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Epidemiological and observational studies have indicated an association between rheumatoid arthritis (RA) and pulmonary arterial hypertension (PAH). However, consistent conclusions have not been reached due to various limitations. In order to determine whether RA and PAH are causally related, we conducted a Mendelian randomization (MR) study with two samples. Data for overall RA (13,621 cases and 262,844 controls), seropositive RA (5103 cases and 402,554 controls), seronegative RA (4192 cases and 311,210 controls), and PAH (248 cases and 289,117 controls) derived from the FinnGen consortium. The inverse variance weighted, along with four other effective methodologies, were employed to comprehensively infer the causal relationships between RA and PAH. To assess the estimation's robustness, a number of sensitivity studies were performed. Causal genetic association was found between seropositive RA and decreased risk of PAH (odds ratio (OR) = 0.812, 95% confidence interval (CI) = 0.687–0.959, p = 0.042), while no causal relationship was found between overall RA or seronegative RA and PAH (OR = 0.871, 95% CI = 0.645–1.175, p = 0.548; OR = 0.791, 95%CI = 0.471–1.328, p = 0.374, respectively). We are the first to use MR analysis to explore the causal relationship between RA and PAH, revealing a decreased risk of PAH in individuals with seropositive RA. Key Points • There is a notable genetic association between seropositive RA and a decreased risk of developing PAH. • No significant association was observed between overall RA or seronegative RA and the risk of PAH. • RA represents a heterogeneous disease, with its seropositive or seronegative forms exhibiting distinct genetic characteristics. [ABSTRACT FROM AUTHOR]

Brucellosis is an infectious bacterial zoonotic disease of domestic and wild animals frequently caused by Brucella abortus, B. ovis, B. melitensis, B. suis, and B. canis species. The present study was conducted on 100 serum samples from swine with a history of abortion and reproductive failure in the southern states of India. The samples were screened by Rose Bengal plate agglutination test (RBPT) and standard tube agglutination test (STAT) for detection and quantification of brucella antibody respectively. The samples were also subjected to 16S rRNA gene and Brucella cell surface salt-extractable (BCSP 31) based PCR assays for Brucella genome screening and confirmation. Brucella genome-positive samples were also subjected to AMOS multiplex PCR for B. abortus, B. ovis, B. melitensis, and B. suis species differential diagnosis. The serological screening revealed 3% (n=3) seropositivity for Brucellosis with antibody tires of 1: 160, 1:160, 1:320 for TL7, TL12 and KA-9 samples respectively. Molecular screening evidenced 5% (n=5) positivity for the Brucella genome including three seropositive samples yielded a specific amplicon of 800 and 223 bp amplicons by 16S rRNA and BCSP-31 PCR respectively. Further species identification by AMOS PCR yielded an amplicon of 498 bp specific to B. abortus genome in all three seropositive samples (TL7, TL12, and KA-9) and two PCR-positive samples (TN17 and KA-21) yielded 285bp amplicon specific to B. suis. Molecular screening of Brucella-positive samples for viral co-infections such as PCV2, PPV, CSFV, and PRRSV evidenced non-involvement of above screened 4 viral aetiologies in all 5 Brucella-positive samples indicating the primary infection of Brucella species.

Objective: Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii. Immunocompromised individuals and pregnant women are at risk, with the latter group being susceptible to miscarriages. This study aimed to determine the seropositivity of T. gondii antibodies and potential risk factors in pregnant women diagnosed with diabetes mellitus. Methods: The research was conducted at the Ankara City Hospital Perinatology Clinic between October 2021 and June 2022. The study included 277 pregnant women diagnosed with diabetes mellitus and 277 healthy pregnant women who had given birth. Retrospective analysis of anti-T. gondii immunoglobulin (Ig)G and IgM levels was performed for patients between January 2020 and February 2022. Participants were administered an informed consent form and a questionnaire. Data were analysed using SPSS 22. Results: Among pregnant women with diabetes, IgG seropositivity was 18.4%, IgM was 0.0%, and IgG+IgM was 0.0%. In healthy pregnant women, IgG seropositivity was 12.3%, IgM was 0.4%, and IgG+IgM was 0.4%. Overall, seropositivity rates were 15.3% for IgG, 0.2% for IgM, and 0.2% for IgG+IgM. The difference between the two groups was statistically significant (p

Objective Background Methods Results Conclusion This study aimed to evaluate the association between rheumatoid arthritis (RA) and subsequent migraine risk using the Korean National Health Insurance Service database.Migraine may be related to immune dysfunction and previous studies have suggested an association with chronic inflammatory rheumatic diseases; however, the relationship between RA and migraine remains unclear.This was a population‐based, nationwide, retrospective, longitudinal cohort study. Participants were enrolled from 2010 to 2017 and followed up until 2019. A total of 42,674 patients who had undergone a health checkup within 2 years prior to the initial diagnosis of RA were included in the study, after applying the exclusion criteria (previous migraine, other rheumatic disease, missing variables of interest). A non‐RA control was obtained by age and sex‐matching (1:5). Finally, 42,644 patients with RA were enrolled, with 213,370 individuals without RA included as controls. Among the patients with RA, 29,744 had seropositive RA (SPRA), and 12,900 had seronegative RA (SNRA). SPRA was defined by the International Classification of Diseases 10th revision (ICD‐10) code M05, prescription of disease‐modifying anti‐rheumatic drugs (DMARDs), and enrollment in a special copayment reduction program. SNRA was defined by the ICD‐10 code M06 and prescription of any DMARD. The primary endpoint was the occurrence of migraine incidents, defined using the ICD‐10 code of migraine (G43).A total of 22,294 migraine cases (17,912/213,370 [8.3%] in controls and 4382/42,674 [10.2%] in RA) were reported during a mean follow‐up of 4.4 years after a 1‐year lag period. Patients with RA had a 1.2‐fold higher risk of migraine compared with controls (adjusted hazard ratio [aHR] 1.21, 95% confidence interval [CI] 1.17–1.26). Increased risk of migraine was found in both patients with SNRA and SPRA compared with controls (aHR 1.20, CI 1.15–1.24 in SPRA; aHR 1.26, CI 1.19–1.34 in SNRA). Compared to patients with SNRA, those with SPRA did not demonstrate a heightened risk (aHR 0.94, CI 0.88–1.01). A significant interaction was confirmed between covariates (male, current smoker, those with diabetes mellitus, and dyslipidemia) and the risk of migraine (p for interaction of <0.05).RA was linked to a higher migraine risk, regardless of seropositivity. [ABSTRACT FROM AUTHOR]

Brucellosis is a commonly neglected zoonosis that remains a serious global public health concern. The epidemiological evolution of human brucellosis has considerably changed over the past few decades, and epidemic geography is continuously expanding. Human brucellosis is emerging and re-emerging, and is imported from areas where it is endemic due to travel, immigration, and international trade. The disease continues to be prevalent in Asia and Africa, including West Asia, Central Asia, North Africa, and East Africa, with the highest incidence in Syria, Kyrgyzstan, Mongolia, Iran, Algeria, and Kenya. Re-emerging cases are frequently recorded in places where brucellosis has been controlled, such as Bosnia, Herzegovina, Azerbaijan, and the USA. In countries with a high disease burden, disease control and eradication have been extremely difficult because of livestock farming being the only source of livelihood, unique religious beliefs regarding animals, nomadic lifestyle, and low socioeconomic levels. Interventions focused on protecting livestock keepers are needed, particularly for those assisting with goat and sheep births and the consumption of raw dairy products. Notably, in most countries with a high disease burden, each period of several years with a low incidence rate was followed by a subsequent increase in cases, highlighting the necessity of continuous investment and surveillance. In addition, advocacy for the inclusion of brucellosis as a globally mandated reported disease, strict restrictions on animal movement, mandated consumption of pasteurized milk, and health education are needed. This study will help form an evidence-based strategy for international organizations to curb the future spread of brucellosis.

ABSTRACTInfection-induced SARS-CoV-2 seroprevalence has been studied worldwide. At Juntendo University Hospital (JUH) in Tokyo, Japan, we have consistently conducted serological studies using the blood residue of healthcare workers (HCWs) at annual health examinations since 2020. In this 2023 study (n = 3,594), N-specific seroprevalence (infection-induced) was examined while univariate and multivariate logistic regression analyses were performed to compute ORs of seroprevalence with respect to basic characteristics of participants. We found that the N-specific seroprevalence in 2023 was 54.1%—a jump from 17.7% in 2022, and 1.6% in 2021—with 37.9% as non-PCR-confirmed asymptomatic infection cases. Those younger than 50 (adjusted OR = 1.62; p

Objectives: Primary: 1) To estimate prevalence of seropositive measles cases among children with fever with maculopapular rashes attending pediatric department of Dr.N.D. Desai hospital, Nadiad during 1st January to 31st May 2023. Secondary: To assess association between Immunization status along with nutritional status among seropositive measles cases diagnosed at pediatric department of Dr.N.D. Desai hospital, Nadiad during 1st January to 31st May 2023. Study design: Retrospective Observational Cross-Sectional Study. Participants: Each and every patient from January to May attending pediatric OPD with fever with maculopapular rashes with seropositive results for measles. Methods: Retrospectively all OPD cases which were reported for fever with maculopapular rash, were studied from January to May 2023 in pediatric department and 30 seropositive cases were traced along with their IPD cases from MRD with permission of superintendent to fill preformed proforma for data collection which was then analyzed. Results: among 30 patients only 7(23.3%) patients were immunized for age. 5(35.7%) patients were found severely acute malnourished while 3(21.4%) were MAM under 5 years of age(n=14). 8(50%) patients were undernourished above 5 years of age(n=16). 15(50%) patients had moderate to severe anemia. Conclusion: along with hampered immunization during covid, increased measles cases are attributed to malnutrition which contributed even more due to harmed health services in this pandemic. [ABSTRACT FROM AUTHOR]

To describe the first case of Pythium insidiosum keratitis masquerading as dematiaceous fungal keratitis in a seropositive male. A 44-year-old seropositive male previously treated for acute retinal necrosis presented with pain and defective vision in the right eye following a mud injury 5 days back. Presenting visual acuity was hand movements close to the face. Ocular examination revealed a 7 × 7 mm dense, greyish-white mid stromal infiltrate with pigmentation and few tentacles. The clinical diagnosis suggested fungal keratitis. Corneal scraping on 10% KOH and Gram stain revealed slender, aseptate hyaline hyphae. Before culture results, the patient was treated with topical 5% natamycin and 1% voriconazole, but the infiltrate progressed. Culture on 5% sheep blood agar revealed white fluffy, submerged, shiny, and appressed colonies, and Pythium insidiosum was confirmed by zoospore formation. The patient was further managed with topical linezolid 0.2% hourly, azithromycin 1% hourly, and adjuvant drugs. This is an uncommon presentation of Pythium keratitis masquerading as dematiaceous fungal keratitis in an immunocompromised male. [ABSTRACT FROM AUTHOR]

Résumé Objectif - Cette étude vise à décrire les particularités sociodémographiques et les motivations des donneurs de sang du Centre de Transfusion Sanguine du Centre Hospitalier Universitaire d’Oran, et à analyser leurs données immuno-hématolo­giques et microbiologiques. Matériels et méthodes - Il s’agit d’une enquête descriptive transversale, réalisée sur une période de trois mois (du 1er Janvier au 31 Mars 2017) au niveau du Centre de Transfusion Sanguine du CHU d’Oran. Cette étude a inclus les donneurs de sang qui se sont présentés au site fixe et ont répondu à unquestionnaire lors du don. Les données biologiques ont été recueillies à partir des registres de qualification immuno-hématologique et microbiologique du don. Résultats - Nous avons colligé 1004 donneurs majoritairement de sexe mascu­lin (sex-ratio 4/1), ayant un âge moyen de 35 ans avec une prédominance de la tranche d’âge [28-37] ans. La classe sociale moyenne est la plus fréquente (67,23%). Les niveaux d’instruction secondaire et supérieur sont prédominants (47,73%). Environ 63% de notre échantillon sont des donneurs de compensation, dont 45% sont des nouveaux donneurs. La moitié des donneurs bénévoles (50,5%) sont des donneurs irréguliers. La motivation principale au don est familiale, suivie par la motivation religieuse et la solidarité. La quasi-totalité de l’effectif est mo­tivée pour un don ultérieur. Près de la moitié des donneurs (47%) sont de groupe O, 34% sont de groupe A, 15% sont de groupe B et 4% sont de groupe AB. La préva­lence des agents infectieux transmissibles par transfusion chez cette population est de 1%. Conclusion - Cette étude a permis de décrire les caractéristiques socio- démo­graphiques et les motivations des donneurs de sang au Centre de Transfusion San­guine d’Oran. Les efforts devront être axés sur la sensibilisation de la population, la qualité du recrutement des donneurs et leur fidélisation, qui est une étape de l’amélioration de la sécurité transfusionnelle. Abstract Objectives - This study aims to describe the socio-demographic characteristics and motivations of blood donors at the Blood Transfusion Center of the University Hospital Center of Oran, to analyze their immuno-hematological and microbiological data. Materials and methods - It is a cross-sectional descriptive study, conducted over a pe­riod of three months (from January 1st to March 31st, 2017) at the Blood Transfusion Center of Oran University Hospital. This study included blood donors who showed up at the fixed site and responded to a questionnaire during the donation. Biological data were collected from immuno-hematological and microbiological qualification records of donation. Results - We collected 1004 predominantly male donors (sex ratio 4/1), with an ave­rage age of 35 years with a predominance of the age group [28-37] years. The average social class is the most common (67.23%). Secondary and universitary education levels are predominant (47.73%). Approximately 63% of our sample are clearing donors, 45% of whom are new donors. Half of the volunteer donors (50.5%) are irregular donors. The main motivation for giving is family, followed by religious motivation and solida­rity. Almost of the participants is motivated for a subsequent donation. 47% of donors have a blood group O, 34% of group A, 15% of group B and 4% of group AB. The preva­lence of infectious transmissible agents by transfusion in this population is 1%. Conclusion - This study described the socio-demographic characteristics and motiva­tions of the blood donors at the Blood Transfusion Center in Oran. Efforts should focus on raising awareness, quality of donor recruitment and retention, which is a step toward improving blood safety.

Objective Atrial fibrillation (AF) is a potentially lethal complication that leads to increased hospitalization, disability and mortality. Furthermore, the risk of cardiovascular disease is increased in RA. We evaluated whether DMARD treatment is associated with incident AF in patients with seropositive RA (SPRA). Methods The South Korean Health Insurance Review and Assessment Service database was used to identify patients newly diagnosed with SPRA between 2010 and 2020. A nested case-control analysis was performed to match AF-affected patients to unaffected controls for age, sex, follow-up duration, and index year of SPRA diagnosis at a 1:4 ratio. Adjusted conditional logistic regression was used to identify the predictive factors for AF. Results Of the 108 085 patients with SPRA, 2,629 (2.4%) developed new-onset AF, and the proportion of females was ∼67%. In the matched population, pre-existing comorbidities of hypertension, chronic kidney disease, and heart failure were associated with increased risk of AF. Meanwhile, the use of methotrexate (MTX) decreased the risk of incident AF [adjusted odds ratio (aOR), 0.89], whereas the use of leflunomide (LEF) increased AF (aOR, 1.21). In a subgroup of patients aged ≥50 years, LEF and adalimumab increased the occurrence of AF, while MTX decreased AF in males and LEF increased this risk in females. Conclusion Although the number of subjects developing new-onset AF was small, MTX decreased and LEF increased incident AF in patients with RA. Especially, a distinct pattern of AF risk with DMARDs usage was observed according to age and sex. [ABSTRACT FROM AUTHOR]

Brucellosis is an infectious disease caused by bacteria of the genus Brucella and classified as a zoonotic disease. Brucellosis is usually asymptomatic in infected female animals, but it can cause placentitis, which leads to abortion in the fifth to ninth months of pregnancy in pregnant animals. Brucella infection is lifelong in animals, and Brucella bacteria can be found in the blood, urine, milk, and sperm. To prevent the spread of brucellosis in beef cattle that will be trafficked through the Pantoloan animal quarantine installation. From January to June, blood serum of male beef cattle was collected at the Pantoloan Animal Quarantine Installation, Palu Agricultural Quarantine. The Rose Bengal Test method was used on up to 7.046 serum samples. In the first semester of 2018, the positive incidence of blood serum testing for beef cattle using the Rose Bengal Test (RBT) method at ten beef cattle traffic frequencies revealed seropositive brucellosis in 38 out of 7,046 samples tested. Beef cattle were sourced from the Central Sulawesi, Gorontalo, and South Sulawesi provinces. Blood serum samples from Central Sulawesi showed the highest positive incidence. Based on the prevalence of seropositive brucellosis based on RBT in beef cattle transported through the Pantoloan animal quarantine installation, several cattle breeding areas should be monitored during subsequent traffic, and public awareness should be raised to prevent the spread of brucellosis.

Hepatitis C virus (HCV) is a blood-borne pathogen that transmits infection via transfusion. Hepatocellular carcinoma is the fifth most common cancer and a major cause of death in patients with chronic HCV infection. Response to treatment is mainly based on the genotypic characterization of HCV. The gold standard for genotyping HCV is by sequencing highly conserved regions such as NS5, core, E1, and 5’UTR. Serum samples of patients who visited the tertiary care hospital with clinical features suggestive of HCV infection formed the study group. HCV genotyping was performed using multiplex Polymerase Chain Reaction in the samples tested positive by Chemiluminescence Immunoassay (CLIA). The viral loads were also performed on selected patient samples. In the present study, Genotype 4 (35.71%), followed by Genotype 3 (17.53%) and 1 & 1b (12.34%) were the common genotypes observed. Genotype 1,1b & 4 mixed type and genotype 4 and 5 mixed type was detected in one sample each (0.65%). The mean measured value of HCV antibody was 11.51 ± 4.57. The viral load was detected in 61 out of 81 samples tested. The mean viral load ranged from 550 to 552769250IU/ml (log 2.74-log 8.74). Genotype 4 was the most common genotype demonstrated in our study as opposed to the other studies were genotype 3 was the dominant one in south India.

Summary: Background: There are limited global data on head-to-head comparisons of vaccine platforms assessing both humoral and cellular immune responses, stratified by pre-vaccination serostatus. The COVID-19 vaccination drive for the Indian population in the age group 18–45 years began in April 2021 when seropositivity rates in the general population were rising due to the delta wave of COVID-19 pandemic during April–May 2021. Methods: Between June 30, 2021, and Jan 28, 2022, we enrolled 691 participants in the age group 18–45 years across four clinical sites in India. In this non-randomised and laboratory blinded study, participants received either two doses of Covaxin® (4 weeks apart) or two doses of Covishield™ (12 weeks apart) as per the national vaccination policy. The primary outcome was the seroconversion rate and the geometric mean titre (GMT) of antibodies against the SARS-CoV-2 spike and nucleocapsid proteins post two doses. The secondary outcome was the frequency of cellular immune responses pre- and post-vaccination. Findings: When compared to pre-vaccination baseline, both vaccines elicited statistically significant seroconversion and binding antibody levels in both seronegative and seropositive individuals. In the per-protocol cohort, Covishield™ elicited higher antibody responses than Covaxin® as measured by seroconversion rate (98.3% vs 74.4%, p

Monitoring SARS-CoV-2 antibody levels can provide insights into a person's immunity to COVID-19 and inform decisions about vaccination and public health measures. Anti-S may be useful as an indicator of an effective immune response. Thus, we conducted this study that aimed to determine the immune response of anti-S antibodies against SARS-CoV-2 for all the vaccine types over time among adult recipients in Malaysia and to determine the associated factors. This study was a cohort that recruited 2513 respondents aged 18 years and above from June to December 2021. Each participant was followed-up for 1-year period from the initial vaccine dose (baseline). We found that the anti-S antibody generally increased for all vaccine types and peaked at two weeks after the second dose vaccination, with Pfizer recipients having the highest median of 100 (100.00-100.00). During the third-month follow-up, the seropositivity of anti-S antibody and the median level decreased for all vaccines. We found that type of vaccines, comorbid status, infection, and booster status were significantly associated with the anti-S antibody level after one year. [ABSTRACT FROM AUTHOR]

Background: HIV positive women are more likely than HIV negative women to have cervical dysplasia. Incidence of HPV-related dysplasia increases as immune function declines. This study focuses on the pap smear abnormalities and associated high risk behaviors between seropositive and seronegative women. Methods: The present hospital based a cross-sectional study was conducted in the Dept of Gynae and Obstetrics, Eden OPD, Medical College and Hospital, Kolkata, West Bengal, India between August 2022 to January 2023. All HIV Seropositive women, attending at Eden OPD during same period after fulfilling the inclusion criteria were included in the study. Statistical data were analysed by using Microsoft Excel and SPSS V.20 software. Results: Among seropositive women, 22%, 12% and 2% women tested to have LSIL, HSIL, SCC respectively. 32% women had inflammatory / NILM report. 84% of Seronegative women tested negative for any malignancy and 2(1.3%) patients had ASCUS report. (abnormal squamous cell o undetermined significance).10%,4%,0.7% of the women without HIV reported LSIL, HSIL, SCC respectively.. Association of report in two groups was statistically significant (p<0.0001). Conclusion: HIV/AIDS is associated with a risk for cervical cytological abnormalities and hence the need for periodic pap smear screening in this high risk group to reduce the global burden of cervical cancer and timely intervention at premalignant stage. [ABSTRACT FROM AUTHOR]

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Abstract Introduction The efficacy of abatacept is enhanced in anti-citrullinated protein antibody (ACPA) and rheumatoid factor (RF)-positive versus -negative patients with rheumatoid arthritis (RA). Four early RA abatacept trials were analyzed to understand the differential impact of abatacept among patients with SeroPositive Early and Active RA (SPEAR) compared to non-SPEAR patients. Methods Pooled patient-level data from AGREE, AMPLE, AVERT, and AVERT-2 were analyzed. Patients were classified as SPEAR if they were ACPA +, RF +, disease duration

In a phase 2 safety and immunogenicity study of a chikungunya virus virus-like particle (CHIKV VLP) vaccine in an endemic region, of 400 total participants, 78 were found to be focus reduction neutralizing antibody seropositive at vaccination despite being ELISA seronegative at screening, of which 39 received vaccine. This post hoc analysis compared safety and immunogenicity of CHIKV VLP vaccine in seropositive (n = 39) versus seronegative (n = 155) vaccine recipients for 72 weeks post-vaccination. There were no differences in solicited adverse events, except injection site swelling in 10.3% of seropositive versus 0.6% of seronegative recipients (p = 0.006). Baseline seropositive vaccine recipients had stronger post-vaccination luciferase neutralizing antibody responses versus seronegative recipients (peak geometric mean titer of 3594 and 1728, respectively) persisting for 72 weeks, with geometric mean fold increases of 3.1 and 13.2, respectively. In this small study, CHIKV VLP vaccine was well-tolerated and immunogenic in individuals with pre-existing immunity. ClinicalTrials.gov Identifier: NCT02562482. [ABSTRACT FROM AUTHOR]

Celiac disease is a global disease requiring genetic susceptibility and gluten exposure to trigger immune‐mediated enteropathy. The effect of the degree of gluten‐containing grain availability on celiac disease prevalence is unknown. Our objective was to compare country‐based gluten availability to celiac prevalence using a systematic literature review. We searched MEDLINE, Embase, Cochrane, and Scopus until May 2021. We included population‐based serum screening with confirmatory testing (second serological study or small intestine biopsy) and excluded specific, high‐risk, or referral populations. We determined country‐specific gluten availability using the United Nations food balance for wheat, barley, and rye. Human leukocyte antigen (HLA) frequencies were obtained from allelefrequencies.net. The primary outcome was association between gluten‐containing grain availability and celiac disease prevalence. Generalized linear mixed models method with Poisson's link was used for analysis. We identified 5641 articles and included 120 studies on 427 146 subjects from 41 countries. Celiac disease prevalence was 0–3.1%, median 0.75% (interquartile range 0.35, 1.22). Median wheat supply was 246 g/capita/day (interquartile range 214.8, 360.7). The risk ratio (RR) for wheat availability on celiac disease was 1.002 (95% confidence interval [CI]: 1.0001, 1.004, P = 0.036). A protective association was seen with barley, RR 0.973 (95% CI: 0.956, 0.99, P = 0.003), and rye, RR 0.989 (95% CI: 0.982, 0.997, P = 0.006). The RR for gross domestic product on celiac disease prevalence was 1.009 (95% CI: 1.005, 1.014, P < 0.001). The RR for HLA‐DQ2 was 0.982 (95% CI: 0.979, 0.986, P < 0.001), and that for HLA‐DQ8 was 0.957 (95% CI: 0.950, 0.964, P < 0.001). In this geo‐epidemiologic study, gluten‐containing grain availability showed mixed associations with celiac disease prevalence. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) is a blood-borne pathogen that transmits infection via transfusion. Hepatocellular carcinoma is the fifth most common cancer and a major cause of death in patients with chronic HCV infection. Response to treatment is mainly based on the genotypic characterization of HCV. The gold standard for genotyping HCV is by sequencing highly conserved regions such as NS5, core, E1, and 5’UTR. Serum samples of patients who visited the tertiary care hospital with clinical features suggestive of HCV infection formed the study group. HCV genotyping was performed using multiplex Polymerase Chain Reaction in the samples tested positive by Chemiluminescence Immunoassay (CLIA). The viral loads were also performed on selected patient samples. In the present study, Genotype 4 (35.71%), followed by Genotype 3 (17.53%) and 1 & 1b (12.34%) were the common genotypes observed. Genotype 1,1b & 4 mixed type and genotype 4 and 5 mixed type was detected in one sample each (0.65%). The mean measured value of HCV antibody was 11.51 ± 4.57. The viral load was detected in 61 out of 81 samples tested. The mean viral load ranged from 550 to 552769250IU/ml (log 2.74-log 8.74). Genotype 4 was the most common genotype demonstrated in our study as opposed to the other studies were genotype 3 was the dominant one in south India. [ABSTRACT FROM AUTHOR]

Background: Autoimmune encephalitis (AE) is an increasingly recognized neuroinflammatory disease entity in which early detection and treatment leads to the best clinical outcomes. Movement disorders occur in AE but their characteristics are not well defined. Objectives: To identify the frequency, classification, and prognostic significance of movement disorders in AE. Methods: We conducted a systematic review and random-effects meta-analysis of movement disorders in cell surface antibody mediated AE. The frequency of any movement disorder as well as the classification of movement disorders in AE serotypes was determined. We looked at adults 18 years and older and included publications that described at least 10 cases. We used the following four electronic databases: Medline (Ovid), EMBASE (Ovid), APA Psychinfo, and Cochrane library. Results: A total of 1,192 titles and abstracts were reviewed. Thirty-seven studies were included in the final meta-analysis. At least one kind of movement disorder was present in 40% of the entire AE cohort, 53% with anti-NMDA receptor antibodies, 33% with anti-CASPR2 antibodies, 30% with anti-LGI1 antibodies and 13% with anti-GABA receptor antibodies. Dyskinesia was the commonest movement disorder in anti-NMDA antibody mediated AE and faciobrachial dystonic seizures were most frequent in anti-LGI1 antibody mediated AE. Patients with amovement disorder tended to have a highermortality. The risk of bias in the included studies was mostly moderate or high. Conclusion: Movement disorders are common in AE and their identification, in conjunction with other clinical and paraclinical features, may facilitate earlier diagnosis. The prognostic implications of movement disorders in AE warrant further dedicated study. [ABSTRACT FROM AUTHOR]

Introduction: Clinical trial findings may not be generalizable to routine practice. This study evaluated sarilumab effectiveness in patients with rheumatoid arthritis (RA) and tested the real-world applicability of a response prediction rule, derived from trial data using machine learning (based on C-reactive protein [CRP] > 12.3 mg/l and seropositivity [anticyclic citrullinated peptide antibodies, ACPA +]). Methods: Sarilumab initiators from the ACR-RISE Registry, with ≥ 1 prescription on/after its FDA approval (2017–2020), were divided into three cohorts based on progressively restrictive criteria: Cohort A (had active disease), Cohort B (met eligibility criteria of a phase 3 trial in RA patients with inadequate response/intolerance to tumor necrosis factor inhibitors [TNFi]), and Cohort C (characteristics matched to the phase 3 trial baseline). Mean changes in Clinical Disease Activity Index (CDAI) and Routine Assessment of Patient Index Data 3 (RAPID3) were evaluated at 6 and 12 months. In a separate cohort, predictive rule was tested based on CRP levels and seropositive status (ACPA and/or rheumatoid factor); patients were categorized into rule-positive (seropositive with CRP > 12.3 mg/l) and rule-negative groups to compare the odds of achieving CDAI low disease activity (LDA)/remission and minimal clinically important difference (MCID) over 24 weeks. Results: Among sarilumab initiators (N = 2949), treatment effectiveness was noted across cohorts, with greater improvement noted for Cohort C at 6 and 12 months. Among the predictive rule cohort (N = 205), rule-positive (vs. rule-negative) patients were more likely to reach LDA (odds ratio: 1.5 [0.7, 3.2]) and MCID (1.1 [0.5, 2.4]). Sensitivity analyses (CRP > 5 mg/l) showed better response to sarilumab in rule-positive patients. Conclusions: In real-world setting, sarilumab demonstrated treatment effectiveness, with greater improvements in the most selective population, mirroring phase 3 TNFi-refractory and rule-positive RA patients. Seropositivity appeared a stronger driver for treatment response than CRP, although optimization of the rule in routine practice requires further data. Plain Language Summary: Rheumatoid arthritis (RA) is a condition that may cause joint damage, if untreated. Sarilumab is an advanced medication, approved for treating moderate-to-severe RA in patients not responding to initial standard medicines. Clinical trials have shown that sarilumab improves RA symptoms; however, some people do not respond. This is a common problem in RA treatment. Physicians measure proteins in people's blood (called biomarkers; e.g., anticyclic citrullinated peptide antibodies [ACPA], C-reactive protein [CRP], and rheumatoid factor [RF]) to predict a medicine's response. A previous study showed that people with positive blood tests for ACPA and CRP (> 12.3 mg/l) responded well to sarilumab; this study was based on machine learning (a branch of science using computers) and identified factors that could be linked to treatment benefits. The present study analyzed routine data of 2949 people from the ACR-RISE Registry and showed an improvement in RA symptoms after 6 and 12 months of sarilumab, with a greater improvement noted in patients previously treated with other medicines. Biomarkers were tested in 205 people to check whether they could predict treatment response in day-to-day life. People were called rule-positive if they tested positive for RF and/or ACPA with CRP > 12.3 mg/l, and otherwise rule-negative. After 24 weeks of treatment, rule-positive people had a greater chance of disease improvement than rule-negative people. These results showed the benefits of sarilumab in RA in routine care and suggested the usefulness of machine learning in identifying biomarkers that physicians can use to make treatment decisions. [ABSTRACT FROM AUTHOR]

Introduction: The efficacy of abatacept is enhanced in anti-citrullinated protein antibody (ACPA) and rheumatoid factor (RF)-positive versus -negative patients with rheumatoid arthritis (RA). Four early RA abatacept trials were analyzed to understand the differential impact of abatacept among patients with SeroPositive Early and Active RA (SPEAR) compared to non-SPEAR patients. Methods: Pooled patient-level data from AGREE, AMPLE, AVERT, and AVERT-2 were analyzed. Patients were classified as SPEAR if they were ACPA +, RF +, disease duration < 1 year, and Disease Activity Score-28 (DAS28) C-reactive protein (CRP) ≥ 3.2 at baseline; non-SPEAR otherwise. Outcomes included: American College of Rheumatology (ACR) 20/50/70 at week 24; mean change from baseline to week 24 for DAS28 (CRP), Simple Disease Activity Index (SDAI), ACR core components; DAS28 (CRP) and SDAI remission. Adjusted regression analyses among abatacept-treated patients compared SPEAR and non-SPEAR patients, and in full trial population estimating how the efficacy of abatacept versus comparators [adalimumab + methotrexate, methotrexate] was modified by SPEAR status. Results: The study included 1400 SPEAR and 673 non-SPEAR patients; most were female (79.35%), white (77.38%), and with a mean age 49.26 (SD 12.86) years old. Around half with non-SPEAR were RF + and three-quarters ACPA +. Stronger improvements from baseline to week 24 were observed in almost all outcomes for abatacept-treated SPEAR versus non-SPEAR patients or versus SPEAR patients treated with comparators. Larger improvements were observed for SPEAR patients among the abatacept-treated population, and more strongly improved efficacy among SPEAR patients for abatacept than comparators. Conclusions: This analysis, including large patient numbers of early-RA abatacept trials, confirmed beneficial treatment effects of abatacept in patients with SPEAR versus non-SPEAR. [ABSTRACT FROM AUTHOR]

Background: Myasthenia gravis (MG), an autoimmune disease, affects the neuromuscular junction. The impaired neuromuscular transmission results in fatigable muscle weakness among MG patients. Positive antibodies are found among MG patients. Aims: The main aim of this study is to evaluate the correlation of MG severity with their anti-muscle-specific kinase (MUSK) and anti-acetylcholine receptor (AChR) antibody status. Moreover, the study also identifies the correlation between the antibodies profile and the severity of a seropositive MG. Setting and Design: This retrospective cross-sectional study was conducted in the tertiary center of the western region of Saudi Arabia named King Abdullah Medical City (Makkah) over 8 years, from January 2011 to December 2019. Materials and Methods: This retrospective cross-sectional study was conducted in Saudi Arabia in King Abdullah Medical City (Makkah) over 8 years, from January 2011 to December 2019 was reviewed. Seventeen patients out of 27 MG patients came out to be seropositive. The correlation was investigated between severity and antibody status. Statistical Analysis: Data were collected in an Excel sheet, and statistical analysis was performed using SPSS 21 software. Results: The results showed that most patients (87.5%) were positive for AChR antibodies only, while others (12.5%) were positive for anti-MUSK and anti-AChR. Thymoma and crisis were observed in 100% with dual seropositivity and 21% with single seropositivity. Conclusion: The study concluded that a severely aggressive course of MG is present among patients. However, detailed clinical trial studies are required for conforming MG severity and dual seropositivity.

Purpose: To study the impact of the novel coronavirus disease-2019 (COVID-19) pandemic on incidence, seasonal variation, clinical presentation, and disease outcome of epidemic retinitis (ER) and to compare clinical outcomes with positive and negative COVID-19 serology. Methods: This is a retrospective, observational study conducted at a tertiary eye care hospital from August 2020 to June 2022. A graph of ER cases against the month of presentation was compared with the graph of the COVID-19 pandemic in the same region. Cases presented before COVID-19 vaccination, with positive COVID-19 serology (Group 1) were compared with cases with negative serology (Group 2). Results: One hundred and thirty-two cases of ER were seen. The least number of cases were seen during and immediately after the peak of the pandemic (May 2021–August 2021). COVID-19 serology was positive in 13 (22 eyes)/60 (21.6%) unvaccinated cases. Along with COVID-19, positive serology for other ER etiologies was seen in 5/13 cases (38.4%). All patients received oral doxycycline with/without steroids. Groups 1 and 2 included 22 and 21 eyes of 13 cases each. Macular edema resolved in 43.6 and 32 days in groups 1 and 2, respectively. Retinitis resolved at 1 month in both groups. Corrected distant visual acuity was 20/50 and 20/70 at the presentation, which improved to 20/20 and 20/25 in groups 1 and 2, respectively. Mean and median follow-up was 6 months and 4.5 months, respectively, in both groups. No complications or recurrences were seen. Conclusion: No significant impact of the COVID-19 pandemic on ER was observed.

Brucellosis stands as a significant zoonotic disease of concern. In Thailand, the first case of human brucellosis emerged in 2003, attributed to goat milk consumption. Subsequently, in 2007, there was a resurgence of brucellosis, which heightened awareness of its implications for public health. Our study was undertaken as part of the 17 th Veterinary Volunteer Project in the Nhong-mamong district, Chainat province from June 21 to June 30, 2023. The aim was to assess the seropositivity of brucellosis in goats and sheep in this area. A total of 649 serum samples were collected from 15 farms and examined using the Rose Bengal test. Our findings revealed that the seropositivity at the farm and individual levels was 13.33% (2/15) and 0.77% (5/649), respectively. Consequently, it became evident that the study area remained at risk for brucellosis infection, posing a threat to both humans and animals, particularly concerning Brucella melitensis in goats and sheep, which could lead to severe illness in humans. Consequently, an early warning surveillance system is essential to protect both animals and public health by providing timely knowledge and control measures. [ABSTRACT FROM AUTHOR]

Purpose: To study the impact of the novel coronavirus disease-2019 (COVID-19) pandemic on incidence, seasonal variation, clinical presentation, and disease outcome of epidemic retinitis (ER) and to compare clinical outcomes with positive and negative COVID-19 serology. Methods: This is a retrospective, observational study conducted at a tertiary eye care hospital from August 2020 to June 2022. A graph of ER cases against the month of presentation was compared with the graph of the COVID-19 pandemic in the same region. Cases presented before COVID-19 vaccination, with positive COVID-19 serology (Group 1) were compared with cases with negative serology (Group 2). Results: One hundred and thirty-two cases of ER were seen. The least number of cases were seen during and immediately after the peak of the pandemic (May 2021-August 2021). COVID-19 serology was positive in 13 (22 eyes)/60 (21.6%) unvaccinated cases. Along with COVID-19, positive serology for other ER etiologies was seen in 5/13 cases (38.4%). All patients received oral doxycycline with/without steroids. Groups 1 and 2 included 22 and 21 eyes of 13 cases each. Macular edema resolved in 43.6 and 32 days in groups 1 and 2, respectively. Retinitis resolved at 1 month in both groups. Corrected distant visual acuity was 20/50 and 20/70 at the presentation, which improved to 20/20 and 20/25 in groups 1 and 2, respectively. Mean and median follow-up was 6 months and 4.5 months, respectively, in both groups. No complications or recurrences were seen. Conclusion: No significant impact of the COVID-19 pandemic on ER was observed. [ABSTRACT FROM AUTHOR]

Abstract Background Leptospirosis is an emerging zoonotic infection worldwide and a cause of life-threatening disease in dogs. Seroprevalence in Swedish dogs is unknown. The aims of the present study were to estimate seroprevalence of pathogenic Leptospira in healthy dogs in Sweden using the microagglutination test (MAT) and a rapid point-of-care enzyme-linked immunosorbent assay (ELISA), and to evaluate risk factors of Leptospira exposure in Swedish dogs. Results Positive MAT titres (≥ 1:50) were detected in 27/369 (7.3%) of included dogs. Five different serovars were represented of which the Saxkoebing serovar was the most common (64.3%), followed by Copenhagi (14.3%), Bratislava (10.7%), Icterohaemorrhagiae (7.1%), and Canicola (3.6%). The ELISA test (SNAP® Lepto) was positive in 3/316 (0.9%) dogs. Living in urban areas and contact with stagnant water were found to be risk factors for Leptospira seropositivity (p

The majority of the children experience milder coronavirus disease 2019 (COVID-19) symptoms. Children represent a significant source of community transmission. Children under 18 years of age account for an estimated 4.8% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections globally. However, no conclusive statements pertaining to the multi-fold aspects of the virus in children could be drawn due to the lower prevalence of pediatric cases. The present study was conducted to identify the indirect impact of SARS-CoV-2 infections on developing herd immunity among children in the age group 3 to 18 years by investigating their antibody levels. In the study, 240 children aged 3~18 years were recruited by the Department of Pediatrics, Government Medical College and Hospital, Amritsar, India, and quantification of the antibodies was performed at the Viral Research and Diagnostic Laboratory (VRDL), Government Medical College (GMC), Amritsar, India. Out of the 240 serum samples, 197 (82.08%) showed seropositivity, while 43 (17.92%) were seronegative. When stratified, it was observed that in the age group 3~6 years, 22.33% of children were found to have anti-SARS-CoV-2 antibodies while in the age groups 7~10 years, 11~14 years, and 15~18 years, respectively, 37.06%, 30.46%, and 10.15% were seropositive. Although there was seroconversion among children which was useful for predicting the next wave, no differences in seropositivity were observed between adults and children.

BackgroundAutoimmune encephalitis (AE) is an increasingly recognized neuroinflammatory disease entity in which early detection and treatment leads to the best clinical outcomes. Movement disorders occur in AE but their characteristics are not well defined.ObjectivesTo identify the frequency, classification, and prognostic significance of movement disorders in AE.MethodsWe conducted a systematic review and random-effects meta-analysis of movement disorders in cell surface antibody mediated AE. The frequency of any movement disorder as well as the classification of movement disorders in AE serotypes was determined. We looked at adults 18 years and older and included publications that described at least 10 cases. We used the following four electronic databases: Medline (Ovid), EMBASE (Ovid), APA Psychinfo, and Cochrane library.ResultsA total of 1,192 titles and abstracts were reviewed. Thirty-seven studies were included in the final meta-analysis. At least one kind of movement disorder was present in 40% of the entire AE cohort, 53% with anti-NMDA receptor antibodies, 33% with anti-CASPR2 antibodies, 30% with anti-LGI1 antibodies and 13% with anti-GABA receptor antibodies. Dyskinesia was the commonest movement disorder in anti-NMDA antibody mediated AE and faciobrachial dystonic seizures were most frequent in anti-LGI1 antibody mediated AE. Patients with a movement disorder tended to have a higher mortality. The risk of bias in the included studies was mostly moderate or high.ConclusionMovement disorders are common in AE and their identification, in conjunction with other clinical and paraclinical features, may facilitate earlier diagnosis. The prognostic implications of movement disorders in AE warrant further dedicated study.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42023386920.

Introduction: This study aims to evaluate the role of ultrasonography (USG) for early diagnosis of clinically suspected dengue fever before it becomes serologically positive and the usefulness of USG in predicting the severity of the disease. Methods: Prospective observational study conducted at a tertiary care hospital from April 2020 to March 2021, 70 cases of clinically suspected dengue within the age group of 6 months to 15 years resenting with fever for less than 5 days underwent whole abdomen and chest ultrasonography. For seropositive cases, ultrasonography findings and their utility in early diagnosis and prediction of disease severity were analyzed along with their correlation to the clinical and laboratory profiles. Results: 75.8% had primary dengue and 24.2% had secondary dengue. 94% of cases demonstrated ultrasonography features suggestive of dengue-like hepatomegaly (81%), ascites (63.8%), splenomegaly (56.9%), gall bladder wall thickness (46.6%), Cholecystitis (44.8%) and Pleural effusion (41.4%). Ascites and pleural effusion correlated well with clinical severity (p5mm correlated well with disease severity. USG showed 94.3% sensitivity, 16.67% specificity, and 81.43% of diagnostic accuracy in the seropositive cases of this study. Conclusion: Ultrasonography is useful not only as an adjuvant for early diagnosis of Dengue fever but also as a marker of disease severity.

Rheumatoid Arthritis (RA) is a systemic disease with many different clinical phenotypes. RA could be classified according to disease duration, seropositivity for rheumatoid factor (RF) and/or anti-citrullinated protein antibodies (ACPA), joint subtype, clinical behaviourbehavior and many other subgroups. In this review, we summarize and discuss the multifaceted aspects of RA, focusing on the relationship between autoimmunity status and clinical outcome, achievement of remission and influence on treatment response, from the 2022 International GISEA/OEG Symposium. [ABSTRACT FROM AUTHOR]

Background: The information on seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among patients with inflammatory bowel disease (IBD) and its comparison to healthy controls is sparse. We compared the seroprevalence rates in patients with IBD and healthy controls (HCs). Methods: Patients with IBD and HCs (contact of patients) underwent SARS-CoV-2 antibody testing (chemiluminescent immunoassay: Siemens kit IgG against antigen-S1RBD) between July 2020 and April 2021. Information on demography, disease characteristics, drug history and past history of SARS-CoV-2 infection were noted. Patients on 5-aminosalicylic acid or no treatment were considered not on immunosuppressants and those who had received steroids, thiopurines or methotrexate within six months of inclusion were considered being on immunosuppressants. Results: A total of 235 patients (51.9%, males; mean age, 38.7 ± 12.4 years; median disease duration, 60 months [interquartile range, IQR: 36–120]) (ulcerative colitis [UC]: 69.4%, Crohn's disease [CD]: 28.9%, IBD unclassified [IBDU]: 1.7%) and 73 HCs (mean age, 39.6 ± 10.9 years, 80% males) were enrolled. Of the 235 patients, 128 (54.5%) patients were on immunosuppressants and 107 (45.5%) were not on immunosuppressants. Seventy-four (31.5%) patients were seropositive, of which two (0.9%) had previous history of SARS-CoV-2 infection and none received coronavirus disease-19 (COVID-19) vaccine. Seroprevalence between IBD patients and HCs (32% vs. 27%, p > 0.05) and between patients with and without immunosuppressants (28.1% vs. 36%, p > 0.05) was similar. Age, gender, disease type, duration and activity in the last six months; and medication use were similar between patients with positive and negative serology. There was a progressive increase in seroprevalence from July 2020 to April 2021. Conclusion: Up to 1/3rd of patients with IBD were seropositive for immunoglobulin G (IgG) SARS-Cov-2 antibody indicating high seroprevalence in patients with IBD from Northern India. [ABSTRACT FROM AUTHOR]

Background: There have been occasional reports on varicella infection among healthcare workers (HCWs) despite varicella-zoster virus (VZV) seropositivity. We compared the levels of humoral and cellular immunity to VZV in seropositive HCWs who had acquired immunity by natural infection or vaccination. Methods: Seropositive healthy HCWs with an apparent history of varicella or VZV vaccination once or twice were recruited. Their samples were assessed for anti-VZV IgG levels, the relative avidity index (RAI), and the frequencies of VZV-specific cytokine-producing or polyfunctional CD4+ or CD8+ T cells. Results: A total of 75 seropositive HCWs (29 with a history of varicella, 25 vaccinated once, and 21 vaccinated twice) were assessed for humoral immunity. Cellular responses could be analyzed in 59 (28, 21, and 10 in the respective groups). The anti-VZV IgG level, RAI, and memory CD4+ T cell responses were significantly higher in the past infection group than in the vaccinated once group. The RAI levels were significantly higher in the past infection group than in the vaccinated twice group. Conclusion: Seropositive HCWs without a varicella history, especially those who received the vaccine only once, had significantly lower levels of immune responses to VZV. Such HCWs might need to comply with airborne precautions.

Brucellosis in cattle herds has caused severe economic losses in many regions worldwide. A cross-sectional study was performed to investigate the presence of Brucella spp. in industrial dairy cattle farms in Iran. For this purpose, 935 blood and 935 milk samples were randomly collected from industrial dairy cattle farms in Iran's Alborz and Tehran provinces. Blood and milk samples were collected on the same day from each cow. Serological, bacteriological, and molecular characterization of Brucella isolates were performed using standard methods. Our results revealed the seroprevalence of brucellosis in dairy cattle farms in the Alborz and Tehran provinces, reaching 19.8%, 6.7%, 5.1%, 14.1%, and 13.1% using the Rose Bengal plate test (RBPT), serum agglutination test (SAT), 2-mercaptoethanol test (2-ME), indirect enzyme-linked immunosorbent assay (i-ELISA) and milk ring test (MRT), respectively. Furthermore, the results of bacterial culture and PCR analyses showed the presence of Brucella abortus among dairy cattle in the Alborz province and Brucella melitensis and B. abortus among dairy cattle in the Tehran province. Moreover, statistical analysis with Cohen's Kappa has highlighted the near-perfect agreement between RBPT and i-ELISA (k = 0.86). In contrast, substantial agreement was shown between RBPT and SAT performance (k = 0.70) and moderate agreement between RBPT and 2-ME (k = 0.67). The findings of this investigation showed shedding of Brucella in the milk of seropositive cows, which is a serious problem involving the maintenance and further spread of Brucella infection on the farm. Therefore, for brucellosis detection or eradication in dairy cattle farms, bacteriological and serological tests of milk samples should be performed along with blood analysis to inhibit the uncontrolled spread of the disease in animals and humans.

Objective: To compare the intraoperative blood loss and adhesions, peri-operative blood and intravenous iron supplementation between hepatitis seropositive and seronegative pregnant women undergoing elective cesarean delivery. Study Design: Cross-sectional, analytical study. Place and Duration of Study: Departments of Anesthesiology and Gynecology & Obstetrics, Combine Military Hospital, Okara Cantt Pakistan, from Oct 2018 to Mar 2019. Methodology: After approval of the hospital ethical committee, 134 (n=67 in each Group) pregnant women were included in our study by convenient sampling. Patients were divided into two groups. Group-A included seronegative pregnant women, whereas Group-B were seropositive pregnant women. Results: There was no difference in the age (p=0.357), gravidity (p=0.159), parity (p=0.226) and the number of cesarean sections (p=0.475) between the two groups. There was no difference in the two groups regarding peri-operative haemoglobin change,with an insignificant reduction of 0.60±1.21 g/dL in Group-A versus a reduction of 0.50±1.08 g/dL in Group-B. A mild level of adhesion was observed intraoperatively in 26(35.6%) in Group-A versus 27(37.5%) in Group-B; p=0.170. Mild difficulty securing hemostasis was reported in 25(34.2%) vs 29(40.2%) patients; p=0.329. 61(83.5%) did not require a peri-operative blood transfusion in Group-A versus 59(81.9%) in Group-B; p=0.528. Conclusion: Our study has shown that the peri-operative haemoglobin level, blood product and intravenous iron supplementation, intra-operative adhesions encountered, and difficulty in hemostasis were comparable between sero-positive and sero-negative viral hepatitis pregnant women.

Background Respiratory syncytial virus (RSV) remains a leading cause of pediatric morbidity, with no approved vaccine. We assessed the safety and immunogenicity of the Ad26.RSV.preF vaccine candidate in adults and children. Methods In this randomized, double-blind, phase 1/2a, placebo-controlled study, 12 adults (18–50 years) and 36 RSV-seropositive children (12–24 months) were randomized 2:1 to Ad26.RSV.preF (1 × 1011 viral particles [vp] for adults, 5 × 1010 vp for children) or placebo, at day 1 and 29, with 6-month immunogenicity and 1-year safety follow-up. Respiratory syncytial virus infection was an exploratory outcome in children. Results In adults, solicited adverse events (AEs) were generally mild to moderate, with no serious AEs. In children, no vaccination-related serious AEs were reported; fever was reported in 14 (58.3%) Ad26.RSV.preF recipients. Baseline pediatric geometric mean titers for RSV A2 neutralization increased from 121 (95% confidence interval [CI], 76–191) to 1608 (95% CI, 730–3544) at day 29, and 2235 (95% CI, 1586–3150) at day 57, remaining elevated over 7 months. Respiratory syncytial virus infection was confirmed in fewer children receiving Ad26.RSV.preF (1, 4.2%) than placebo (5, 41.7%). Conclusions Ad26.RSV.preF demonstrated immunogenicity in healthy adults and toddlers, with no safety concerns raised. Evaluations in RSV-seronegative children are underway. [ABSTRACT FROM AUTHOR]

Background: Myasthenia gravis (MG), an autoimmune disease, affects the neuromuscular junction. The impaired neuromuscular transmission results in fatigable muscle weakness among MG patients. Positive antibodies are found among MG patients. Aims: The main aim of this study is to evaluate the correlation of MG severity with their anti-muscle-specific kinase (MUSK) and anti-acetylcholine receptor (AChR) antibody status. Moreover, the study also identifies the correlation between the antibodies profile and the severity of a seropositive MG. Setting and Design: This retrospective cross-sectional study was conducted in the tertiary center of the western region of Saudi Arabia named King Abdullah Medical City (Makkah) over 8 years, from January 2011 to December 2019. Materials and Methods: This retrospective cross-sectional study was conducted in Saudi Arabia in King Abdullah Medical City (Makkah) over 8 years, from January 2011 to December 2019 was reviewed. Seventeen patients out of 27 MG patients came out to be seropositive. The correlation was investigated between severity and antibody status. Statistical Analysis: Data were collected in an Excel sheet, and statistical analysis was performed using SPSS 21 software. Results: The results showed that most patients (87.5%) were positive for AChR antibodies only, while others (12.5%) were positive for anti-MUSK and anti-AChR. Thymoma and crisis were observed in 100% with dual seropositivity and 21% with single seropositivity. Conclusion: The study concluded that a severely aggressive course of MG is present among patients. However, detailed clinical trial studies are required for conforming MG severity and dual seropositivity. [ABSTRACT FROM AUTHOR]

The detection of human cytomegalovirus (HCMV) in an individual's bodily fluid by culture techniques or through HCMV DNA detection by polymerase chain reaction, is known as HCMV shedding. Human cytomegalovirus shedding has the potential to transmit HCMV infection, where an individual can become infected with HCMV through contact with the bodily fluid of another individual containing HCMV. Human cytomegalovirus shedding can occur in primary infection and in non‐primary infection for individuals with prior infection (HCMV seropositive). Human cytomegalovirus infection causes few or no symptoms in a pregnant woman, but can cause significant harm to her foetus if congenital CMV (cCMV) infection occurs. The association between HCMV shedding in HCMV seropositive pregnant women and the vertical transmission of HCMV to result in cCMV infection is poorly investigated, challenged by a limited understanding of the distribution of HCMV shedding in HCMV seropositive pregnant women. We systematically reviewed the published literature to describe the prevalence of HCMV shedding in HCMV seropositive women during pregnancy up to delivery. This analysis identified nine studies that met our eligibility criteria. In these studies, the prevalence of HCMV shedding in any bodily fluid of HCMV seropositive women during pregnancy and at delivery ranged from 0% to 42.5%. A meta‐analysis, performed on six of the nine studies with suitable sample sizes, estimated a pooled prevalence of 21.5% [95% CI 12.7%,30.3%]. To our knowledge, this is the first review to systematically search the literature to summarise the prevalence of HCMV shedding in HCMV seropositive pregnant women. These estimates can help in the development of disease burden models and therapeutic or preventative strategies against cCMV infection in the context of non‐primary maternal HCMV infection. [ABSTRACT FROM AUTHOR]

Brucellosis poses a significant threat to public health in China. This study utilized a range of epidemiological indices, including seroprevalence and the number of reported cases, to illustrate the epidemic profile of the disease. Although the seroprevalence of brucellosis in animals (including sheep, goats, cattle, and swine) steadily decreased from a severe epidemic level in the 1950s to a low endemic level by 1989, the disease reemerged in 2000. Subsequently, there has been a persistent increase in the frequency of outbreaks and the number of reported cases from 2006 to 2021, with over 98% of reported cases occurring in sheep and cattle. During this period, the culling rate declined, while infection rates increased, nearly reversing their respective trajectories. The decrease in the culling rate of positive animals coincided with an increase in infection rates, indicating that infection among these animals was persistent and circulating. In the southern regions of China, 6.34% (34,070 of 537,797) of cases were reported between 2006 and 2021, whereas in the northern regions, 93.67% (503,727 of 537,797) of cases occurred during the same timeframe. Each time cases increased in the south, they lagged 2 to 5 years behind those in the north, suggesting that stringent control measures for sheep and cattle in the north should be prioritized. These findings provide critical insights into developing control strategies to mitigate the spread of the disease., Competing Interests: No conflicts of interest., (Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2024.)

Aims and Objectives: Mouth acts as a mirror for most of the underlying systemic diseases. Very few studies were done in south Indian population to observe the oral manifestations of human immunodeficiency virus (HIV) in relation to the cluster of differentiation 4 (CD4) count, and this study mainly highlights the presenting complaint of HIV patients during their dental visit. The study was aimed to determine the chief complaints of patients along with oral manifestations of HIV and correlate them to CD4 count. Materials and Methods: One hundred consecutive HIV-positive patients were considered for the study. All the oral manifestations and the chief complaints along with the calculated CD4 counts were noted and the results were correlated. Spearman correlation was used for CD4 count and other oral manifestations. Results: The mean CD4 counts were 421 cells/mm3 with a standard deviation (SD) of 404.34 for the most common oral manifestation of burning mouth and 176.5 cells/mm3 for the least common manifestation of malignancies. The CD4 count ranged from 120 to 1100 cells/mm3. The mean age and CD4 count were 38 years and 398.86, respectively. There was a statistically significant correlation with candidiasis and gingivitis, and the rest of the conditions were insignificant. Conclusion: The study results suggest that the chief complaint of presentation of an HIV-positive patient is pain due to carious teeth/abscess followed by burning mouth, with candidiasis being the most common disease.

Abstract West Nile virus (WNV) is a mosquito‐borne virus of a re‐emergence importance with a wide range of vertebrate hosts. Granted, it causes asymptomatic infection, but fatal cases and neurologic disorders were also recorded, especially in humans, horses and some exposed birds. The virus is globally spread and birds are considered an amplifying and reservoir host of WNV, helping to spread the disease due to their close contact with main hosts. In this study, we aimed to detect the presence of antibodies against WNV in backyard hens that were reared in the western Anatolian part of Turkey. A total of 480 chicken sera were randomly collected from six provinces in the west of Turkey (Mugla, Izmir, Aydin, Afyonkarahisar, Kutahya and Manisa) with 80 samples from each province (40 in spring and 40 in fall seasons). They were tested by using a competitive ELISA method to identify the specific avian antibodies of IgG that produced against the WNV envelope proteins (pr‐E). Twelve of 480 (2.5%) sera were found seropositive, three of these positive sera were detected from the Izmir province (3.75%) collected in the spring session and the other nine positive sera were detected from the Mugla province (11.25%) collected in the fall session. Both of these provinces are located seaside and have suitable climate conditions for vectors of infection. The results indicated that WNV infection is in circulation in these provinces, and that may put the other susceptible vertebrates under risk of infection.

Ahmed Seri,1,2 Hala Kamal Ali Mohamed,3– 5 Mohammed Elmujtba Adam Essa,6 Elnour Mohammed Elagib,7,8 Noha Ibrahim Ahmed Eltahirm,7,8 Salma Mohammed Alfatih Mansour,9 Abdelkareem A Ahmed6 1Department of Clinical Immunology, Royal Care International Hospital, Khartoum, Sudan; 2Department of Immunology, Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; 3Department of Microbiology, Faculty of Medicine, African International University (AIU), Khartoum, Sudan; 4Department of Clinical Immunology, Sudan Medical Specialization Board (SMSB), Khartoum, Sudan; 5Faculty of Medicine, Sudan University of Science and Technology, Khartoum, Sudan; 6Department of Clinical Medicine, Medical and Cancer Research Institute, Nyala, Sudan; 7Department of Rheumatology, Omdurman Military Hospital, Khartoum, Sudan; 8Department of Medicine, Faculty of Medicine, Karary University, Khartoum, Sudan; 9Department of Medicine, Faculty of Medicine, University of Khartoum, Khartoum, SudanCorrespondence: Mohammed Elmujtba Adam EssaDepartment of Clinical Medicine, Medical and Cancer Research Institute, Nyala, SudanTel +249 90700938Email Awadali818@yahoo.comIntroduction: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation of the synovial membrane. RA is classified as seropositive or seronegative, according to the absence or presence of primarily IgM RF, RF, and/or ACPA. The aim of this study is to identify the relationship between the serotype of rheumatoid arthritis and the level of ESR.Methods and Materials: This is a descriptive, cross-sectional study done in Omdurman military hospital, Khartoum, Sudan. Conducted with 60 patients with RA, data were collected through a designated questionnaire which included demographic, age, gender, duration of the disease, laboratory finding. All the patients in the study were treated with conventional DMARDs and diagnosed according to the 2010 ACR/EULAR criteria; their disease activity status was assessed by DAS28/ESR. Data were analyzed using SPSS version 23.Results: The study found that 91.7% of the patients were females, patients of age group between 36 and 50 years had the highest percentage at 38.3% followed by those between 51 and 70 years and the least age group between 20 and 35 years, 36.7% and 15%, respectively. Of all the patients 61.7% were found to be SPRA, while the remaining 38.3% were seronegative (SNRA). Altogether 55% of the patients had moderate disease activity, followed by 16.7% who had a remission, 15% had high disease activity and the remaining 13.3% had low disease activity. The metacarpophalangeal (MCP) joint was found to be the only joint that was significantly associated with DAS28 and its involvement was greater among seropositive patients. The most affected joints were found to be shoulders, knees, wrist, MCP, PIP and elbow, in that order.Conclusion: Females, middle-age group and shoulder joint were the most affected. Most RA was found to be SPRA, and the seropositive group was found to be more associated with high disease activity, while the seronegative group was associated with remission and low disease activity.Keywords: seropositive, seronegative, RA, female, high disease activity

IntroductionMultisystem Inflammatory Syndrome in children (MIS-C) is a serious inflammatory sequela of SARS-CoV2 infection. The pathogenesis of MIS-C is vague and matrix metalloproteinases (MMPs) may have an important role. Matrix metalloproteinases (MMPs) are known drivers of lung pathology in many diseases.MethodsTo elucidate the role of MMPs in pathogenesis of pediatric COVID-19, we examined their plasma levels in MIS-C and acute COVID-19 children and compared them to convalescent COVID-19 and children with other common tropical diseases (with overlapping clinical manifestations).ResultsChildren with MIS-C had elevated levels of MMPs (P < 0.005 statistically significant) in comparison to acute COVID-19, other tropical diseases (Dengue fever, typhoid fever, and scrub typhus fever) and convalescent COVID-19 children. PCA and ROC analysis (sensitivity 84–100% and specificity 80–100%) showed that MMP-8, 12, 13 could help distinguish MIS-C from acute COVID-19 and other tropical diseases with high sensitivity and specificity. Among MIS-C children, elevated levels of MMPs were seen in children requiring intensive care unit admission as compared to children not needing intensive care. Similar findings were noted when children with severe/moderate COVID-19 were compared to children with mild COVID-19. Finally, MMP levels exhibited significant correlation with laboratory parameters, including lymphocyte counts, CRP, D-dimer, Ferritin and Sodium levels.DiscussionOur findings suggest that MMPs play a pivotal role in the pathogenesis of MIS-C and COVID-19 in children and may help distinguish MIS-C from other conditions with overlapping clinical presentation.

Background: Leptospirosis is an emerging zoonotic infection worldwide and a cause of life-threatening disease in dogs. Seroprevalence in Swedish dogs is unknown. The aims of the present study were to estimate seroprevalence of pathogenic Leptospira in healthy dogs in Sweden using the microagglutination test (MAT) and a rapid point-of-care enzyme-linked immunosorbent assay (ELISA), and to evaluate risk factors of Leptospira exposure in Swedish dogs. Results: Positive MAT titres (≥ 1:50) were detected in 27/369 (7.3%) of included dogs. Five different serovars were represented of which the Saxkoebing serovar was the most common (64.3%), followed by Copenhagi (14.3%), Bratislava (10.7%), Icterohaemorrhagiae (7.1%), and Canicola (3.6%). The ELISA test (SNAP® Lepto) was positive in 3/316 (0.9%) dogs. Living in urban areas and contact with stagnant water were found to be risk factors for Leptospira seropositivity (p < 0.05) in a multivariable logistic regression model. Conclusion: In this first seroprevalence study of Leptospira in Swedish dogs, it was shown that healthy dogs without recent (24 months) travel history and antileptospira vaccination had been exposed to pathogenic Leptospira interrogans serovars. Contact with stagnant water and living in urban areas were independent risk factors for seropositivity. [ABSTRACT FROM AUTHOR]

Respiratory syncytial virus (RSV) remains the most common cause of lower respiratory tract infections in children worldwide. Development of a vaccine has been hindered due the risk of enhanced respiratory disease (ERD) following natural RSV exposure and the young age (<6 months) at which children would require protection. Risk factors linked to the development of ERD include poorly neutralizing antibody, seronegative status (never been exposed to RSV), and a Th2-type immune response. Stabilization of the more antigenic prefusion F protein (PreF) has reinvigorated hope for a protective RSV vaccine that elicits potent neutralizing antibody. While anecdotal evidence suggests that children and adults previously exposed to RSV (seropositive) are not at risk for developing vaccine associated ERD, differences in host immune responses in seropositive and seronegative individuals that may protect against ERD remain unclear. It is also unclear if vaccine formulations that skew towards Th1-versus Th2-type immune responses increase pathology or provide greater protection in seropositive individuals. Therefore, the goal of this work was to compare the host immune response to a stabilized prefusion RSV antigen formulated alone or with Th1 or Th2 skewing adjuvants in seronegative and seropositive BALB/cmice. We have developed a novel BALB/c mouse model whereby mice are first infected with RSV (seropositive) and then vaccinated during pregnancy to recapitulate maternal immunization strategies. Results of these studies show that prior RSV infection mitigates vaccine-mediated skewing by Th1- and Th2-polarizing adjuvants that was observed in seronegative animals. Moreover, vaccination with PreF plus the Th1-skewing adjuvant, Advax, increased RSV F85-93-specific CD8 T cells in both seronegative and seropositive dams. These data demonstrate the importance of utilizing seropositive animals in preclinical vaccine studies to assess both the safety and efficacy of candidate RSV vaccines. [ABSTRACT FROM AUTHOR]