Detection of Canine Parvovirus Type 2 by Designing Multiple Methods and Genetic Characterization in Iran

Canine parvovirus infection is the most highly infectious in dogs younger than six months. Our study aimed to design and optimize an In-house PCR Assay for Rapid Detection of parvovirus type 2 and compares it with REAL-TIME PCR and LAMP Assay and phylogenetic analysis. The virulence gene selected for the categories was vp₂ for CPV-2. PCR products were cloned in pTZ57R/T plasmid for preparation of positive control. Determination of the specificity of primers was done with the negative control virus genomes, and the limit of detection was determined for the Homemade PCR, REAL-TIME PCR, LAMP, and to perform a phylogenetic study using partial vp₂ gene sequences. Added analysis of PCR products using agarose gel electrophoresis for the vp₂ gene showed 485bp, and GAPDH 900 bp bands, respective amplification using negative control genomes as template was negative. The least detectable copy number for the vp₂ gene in a 25 µl PCR reaction equals 19 copies by homemade PCR, LAMP, and REAL-TIME PCR 25 and 21 copies, respectively. The phylogenetic analysis for the five field sequences formed three distinct clusters. The in-house PCR has advantages such as high specificity, sensitivity, and the ability to detect major CPV-2 pathogens. This assay may replace the previous laboratory methods and work as an essential supplement to the more time-consuming assays. Phylogenetic analysis is necessary for epidemiological studies to control and prevent disease.

Microplastics fouling and interaction with polymeric membranes: A review

The emergence and accumulation of microplastics (MPs) in various aquatic environments have recently raised significant concerns. Wastewater treatment plants (WWTPs) have been identified as one of the major sources of MPs discharge to the environment, implying a substantial need to improve advanced techniques for more efficient removal of MPs. Polymeric membranes have been proven effective in MPs removal. However, fouling is the main drawback of membrane processes and MPs can foul the membranes due to their small size and specific surface properties. Hence, it is important to investigate the impacts of MPs on membrane fouling to develop efficient membrane-based techniques for MPs removal. Although membrane technologies have a high potential for MPs removal, the interaction of MPs with membranes and their fouling effects have not been critically reviewed. The purpose of this paper is to provide a state-of-the-art review of MPs interaction with membranes and facilitate a better understanding of the relevant limitations and prospects of the membrane technologies. The first section of this paper is dedicated to a review of recent studies on MPs occurrence in WWTPs aiming to determine the most frequent MPs. This is followed by a summary of recent studies on MPs removal using membranes and discussions on the impact of MPs on membrane fouling and other probable issues (abrasion, concentration polarisation, biofouling, etc.). Finally, some recommendations for further research in this area are highlighted. This study serves as a valuable reference for future research on the development of anti-fouling membranes considering these new emerging contaminates.

Managing STEMI & other time sensitive cardiac emergencies by using smart phones-a study utilizing social media as tool to integrate local health network in remote areas of India-save Heart initiative

Introduction

Kashmir is a resource limited, region of India having its own distinctive regional challenges, operational limitations and poor accessibility of remote areas to health care. Utilizing smart phones as a medium for providing access to the optimum cardiac care in the remotest of the areas of our region served as a platform for SAVE HEART INITIATIVE (SHI) launched in the form of Social Media Whatsapp Group connecting peripheral hospitals (spokes) in the Kashmir region to experts (Hub).

Material and methods

SHI, a novel initiative was started voluntarily by a team of cardiologists and physicians. All the government hospitals along with their Emergency (ER) teams were roped in, integrated with expert physicians and cardiologists via whats app based technology creating a virtual cardiac ER facility and a CYBER HUB where teams of experts lended optimum support to all the peripheral hospitals of the region which acted as CYBER SPOKES of the initiative. Simultaneously all the peripheral hospitals upgraded to a functional Emergency room with all the emergency drugs available including the clot busters as streptokinase and vital anti arrhythmic drugs free of cost. Emergency room proformas, algorithms, protocols were created and standardized to aid in management. CME's regarding cardiac emergencies and response workshops were organized at regional institutes regularly for capacity building locally. The decision to use whatsapp as technology in medical care was taken due to its unique features of being readily available, handy technology, and as it could transfer all data in form of text, images, audios, visuals to and from the cyber spokes and cyber hubs respectively.

Results

Within 500 days of the initiative about 130 hospitals and 1200 doctors were taken on board. A total of 38000 ECGs were analyzed till date wherein the average response time in this social media group to any case was 1–2 minutes mostly and the diagnostic delays decreased to minimum. This initiative managed 950 STEMI's with thrombolysis, 2723 NSTEMI, 5320 arrhythmias, 345 heart blocks, 16 pulmonary thrombo-embolisms, 53 PCI decisions.

Conclusion

Our experiment demonstrated the feasibility of the approach adopted for better cardiac care that reached the poorest living in far flung area without any extra burden to the state exchequer. SHI reduced morbidity, mortality; CCU occupancy rate in tertiary care brought down undue referrals and established a vibrant patient tracking system in the region depicting its success. Using Smartphone based technology in time sensitive cardiac events seems to be the most vibrant, novel and viable option being available, portable, efficient, and cost-effective, with least technical glitches. It seems to be the way forward in providing optimum and timely treatment in all acute cardiac emergencies in resource deficient regions as Kashmir.

Funding Acknowledgement

Type of funding source: None

Cost-effectiveness analysis of selective first-line use of biologics for unresectable RAS wild-type left-sided metastatic colorectal cancer

Background

Evidence from a retrospective analysis of multiple large phase iii trials suggested that primary tumour location (ptl) in RAS wild-type metastatic colorectal cancer (wtRAS mcrc) might have predictive value with respect to response to drug therapies. Recent studies also show a potential preferential benefit for epidermal growth factor inhibitors (egfris) for left-sided tumours. In the present study, we aimed to determine the incremental cost-effectiveness ratio (icer) for the first-line use of an egfri for patients with left-sided wtRAS mcrc.

Methods

We developed a state-transition model to determine the cost effectiveness of alternative treatment strategies in patients with left-sided mcrc:■ Standard of care■ Use of an egfri in first-line therapyThe cohort for the study consisted of patients diagnosed with unresectable wtRAS mcrc with an indication for chemotherapy and previously documented ptl. Model parameters were obtained from the published literature and calibration. The perspective was that of a provincial ministry of health in Canada. We used a 5-year time horizon and an annual discount rate of 1.5%.

Results

Selecting patients for first-line egfri treatment based on left-sided location of their colorectal primary tumour was more effective than the standard of care, resulting in an increase in quality-adjusted life-years (qalys) of 0.226 (or 0.644 life-years gained). However, the strategy was also more expensive, costing an average of $60,639 more per patient treated. The resulting icer was $268,094 per qaly. A 35% price reduction in the cost of egfri would be needed to make this strategy cost-effective at a willingness-to-pay threshold (wtp) of $100,000 per qaly.

Conclusions

Selective use of an egfri based on ptl was more cost-effective than unselected use of those agents; however, based on traditional wtp thresholds, it was still not cost-effective. While awaiting the elucidation of more precise predictive biomarkers that might improve cost-effectiveness, the price of egfris could be reduced to meet the wtp threshold.

EGFR rs11506105 and IFNL3 SNPs but not rs8099917 are strongly associated with treatment responses in Iranian patients with chronic hepatitis C

Interferon lambda 3 (IFNL3) and epidermal growth factor receptor (EGFR) single nucleotide polymorphisms (SNPs) may play a key role in the spontaneous clearance of hepatitis C virus (HCV) and treatment responses. The aim of this study was to evaluate the effect of IFNL3 SNPs and EGFR rs11506105 on treatment outcomes in patients with chronic HCV (CHC). IFNL3 SNPs and EGFR rs11506105 were genotyped by PCR-restriction fragment length polymorphism and PCR-sequencing, respectively, in 235 naïve patients with CHC infection. The frequency of rapid virologic response (RVR), complete early virologic response (cEVR) and sustained virologic response (SVR) were 52.3%, 76.2% and 64.7% respectively. The results of this study showed that RVR was associated with ALT (P=0.015), AST (P=0.020), IFNL3 rs12979860 (CC) (P=0.043), rs12980275 (AA) (P=1 × 10-4), and EGFR rs11506105 (AA) (P=0.010), and IFNL3 rs12979860 (CC) (P=0.048), rs12980275 (AA) (P=0.022), and EGFR rs11506105 (AA) (P=0.006) were correlated with cEVR. HCV genotype (P=0.007), IFNL3 rs12979860 (CC) (P=0.023), IFNL3 rs12980275 (AA) (P=1 × 10-4), EGFR rs11506105 (AA) (P=0.005), RVR (P=1 × 10-4), and cEVR (P=0.003) were significant predictors for SVR. These results, for the first time, revealed that beside IFNL3 SNPs, EGFR rs11506105 is strongly associated with RVR, cEVR and SVR. EGFR rs11506105 besides IFNL3 SNPs could predict treatment responses in CHC patients.

Assessment of morphological and functional changes in neonate vitrified testis grafts after host treatment with melatonin

This study was conducted to assess the effect of melatonin on the structure of testis and spermatogenesis dynamics in neonate vitrified testis grafts. Neonate vitrified testes, candidates for transplantation heterotopically to experiment or control groups, were warmed in thawing media which had or did not have a supplement of 100 μM melatonin, respectively. Following transplantation, melatonin (20 mg/ /kg/day) or saline solution was intraperitoneally injected into the treated and the non-treated groups, respectively. The initiating spermatogenesis, spermatogonia survival, and structure of tissue in the testis graft were examined. Cell apoptosis (TUNEL assay) and proliferation (Brdu assay) in germ cells were determined. Histological studies revealed the dynamic of the spermatogenesis process in the vitrified testis graft. However, dilation of the lumen accompanied by a disorganised epithelium in the non-treated group was higher than in the treated group. Furthermore, the proportion of apoptotic germ cells together with a reduced proportion of proliferated germ cells was higher in the non-treated group than in the treated group. Overall, the number of seminiferous tubules in the testes grafts of both groups remained steady. However, the non-treated testes grafts contained more damaged seminiferous tubules than the treated ones. The thickness of the seminiferous tubules was greater in the melatonin treated group than in the non-treated group. In fact, the thickness of germinal epithelium was significantly higher in the treated group than in the non-treated group. The study may show a positive effect from melatonin resulting in more grafts restoring puberty. Furthermore, the associated increase in the healthy number of seminiferous tubules suggests that melatonin may have a preventative ischaemia/antioxidant role and in fact may be useful to initiate the spermatogenesis process.

Women pose innocent victims of landmines in postwar iran

BACKGROUND

Although in the last few years there has been an increasing attention to the problem of landmines, to date, the implications of women being victims of landmine has not been duly dealt with in the world including Iran, which is estimated to be the second most landmine infested country in the world. Still, provinces by the west border of Iran, 18 years after cessation of Iraq-Iran war suffer from the burden of vast areas, highly infested with landmines. This study aimed to provide a gender focused insight into landmine accidents in Iran

METHODS

In this retrospective study, women with documented deaths or injuries due to landmine and/or unexploded ordnances (UXO) explosions as documented in their medical records between Jul 1988 (after ceasefire) and Feb 2003 were studied in 5 western provinces of Iran. Data was analyzed by SPSS for Windows Version 11. P value under 0.05 was considered statistically significant

RESULTS

During the 14-year study period, 252 women from 5 western provinces of Iran were reported to have injuries or death due to landmine and UXOs. All of the victims were civilians and the majority of them (47.6%) had one or more amputations. Most of them were injured in the period between1994 and 1998. The majority of the patients were young.

CONCLUSION

Women who should take care of themselves as well as their families are more prone to sufferings inflicted by landmines and UXO.

Pattern of motorcycle-related injuries in Tehran, 1999 to 2000: a study in 6 hospitals

We studied motorcycle-related injuries in Tehran from 23 August 1999 to 21 September 2000 in 6 hospitals. Data were obtained from the trauma registry and questionnaires completed by trained physicians. Of a total of 8500 patients with trauma injuries, 1332 were motorcyclists, with a male to female ratio of 15:1. Of these, 1226 patients were driving the motorcycle at the time of the accident and 75 were pillion passengers. Crashes involving another vehicle were the commonest kind of accident (72.5%). Helmet use was noted in only 8.6% of cases. There were 28 fatalities and head injuries were the prominent cause of death. Of those who died, none had been wearing a helmet at time of the crash. Only 2.7% of helmeted riders sustained a head injury, compared with 11.2% of riders without a helmet. The commonest musculoskeletal injury was fracture: tibial fracture with 509 cases (49.8%) comprised the largest proportion.

Injuries caused by falls from trees in Tehran, Islamic Republic of Iran

Although falls from trees are rare, the consequences can be severe. Over 13 months in 6 hospitals in Tehran 49 (0.57%) of 8500 registered trauma patients had fallen from trees. The mean age was 31 years (range 6 to 74 years) and 21 (42.9%) were aged < 20 years. Home and recreational/sports grounds were the most common sites of trauma. Most falls occurred during leisure time; only 3 (6.1%) were occupation-related. Eleven patients (22.4%) sustained a fracture of the spinal column; 2 of them became permanently paraplegic and 2 others who had severe thoracic vertebral fractures and paraplegia on first observation were transferred to other hospitals for treatment. Due to the severity of this type of injury, especially among the young, effective preventive efforts may be necessary.

Urban injuries in Tehran: demography of trauma patients and evaluation of trauma care

Trauma now attracts more attention than ever before as a major cause of death and disability in developed and developing countries. To describe the characteristics and outcome of injuries in our environment, and to identify and discuss possible preventative and management protocols that may also be adopted in developing countries, we designed a prospective study on all trauma patients consecutively attending three emergency departments over a period of 1 year in Tehran, Iran. Among the total of 58013 patients studied, workers were the most vulnerable occupational group and deserve special preventative measures. The high frequency of traffic (especially pedestrian) accidents suggests that considerable progress is required in preventing these injuries. Our hospitalized patients were comparable with patients in the Major Trauma Outcome Study (m=0.890), and the z (-15.485) and w (-2.447) statistics showed an unsatisfactory quality of care, which may partly be due to less usage of ambulances, the long time of transportation to hospital, frequent referrals between centres, and delayed and inadequate resuscitation by the emergency services. Based on our findings and the fact that the positive effect of trauma systems on outcome has been well documented, we suggest that an integrated trauma system be established in Tehran to improve the quality of trauma care.