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Lupus glomerulonephritis (LN) is a complex autoimmune disease characterized by circulating autoantibodies, immune-complex deposition, immune dysregulation and defects in regulatory T cell (Tregs). Treatment options rely on general immunosuppressants and steroids that have serious side effects. Approaches to target immune cells, such as B cells in particular, has had limited success and new approaches are being investigated. Defects in Tregs in the setting of autoimmunity is well known and Treg-replacement strategies are currently being explored. The aim of this minireview is to rekindle interest on Treg-targeting strategies. We discuss the existing evidences for Treg-enhancement strategies using key cytokines interleukin (IL)-2, IL-33 and IL-6 that have shown to provide remission in LN. We also discuss strategies for indirect Treg-modulation for protection from LN.

Volatile organic compounds (VOCs) are hazardous for both environment and human health. With increase in the usage of VOCs containing products, the extent of hazard is inceasing at an alarming rate. Therefore, the monitoring and sensing of VOCs become a need of the hour. Keeping in view, in the present work, We had studied the effect of rGO doping on the sensing performance of WO3–SnO2 ​mixed metal oxide for Propan-2-ol. The optical characterization of as-prepared samples were done using UV/Vis and FTIR spectroscopy. The structural and morphological analysis was studied using XRD and FESEM technique, respectively. The electrical studies were checked by I–V measurements. The sensing parameters such as sensitivity, response, recovery time, effect of temperature and concentrations, as well as stability were also studied. .

Rapid identification and tracking of emerging SARS-CoV-2 variants are critical for understanding the transmission dynamics and developing strategies for interrupting the transmission chain. Next-Generation Sequencing (NGS) is an exceptional tool for whole-genome analysis and deciphering new mutations. The technique has been instrumental in identifying the variants of concern (VOC) and tracking this pandemic. However, NGS is complex and expensive for large-scale adoption, and epidemiological monitoring with NGS alone could be unattainable in limited-resource settings. In this study, we explored the application of RT-qPCR-based detection of the variant identified by NGS. We analyzed a total of 78 deidentified samples that screened positive for SARS-CoV-2 from two timeframes, August 2020 and July 2021. All 78 samples were classified into WHO lineages by whole-genome sequencing and then compared with two commercially available RT-qPCR assays for spike protein mutation(s). The data showed good concordance between RT-qPCR and NGS analysis for specific SARS-CoV-2 lineages and characteristic mutations. RT-qPCR assays are quick and cost-effective and thus can be implemented in synergy with NGS for screening NGS-identified mutations of SARS-CoV-2 for clinical and epidemiological interest. Strategic use of NGS and RT-qPCR can offer several COVID-19 epidemiological advantages.

Leprosy is a zoonosis in the southern United States involving humans and wild armadillos. The majority of patients presenting with zoonotic strains of Mycobacterium leprae note extensive outdoor activity but only rarely report any history of direct contact with wild armadillos. Whether M. leprae is transmitted to new vertebrate hosts through the environment independently or with the aid of other organisms, e.g., arthropod vectors, is a fundamental question in leprosy transmission. The objectives of this study were to assess the potential for ticks to transmit M. leprae and to test if viable M. leprae can be maintained in tick-derived cells. To evaluate tick transmission, nymphal Amblyomma maculatum ticks were injected with isolated M. leprae. Infection and transmission were assessed by qPCR. Ticks infected as nymphs harbored M. leprae through vertical transmission events (nymph to adult and adult to progeny); and, horizontal transmission of M. leprae to a vertebrate host was observed. Mycobacterium leprae DNA was detected in multiple tick life cycle stages. Likewise, freshly isolated M. leprae (Thai-53) was used to infect a tick-derived cell line, and enumeration and bacterial viability were assessed at individual time points for up to 49 days. Evaluations of the viability of long-term cultured M. leprae (Thai-53 and Br4923) were also assessed in a mouse model. Tick-derived cells were able to maintain viable M. leprae over the 49-day course of infection and M. leprae remained infectious within tick cells for at least 300 days. The results of this study suggest that ticks themselves might serve as a vector for the transmission of M. leprae and that tick cells are suitable for maintenance of viable M. leprae for an extended period of time.

Thoracic aortic aneurysm (TAA) is a dilation of the aorta of >150% of its normal diameter for a given segment. Weakening of aortic walls results in saccular, fusiform, or diffuse dilation. The incidence of TAA is about 10 for every 100,000 adults, with 20% being of familial origin. TAA carries a high risk of morbidity and mortality, with surgery and thoracic endovascular aortic repair being the definitive treatment. In this case report, we present an innovative approach for addressing concomitant coronary artery disease and TAA repair using double-arterial cannulation and differential hypothermic circulatory arrest without any postoperative neurological sequelae.

Background: Scrub typhus is endemic in the various parts of the world and especially in the Indian subcontinent. Splenic infarcts and abscess are largely unknown in scrub typhus. These can be a source of persistent abdominal pain in the left hypochondriac region. Clinical Description: A 9-year-old child presented with a 7-day history of fever, loose stools, respiratory distress, and abdominal pain. On examination, she was febrile, had tachypnea, tachycardia, pallor, and facial puffiness. Systemic examination showed pleural effusion and hepatomegaly. Acute febrile illness with third spacing led to differentials of tropical infections (dengue, scrub typhus, enteric fever, and malaria). Management: Dengue, enteric fever, and malaria were ruled out on investigations. Scrub IgM enzyme-linked immunosorbent assay was positive. Ultrasound of the abdomen showed multiple splenic anechoic lesions suggestive of abscesses. Contrast-enhanced computed tomography (CT) confirmed the findings. Ultrasonography-guided aspiration of the lesion revealed blood-stained pus. The gram stain was negative, and culture was sterile. The final diagnosis was scrub typhus with splenic abscess. Her symptoms resolved with doxycycline therapy. Conclusion: Involvement of the spleen resulting in infarct and abscess is a rare complication in scrub typhus and can lead to persisting abdominal symptoms. Splenic infarction is not a well-known complication in patients of scrub typhus; hence, it may lead to under diagnosis of the condition. An abdominal ultrasound or if required, CT scan of the abdomen might be needed in cases with persistent abdominal symptoms to rule out this rare complication.

Background: Prevalence of cancer in urban India is seeing a discernible increase due to lifestyle modifications and adverse environmental exposures. The pattern of cancer incidence varies from one region to another within a large country like India. Aim and Objectives: This study was conducted to understand the socioclinical profile of the patients attending a tertiary care hospital in east Delhi for the treatment of cancer. Methods: Patients above the age of 18 years, who had been diagnosed with cancer, were recruited for our study and their socioclinical details were elicited. After 3 months they were reassessed and their treatment and side-effect profile were studied. Results: Majority of our patients were diagnosed with cancers of the oral cavity and were married men in age group of 40–60 years, residing in the National Capital Region. Patients diagnosed with breast cancer were more likely to receive chemotherapy and suffer from side effects of treatment like nausea, anorexia, and loss of weight. Conclusion: Physicians need to be aware of these complications and should incorporate a proper counselling mechanism before treatment is started in such patients. Family physicians play a defining role in the palliative management since he remains a trusted face in his community and can provide professional and psychotherapeutic support.

Abstract New applications for virtual healthcare have resulted in an expansion of medical care beyond traditional healthcare settings. However, the rapid development of telemedicine as a field has resulted in poor standardization of the care provided through this new medium. The authors outline core competencies to be used in developing training programs for practicing physicians, medical students, and other clinicians using telemedicine as a medium for providing patient care. These competencies aim to provide a framework for defining a standard of care in telemedicine and the ultimate development of a certification in the field.

Come this year I will be celebrating a milestone birthday, 25 years old. There are many significant milestones associated with that age; however, there is one milestone that I have been taking for granted… It is the age in which my parents’ employers drug plan will stop covering my medications. The realization that “free” medications were soon going to be a luxury of the past gave me a moment of pause, I asked myself, how does a country who prides itself on national healthcare still have people budgeting to buy life sustaining medications? The reality of that answer being the healthcare system we are so proud of is seemingly flawed.

Several species of Spilanthes, commonly known as the ‘toothache’ plants, are widely used by different communities as food ingredient in their traditional cuisines. Different parts of these plants are also used as medicine to treat diseases such as oral ulcers, stomatitis and toothache. The N-alkylamides (NAAs) present in Spilanthes species have been attributed to the biological properties such as anti-inflammatory, antimicrobial, aphrodisiac, antioxidant, insecticidal, larvicidal and astringent effects exhibited by this crop. Presence of NAA further allows usage of these plants as functional foods and cosmetics. Though interest in NAAs is enormous there is lack of studies with respect to the source material, mode of their action and user safety of NAA containing products. Therefore, a systematic survey of literature was done to present food and medicinal uses of Spilanthes plants, information on their NAAs, their distribution, biosynthesis, pharmacology, commercial potential and research lacunae. The review also attempts to caution the misnomer on the source material used for preparation of drugs from Spilanthes with a brief discussion on the plant's nomenclature and taxonomy.

OBJECTIVES:. Preclinical studies provide an opportunity to evaluate the relationship between sex and sepsis, and investigate underlying mechanisms in a controlled experimental environment. The objective of our systematic review was to assess the impact of biological sex on treatment response to fluid and antibiotic therapy in animal models of sepsis. Furthermore, we provide a narrative elaboration of sex-dependent differences in preclinical models of sepsis. DATA SOURCES:. MEDLINE and Embase were searched from inception to March 16, 2020. STUDY SELECTION:. All studies reporting sex-stratified data comparing antibiotics and/or fluid resuscitation with a placebo or no treatment arm in an in vivo model of sepsis were included. DATA EXTRACTION:. Outcomes of interest were mortality (primary) and organ dysfunction (secondary). Risk of bias was assessed. Study selection and data extraction were conducted independently and in duplicate. DATA SYNTHESIS:. The systematic search returned 2,649 unique studies, and two met inclusion criteria. Both studies used cecal ligation and puncture models with imipenem/cilastatin antibiotics. No eligible studies investigated fluids. In one study, antibiotic therapy significantly reduced mortality in male, but not female, animals. The other study reported no sex differences in organ dysfunction. Both studies were deemed to be at a high overall risk of bias. CONCLUSIONS:. There is a remarkable and concerning paucity of data investigating sex-dependent differences in fluid and antibiotic therapy for the treatment of sepsis in animal models. This may reflect poor awareness of the importance of investigating sex-dependent differences. Our discussion therefore expands on general concepts of sex and gender in biomedical research and sex-dependent differences in key areas of sepsis research such as the cardiovascular system, immunometabolism, the microbiome, and epigenetics. Finally, we discuss current clinical knowledge, the potential for reverse translation, and directions for future studies. REGISTRATION:. PROSPERO CRD42020192738.