Infectious disorders drug targets最新文献

Introduction: Hematocervix and hematometra are uncommon manifestations of cervical intraepithelial neoplasia (CIN). While cervical stenosis is more commonly associated with senile at-rophy or post-procedural scarring, its occurrence in the context of CIN remains exceptionally rare.

Case presentation: A 49-year-old female presented to the gynaecology outpatient department with complaints of diffuse pain in the lower abdomen for the last 3 months. On examination, the vagina appeared atrophic, and a reddish-blue swelling was noted at the location of the cervix. Cough impulse was positive. On bimanual examination, the uterus was approximately 10 weeks in size, and a glob-ular swelling was palpable in the cervical region, which was soft, cystic, and boggy to the touch. USG and MRI confirmed hematocervix likely due to stenosis of the external os. On dilatation of the exter-nal os, about 250 ml of dark brown chocolate-coloured thick fluid was drained. Cervical biopsy was suggestive of intra-epithelial dysplasia (CIN III). HPV testing was positive for HPV-16. The patient was counselled for LEEP, followed by close surveillance, but instead she opted for a hysterectomy. Histopathology confirmed CIN III with features suggestive of cervical thinning characterized by ep-ithelial atrophy, underlying stromal fibrosis, and chronic inflammatory infiltrates comprising lym-phocytes and plasma cells, indicative of a longstanding inflammatory process.

Conclusion: Severe cervical thinning and hematocervix are uncommon but significant presentations of CIN. A high index of suspicion, timely histopathological evaluation, and appropriate management are essential in preventing adverse outcomes. This case highlights the importance of a comprehensive assessment in patients presenting with similar findings, particularly in those with risk factors or a history of cervical disease.

Introduction: Although cases of squamous cell carcinoma of the cervix are declining, the increase in adenocarcinoma and in situ adenocarcinoma raises new concerns and requires improvements in diagnostic and therapeutic strategies. This study investigates the relationship between advanced CIN3 and concurrent cervical glandular diseases, emphasising the importance of high-risk HPV genotypes in the progression of these conditions.

Methods: The clinical data of 104 patients who underwent conization for CIN3 at our centre in the last 10 years were reviewed. Cytological and histological diagnoses were performed according to the 2014 Bethesda system and WHO classification criteria, respectively. The analysis included patient age, HPV genotype of the surgical specimen, length of the cone, resection margin status, and follow-up details.

Results: Of the 104 patients, 92 (88.46%) were diagnosed with single CIN3 lesions (group 1), while 12 patients (11.54%) had coexisting glandular CIN3 lesions (group 2). All women tested were found to be positive for high-risk HPV (HPV-HR). The HPV18 genotype was found to be statistically more prevalent in group 2 (41.7%) than in group 1 (13%) (p = 0.011). At the first follow-up, HPV persistence was observed in 14/92 (15.2%) patients in group 1 and 10/12 (83.3%) patients in group 2 (p= 0.00001). Finally, the recurrence rate was 6.5% (6/92) in group 1 vs 30% (3/10) in group 2 (p= 0.012).

Discussion: In the management of cervical lesions, glandular pathology may go undetected at initial diagnosis, as it is often not visible on colposcopy or cytology. It is only through excisional treatment, which allows a more detailed analysis of the tissue, that these lesions can be identified. The presence of an associated glandular lesion radically changes the clinical picture and therapeutic management, requiring a more radical approach than that expected for an isolated CIN3 lesion.

Conclusions: The results of the study not only highlight the complexity of CIN3 associated with AIS/AC lesions, but also the importance of an integrated strategy that includes early diagnosis, appropriate treatment, and rigorous follow-up. The ultimate goal is the improvement of clinical outcomes and quality of life for cervical cancer patients.

The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the current coronavirus disease 2019 (COVID-19) pandemic, which has disclosed alarming challenges to global health. The disease demonstrates several clinical issues, from mild symptoms to severe acute respiratory-related problems, including multi-organ failure. The virus is key in COVID-19's pathogenesis, triggering different inflammatory responses. A well-known inflammatory biomarker, C-reactive protein (CRP), has become a possible diagnostic and prognostic marker in COVID-19 patients. This review aims to explain CRP in COVID patients and disease progression. It also shows how it can have a predictive value for clinical outcomes and potential therapeutic purposes. Additionally, we address the limitations and offer recommendations for future CRP studies. Overall, this review underscores the potential of CRP as a promising biomarker for managing COVID-19 and highlights the necessity of further research to understand its clinical significance thoroughly.

Introduction: The prevalence of irritable bowel syndrome (IBS) is estimated to range from 10% to 20%. The symptoms of IBS have been associated with an increased presence of Escherichia coli bacteria in the bowel. Treatment is often complicated by the growing prevalence of antibioticresistant strains, particularly those producing extended-spectrum β-lactamases (ESBLs) and carbapenemases. Given the clinical significance of antibiotic resistance in E. coli among IBS patients, this study aimed to investigate the phenotypic and genotypic characteristics of ESBL- and carbapenemase-producing E. coli isolates.

Methods: The isolates were obtained from stool samples of IBS patients and identified using conventional biochemical methods. Phenotypic tests were conducted to detect ESBL- and carbapenemaseproducing strains. Polymerase chain reaction (PCR) was employed to identify genes associated with ESBL and carbapenemase production. Additionally, biofilm formation was assessed using a microtiter plate assay.

Results: A total of 67 E. coli isolates were recovered from patients. Of these, 37 (55.2%) were phenotypically positive for ESBL or carbapenemase production. PCR analysis revealed that 18 isolates (26.9%) harbored at least one ESBL gene, while 16 (23.9%) carried at least one carbapenemaserelated gene. The most prevalent ESBL gene was blaTEM (23.9%), while blaOXA-23 and blaKPC were the most common carbapenemase genes (each found in 10.4% of isolates). Notably, all isolates exhibited biofilm-forming ability, with nearly half (49.25%) forming strong biofilms.

Conclusion: The notable prevalence of ESBL- and carbapenemase-producing E. coli among IBS patients may significantly affect patient outcomes, underscoring the need for targeted antibiotic stewardship and monitoring of biofilm-forming, drug-resistant strains.

Background: Onychomycosis is a chronic fungal nail infection caused by dermatophytes, yeasts, and non-dermatophyte molds. Confirming the causative organism is critical for guiding appropriate anti-fungal therapy.

Case presentation: This study reports the case of a male patient with nail discoloration, thickening, and dystrophy that were clinically suggestive of onychomycosis. Nail clippings were collected, cultured on Sabouraud Dextrose Agar, and examined microscopically. Colonies were identified by lactophenol cotton blue staining and confirmed using scanning electron microscopy. Morphological features, including pseudohyphae, blastoconidia, and chlamydospores, confirmed Candida albicans as the causative agent. The study focused on the laboratory isolation and identification of the causative fungal pathogen from nail specimens, a critical step for accurate diagnosis.

Conclusion: This case emphasizes the value of simple, economical microscopy-based methods for identifying Candida albicans in onychomycosis and underscores their role in supporting clinical management.

After recovering from COVID-19, several patients experienced beta-cell dysfunction, insulin resistance, pancreatic dysfunction, reduced insulin production, and New Onset Diabetes Mellitus (NODM). The purpose of this review was to examine the potential advantages of black seeds (Nigella sativa or N. sativa) in the treatment of post-COVID NODM. With a focus on pertinent publications, the literature search was carried out utilizing electronic databases such as Medline, PubMed, PMC, Scopus, Web of Science, Science Direct, Google Scholar, and reference lists. Numerous RCTs, systematic reviews, and meta-analyses have established N. sativa's antidiabetic potential as well as its other pleiotropic effects, such as its anti-inflammatory, antioxidant, and anti-COVID properties. Through a variety of possible mechanisms, N. sativa may reduce glycated Hemoglobin (HbA1c), Postprandial Blood Glucose (PPBG), Fasting Blood Glucose (FBG), and other indices. The long-term effects of N. sativa in the treatment of COVID-associated NODM should be investigated in future studies.

Introduction: Rhipicephalus (Boophilus) microplus is a parasitic tick that significantly impacts livestock production through economic losses and the transmission of diseases. Resistance to conventional acaricides, such as organophosphates, has prompted the search for alternative control strategies. Coumarin derivatives (Cds), due to their structural diversity and biological activity, have emerged as promising candidates for tick management.

Methods: Twelve CDs were synthesized via Pechmann condensation under eco-friendly conditions and evaluated for acaricidal activity using the Adult Immersion Test (AIT) on engorged female ticks of the R. (B.) microplus Montecitos strain. Survival was monitored every 24 hours for 96 hours. Data were analyzed using Cox proportional hazards regression and Kaplan-Meier survival estimators to assess the effect of time, concentration, and compound type on tick mortality.

Results: Survival decreased with increasing Cd concentration. Compounds C2 (5,7-dihydroxy-4-methylcoumarin), C4 (5-hydroxy-3,4,7-trimethyl-coumarin), and C11 (7-cinnamyloxy-4-methyl-coumarin) achieved the survival rates of ≤3% at 10 mg/ml within 96 hours, showing significantly greater efficacy than the organophosphate ethion, to which the Montecitos strain showed resistance (survival >98%). A hormetic response was observed in some treatments, with low concentrations inducing moderate tolerance.

Discussion: The acaricidal activity of Cds was closely related to structural features, particularly substitutions at C-4 and C-7 positions. The multifunctional mechanisms of coumarins, including interference with calcium signaling and detoxification pathways, may reduce resistance development. The ineffectiveness of ethion reinforces the need for novel control strategies. Ethanol as a solvent did not affect tick survival, confirming the bioactivity was due to the Cds themselves.

Conclusion: Coumarin derivatives synthesized under sustainable conditions demonstrate strong acaricidal potential, especially C2, C4, and C11. These compounds could serve as eco-friendly alternatives to conventional acaricides in controlling R. (B.) microplus, particularly in populations resistant to conventional treatments. Furthermore, in vivo and environmental impact studies are recommended to validate their practical application.

The COVID-19 pandemic has profoundly impacted global health, society, and economies, prompting unprecedented investments in biomedical research and vaccine de-velopment. Leveraging knowledge from previous coronavirus outbreaks, scientists rapidly developed vaccine candidates aiming to elicit strong antibody responses and target alterna-tive receptor-binding motifs. Remarkably, the effectiveness of these vaccines exceeded in-itial expectations, playing a pivotal role in controlling the pandemic. This review explores the latest technological advancements in vaccine development, including mRNA plat-forms, viral vectors, and protein subunit approaches, and highlights the critical importance of the vaccine development process. We analyze challenges encountered during the pan-demic, such as disease prevention, variation in prophylaxis, and rapid clinical evaluation. Insights gleaned from the literature on vaccine research, development, and drug testing provide a foundation for improved strategies in addressing future pandemics and shaping our responses to upcoming public health emergencies.

Introduction: Although 5-nitroimidazoles, primarily metronidazole (MTZ), are the primary drugs of choice for trichomoniasis, resistance to metronidazole appears to be increasing. Considering observed differences in drug resistance across various populations, this systematic review and meta-analysis was designed to determine the global prevalence of 5-nitroimidazole resistance among T. vaginalis.

Methods: We conducted a thorough search of international databases, including Web of Science, Medline, Scopus, SID, Magiran, and Iran-Medex using a variety of relevant keywords and their synonyms. Studies meeting the inclusion criteria were selected for the meta-analysis phase. To combine the findings, we employed a random-effects model.

Results: Of the 469 studies initially assessed, 16 were selected for the meta-analysis. Based on a random effect meta-analysis (I2 = 94.87 %, P= 0.001), the pooled prevalence rate of resistance to metronidazole was estimated at 14.8% (95% CI: 7.8-26.2%), which was statistically significant.

Discussion: The results of this study highlight the emergence of resistance to 5-nitroimidazoles, which poses a significant public health challenge.

Conclusion: Our findings emphasize the need for further research and the pursuit of new treatment options for resistant strains of T. vaginalis.