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आयतन 7, मुद्दा 9 (2021)

छोटी समीक्षा

Empiric Antibiotic Regimens and the Incidence of Acute Kidney Injury in Hospitalized Black Patients

Andrew A Yabusaki*

The selection of inpatient empiric antibiotic regimens is a significant challenge for hospitalists and clinicians today. Much is known about the increased incidence of acute kidney injury associated with the use of vancomycin and piperacillin-tazobactam in combination compared to vancomycin and other beta-lactam combinations. What is less clear is the incidence of antibiotic associated acute kidney injury and outcomes in Black patients. Incidence rates of acute kidney injury are already known to be higher in Black patients compared to white patients, which makes extrapolating the risks of antibiotic associated acute kidney injury challenging. In addition, only one research paper has included a study population with greater than 50% Black patients.

सम्मेलन की कार्यवाही

Control the second wave of COVID-19 through vaccines, advance treatment methods and control measures

Jayashri Mahalingam

With the continued raise of COVID 19 cases till now , there is a concern about a second wave. The response to the pandemic with advance diagnostic tools, readily available repurposable anti viral drugs and attendant measures to control SARS COV-2 Infections are of vital importance at this juncture. Using the advanced diagnostic tools the new strains are identified and analysed. RT-PCR is the gold standard method to diagnose and it has been upgraded with point of care test. Recent advances like crisper technology, Spike protein detection, IgM & IgG ELISA are useful tools in timely diagnosis. Supportive treatments like mechanical ventilation & ECMO remain the primary methods to treat the severe cases. Therapeutic options are anti viral & anti inflammatory drugs, interferon, Plasma therapy, RNAi , monoclonal antibody and mesenchymal stem cell therapy. Different types of vaccines like mRNA, DNA, Viral vector and inactivated vaccines are available and vaccination is going on worldwide. In India, Covaxin (inactivated –BBV152) and Covishield ( ChADOX1 –nCOV19 – AZD1222) are the major vaccines being given to the populations. Trend of second wave has a higher peak than the first wave, the basic reproduction number R0 being less than 2.3. We have found that second wave can be interpreted as non linear interactions between disease dynamics and social behaviour. Further development of mathematic model helps us to explore disease behaviour & Interactions, there by assisting to predict epidemiological and social condition together in this pandemic

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Canine mesenchymal stem cells exert antimicrobial effect on skin wound bacteria

Wael Abo Elkheir

This study was carried-out on MSC that isolated and obtained from dog bone marrow and cultured to explore its antibacterial effect on S. aureus and E. coli isolated from donkey wound. The acquisition MSCs was carried-out on general anaesthesia, a 13-gauge needle was used to penitrate the cortex of the iliac crest of each dog, and about 10 ml of bone marrow was drawn in a syringe containing 1500 IU of heparin. In vitro characterisation of MSCs: On day 14, cells were identified as being MSCs by their plastic adherence, morphology; the adherent colonies of spindle fibroblast-like cells were trypsinised, and counted.., flow cytometry analysis of the surface markers against the selected phenotypes following cell surface protein expression (CD44 ,CD29, CD73, CD90, CD105, CD166, CD271 ,CD45, CD34, CD13, and c-kit (all from BD Biosciences). BM-MSC at third passage were cultured in DMEM (Dulbecco’s Modified Eagle Medium) deprived of FCS (fetal calf serum ), and supernatants were collected after 6 or 24 hours microvesicles. MVs purification was performed using the ExoQuick-TC exosome precipitation solution (ExoQuick; System Biosiences) , and storage at −80°C until further use.

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Hematological Abnormalities Associated with COVID-19 infection

Hala Gabr Ahmed

Since its appearance in December 2019 in Wuhan, China, COVID-19 has been known as a respiratory virus with all its complications mainly on the respiratory system. As the disease progressed and reached the pandemic level, meticulous observations regarding the clinical presentation, laboratory parameters, and other investigations revealed widespread effect on various organs. Hematological changes are common in patients with COVID-19, which include reduced lymphocyte count and platelet count but normal white blood cell count. Prolonged activated partial thromboplastin time, 26% had elevated D-dimer levels, and most patients had normal prothrombin time (PT).
Hematological complications were implicated in one of the causes of death associated with covid-19, thrombosis. Other hematological abnormalities including leucopenia, thrombocytopenia and dysplastic myelopoiesis were occasionally encountered

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The historical/evolutionary cause and possible treatment of pandemic covid-19 (sars-cov-2, 2019-corona virus): world-war iii: the blackout of the modern world by neglected small infectious agent

Sorush Niknamian

A virus is a small infectious agent that replicates only inside the living cells of an organism. Viruses can infect all types of life forms, from animals and plants to microorganisms, including bacteria and Archaea. In evolution, viruses are an important means of horizontal gene transfer, which increases genetic diversity in a way analogous to sexual reproduction. Influenza (Including (COVID-19), is an infectious disease caused by an influenza virus. Some viruses especially smallpox, throughout history, has killed between 300500 million people in its 12,000-year existence. As modern humans increased in numbers, new infectious diseases emerged, including SARS-CoV-2. We have two groups of virus, RNA and DNA viruses. The most brutal viruses are RNA ones like COVID-19 (Sars-CoV-2). Introduction: Corona viruses are a group of viruses that cause diseases in mammals and birds. In humans, corona viruses cause respiratory tract infections that are typically mild, such as some cases of the common cold (among other possible causes, predom inantly rhinoviruses), though rarer forms can be lethal, such as SARS, MERS and COVID-19. Symptoms vary in other species: in chickens, they cause an upper respiratory tract disease, while in cows and pigs they cause diarrhea

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Local and general safety of a monovalent vaccine against Distemper under normal conditions of use in privately owned young and adult ferrets

Therese Butuad

Ferrets are sensitive and prone to adverse reactions, underlining the importance to conduct safety studies for species-targeted vaccines development. This field study aimed to assess local and general safety of a new distemper vaccine specifically intended for ferrets (Musteligen, Virbac France). A total of 153 ferrets underwent vaccination (2 subcutaneous injections; D0 and D28) an were divided into 3-age groups (young: 8 & 9 week-old; adult: over 3 month-old). Criteria assesse by veterinarians, after each vaccination and during 42 days, were rectal temperature, bodyweight frequency and severity of the signs. Ferrets of 8 weeks of age had a significant lower bodyweight than 9-week old and adult ferrets. Temperatures and body weight remained stable throughout the study for all animals. A few 9-week-old and adult ferrets presented systemic reaction signs consisting in slight apathy, decreased appetite, vomiting and diarrhoea. Such transient signs spontaneously resolved within 1 to 9 days. Moderate swelling was observed at the injection site (≤1.5 cm; in [3-7]% of all animals) and was very rarely associated with pain [1.6-2]%; all local signs resolving within a day. Enlarged lymph nodes following vaccination were only found in 8-week-old ferrets (21-31%), associated with more common local and systemic signs than 9-week old and adult ferrets. This new vaccine was well tolerated, with observed reactions similar to those usually reported with parenteral vaccination. It was safe to use in ferrets over 9 weeks of age and above the recommended minimal weight (300 gr. for females vs . 350 gr. for males).

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Histone like protein hupb of mycobacterium tuberculosis promote survival during stress conditions

Krishnamohan Atmakuri

Therapeutics treatment of TB patients has led to selective emergence of MDR- and XDR-Mtb strains. One such known target is Mtb’s histone like protein, HupB belonging to class of Nucleoid associated proteins (NAP). NAPs are small, basic bacterial proteins that bind DNA to drive chromatin structure and DNA-dependent processes. In other bacterial sp., HU (a histone like protein) through nucleoid reorganization possibly inhibits cellular metabolism and reduces bacterial growth during adaptation to stress conditions. Histone-like protein (Hlp) of Mycobacterium smegmatis (Msmeg), a nonpathogenic soil variant of Mycobacterium tuberculosis (Mtb) play role in adaptation to environmental stress. Mtb encodes a histone-like protein HupB (in-vivo essential) that has also been targeted with drugs. However, its in-vivo functions are largely unexplored. Here, we explore role of Mtb HupB during stress imposed by macrophages. For this, we have set up host stimulated stress assays as well as in vitro infection assays in cell line. Our data supports the role of hupB during stress. To further evaluate its functionality, we generated the Mtb ΔHupB which showed growth defect and change in colony morphology in comparison to that of Mtb. Our mutant also showed susceptibility to host induced stress. Thus, targeting HupB may be an essential strategy that can be deployed to tackle this pathogenic bacterium. As of now, it is not a target either with any first line or second line drugs. Our study to understand HupB’s role during macrophage-induced stress might lead way to further confirm if HupB must be considered a potential target

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Personalized and precision medicine (ppm) as a unique healthcare model to be set up via biodesign and translational applications and upgraded business modeling to secure the human healthcare, wellness and biosafety

Sergey Suchkov

A new systems approach to subclinical and/or clinical states of the disease and wellness being personalized resulted in a new trend in the healthcare services, personalized and precision medicine (PPM). To achieve the implementation of PPM concept, it is necessary to create a fundamentally new strategy based upon the biomarkers and targets to have a unique impact for the daily Practice, Biopharma and Biotech. In this sense, despite breakthroughs in research the translation of discoveries into therapies for patients has not kept pace with medical need.
Translational researchers, bio-designers and manufacturers are beginning to realize the promise of PPM, translating to direct benefit to clinical practice. For instance, companion diagnostics tools, theranosticums, molecular imaging and targeted therapies represent important stakes for the Biopharma in terms of market access, of return on investment and of image among the prescribers. So, developing the next-generation medicines and diagnostic tools requires changes to traditional clinical trial designs, that result in new types of data. Making the best use of those innovations and being ready to demonstrate results for regulatory bodies requires specialized knowledge that many clinical development teams don’t have. Navigating those complexities and ever-evolving technologies will pass regulatory muster and provide sufficient data for a successful launch of PPM, is a huge task. So, partnering and forming strategic alliances between researchers, bio-designers, clinicians, business, regulatory bodies and government can help ensure an optimal development program that leverages the Academia and industry experience and FDA’s new and evolving toolkit to speed our way to getting new tools into the innovative markets.
Healthcare is undergoing a global transformation. This is the reason for developing global projects in the area of PPM and TraMed to elicit the content of the new trend. The latter would provide a unique platform for collaboration among thought leaders and stakeholders with an interest in improving the system of healthcare delivery on one hand and drug discovery, development, and translation, on the other one, whilst educating the policy community about issues where biomedical science and policy intersect.

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