This report describes an approach to recover SARS-CoV-2 RNA from rapid antigen test kit (RTK-antigen) cassettes for whole-genome sequencing (WGS). RNA samples were recovered from 33 RTK-antigen cassettes for WGS, with 18 samples achieving more than 80% genome coverage. This work provides a proof-of-concept that positive RTK-antigen cassettes can be safely transported, stored and subjected to WGS, enabling swift identification of circulating variants.

Introduction: Assessing radiation exposure is a vital step in determining the potential health risks associated with radiation and identifying the necessity for protective measures. The study assesses the occupational radiation dose encountered by undergraduate students specializing in diagnostic imaging and radiotherapy (DIR) during their clinical training in the radiology department. Materials and methods: An analysis was conducted to compare individual exposure doses with the dose limits established by the International Commission on Radiological Protection (ICRP), concurrently assessing the variations in mean effective doses among distinct student cohorts. Optically stimulated luminescence dosimeters (OSLD) were employed to monitor 143 students across five cohorts from 2017 to 2022. The electronic Secondary Standard Dosimetry Laboratory (e-SSDL) information security management system tracked the deep (Hp(10)) and shallow (Hp(0.07)) dose equivalents of DIR students. Results: The mean values for accumulated Hp(10) and Hp(0.07) were found to be 0.51 and 0.50 mSv, respectively, averaged over 800 hours of clinical training. The highest recorded exposure was 1.30 mSv, signifying that the radiation exposure experienced by DIR students was well below the threshold. The mean annual effective radiation dose per student amounted to 0.17 mSv. Small but significant difference (p < 0.001) in the radiation exposure between five cohorts was observed with increments over a 5-year period. Conclusion: The students' radiation dose was notably below the ICRP dose limit of 6 mSv/ year designated for trainees. These results indicate the efficacy of the existing radiation protection measures during clinical training, reducing the likelihood of overexposure

Malaria is a life-threatening, preventable, and curable vector borne disease caused by parasites that are transmitted to people through the bites of infected female Anopheles. The WHO Global Report 2010-2016 reported insecticide resistance in malaria. The main objective of this study is to determine the effectiveness of new generation Long-Lasting Insecticidal Nets (LLIN) compared to standard LLIN and untreated nets in terms of the mortality rate of adult female Anopheles gambiae. A comprehensive review of the literature was published in three databases (PubMed, Ovid, EBSCO Host) since 2010. Publications were searched with keywords including malaria, long-lasting treated bed net, long lasting insecticide-treated bed net, LLIN, and experimental hut. The search has identified 60 articles. Based on the PRISMA flowchart, 10 articles are qualified for data collection and analysis. The gathered data was analysed using Review Manager. Following meta-analysis between subgroups, a risk difference of 0.31 between standard LLINs versus untreated net (p<0.001, I²=100% 95% CI:0.01,0.60). A comparison of upgraded LLINs with the untreated net has shown a significant difference with a pooled risk difference of 0.54 favours upgraded LLINs (p<0.001, I²=100% 95% CI: 0.54,0.84). Comparison between upgraded LLINs versus standard gave an overall risk difference of 0.24 (p < 0.001, I² = 100%, 95% CI: 0.10–0.39). Upgraded LLINs significantly increase Anophelesmortality compared to standard LLINs and untreated nets, suggesting their potential for improved malaria control. Thus, using upgraded nets in the field and translating them into malaria preventive programs would help achieve the target and improve healthoutcomes for those living in endemic areas.

Dengue remains a public health threat that consumes a significant number of resources for its prevention and control. This systematic review aimed to solidify recent costing evidence in dengue management among South East Asian (SEA) countries. All studies conducted between 2010 and 2020 were retrieved using four international databases i.e. PubMed, Scopus, Web of Science, and Emerald Insight. The review was reported according to PRISMA guidelines. Quality assessments were done independently by two reviewers using a checklist adapted for the cost of illness studies. We identified 13 original articles representing several SEA countries. Among the common reported costing measure include total cost/ health expenditure; direct medical cost; direct non-medical cost; and indirect cost. The estimated total cost for dengue management varied between countries largely due to the difference in the total incidence of dengue cases. The estimated cost spent on dengue per capita GDP ranges from less than 0.001% to 0.1%, depending on the recorded number of dengue cases of the year. The majority of the articles focused on the economic burden from the perspective of treatment such as hospitalization and ambulatory care. In a nutshell, the economic burden of managing dengue infection is costly and the evidence suggests a steady increase in health expenditure with the growing number of dengue cases

Aims: The study was aimed to explore the antimicrobial potential of ethanolic leaf extracts of Eucalyptus globulus, Moringa oliefera, Syzygium cumini and Citrus limon against antibiotic-resistant Clostridium perfringens type D (n=5). Methodology and results: Antibiotic resistance pattern of C. perfringens type D isolates against tetracycline, gentamicin, ceftriaxone, amoxicillin and streptomycin was evaluated by disc diffusion method. Well diffusion and micro broth dilution methods were used to determine the anti-bacterial activity, sub-inhibitory concentrations and antibiotic resistance modulating effects of the plant extracts. Ethanolic extract of E. globules was selected to evaluate its modulatory impact and subjected to GC-MS analysis to separate and identify the phytochemicals. The results showed that the isolates were resistant to gentamicin (0 ± 0.00 mm), streptomycin (0 ± 0.00 mm), tetracycline (13.2 ± 2.28 mm) and ceftriaxone (0 ± 0.00 mm) while sensitive to amoxicillin (23.8 ± 1.30 mm) and tetracycline (13.2 ± 2.28 mm). Eucalyptus globulus exhibited the maximum anti-bacterial activity with a zone of inhibition (ZOI) of 14.6 ± 0.54 mm and minimum inhibitory concentration (MIC) (1500 ± 947.85 µg/mL). Other plant extracts (M. oliefera, S. cumini and C. limon) also showed anti-bacterial activity but couldn’t modulate the resistance. The activity of ceftriaxone associated with E. globulus extract was improved with 20.2 ± 0.20 mm ZOI at 78.125 µg/mL sub-inhibitory concentration. Conclusion, significance and impact of study: The study results indicate the possible use of the ethanolic extract of E. globulus alone or in combination with common antibiotics for the treatment of C. perfringens infections in small ruminants.

It is paramount to assess the risk of biases in may arise from diagnostic test accuracy (DTA) study as it will affect the accuracy and validity of the tests. These biases can be found in published researches and here we look at COVID-19 DTA studies. The evaluation of bias risk in diagnostic research is mainly performed using QUADAS-2. The aim of this review was to determine potential selection and information biases in diagnostic test accuracy studies and strategies to minimize risk of biases. Literature review related to diagnostic test accuracy study is identified through an online search of databases namely PubMed, ScienceDirect, Research Gate, Google Scholar, and official government websites range. Six potential biases in four QUADAS-2 domains are identified in COVID-19 diagnostic test accuracy study which are 1) spectrum bias in patient selection; 2) interpretation bias in index test; 3) differential misclassification bias and nondifferential misclassification bias in reference standard; and 4) partial verification bias and differential verification bias in patient flow. The identified biases exert effects on accuracy of COVID-19 diagnostic tests. Six strategies are recommended to reduce these biases, hence, improving the accuracy of COVID-19 diagnostic tests. The best diagnostic test can give benefits to the population in the mass screening program during COVID-19.

Severe hyponatraemia is defined as a sodium level of less than 120 mEq/L, and it is frequently accompanied by neurological symptoms like coma, convulsions, respiratory arrest, and death. Clinical cardiac toxicity from hyponatremia, such as bradyarrhythmia, is extremely rare. In this article, we present a case of acute severe hyponatraemia that induced unstable bradyarrhythmia and led to refractory bradycardia, which did not improve despite receiving treatment in accordance with the standard Advanced Cardiovascular Life Support protocol. The patient’s bradyarrhythmia has completely resolved with the administration of 3% hypertonic saline, which restored her sodium levels. Due to the possibility that severe hyponatremia may contribute to the aetiology of cardiac malfunction, this case raises awareness about the significance of closely monitoring electrocardiograms and telemetry in patients with severe hyponatremia.

Methods: Patients ASD having 2-year data were included and divided into 3CO and non-3CO (remaining ASD cohort) groups. For the subanalysis, patients were stratified based on whether they were undergoing primary (P3CO) or revision (R3CO) surgery. Multivariate analysis controlling for age, Charlson comorbidity index, body mass index, baseline pelvic incidence–lumbar lordosis, and fused levels evaluated the complication rates and radiographic and patient-reported outcomes between the 3CO and non-3CO groups. Results: Of the 436 patients included, 20% had 3COs. 3COs were performed in 16% of P3COs and 51% of R3COs. Both 3CO groups had greater severity in deformity and disability at baseline; however, only R3COs improved more than non-3COs. Despite greater segmental correction, 3COs had much lower rates of aligning in the lumbar distribution index (LDI), higher mechanical complications, and more reoperations when performed below L3. When comparing P3COs and R3COs, baseline lumbopelvic and global alignments, as well as disability, were different. The R3CO group had greater clinical improvements and global correction (both p<0.04), although the P3CO group achieved alignment in LDI more often (odds ratio, 3.9; 95% confidence interval, 1.3–6.2; p=0.006). The P3CO group had more neurological complications (30% vs. 13%, p=0.042), whereas the R3CO tended to have higher mechanical complication rates (25% vs. 15%, p=0.2). Conclusions 3COs showed greater improvements in realignment while failing to demonstrate the same clinical improvement as primaries without a 3CO. Overall, when suitably indicated, a 3CO offers superior utility for achieving optimal realignment across primary and revision surgeries for ASD correction.

Atrial fibrillation (AF) is a prevalent cardiac arrhythmia affecting millions of individuals worldwide and posing significant challenges to healthcare systems. The growing body of research has uncovered sex-related differences in AF pathophysiology, including the role of fatty acid-binding protein 4 (FABP4) and leptin as potential biomarkers. FABP4 and leptin, key adipokines involved in cardiovascular health, have been linked to inflammation, oxidative stress, and endothelial dysfunction, all of which may contribute to AF development. These adipokines exhibit sex-specific differences in their concentrations, with females generally showing higher FABP4 levels and males displaying distinct leptin profiles. Furthermore, hormonal influences, particularly estrogen, and testosterone, play significant roles in shaping AF risk and atrial remodeling. Estrogen is associated with cardioprotective effects, while testosterone may exert proarrhythmic effects. Understanding these sex-specific mechanisms could lead to more tailored and effective clinical management of AF. The future of AF research holds promise for precision medicine, novel therapeutic targets, artificial intelligence integration, and personalized care approaches. Emphasizing patient-centered care, telemedicine, and multidisciplinary collaboration can further enhance AF management and improve patient outcomes. In conclusion, recognizing and addressing sex-related factors in AF pathophysiology offer opportunities for gender-responsive interventions and advancements in AF management. Implementing these insights may pave the way for targeted therapies and improved quality of life for individuals affected by AF.

Objective: The study examined the efficacy of various generations of cephalosporins against biofilms developed by pathogenic S. aureus and E. coli. Methods: The development of biofilms by both bacteria was assessed using petri-plate and microplate methods. Biofilm hydrolysis and inhibition were tested using first to fourth generations of cephalosporins, and the effects were analyzed by crystal violet staining and phase contrast microscopy. Results: Both bacterial strains exhibited well-developed biofilms in petri-plate and microplate assays. Cefradine (first generation) showed 76.78% hydrolysis of S. aureus biofilm, while significant hydrolysis (59.86%) of E. coli biofilm was observed by cefipime (fourth generation). Similarly, cefuroxime, cefadroxil, cefepime, and cefradine caused 78.8%, 71.63%, 70.63%, and 70.51% inhibition of the S. aureus biofilms, respectively. In the case of E. coli, maximum biofilm inhibition (66.47%) was again shown by cefepime. All generations of cephalosporins were more effective against S. aureus than E. coli, which was confirmed by phase contrast microscopy. Conclusions and Relevance: Cephalosporins exhibit dual capabilities of hydrolyzing and inhibiting S. aureus and E. coli biofilms. First-generation cephalosporins exhibited the highest inhibitory activity against S. aureus, while the third and fourth generations significantly inhibited E. coli biofilms. This study highlights the importance of tailored antibiotic strategies based on the biofilm characteristics of specific bacterial strains.