 mg L−1 of Fusarium oxysporum as compared with control. Moreover, the cultures possessed the highest antioxidant capacity, as determined by 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS•+) radical cation based assay and α, α-diphenyl-β-picrylhydrazyl (DPPH) free radical scavenging assay, ((821.51 ± 3.20 µmol TEAC per mg DW of ABTS inhibition) (91% ± 1.45 of DPPH inhibition)) at 10 mg L−1 concentration of Fusarium oxysporum, and the maximum ferric ion reducing activity (219.29 ± 2.36 µmol TEAC per mg DW) was noticed at 1.0 mg L−1 concentration of F. oxysporum. Fagonia indica cultures also indicated the highest percent inhibition against cyclooxygenases (COX-1: 51.93% ± 1.74 and COX-2: 40.57% ± 1.99), lipoxygenase (15-LOX: 65.72% ± 1.44), and phospholipase A2 (sPLA2: 49.29% ± 1.75), when treated with different concentrations of F. oxysporum. HPLC analyses showed a significant accumulation of pharmacologically active components in the treated samples, with kaempferol (1245.56 mg g−1) and myricetin (1139.63 mg g−1) as the most accumulated compounds in the cultures with 10.0 mg L−1 concentration of Fusarium in contrast to the control. These findings revealed that in callus cultures of F. indica, F. oxysporum could boost biomass accumulation and secondary metabolite production

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Abstract Objective: The objective was to bring evidence about the contribution of seasonal migration to defaulting and low treatment success rate (TSR) in Balochistan province of Pakistan. Methods: Directly Observed Therapy (DOTS) has been implemented in 22 districts of Balochistan province. A cohort study was conducted in five randomly selected districts between October 2005 and March 2006. A total of 291 new PTB patients during the two quarters were interviewed before summer migration by using a structured and pre-tested interview schedule regarding their health seeking behavior and other determinants about seasonal migration to determine default and TSR among migrant and non-migrant patients. Results: The overall default rate at surveyed districts was very low (2.4%) as compared to national level which is 17%, whereas it was 4.4% among migrant patients. It was evident that TSR was also high which was 96% and 100% among migrant and non-migrant patients respectively. It shows that migration has very low impact on default and low TSR. The main factors of low default and high TSR were the high commitment of patients for seeking their medical checkup as well as regularity in medication by both migrant as well as non-migrant patients. Conclusion: The high degree of commitment for seeking medical checkup and regularity in medication were the two main factors for low default rate and high TSR in the surveyed districts. Introduction Tuberculoses is endemic in Pakistan. With the population of 152 million about 1.5 million people are infected and Pakistan ranks sixth among the 22 high-burden tuberculosis countries worldwide (177 per 100,000) and death toll due to TB mounts to round 50,000 annually. 1 About 75% patients fall in the earning age group 14-49 years

Socio demographic characteristics of TB and non-TB cases and odds ratios (95% CI) for risk factors for tuberculosis.

<p>OR = odds ratio; AOR = adjusted odds ratio; CI = confidence interval.</p