Pub Date : 2023-09-01DOI: 10.4103/1995-7645.345946
Lee Phone Youth Zen, Meng Yee Lai, Mohd Hafizi Abdul Hamid, Jenarun Jelip, Rose Nani Mudin, Noor Hafizan Bt Mat Salleh, Netty Darwina Dawam, Nirzayanna Eyan Abdul Ajak, Mohd Ashrin Afiq Bin Zainudin, Yee Ling Lau
In a point of care setting for the diagnosis of malaria, DNA extraction using conventional methods are time-consuming and complicated. Therefore, in this study we aim to utilize a simple nucleic acid extraction method to directly extract DNA from blood. This would in turn reduce the time, cost and equipment needed to perform DNA extraction. This method is then coupled with LAMP assay for rapid diagnosis of malaria. We obtained 77 malaria samples, of which 36 were Plasmodium (P.) knowlesi, 10 P. vivax, 10 P. falciparum, 1 P. malariae and 20 healthy blood samples from district hospitals from Selangor, Kelantan, Negeri Sembilan, Pahang, and Perak, from 2019 to 2021. All malaria samples tested by LAMP or nested PCR were collected prior to antimalarial treatment. All malaria samples collected were confirmed by microscope at the hospital and cross-checked by Medical Laboratory Technician at the District Health Office. The samples were confirmed by microscopic examination and nested PCR as described by Snounou et al[1] and Imwong et al[2]. The LAMP assay and primers were adapted from Lau et al[3]. The extraction method and buffers were adapted from Zou et al[4] with minor modifications. Blood samples of 60 μL, and 240 μL of lysis buffer [800 mM guanidine hydrochloride, 50 mM Tris (pH 8), 0.5% Triton™ X-100, 1% Tween-20, 40 μg/mL Proteinase K] was used. The tube consisting of blood and lysis buffer mixture was constantly inverted for until homogenous. A 6 mm diameter Whatman grade 1 qualitative filter paper was inserted into the tube was mixed constantly for 1 minute. The filter paper was then removed from the blood lysis mixture and washed in 1 mL of washing buffer [10 mM Tris (pH 8.0), 0.1% Tween-20]. The filter paper was then mixed constantly in the washing buffer for 1 minute. Following that, the filter paper was removed and dipped 5 times into the PCR tube consisting of the LAMP reaction before removing the filter paper. The LAMP assay was incubated in a Loopamp Real time turbidimeter LA 500 (Eiken Chemical Co., Ltd., Japan) at 65 °C for 60 minutes and inactivated at 80 °C for 2 minutes. Limit of detection of the method was performed by using P. knowlesi strain A1H1 obtained from the Department of Parasitology, Faculty of Medicine, Universiti Malaya. P. knowlesi strain A1H1 culture blood was ten-fold serially diluted to parasitemia of 1%, 0.1%, 0.01%, 0.001% and 0.000 1% respectively with healthy blood, and was tested with the above method in triplicates. The clinical sensitivity and specificity of LAMP assay was determined using microscopy as the reference standard methods. Sensitivity was calculated as (number of true positives)/(number of true positives+number of false negatives), and specificity was calculated as (number of true negatives)/(number of true negatives+number of false positives). The DNA extraction method coupled with LAMP has a detection limit of 0.001% parasitemia (5 parasites/μL of blood) (Figure 1). A highly trained technician u
在疟疾诊断的医疗点环境中，使用传统方法提取DNA既耗时又复杂。因此，在本研究中，我们的目标是利用简单的核酸提取方法直接从血液中提取DNA。这反过来又会减少时间、成本和进行DNA提取所需的设备。然后，将该方法与LAMP试验相结合，用于疟疾的快速诊断。2019年至2021年，我们从雪兰莪州、吉兰丹州、森美兰州、彭亨州和霹雳州的地区医院获得77份疟疾样本，其中诺氏疟原虫36份、间日疟原虫10份、恶性疟原虫10份、疟疾疟原虫1份和健康血液样本20份。通过LAMP或巢式PCR检测的所有疟疾样本均在抗疟疾治疗前收集。收集的所有疟疾样本都在医院用显微镜进行了确认，并由区卫生办事处的医学实验室技术员进行了交叉检查。根据snoounou等[1]和Imwong等[2]的描述，通过显微镜检查和巢式PCR对样品进行确认。LAMP实验和引物均改编自Lau等[3]。提取方法和缓冲液采用邹等[4]，稍作修改。血液样品为60 μL，溶解缓冲液240 μL [800 mM盐酸胍，50 mM Tris (pH 8)， 0.5% Triton™X-100, 1% Tween-20, 40 μg/mL蛋白酶K]。由血液和溶解缓冲液组成的试管不断倒置，直至均匀。将直径6 mm的Whatman 1级定性滤纸插入管中，持续混合1分钟。然后将滤纸从血液溶解混合物中取出，用1ml洗涤缓冲液[10 mM Tris (pH 8.0)， 0.1% Tween-20]洗涤。将滤纸在洗涤缓冲液中不断混合1分钟。取下滤纸，将滤纸浸入LAMP反应组成的PCR管中5次，取下滤纸。LAMP实验在Loopamp实时浊度计LA 500 (Eiken Chemical Co.， Ltd, Japan)中65°C孵育60分钟，80°C灭活2分钟。方法的检出限为马来大学医学院寄生虫学教研室获得的诺氏疟原虫A1H1株。诺氏疟原虫A1H1培养血与健康人血分别稀释10倍至1%、0.1%、0.01%、0.001%和0.000 1%的寄生虫血症，分3次采用上述方法检测。以镜检法为参考标准方法，测定LAMP法的临床敏感性和特异性。敏感度计算为(真阳性数)/(真阳性数+假阴性数)，特异性计算为(真阴性数)/(真阴性数+假阳性数)。结合LAMP的DNA提取方法的检出限为0.001%寄生虫血症(5只寄生虫/μL血液)(图1)。训练有素的技术人员使用显微镜可以可靠地检测到50只寄生虫/μL血液，而实验室PCR方法的检出限为0.5至5只寄生虫/μL[5]。在进行检出限时，所有寄生率高于0.001%的样品均能扩增成功，而在0.000 1%寄生率的样品中有1/3阳性扩增。将LAMP的临床敏感性与常规巢式PCR和镜检结果进行比较。采用巢式PCR和镜检相结合的方法对77份样本进行了诊断。在采用巢式PCR和镜检诊断的77份样本中，有诺氏疟原虫(36份)、恶性疟原虫(10份)、间日疟原虫(10份)、疟疾疟原虫(1份)和20份疟原虫阴性样本。36株诺氏单胞菌中，有3株用LAMP联合替代DNA提取法未检出。该方法成功扩增了所有恶性疟原虫(n=10)、间日疟原虫(n=10)和疟疾疟原虫(n=1)阳性样本。20份健康血液样本未显示任何扩增。与显微镜法相比，LAMP联合DNA提取方法的灵敏度为94.7%，特异性为100%。图1所示。:环介导等温扩增DNA提取法的检出限。根据Loopamp实时浊度计LA 500 (Eiken Chemical Co.， Ltd, Japan)获得的结果绘制了图表。x轴表示时间，y轴表示浊度。标签如下，1%:1%诺氏疟原虫A1H1培养物;0.1%: 0.1%诺氏疟原虫A1H1培养物;0.01%: 0.01%诺氏疟原虫A1H1培养物;0.001%: 0.001%寄生虫血症诺氏疟原虫A1H1培养;0.000 1%: 0.000 1%诺氏疟原虫A1H1培养;-ve:双蒸馏水(无目标控制)。与镜检相比，替代DNA提取法联合LAMP的临床敏感性为94.7%，临床特异性为100%。 3个样品LAMP扩增失败可能是由于DNA的降解。为了证实DNA的降解，对这三个样本进行巢式PCR，没有观察到扩增。这些样品在-20°C下保存一年以上。在常温、4℃和-20℃下短期保存对DNA的产率影响较大[6]。采用异丙醇沉淀法、甲酰胺裂解物法、非有机溶剂萃取法和玻璃颗粒吸附法等传统方法提取基因组DNA耗时长，而苯酚和氯仿法使用有毒试剂，不适合现场诊断。大多数商业DNA提取试剂盒需要多个液体处理步骤[7]，不适合护理点。DNA提取方法的另一种方法是使用菲茨科/弗林德技术协议(FTA)纸，一种基于纤维素的DNA提取方法。FTA纸是一种以纤维素为基础的吸收性纸，经过专有的化学混合物处理，具有良好的保存和储存能力。然而，与使用未经处理的滤纸相比，基于FTA的DNA提取方法仍然被认为是昂贵的。根据Whatman的价格目录[8]，单次使用的FTA血液试剂盒的成本为10.48美元，而用于所提出的提取方法的70 mm直径的Whatman一级定性滤纸的成本仅为0.11美元。邹等人[4]发表的论文发现，纤维素基滤纸可以快速结合核酸，在短暂的洗涤步骤中保留核酸以去除污染物，然后直接洗脱进入扩增反应。然后，他们将滤纸改造成试纸，并且能够在不到30秒的时间内从各种生物样本中提取核酸，而不需要任何专门的设备[4]。在这项研究中，我们将这种方法用于疟疾的诊断。使用直径6毫米的滤纸代替，以便更大的表面积有助于DNA的结合。将洗涤液的体积从200 μL增加到1 mL，因为我们发现更大的体积有助于滤纸上污染物的扩散。然后将滤纸浸入LAMP测定中，使疟原虫DNA模板存在于测定中。总之，这里提出的方法允许扩增疟原虫DNA的时间和成本效益的方式。使用这种方法更容易获得和负担得起疟疾诊断，因此它将在资源有限的地区有用。利益冲突声明作者声明他们没有利益冲突。本研究经UMMC医学伦理委员会(MEC参考号817.18和908.11)和国家医学研究登记处(参考号817.18和908.11)批准。nmrr - 12 - 1105 - 13079)。本研究由马来西亚高等教育部长期研究资助计划(LRGS)资助，编号:LRGS/1/2018/UM/01/1/4。作者的贡献LPYZ和YLL使研究概念化。LPYZ整理数据，正式分析，调查，验证并撰写原始草案。YLL获得资金并管理该项目。YLL和MYL监督这个项目。mha, JJ, RNM, NHMS, NDD, NEAA和MAABZ提供了资源。所有作者都参与了审稿和编辑工作。《华尔街日报》的出版商对已出版地图的管辖权要求和机构关系保持中立。
{"title":"A simple and purification-free nucleic acid extraction method for rapid diagnosis of malaria","authors":"Lee Phone Youth Zen, Meng Yee Lai, Mohd Hafizi Abdul Hamid, Jenarun Jelip, Rose Nani Mudin, Noor Hafizan Bt Mat Salleh, Netty Darwina Dawam, Nirzayanna Eyan Abdul Ajak, Mohd Ashrin Afiq Bin Zainudin, Yee Ling Lau","doi":"10.4103/1995-7645.345946","DOIUrl":"https://doi.org/10.4103/1995-7645.345946","url":null,"abstract":"In a point of care setting for the diagnosis of malaria, DNA extraction using conventional methods are time-consuming and complicated. Therefore, in this study we aim to utilize a simple nucleic acid extraction method to directly extract DNA from blood. This would in turn reduce the time, cost and equipment needed to perform DNA extraction. This method is then coupled with LAMP assay for rapid diagnosis of malaria. We obtained 77 malaria samples, of which 36 were Plasmodium (P.) knowlesi, 10 P. vivax, 10 P. falciparum, 1 P. malariae and 20 healthy blood samples from district hospitals from Selangor, Kelantan, Negeri Sembilan, Pahang, and Perak, from 2019 to 2021. All malaria samples tested by LAMP or nested PCR were collected prior to antimalarial treatment. All malaria samples collected were confirmed by microscope at the hospital and cross-checked by Medical Laboratory Technician at the District Health Office. The samples were confirmed by microscopic examination and nested PCR as described by Snounou et al[1] and Imwong et al[2]. The LAMP assay and primers were adapted from Lau et al[3]. The extraction method and buffers were adapted from Zou et al[4] with minor modifications. Blood samples of 60 μL, and 240 μL of lysis buffer [800 mM guanidine hydrochloride, 50 mM Tris (pH 8), 0.5% Triton™ X-100, 1% Tween-20, 40 μg/mL Proteinase K] was used. The tube consisting of blood and lysis buffer mixture was constantly inverted for until homogenous. A 6 mm diameter Whatman grade 1 qualitative filter paper was inserted into the tube was mixed constantly for 1 minute. The filter paper was then removed from the blood lysis mixture and washed in 1 mL of washing buffer [10 mM Tris (pH 8.0), 0.1% Tween-20]. The filter paper was then mixed constantly in the washing buffer for 1 minute. Following that, the filter paper was removed and dipped 5 times into the PCR tube consisting of the LAMP reaction before removing the filter paper. The LAMP assay was incubated in a Loopamp Real time turbidimeter LA 500 (Eiken Chemical Co., Ltd., Japan) at 65 °C for 60 minutes and inactivated at 80 °C for 2 minutes. Limit of detection of the method was performed by using P. knowlesi strain A1H1 obtained from the Department of Parasitology, Faculty of Medicine, Universiti Malaya. P. knowlesi strain A1H1 culture blood was ten-fold serially diluted to parasitemia of 1%, 0.1%, 0.01%, 0.001% and 0.000 1% respectively with healthy blood, and was tested with the above method in triplicates. The clinical sensitivity and specificity of LAMP assay was determined using microscopy as the reference standard methods. Sensitivity was calculated as (number of true positives)/(number of true positives+number of false negatives), and specificity was calculated as (number of true negatives)/(number of true negatives+number of false positives). The DNA extraction method coupled with LAMP has a detection limit of 0.001% parasitemia (5 parasites/μL of blood) (Figure 1). A highly trained technician u","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135587960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.4103/1995-7645.386076
Bin Liu, Liang Li, Lei Liu, Min Ye, Wei Zhang, Xiangdong Zhou, Qi Li
Objective: To evaluate the clinical safety and efficacy of Lianhuaqingwen (LHQW) capsules in patients with high-risk common type COVID-19 pneumonia. Methods: A retrospective multicenter study on 383 high-risk common type COVID-19 pneumonia cases was conducted. Patients were categorized as the standard treatment (SDT) group ( n =168) and the LHQW+SDT group ( n =215). The primary endpoint was the rate of symptom (fever, fatigue, coughing) recovery and the secondary endpoints included the time to symptom recovery, the proportion of patients with improvement in chest CT images, the proportion of patients with clinical cure, the timing and rate of negative conversion of SARS-CoV-2 RNA assay. Results: The recovery rate was significantly higher in the LHQW+SDT group as compared with the SDT group (89.7% vs. 72.0%, P<0.01). The combined use of LHQW+SDT also showed shorter time for symptom recovery, as well as shorter time for individual symptom of fever, fatigue and coughing recovery than use of SDT alone. A higher proportion of patients in the LHQW+SDT group with improvements in chest CT images and clinical cure (77.7% vs. 57.1%, P <0.01) but the proportion of patients deteriorating to severe cases (1% vs. 25%, P <0.01) in this group was significant lower than those in the SDT group. No significant difference in negative conversion rate of viral assay results was observed (76.8% vs. 75.0%, P >0.05). No serious adverse events were reported. Conclusions: LHQW capsules could be recommended to ameliorate clinical symptoms and reduce the rate of deteriorating to severe cases for high-risk common type COVID-19 pneumonia.
目的:评价连花清文胶囊治疗新型冠状病毒肺炎高危型患者的临床安全性和有效性。方法:对383例普通型肺炎高危患者进行回顾性多中心研究。患者分为标准治疗(SDT)组(n =168)和LHQW+SDT组(n =215)。主要终点为症状(发热、乏力、咳嗽)恢复率，次要终点包括症状恢复时间、胸部CT图像改善患者比例、临床治愈患者比例、SARS-CoV-2 RNA检测时间和阴性转化率。结果:LHQW+SDT组的恢复率明显高于SDT组(89.7% vs. 72.0%， P<0.01)。LHQW+SDT联合使用症状恢复时间也比单独使用SDT短，发热、乏力、咳嗽单项症状恢复时间也比单独使用SDT短。LHQW+SDT组胸部CT图像改善及临床治愈率较高(77.7% vs. 57.1%， P <0.01)，但恶化至重症的比例显著低于SDT组(1% vs. 25%， P <0.01)。病毒检测结果的阴性转化率(76.8% vs. 75.0%)差异无统计学意义(P >0.05)。无严重不良事件报告。结论:LHQW胶囊可改善COVID-19常见高危型肺炎患者的临床症状，降低病情恶化至重症的发生率。
{"title":"Efficacy and safety of Lianhuaqingwen capsules in high-risk common type COVID-19 pneumonia: A multicenter retrospective study","authors":"Bin Liu, Liang Li, Lei Liu, Min Ye, Wei Zhang, Xiangdong Zhou, Qi Li","doi":"10.4103/1995-7645.386076","DOIUrl":"https://doi.org/10.4103/1995-7645.386076","url":null,"abstract":"Objective: To evaluate the clinical safety and efficacy of Lianhuaqingwen (LHQW) capsules in patients with high-risk common type COVID-19 pneumonia. Methods: A retrospective multicenter study on 383 high-risk common type COVID-19 pneumonia cases was conducted. Patients were categorized as the standard treatment (SDT) group ( n =168) and the LHQW+SDT group ( n =215). The primary endpoint was the rate of symptom (fever, fatigue, coughing) recovery and the secondary endpoints included the time to symptom recovery, the proportion of patients with improvement in chest CT images, the proportion of patients with clinical cure, the timing and rate of negative conversion of SARS-CoV-2 RNA assay. Results: The recovery rate was significantly higher in the LHQW+SDT group as compared with the SDT group (89.7% vs. 72.0%, P<0.01). The combined use of LHQW+SDT also showed shorter time for symptom recovery, as well as shorter time for individual symptom of fever, fatigue and coughing recovery than use of SDT alone. A higher proportion of patients in the LHQW+SDT group with improvements in chest CT images and clinical cure (77.7% vs. 57.1%, P <0.01) but the proportion of patients deteriorating to severe cases (1% vs. 25%, P <0.01) in this group was significant lower than those in the SDT group. No significant difference in negative conversion rate of viral assay results was observed (76.8% vs. 75.0%, P >0.05). No serious adverse events were reported. Conclusions: LHQW capsules could be recommended to ameliorate clinical symptoms and reduce the rate of deteriorating to severe cases for high-risk common type COVID-19 pneumonia.","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To evaluate the prevalence and types of complementary and alternative medicine (CAM) modalities among patients with cancer in Karachi, Pakistan. Methods: This descriptive cross-sectional study was conducted from March 2021 to December 2021. Five hundred patients with cancer were invited to participate in the study. Electronic databases, namely, Google scholar, Publons, EMBASE, PubMed, Chinese National Knowledge Infrastructure Database, and ResearchGate was used for questionnaire designed. The self-administered survey included questions on demographic characteristics, education level, socio-economic conditions and information about CAM therapies, prevalence, effectiveness, and common CAM modalities. Statistical analysis was conducted using SPSS software version 22. Results: Out of the 500 invited patients, 433 (86.6%) successfully completed and returned the questionnaires. In contrast to patients who were with younger, highly educated, professionally active, higher income, and had advanced cancer, time since diagnosis, type of treatment, cancer types and family history are significantly associated with CAM use. The results showed that 59.8% of the participants were acquainted with complementary and/or alternative medicine and considered safe owing to its natural ingredients. The prevalence of CAM usage among cancer patients was 40.9% and the most widely used CAM modality was herbal medicine (27.7%) and dietary supplements (28.8%). Patients used CAM as a complementary therapy to improve the morphological parameter (28.2%), strengthen the immune system (6.8%), and to decrease the side effects of conventional treatment (18.1%). Most of the respondents get the information regarding CAM therapy from the electronic media (43.2%) and the family members (48%) rather than healthcare personnel. Conclusions: Participants used CAM modalities along with the conventional health care practices. Further multicentre studies should be conducted to provide information regarding the usage of CAM therapies and their eventual benefits in patients with cancer.
目的:评估巴基斯坦卡拉奇地区癌症患者补充和替代医学(CAM)模式的流行程度和类型。方法:该描述性横断面研究于2021年3月至2021年12月进行。500名癌症患者被邀请参加这项研究。问卷设计采用Google scholar、Publons、EMBASE、PubMed、Chinese National Knowledge Infrastructure Database、ResearchGate等电子数据库。自我管理的调查包括人口特征、教育水平、社会经济条件和辅助生殖疗法的信息、流行程度、有效性和常见的辅助生殖疗法模式。采用SPSS软件22进行统计分析。结果:入选500例患者中，433例(86.6%)成功填写并归还问卷。与年轻、高学历、职业活跃、高收入和晚期癌症患者相比，自诊断以来的时间、治疗类型、癌症类型和家族史与CAM的使用显著相关。结果显示，59.8%的参与者了解补充和/或替代医学，并认为其天然成分是安全的。癌症患者CAM使用率为40.9%，使用最多的CAM方式为中草药(27.7%)和膳食补充剂(28.8%)。患者将CAM作为辅助治疗，改善形态学参数(28.2%)，增强免疫系统(6.8%)，减少常规治疗的副作用(18.1%)。大多数受访者是通过电子媒体(43.2%)和家庭成员(48%)而不是卫生保健人员获得CAM治疗的信息。结论:参与者使用CAM模式与传统的卫生保健做法。应该进行进一步的多中心研究，以提供有关辅助生殖疗法的使用及其对癌症患者的最终益处的信息。
{"title":"Attitudes and understanding of complementary and alternative medicine in cancer care: An exploratory study of patients' perspectives in Karachi, Pakistan","authors":"Shahlla Imam, Muneeba Aijaz, Wajiha Iffat, Shazia Qasim Jamshed, Nahlah Elkudssiah Ismail, Ganesh Sritheran Paneerselvam, Khang Wen Goh, Long Chiau Ming, Halima Sadia, Iqbal Azhar","doi":"10.4103/1995-7645.386075","DOIUrl":"https://doi.org/10.4103/1995-7645.386075","url":null,"abstract":"Objective: To evaluate the prevalence and types of complementary and alternative medicine (CAM) modalities among patients with cancer in Karachi, Pakistan. Methods: This descriptive cross-sectional study was conducted from March 2021 to December 2021. Five hundred patients with cancer were invited to participate in the study. Electronic databases, namely, Google scholar, Publons, EMBASE, PubMed, Chinese National Knowledge Infrastructure Database, and ResearchGate was used for questionnaire designed. The self-administered survey included questions on demographic characteristics, education level, socio-economic conditions and information about CAM therapies, prevalence, effectiveness, and common CAM modalities. Statistical analysis was conducted using SPSS software version 22. Results: Out of the 500 invited patients, 433 (86.6%) successfully completed and returned the questionnaires. In contrast to patients who were with younger, highly educated, professionally active, higher income, and had advanced cancer, time since diagnosis, type of treatment, cancer types and family history are significantly associated with CAM use. The results showed that 59.8% of the participants were acquainted with complementary and/or alternative medicine and considered safe owing to its natural ingredients. The prevalence of CAM usage among cancer patients was 40.9% and the most widely used CAM modality was herbal medicine (27.7%) and dietary supplements (28.8%). Patients used CAM as a complementary therapy to improve the morphological parameter (28.2%), strengthen the immune system (6.8%), and to decrease the side effects of conventional treatment (18.1%). Most of the respondents get the information regarding CAM therapy from the electronic media (43.2%) and the family members (48%) rather than healthcare personnel. Conclusions: Participants used CAM modalities along with the conventional health care practices. Further multicentre studies should be conducted to provide information regarding the usage of CAM therapies and their eventual benefits in patients with cancer.","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.4103/1995-7645.386077
Harpreet Singh Pawar, Itu Singh, Harish Kumar Sagar
Rationale: Leprosy, a chronic granulomatous disease often present clinically as erythema nodosum leprosum, a type 2 reaction. The involvement of cochlear part of audiovestibular system is a rarity. Patient concerns: A 26-year-old male patient with lepromatous leprosy developed bilateral sensorineural hearing loss (SNHL) during type 2 reactional episode. Diagnosis: Recurrent erythema nodosum leprosum in rifampicin-resistant lepromatous leprosy. Interventions: Corticosteroids and second-line multidrug therapy. Outcomes: The patient improved significantly and was further referred for management of psychosocial impact due to sensorineural hearing loss. Lessons: The hearing impairment is a rare complication of type 2 reaction. Any patient with suspected cranial nerve involvement should essentially be screened by tuning fork tests for early detection of hearing impairment and offer timely intervention as required. All high bacteriological index cases should be investigated for antimicrobial resistance in high endemic areas.
{"title":"Type 2 reaction associated sensorineural hearing loss in a drug resistant lepromatous leprosy patient: A case report","authors":"Harpreet Singh Pawar, Itu Singh, Harish Kumar Sagar","doi":"10.4103/1995-7645.386077","DOIUrl":"https://doi.org/10.4103/1995-7645.386077","url":null,"abstract":"Rationale: Leprosy, a chronic granulomatous disease often present clinically as erythema nodosum leprosum, a type 2 reaction. The involvement of cochlear part of audiovestibular system is a rarity. Patient concerns: A 26-year-old male patient with lepromatous leprosy developed bilateral sensorineural hearing loss (SNHL) during type 2 reactional episode. Diagnosis: Recurrent erythema nodosum leprosum in rifampicin-resistant lepromatous leprosy. Interventions: Corticosteroids and second-line multidrug therapy. Outcomes: The patient improved significantly and was further referred for management of psychosocial impact due to sensorineural hearing loss. Lessons: The hearing impairment is a rare complication of type 2 reaction. Any patient with suspected cranial nerve involvement should essentially be screened by tuning fork tests for early detection of hearing impairment and offer timely intervention as required. All high bacteriological index cases should be investigated for antimicrobial resistance in high endemic areas.","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135587958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.4103/1995-7645.383910
Saurabh Bhargava
{"title":"Snakebite: A neglected tropical disease that can stymie progress toward the Sustainable Development Goals","authors":"Saurabh Bhargava","doi":"10.4103/1995-7645.383910","DOIUrl":"https://doi.org/10.4103/1995-7645.383910","url":null,"abstract":"","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.4103/1995-7645.383908
N. Yakut, Z. Ergenç, Sevgi Tuncay, Sezin Bayraktar, Elvan Sayin, A. İlki, E. Kepenekli
Objective: To describe clinical and epidemiological characteristics, antimicrobial susceptibility and mortality-associated factors of healthcare-associated infections (HCAIs) caused by Staphylococcus (S.) aureus in children. Methods: We conducted a retrospective, single-centre study of pediatric HCAIs caused by S. aureus from a tertiary care hospital in Turkey between February 2014 and December 2019. The clinical and epidemiological characteristics and antimicrobial susceptibility of the methicillin-susceptible and methicillin-resistant S. aureus (MSSA and MRSA) isolates was evaluated. Results: A total of 310 pediatric patients were examined. Overall, 225 (72.6%) isolates were MSSA and 85 (27.4%) were MRSA. All S. aureus isolates were susceptible to teicoplanin, vancomycin, linezolid, tigecycline, mupirocin, and daptomycin. Penicillin resistance rates were high (89.0%), while fosfomycin, gentamicin, and clindamycin resistance rates were low (1.3%, 1.0%, and 2.3%, respectively). Except susceptibility to fosfomycin, which was significantly lower in 2014 compared to 2018 and 2019, no significant difference was found in the antimicrobial susceptibility of S. aureus isolates between the years. Baseline characteristics and mortality rate were similar comparing MRSA and MSSA causing HCAIs. The mortality rate of HCAIs caused by S. aureus was 6.5% (20 patients). Malignancy was an independent risk factor associated with mortality in the multivariate analysis (OR 5.446, 95% CI 1.573-18.849). Conclusions: Our findings demonstrate that MSSA remained the most causative agent of HCAIs caused by S. aureus. The mortality rate was 6.5%, the antibiotic resistance rate was quite high for penicillin and diagnosis of malignancy was the main risk factor for increasing mortality in children. These findings could help improve the management of HCAIs caused by S. aureus in children.
{"title":"Healthcare-associated Staphylococcus aureus infections in children in Turkey: A six-year retrospective, single-center study","authors":"N. Yakut, Z. Ergenç, Sevgi Tuncay, Sezin Bayraktar, Elvan Sayin, A. İlki, E. Kepenekli","doi":"10.4103/1995-7645.383908","DOIUrl":"https://doi.org/10.4103/1995-7645.383908","url":null,"abstract":"Objective: To describe clinical and epidemiological characteristics, antimicrobial susceptibility and mortality-associated factors of healthcare-associated infections (HCAIs) caused by Staphylococcus (S.) aureus in children. Methods: We conducted a retrospective, single-centre study of pediatric HCAIs caused by S. aureus from a tertiary care hospital in Turkey between February 2014 and December 2019. The clinical and epidemiological characteristics and antimicrobial susceptibility of the methicillin-susceptible and methicillin-resistant S. aureus (MSSA and MRSA) isolates was evaluated. Results: A total of 310 pediatric patients were examined. Overall, 225 (72.6%) isolates were MSSA and 85 (27.4%) were MRSA. All S. aureus isolates were susceptible to teicoplanin, vancomycin, linezolid, tigecycline, mupirocin, and daptomycin. Penicillin resistance rates were high (89.0%), while fosfomycin, gentamicin, and clindamycin resistance rates were low (1.3%, 1.0%, and 2.3%, respectively). Except susceptibility to fosfomycin, which was significantly lower in 2014 compared to 2018 and 2019, no significant difference was found in the antimicrobial susceptibility of S. aureus isolates between the years. Baseline characteristics and mortality rate were similar comparing MRSA and MSSA causing HCAIs. The mortality rate of HCAIs caused by S. aureus was 6.5% (20 patients). Malignancy was an independent risk factor associated with mortality in the multivariate analysis (OR 5.446, 95% CI 1.573-18.849). Conclusions: Our findings demonstrate that MSSA remained the most causative agent of HCAIs caused by S. aureus. The mortality rate was 6.5%, the antibiotic resistance rate was quite high for penicillin and diagnosis of malignancy was the main risk factor for increasing mortality in children. These findings could help improve the management of HCAIs caused by S. aureus in children.","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48193094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.4103/1995-7645.383909
Emily Schembri, Angus Campbell, Juan Villanueva-Cabezas
{"title":"South Asian dairy smallholders: A review of practices and zoonoses","authors":"Emily Schembri, Angus Campbell, Juan Villanueva-Cabezas","doi":"10.4103/1995-7645.383909","DOIUrl":"https://doi.org/10.4103/1995-7645.383909","url":null,"abstract":"","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42314744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.4103/1995-7645.380728
Rowalt C Alibudbud
{"title":"Addressing the needs and rights of sex workers for HIV healthcare services in the Philippines","authors":"Rowalt C Alibudbud","doi":"10.4103/1995-7645.380728","DOIUrl":"https://doi.org/10.4103/1995-7645.380728","url":null,"abstract":"","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42952619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.4103/1995-7645.383912
Süleyman Yıldırım, Celalettin Yılmaz, Gülru Polat, Serap Argun Baris, İlknur Başyiğit, İlknur Kaya, Ceyda Anar, Mihriban Bozkurt, Hüsnü Baykal, Hulya Dirol, Gamzenur Ozbey, Emine Ozsari, Emel Cireli, Ali Kadri Çırak, Dursun Tatar, Mine Gayaf, Selen Karaoglanoglu, Yener Aydin, Atilla Eroglu, Yıldız Olçar, Berna Botan Yıldırım, Bengül Gürsoy, Deniz Demir Yılmaz, Elif Yelda Ozgun Niksarlioglu, Ramazan Eren, Ayşegül Tomruk Erdem, Müge Meltem Tor, Fusun Fakili, Mustafa Çolak, Merve Erçelik, Ali Tabaru, Özlem Ediboglu
Objective: To identify the clinical characteristics and outcomes of hospital-acquired SARS-CoV-2 infection during the vaccination period nationwide in Turkey. Methods: COVID-19 patients followed in the pandemic services across Turkey between January 1, 2021, and March 31, 2022 were investigated retrospectively. Nosocomial COVID-19 was defined as a patient neither diagnosed with COVID-19 nor suspected COVID-19 at the hospital admission and was confirmed COVID-19 ≥5 days after hospital admission. The primary outcome of this study was in-hospital mortality; demographic features and vaccination status was compared between survivors and non-survivors. Results: During the study period, 15 573 COVID-19 patients were followed in 18 centers and 543 (3.5%) patients were nosocomial COVID-19. Most patients with nosocomial COVID-19 (80.4%) were transferred from medical wards. 162 (29.8%) of the patients with nosocomial COVID-19 admitted to the intensive care unit due to disease severity and 138 (25.4%) of the patients died during hospital stay. Advanced age (≥65 years) and number of comorbid diseases (≥2) was found to be associated with mortality in nosocomial COVID-19 ( OR 1.74, 95% Cl 1.11-2.74 and OR 1.60, 95% Cl 1.02-2.56, respectively). Vaccination was associated with survival in nosocomial COVID-19 ( OR 0.25, 95% Cl 0.16-0.38). Conclusions: Patients with nosocomial COVID-19 had increased admission to intensive care units and higher mortality rate. Vaccination can decrease the in-hospital mortality rate.
{"title":"Clinical characteristics and outcomes of nosocomial COVID-19 in Turkey: A retrospective multicenter study","authors":"Süleyman Yıldırım, Celalettin Yılmaz, Gülru Polat, Serap Argun Baris, İlknur Başyiğit, İlknur Kaya, Ceyda Anar, Mihriban Bozkurt, Hüsnü Baykal, Hulya Dirol, Gamzenur Ozbey, Emine Ozsari, Emel Cireli, Ali Kadri Çırak, Dursun Tatar, Mine Gayaf, Selen Karaoglanoglu, Yener Aydin, Atilla Eroglu, Yıldız Olçar, Berna Botan Yıldırım, Bengül Gürsoy, Deniz Demir Yılmaz, Elif Yelda Ozgun Niksarlioglu, Ramazan Eren, Ayşegül Tomruk Erdem, Müge Meltem Tor, Fusun Fakili, Mustafa Çolak, Merve Erçelik, Ali Tabaru, Özlem Ediboglu","doi":"10.4103/1995-7645.383912","DOIUrl":"https://doi.org/10.4103/1995-7645.383912","url":null,"abstract":"Objective: To identify the clinical characteristics and outcomes of hospital-acquired SARS-CoV-2 infection during the vaccination period nationwide in Turkey. Methods: COVID-19 patients followed in the pandemic services across Turkey between January 1, 2021, and March 31, 2022 were investigated retrospectively. Nosocomial COVID-19 was defined as a patient neither diagnosed with COVID-19 nor suspected COVID-19 at the hospital admission and was confirmed COVID-19 ≥5 days after hospital admission. The primary outcome of this study was in-hospital mortality; demographic features and vaccination status was compared between survivors and non-survivors. Results: During the study period, 15 573 COVID-19 patients were followed in 18 centers and 543 (3.5%) patients were nosocomial COVID-19. Most patients with nosocomial COVID-19 (80.4%) were transferred from medical wards. 162 (29.8%) of the patients with nosocomial COVID-19 admitted to the intensive care unit due to disease severity and 138 (25.4%) of the patients died during hospital stay. Advanced age (≥65 years) and number of comorbid diseases (≥2) was found to be associated with mortality in nosocomial COVID-19 ( OR 1.74, 95% Cl 1.11-2.74 and OR 1.60, 95% Cl 1.02-2.56, respectively). Vaccination was associated with survival in nosocomial COVID-19 ( OR 0.25, 95% Cl 0.16-0.38). Conclusions: Patients with nosocomial COVID-19 had increased admission to intensive care units and higher mortality rate. Vaccination can decrease the in-hospital mortality rate.","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134998121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.4103/1995-7645.383911
Majid Ghafouri, Seyed Mojtabaei, A. Shokri
Rationale: Anthrax is a zoonotic disease caused by spores of Gram-positive Bacillus anthracis, commonly affects mammals and in rare cases birds. Human infection occurs accidentally through direct or indirect exposure to animal or their products. Patient concerns: A 63-year-old man was referred to our hospital with flu-like symptoms and severe swelling and redness on the face, the roof of the mouth, and nostrils. He had a history of direct contact with a slaughtered mutton two days ago. He declared controlled diabetes, hypertension, hypertriglyceridemia, and heart failure. Lungs were normal in lung high resolution CT, but multiple lymphadenopathies were seen in the mediastinum. Bilateral axillary lymphadenopathy with a maximum sad of 23 mm and pleural effusion on the right side was observed. CT scan of the nose and sinuses showed an increased density of polyps in the left maxillary sinus. Slides were prepared from the patient's lesions and examined under a light microscope. Bacillus shape with Streptococcus bacteria was seen. Diagnosis: Anthrax co-infection with herpes systemic virus and Streptococcus pyogenes. Interventions: Multidrug therapy started with appropriate antibiotics. Outcomes: The symptoms of the patient gradually disappeared. The patient was discharged without any complications. Lessons: Cutaneous anthrax in endemic areas in patients with skin presentations and a history of contact with infected animals or products should be considered a differential diagnosis. This is more important in mixed infections where the main cause of the problem may be hidden.
{"title":"Cutaneous anthrax associated with facial palsy: A case report","authors":"Majid Ghafouri, Seyed Mojtabaei, A. Shokri","doi":"10.4103/1995-7645.383911","DOIUrl":"https://doi.org/10.4103/1995-7645.383911","url":null,"abstract":"Rationale: Anthrax is a zoonotic disease caused by spores of Gram-positive Bacillus anthracis, commonly affects mammals and in rare cases birds. Human infection occurs accidentally through direct or indirect exposure to animal or their products. Patient concerns: A 63-year-old man was referred to our hospital with flu-like symptoms and severe swelling and redness on the face, the roof of the mouth, and nostrils. He had a history of direct contact with a slaughtered mutton two days ago. He declared controlled diabetes, hypertension, hypertriglyceridemia, and heart failure. Lungs were normal in lung high resolution CT, but multiple lymphadenopathies were seen in the mediastinum. Bilateral axillary lymphadenopathy with a maximum sad of 23 mm and pleural effusion on the right side was observed. CT scan of the nose and sinuses showed an increased density of polyps in the left maxillary sinus. Slides were prepared from the patient's lesions and examined under a light microscope. Bacillus shape with Streptococcus bacteria was seen. Diagnosis: Anthrax co-infection with herpes systemic virus and Streptococcus pyogenes. Interventions: Multidrug therapy started with appropriate antibiotics. Outcomes: The symptoms of the patient gradually disappeared. The patient was discharged without any complications. Lessons: Cutaneous anthrax in endemic areas in patients with skin presentations and a history of contact with infected animals or products should be considered a differential diagnosis. This is more important in mixed infections where the main cause of the problem may be hidden.","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46643664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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