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The use of prophylactic antisepsis to protect against coronavirus disease 2019 (COVID-19) has been suggested. This study investigated hydrogen peroxide antisepsis (HPA) at two hospitals in Ghana.Cases of COVID-19 among healthcare workers (HCWs) using hydrogen peroxide (HP-HCWs) or not using hydrogen peroxide (NHP-HCWs), vaccinated or unvaccinated, were recorded at Shai-Osudoku Hospital (SODH), Dodowa, and Mount Olives Hospital (MOH), Techiman, between May 2020 and December 2021. The effect of HPA in all inpatients at MOH was also observed. Permutation tests were used to determine P values.At SODH, there were 62 (13.5%) cases of COVID-19 among 458 NHP-HCWs but no cases among eight HP-HCWs (P=0.622) from May to December 2020. Between January and March 2021, 10 (2.7%) of 372 NHP-HCWs had COVID-19, but there were no cases among 94 HP-HCWs (P=0.206). At MOH, prior to HPA, 17 (20.2%) of 84 HCWs and five (1.4%) of 370 inpatients had COVID-19 in July 2020. From August 2020 to March 2021, two of 54 (3.7%) HCWs who stopped HPA had COVID-19; none of 32 NHP-HCWs contracted COVID-19. At SODH, none of 23 unvaccinated HP-HCWs and 35 (64%) of 55 unvaccinated NHP-HCWs had COVID-19 from April to December 2021 (P0.0001). None of 34 vaccinated HP-HCWs and 53 (13.6%) of 390 vaccinated NHP-HCWs had COVID-19 (P=0.015). No inpatients on prophylactic HPA (total 7736) contracted COVID-19.Regular, daily HPA protects HCWs from COVID-19, and curtails nosocomial spread of SARS-CoV-2.

Background Angiotensin converting enzyme II (ACE2) is the cellular receptor for SARS-CoV-2, so ACE2-expressing cells can act as target cells and are susceptible to infection. ACE2 receptors are highly expressed in the oral cavity so this may be a potential high-risk route for SARS-CoV-2 infection. Furthermore, the virus can be detected in saliva, even before COVID-19 symptoms appear, with the consequent high risk of virus transmission in asymptomatic/pre-symptomatic patients. Reducing oral viral load could lead to a lower risk of transmission via salivary droplets or aerosols and therefore contribute to the control of the pandemic. Aim To evaluate the available evidence testing the in vitro and in vivo effects of oral antiseptics to inactivate or eradicate coronaviruses. Methods The criteria used were those described in the PRISMA® Declaration for performing systematic reviews. An electronic search in MEDLINE (via PubMed) and in Web of Sciences, using the terms MeSH: “mouthwash” OR “oral rinse” OR “mouth rinse” OR “povidone iodine” OR “hydrogen peroxide” OR “cetylpyridinium chloride” AND “COVID-19” OR “SARS-CoV-2” OR “coronavirus” OR “SARS” OR “MERS”. Findings The initial search strategy identified 619 articles on two electronic databases. A total of 17 articles were included assessing the virucidal efficacy of oral antiseptics against coronaviruses. Conclusions There is sufficient in vitro evidence to support the use of antiseptics to potentially reduce the viral load of SARS-CoV-2 and other coronaviruses. However, in vivo evidence for most oral antiseptics is limited. Randomized clinical trials with a control group are needed to demonstrate its clinical efficacy.

Neoplastic events are marked by uncontrolled cell proliferation. One major focus of cancer research has been to identify treatments that reduce or inhibit cell growth. Over the years, various compounds, both naturally occurring and chemically synthesized, have been used to inhibit neoplastic cell proliferation. Two such oncostatic agents, melatonin and retinoic acid, have been shown to suppress the growth of hormone-responsive breast cancer. Currently, separate clinical protocols exist for the administration of retinoids and melatonin as adjuvant therapies for cancer. Using the oestrogen receptor (ER)-positive MCF-7 human breast tumour cell line, our laboratory has studied the effects of a sequential treatment regimen of melatonin followed by all-trans retinoic acid (atRA) on breast tumour cell proliferation in vitro. Incubation of hormonally responsive MCF-7 and T47D cells with melatonin (10(-9) M) followed 24 h later by atRA (10(-9) M) resulted in the complete cessation of cell growth as well as a reduction in the number of cells to below the initial plating density. This cytocidal effect is in contrast to the growth-suppressive effects seen with either hormone alone. This regimen of melatonin followed by atRA induced cytocidal effects on MCF-7 cells by activating pathways leading to apoptosis (programmed cell death) as evidenced by decreased ER and Bcl-2 and increased Bax and transforming growth factor beta 1 (TGF-beta1) expression. Apoptosis was reflected morphologically by an increase in the number of lysosomal bodies and perinuclear chromatin condensation, cytoplasmic blebbing and the presence of apoptotic bodies. The apoptotic effect of this sequential treatment with melatonin and atRA appears to be both cell and regimen specific as (a) ER-negative MDA-MB-231 and BT-20 breast tumour cells were unaffected, and (b) the simultaneous administration of melatonin and atRA was not associated with apoptosis in any of the breast cancer cell lines studied. Taken together, the results suggest that use of an appropriate regimen of melatonin and atRA should be considered for preclinical and clinical evaluation against ER-positive human breast cancer. Images Figure 2 Figure 3 Figure 4 Figure 5 Figure 6

Size, incidence, and volume density of atrial specific granules (ASG) in right atrial cells from five animals each of the rat (average weight 210 g), mouse (average weight 28 g), fruit-eating bat Megaloglossus woermanni (BMW;average weight 35 g), and the insect-eating bat Pipistrellus pipistrellus (BPP; average weight 6 g) have been compared via ultrastructural morphometry. In all three parameters of granule measurement, significantly higher figures were obtained in the rodents than in the bats. However, between the rat and the mouse, as also between the two species of bats, no significant differences were noted in any of the measurements. These results therefore do not support the prevalent view that the number and size of the granules decrease with increase in size of the animal species. The low content of ASG in atrial cells of the bats is probably an indication of low demand for the natriuretic hormone of the granule, because, in such animals, and particularly in flight, conservation of fluid and electrolytes is of paramount importance. This suggests that granule content is adapted to fluid and electrolyte regulation in relation to the functional capacity of the animal. We also observed ASG-like sgtructures in endothelial cells of capillaries of bat tissue but not in rodents. The function of these granules or whether or not they represent atrial specific ones is not clear from the present study. © Wiley-Liss, Inc.

Specific heart granules in the grey seal, Halichoerus grypus, a marine mammal, were studied and compared with those in the Wistar rat by ultrastructural morphometry. There is extreme paucity of these granules in atrial cells of the seal, even in the region of the Golgi apparatus, compared with those in the rat. By numerical concentration, granules in the seal are 23 times fewer in number than in the rat. They are also fewer in number than in bats and hamsters for which data is available. The mean (+/-SEM) diameter of heart granules in the seal is significantly less (188 +/- 5.3 nm) than that of the rat (226 +/- 4.6 nm). These observations, the first in a marine mammal, are of interest in relation to the need for conservation of water and electrolytes in pennipids.

Cells of the impulse-generating and conducting tissues of the insect-eating bat Pipistrellus pipistrellus were studied and evaluated using ultrastructural morphometry. Sinoatrial node cells are smaller than working atrial cells and measure about 6.5 microm in diameter. Their mitochondira and myofibril content constitute 23% and 19% of cytoplasmic volume, respectively. Corresponding values for working atrial cells are 23% and 52%. Atrioventricular node cells are 4.2 microm in diameter and contain abundant glycogen in the cytoplasm. The fractional volume of mitochondria in about 24% while that of myofibrils is 7%. Cells of the bundle of His are larger (6-8 microm diameter) and contain more cellular organelles than do nodal cells. Their mitochondria and myofibril contents are 25% and 25%, respectively. Cells in the proximal part of the right bundle branch are slender with diameters averaging 3.4 microm. Mitochondrial content is 23% while myofibrils occupy 20% of the cytoplasmic volume of these cells. Distally located bundle branch cells measure 7-10 microm in diameter with mitochondria and myofibril volumes of 30% and 33%. Subendocardial cells in the ventricular free wall are large reaching 28 microm in diameter (cf. 14-18 microm in working ventricular cells) and have mitochondira and myofibril volume fractions of 32% and 29%, respectively (35%40% for working ventricular cells).

The ultrastructure of the myocardium of the large (285 gm) fruit-eating bat (Eidolon helvum) provides further evidence that, among mammalian species, different types of cardiac myocytes are morphologically heterogeneous. Atrial cells of this species, like those of smaller bats previously studied, have few of the natriuretic hormone-containing granules. These granules are also small, with a mean diameter of 176 +/- 3.9 nm, in comparison with those of the rat (230 +/- 5.8 nm) and mouse (211 +/- 4.7 nm). In all types of myocytes of the bat investigated, mitochondrial matrix granules are more prominent than in those of the rat and mouse. Also distinctive are the Purkinje cells which, aside from their large size (30 microns) and lack of T-tubules, have atrial granule-like inclusions. These cells are well endowed with mitochondria (28% of cytoplasmic volume) and with lipid bodies but have few glycogen granules. Their myofibrillae (33%) are well aligned. The ventricular cells (average diameter 14 microns) have nearly equal volumes of mitochondria (41%) and myofibrils (47%). Mitochondrial cristae, however, are not compactly organized. Lipid material is found in the matrix of the mitochondria. Extensive evaginations of endothelial cells of the bat endocardium appear continuous with endothelial vacuoles. In these endothelial cells, there are also many dense granules of varying shapes and sizes.

A comparative morphometric study of ventricular myocardial cells of the West African insect-eating the Pipistrellus pipistrellus, the hamster and the rat revealed significant differences in volume fractions of mitochondria myofibrils, lipid bodies and T tubules. In the cells of the bat, mitochondria constitute 35% of cytoplasmic volume compared with 29 and 30% in the hamster and rat, respectively. Notably, crista density is much higher in the bat cells (3.58 x 10(5) cm-1) than in those of the hamster (2.59 x 10(5) cm-1) and of the rat (2.48 x 10(5) cm-1). Myofibril concentration is 40% in the bat, 53% in the hamster and 55% in the rat. There is greater numerical density of lipid bodies in the bat (212.27 x 10(9) cm-3) than in the hamster (139.20 x 10(9) cm-3) and in the rat (114.00 x 10(9) cm-3). The volume occupied by T tubules is 0.02 in the bat and hamster, and 0.009 in the rat. These differences suggest structural design for efficient metabolic activity in the bat which, among mammals, has high exercise tolerance.

Ultrastructural studies, including a preliminary morphometric analysis, of the right ventricular myocardium in the West African bat Eidolon helvum show that the myocytes contain a wider T-tubule system and a higher proportion of mitochondria and lipid droplets than in typical terrestrial mammals such as the rat; these features in the bat are even mor pronounced than in hibernating species such as the golden hamster. In addition to having coupling arrangements with T-tubules and surface sarcolemma, cisterns of junctional sarcoplasmic reticulum are closely apposed to mitochondria and lipid droplets.

Electron microscope studies of the myocardium of the golden hamster revealed that the primary T-tubules in ventricular and atrial myocytes are substantially wider than their counterparts in most other mammalian species. Another feature is the presence of numerous lipid bodies but these are not as closely apposed to mitochondria as in seal myocardial cells. General atrial myocardial cells in the hamster contain numerous electron-dense spherical granules but these are absent from cells of the nodal and conducting system; in regard to these latter features in hamster resembles most other mammals.