Proteomic Investigation of COVID-19 Severity During the Tsunamic Second Wave in Mumbai

Maharashtra was severely affected during the noxious second wave of COVID-19, with the highest number of cases recorded across India. The emergence of new symptoms and dysregulation of multiple organs resulted in high disease severity during the second wave which led to increased difficulties in understanding the molecular mechanisms behind the disease pathology. Exploring the underlying factors can help to relieve the burden on the medical communities to some extent by prioritizing the patients and, at the same time, opening avenues for improved treatments. In the current study, we have performed a mass-spectrometry-based proteomic analysis to investigate the disease pathology using nasopharyngeal swab samples collected from the COVID-19 patients in the Mumbai region of Maharashtra over the period of March-June 2021, the peak of the second wave. A total of 59 patients, including 32 non-severe and 27 severe cases, were considered for this proteomic study. We identified 23 differentially regulated proteins in severe patients as a host response to infection. In addition to the previously identified innate mechanisms of neutrophil and platelet degranulation, this study revealed significant alterations of anti-microbial peptide pathways in severe conditions, illustrating its role in the severity of the infectious strain of COVID-19 during the second wave. Furthermore, myeloperoxidase, cathepsin G, and profilin-1 were identified as potential therapeutic targets of the FDA-approved drugs dabrafenib, ZINC4097343, and ritonavir. This study has enlightened the role of the anti-microbial peptide pathway associated with the second wave in India and proposed its importance in potential therapeutics for COVID-19.

Progressive Trends on the Biomedical Applications of Metal Organic Frameworks

Novel materials have been developed because of technological advancements combined with material research. Metal-organic frameworks (MOF) technology has been investigated for biomedical applications in this line. Nonetheless, as our team has learned from current literature, selecting metal ions/organic linkers, synthesis techniques, water stability/solubility, toxicity, and the possibility of biomolecules/drugs (enzyme, protein, DNA/RNA, and antibodies, among others) tagging/conjugation are the major challenges/factors. These issues/factors have an impact on MOFs’ performance in biomedical applications, and they also raise a lot of doubts about its real-time biological utility in the near future. We targeted a comprehensive review on the MOFs for biomedical applications to keep these considerations in mind. The evolution of MOF technology is based on their interesting features such as biological or pharmacological activity, biocompatibility, limited toxicity, and particular host–guest interactions, as well as environmental friendliness. In this paper, we have summarized the state-of-the-art progress pertaining to MOFs’ biomedical applications such as biosensing, biomedical, and drug delivery applications in this field that is still very new.

Relative capability demonstration of luminescent Al-MOFs for ideal detection of nitroaromatic explosives

Here, we have synthesised three luminescent Al MOFs i.e., Al-NTP, Al-FDA, and Al-TDA, using common metal ions (AlCl₃·6H₂O) with different carboxylic acid organic linkers (5-nitroisophthalic acid, 2,5-furan dicarboxylic acid, and 2,5-thiophenedicarboxylic acid) in a semi-aqueous medium. The structural analysis of Al-MOFs has been confirmed through powder X-ray diffraction (PXRD), Fourier transform infrared spectroscopy and absorption spectroscopy. Afterward, the optical properties of all three Al-MOFs were confirmed using photoluminescence spectroscopy and demonstrated for the detection of nitroaromatic explosives. We have observed host-guest interaction through a quenching mechanism. Among the three synthesised Al-MOFs, Al-NTP MOF exhibit 0.014 ppm lowest limit of detection in chloroform at room temperature. Our comparative study results reveal that the selection of the organic linker and solvent plays a critical role in MOF based sensing applications.

The Contralateral Ear in Unilateral Chronic Otitis Media - Does it Need Reckoning ?

Introduction     This comparative study aims to analyze findings and their significance in the contralateral ears of patients with unilateral Chronic Otitis Media (COM) and compare it with a control group of healthy subjects. Materials and Methods      One hundred patients of unilateral COM and 100 healthy individuals were included in this study from Jan 2015 to July 2016. The findings were noted in the contralateral ears of patients with unilateral COM and 100 control subjects. The changes found in the contralateral ears were assessed statistically for significance. Results In 100 cases of unilateral COM, 58 patients had some abnormality in the contralateral ear. Myringosclerosis patches being the most common finding were seen in 29 patients followed by TM retractions seen in 28 patients. Prevalence of abnormal findings was found to be significantly higher in the squamous group as compared to the mucosal group.  In 100 ears in the control group, only 11 % had positive findings. TM retractions were seen in 5 subjects (3 Attic and 2 Pars tensa retractions).  Conclusion             It can be statistically concluded that the disease of COM in one ear affects the contralateral ear slowly and silently. Hence both ears are affected as pairs and a slow pathological process continues behind an intact TM and kept hidden from the view unless it is actively sought for. Contralateral ears should also be actively followed up, in cases of unilateral COM in order to pick up disease harboring silently.

Chronic hepatitis C in northern India--the pathological and clinical spectrum

BACKGROUND

The aim of the study was to analyse the morphology, clinical presentation and predisposing factors for chronic hepatitis C infection.

METHODS

Clinical presentation of 220 patients who presented with hepatitis C virus infection over five years period (January 1996 to December 2000) were recorded. Liver biopsy specimens from 80 adult patients with chronic hepatitis C virus were evaluated using a semiquantitative scoring system. The possible predisposing risk factors for infection in these patients were recorded.

RESULTS

Grading of chronic hepatitis C was minimal/mild in 51 (64%) cases. Seven (8.7%) had high-grade necroinflammatory activity. Fibrosis was absent in 22(27.5%), mild in 29(36.25%), moderate in 11 (13.75%) and 18(22.5%) had evidence of cirrhosis. No significant correlation was found between the level of transaminases and degree of fibrosis or grade of inflammation. More number of patients with history of alcohol consumption had moderate/severe grade of necroinflammatory activity and cirrhosis as compared to those not taking alcohol at all. Potential predisposing factors were use of unsterile syringes, previous surgery and tattooing in multivariate analysis.

CONCLUSION

Nearly two-thirds of patients of chronic hepatitis C where liver biopsy was possible have minimal/mild disease at time of diagnosis; 22% have cirrhosis. Though disease severity can only be assessed by liver histology, liver biopsy may not be possible in a sizeable proportion of patients as they present with advanced liver disease. Most of the patients do not have specific symptoms. Reusable needles/syringes is the commonest potential risk factor.

Hepatitis C--knowledge & practices among the family physicians

BACKGROUND

Hepatitis C virus (HCV) is an important cause of end stage chronic liver disease worldwide. There is plethora of informations on hepatitis C virus in the recent hepatology related periodicals. However, family physicians to whom such patients initially present, should be aware of various aspects of hepatitis C virus infection. Therefore, the present study evaluated the information on hepatitis C virus known to practicing family physician in the state of Punjab.

MATERIAL & METHODS

Nine hundred thirty six family physicians were randomly selected from 7 districts of Punjab and were mailed a questionnaire designed to test their knowledge on HCV, its transmission, clinical presentation, complications and treatment. In addition, questions were asked to assess commonly employed mode of therapy for short duration illnesses and the practice of reusing syringes/needles. All question had unequivocal answer. The questionnaire reply was anonymous.

RESULTS

Only 28% (n = 262) doctors returned the questionnaire. The response to different sections of questionnaire was variable. Seventy six percent doctors (n = 176) were aware that HCV is parenterally transmitted. 18% (n = 41) doctors were still reusing needles and syringes. Fifty eight percent (n = 134) doctors considered hepatitis C as a common cause of acute viral hepatitis. Only 72% (n = 166) of doctors knew about the relevant tests for diagnosis of hepatitis C.

CONCLUSIONS

Despite having knowledge about parenteral route of transmission of HCV infection, a sizeable proportion of family physicians in the Punjab state continues to reuse needles and syringes. Information on the virology, clinical presentation, diagnostic tests and management approaches were lacking among a substantial proportion of family physician. Therefore, awareness about HCV need to be increased among the practicing physicians.

Chronic hepatitis C--treatment results in northern India

BACKGROUND

There have been major innovations in the treatment of chronic hepatitis C in the last decade. The course of the disease is variable and host, viral and environmental factors can influence the disease course and response to various treatment protocols. Data on the therapeutic response among north Indian patients with chronic hepatitis 'C' is limited. Therefore, we analysed our results of treatment among patients with chronic hepatitis C.

MATERIAL & METHODS

A total of 55 patients with chronic hepatitis C were treated. Forty nine patients completed treatment with either interferon alpha 2b alone (n = 12) or combination of interferon alpha 2b and ribavarin (n = 37). All the patients were seropositive for anti HCV and, HCV RNA. All of them had elevated ALT and histological features of chronic hepatitis. Response to treatment was evaluated as end treatment response (ETR) i.e. HCV RNA not detected at end of treatment and sustained response (SR) i.e. HCV RNA not detected six months after completing the treatment. Adverse effects were also recorded.

RESULTS

Overall, ETR was documented among in 69% of the patients and SR in 45% patients. Sustained response rate was higher with combination therapy as compared to interferon alone i.e. (51% vs 25%). Sustained response with induction dosing was 57%. Treatment had to be stopped in 3 patients due to major side effects like psychiatric disorders (2) and hypotension (1) and 3 patients were lost to follow up during the course of therapy.

CONCLUSION

Sustained virological response with combination therapy is better than with interferon alone. Induction dosing improves the sustained virological response further. Major side effects with the antiviral drugs necessitating drug withdrawal is infrequent.

Methylprednisolone acetate versus oral prednisolone in moderately active ulcerative colitis

BACKGROUND

Patients with active ulcerative colitis are treated with corticosteroids. We compared the efficacy and safety of intramuscular depot preparation of methylprednisolone acetate with oral prednisolone in the treatment of moderately active ulcerative colitis.

DESIGN

Open labeled, randomized, prospective, four-month study.

METHODS

40 patients with moderately active ulcerative colitis (activity index 150-220) were randomized into two groups. Group A (n=21) received methylprednisolone acetate (80 mg intramuscularly once weekly for 6 weeks). Group B (n=19) received oral prednisolone (40 mg/day) in a 'tailing-off' regimen. In addition, patients in both the groups received sulfasalazine. Patients were followed up at 1, 2, 3, 4, 8, 12 and 16 weeks. The primary measure of therapeutic response was activity index. An index of <150 was considered as clinical remission. Secondary efficacy was assessed by subjective evaluation of acceptability of treatment by the patient.

RESULTS

After one week of treatment, the decrease in mean activity index was significantly more with oral prednisolone (p<0.05), and five 5 patients (23.8%) in Group A and 12 (63.2%) in Group B were in clinical remission (p<0.05). However, after 2 weeks and beyond, the mean activity index and the number of patients with clinical remission were comparable in the two treatment groups.

CONCLUSIONS

Methylprednisolone acetate as a depot preparation and oral prednisolone are equally effective in inducing remission in patients with moderately active ulcerative colitis. Though symptomatic improvement is quicker with oral prednisolone, the remission rate with the two drugs was similar after 2 weeks of treatment.