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Abstract

Background

Brucellosis is an infectious zoonosis, which greatly afflicts human health and animal productivity.

Objectives

To describe the trends and epidemiological characteristics of human brucellosis in Nahavand county, Hamadan Province, western Iran over 8 years (2010–2017).

Methods

In this registry-based longitudinal study, we analyzed all reported cases of human brucellosis, including 1,130 patients from 2010 to 2017. A checklist including demographic and clinical characteristics of patients with reported cases of brucellosis had been used to gather data. We calculated annual percent changes (APCs) and average annual percent changes (AAPCs) using Joinpoint software to determine the trend of brucellosis using a segmented regression model.

Results

Among the patients, 60.9% were male and 87.3% lived in rural areas. The mean age of the patients was 35.9 ± 18.34 years. Compared with male patients, female patients were more affected when they were elderly (15.6% men vs. 24.2% women for those aged ≥55 years) (P = 0.001). Of patients with brucellosis, 65.2% had consumed unpasteurized dairy products and 82.3% had a history of contact with animals. The incidence of human brucellosis in Nahavand county increased between 2010 and 2014, then decreased in 2015, and thereafter remained steady. Per 100,000 population, the AAPC pertaining to the incidence was 17.4 in the male population (95% CI: 4.4, 31.9), 13.8 in the female population (95% CI: 0.2, 29.3), and 16.1 in rural dwellers (95% CI: 2.2, 31.8) indicating an increasing trend from 2010 to 2017 (P < 0.05).

Conclusion

The incidence of brucellosis in the western part of Iran is high and remains a challenging health problem. In the present study, age, job, sex, and seasonal changes are important risk factors for human brucellosis.

Abstract

Nigella sativa (commonly known as black seed or black cumin), from the family Ranunculaceae, is a plant that grows in countries bordering the Mediterranean Sea. This narrative review discusses the toxicological profile reported by short- to long-term studies that examined different extracts and oils of N. sativa seeds. Scientific databases including Web of Science, PubMed, Scopus, and Google Scholar were searched using appropriate keywords. LD50 for administered N. sativa seed fixed oil varied from 28.8 mL/kg to 3,371 mg/kg in mice, while 21 g/kg of aqueous, methanol, and chloroform extracts of N. sativa did not lead to any mortality. Subacute toxicity evaluations indicated that aqueous, methanol, and chloroform extracts of N. sativa at doses as high as 6 g/kg do not produce toxicity. Investigation of chronic toxicity found that 2 mL/kg of N. sativa fixed oil is slightly toxic. Cytotoxicity studies indicated that N. sativa chloroform and petroleum ether extracts are more cytotoxic than its other extracts. Although studies that assessed N. sativa toxicity generally introduced it as a safe medicinal herb, to draw a more definitive conclusion on its safety, more detailed studies must be conducted.

Abstract

The rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the coronavirus disease 2019 (COVID-19) pandemic. Although COVID-19 is a class B infectious disease, the prevention and control measures used for it in China are commonly used for class A infectious diseases. In the process of the spread of the disease, hospitals will be a key point to influence this pandemic. To prevent and control nosocomial infection of SARS-CoV-2, methods and measures were formulated from the relevant laws and regulations of the National Health Commission of the People's Republic of China, practical experience of the pandemic, and evidence-based medicine in the hospitals fighting this disease. Thus, this report may provide useful recommendations for the prevention and control of COVID-19 in hospitals and clinics.

Abstract

Background

Glucose-6-phosphate dehydrogenase (G6PD) is essential to produce reduced nicotinamide adenine dinucleotide phosphate, which is required to protect cells against oxidative stress. G6PD deficiency is a genetic variation that may lead to hemolysis with potential consequences, such as kidney failure, and patients often experience low quality of life.

Objectives

To establish a simple, efficient, and optimized method to produce a G6PDViangchan variant and characterize the phenotypes of recombinant human wild-type G6PD and G6PDViangchan.

Methods

G6PD was amplified by polymerase chain reaction (PCR) from a human cDNA plasmid, and the gene for G6PDViangchan was amplified by initiating a mutation at location 871 (G>A) through site-directed mutagenesis. Protein expression and western blotting were conducted after successful cloning. The enzymatic activity of both proteins was assessed spectrophotometrically after purification.

Results

Both amplicons were successfully cloned into a pET26b(+) expression vector and transformed into Escherichia coli BL21 (DE3) cells for overexpression as C-terminally histidine-tagged recombinant proteins. Western blotting confirmed that both proteins were successfully produced at similar levels. The enzymes were purified by immobilized metal (Co) affinity chromatography. Postpurification assay of enzyme activity revealed about 2-fold differences in the levels of specific activity between the wild-type G6PD (155.88 U/mg) and G6PDViangchan (81.85 U/mg), which is consistent with earlier reports. Analysis in silico showed that the coding change in G6PDViangchan has a substantial effect on protein folding structure.

Conclusions

We successfully cloned, expressed, and purified both wild-type G6PD and G6PDViangchan proteins. Such a protocol may be useful for creating a model system to study G6PD deficiency disease.

Abstract

Background

A Thai-version of the Migraine Specific Quality of Life Questionnaire (MSQ 2.1) is available, but a qualified questionnaire used specifically for disability assessment was not available. The most relevant practical disability assessment tested during this study was the Migraine Disability Assessment (MIDAS) Questionnaire.

Objectives

To test the concurrent validity, test–retest reliability, and internal consistency of a Thai-version MIDAS questionnaire, and factors to predict disability in people with migraine.

Methods

We conducted the present prospective study at a tertiary care teaching hospital in Bangkok. The original English MIDAS Questionnaire was translated into Thai with back-translation into English and the language equivalence was assessed. The Thai-version MIDAS Questionnaire was tested for concurrent validity, test–retest reliability, and internal consistency, and factors including duration of migraine history, migraine characteristics, and comorbidity were assessed for the ability to predict migraine-related disability of migraineurs.

Results

Of the 58 participants, 31 were eligible to be included. The validity of the Thai-version questionnaire between the MIDAS total score and the mean headache severity (question B), the mean pain duration per attack, and the mean pain numerical rating scale (NRS) score were moderately correlated with a Spearman correlation coefficient range 0.42–0.58. The test–retest reliability of MIDAS grade had a weighted κ of 0.66, and for individual questions of the MIDAS total score, questions A and B assessed by intraclass correlation coefficients ranged 0.89–0.98. The internal consistency had a Cronbach α of 0.98. The mean pain NRS score in the past 3 months was an independent predictive factor for migraine-related disability.

Conclusion

The Thai-version MIDAS Questionnaire has moderate concurrent validity, acceptable internal consistency, and excellent test–retest reliability. It would be helpful to assess clinical outcomes. Future study with a standardized translation process for the Thai-version questionnaire and a larger sample size is warranted to confirm internal consistency and determine all probable predictive factors for migraine-related disability.

Abstract

Background

Favipiravir is a promising drug for COVID-19, but evidence from a robust clinical trial is limited.

Objective

To describe the demographics, clinical characteristics, and various antiviral treatment regimens (with and without favipiravir) of patients with severe and nonsevere COVID-19.

Method

We conducted a retrospective observational study in all COVID-19 patients admitted at Bamrasnaradura Infectious Diseases Institute (BIDI) from January 8 to March 30, 2020. We compared the demographics, clinical characteristics, and various antiviral treatment regimens of 12 severe and 29 nonsevere COVID-19 patients in Thailand.

Results

Adjunctive favipiravir was given to only severe cases. The median length of hospitalization of patients either receiving favipiravir or not receiving favipiravir was not significantly different (P = 0.8549), but those who received adjunctive favipiravir became reverse transcriptase–polymerase chain reaction negative 2 days sooner than the other group (median: 6 days vs. 8 days; P = 0.1125).

Conclusion

The findings suggested that adjunctive favipiravir might not be effective for patients with severe COVID-19, but further studies with larger sample sizes are needed.

Abstract

Background

Pneumonia causes significant incidence in children younger than 5 years. Most fatalities are resulted from complications. High rates of cardiac events were detected in adult studies but usually related to underlying diseases.

Objective

To study the cardiac effects of community-acquired pneumonia (CAP) with respiratory failure (RF) in healthy children.

Methods

The prospective cohort study was conducted in children aged 2–59 months with CAP and RF. Cardiac enzyme assessments, chest radiography, electrocardiography, and echocardiography were performed at the admission date and 2 weeks after admission. t-test and chi-square test were used for comparison between first and second investigations, and the statistically significance level was a P <0.05.

Results

Of the 135 patients, pericardial effusion occurred in 80 (59%), valvular regurgitation in 30 (22%), ST/T changes in 66 (49%), cardiac arrhythmia in 7 (5%), and myocardial injury in 83 (62%). Significant improvement of cardiothoracic-ratio, heart rate, ST/T changes, cardiac arrhythmia, troponin T, myocardial performance, and left-ventricular ejection fraction was demonstrated at second investigations. Three mortality cases exhibited evidence of congestive heart failure (CHF).

Conclusion

Children with CAP and RF had several cardiac effects even in healthy children. Most cardiac effects were mild and transient. Mortality cases were revealed evidence of congestive heart failure (CHF). Future research should be designed to find out the characteristics and predictors of CHF for early recognition and therapeutic strategy.

Abstract

Background

Gastrointestinal stromal tumor (GIST) was the most common mesenchymal tumor of the gastrointestinal tract predominately occurring in the stomach. Although GIST was a rare disease, it was considered to be a life-threatening malignancy.

Objective

To explore the current status of gastric GIST in Thai patients.

Method

The medical records of patients who were diagnosed with histologically proven gastric GIST from 2012 to 2016 in King Chulalongkorn Memorial Hospital were reviewed.

Results

Of 22 patients, there were 14 (63.6%) females and 8 (36.4%) males with the mean age of 62.6 ± 14.8 years. The average duration before the first presentation was 12 weeks. The initial symptoms were upper gastrointestinal bleeding (50.0%) followed by abdominal pain (31.8%). Tumor mostly located at the proximal part (fundus and cardia) in 20 (90.9%) patients. At the time of the diagnosis, three patients (13.6%) had distant metastasis. Of this group, 77.3% underwent surgical treatment.

Discussion

Although gastric GIST was an uncommon disease, early diagnosis and prompt treatment could save the lives of many patients.

Abstract

Background

Gastric cancer (GC) is the common cause of cancer-related deaths worldwide and inflammation represents the early phases in the GC.

Objective

To review the tumor necrosis factor (TNF)-α-308 G>A (GG, GA, and AA) in GC by meta-analysis studies for any differences in TNF-α-308 G>A gene polymorphisms.

Methods

Case–control studies published from 2003 to 2017 were identified by searching PubMed, EMASE, and the Internet with the English language. The analysis published on TNF-α-308 G>A polymorphism was analyzed and a limited number of articles were included in the present study. TNF-α-308 G>A from 4,157 patients and 5,185 healthy controls was evaluated. Studies were evaluated using Cochrane Q-test and publication bias was evaluated by constructing funnel plots.

Results

Overall, TNF-α-308 GA genotype showed significant association [P < 0.0001, odds ratio (OR), 95% confidence interval (CI) = 0.82 (0.74–0.91)]. However, meta-analysis of TNF-α-308 genotypes (GG, GA, AA, and GA + AA) between GC patients and controls showed nonsignificant association with GC [P > 0.05, recessive model: OR = 1.38, 95% CI: 1.15–1.66; dominant model: OR = 1.23, 95% CI: 1.09–1.39; (G/A) vs. (G/G): OR = 1.15, 95% CI: 1.02–1.28; (A/A) vs. (G/G): OR = 1.44, 95% CI: 1.19–1.73]. Analysis stratified by ethnicity showed same results in Asian and Caucasian populations.

Conclusions

Results revealed nonsignificant association of TNF-α-308 genotypes (GG, GA, AA, and GA + AA) and GC. TNF-α-308GA genotype showed significant association whereas homozygous genotype AA did not show association with GC risk.