Tuberculosis is a major health issues worldwide. Every year more than 9 million new cases are reported worldwide with death rate of around 2 million each year. Rapid and accurate diagnosis of tuberculosis in population is most supportive in proper medication and early recovery. The golden standard method for diagnosis of tuberculosis in patient is formerly culture method which is time consuming and cumbersome. Various other techniques used in the diagnosis of tuberculosis have poor sensitivity and specificity however serum adenosine deaminase (ADA) has emerged as a potent biochemical marker that can be used as tool for the diagnosis of tuberculosis for rapid, easy and better result. Increased level of ADA in blood generally indicates the presence of tuberculosis. In the present study, the serum ADA level was examined in 75 healthy control and 75 tuberculosis patients with positive sputum smear for acid fast bacilli (AFB), having clinical symptoms were diagnosed for pulmonary tuberculosis and radiological impression for extra pulmonary tuberculosis. The selection of cases and control were based on the inclusion and exclusion criteria. Samples were collected at the outpatient department of National Tuberculosis Centre, Nepal after asking simple questionnaires. Modified Guisti and Galanti method was adopted for estimation of serum ADA from pooled and processed blood samples. There was significant difference (p<0.001) in mean rank of level of serum ADA among the TB cases to controls. The P-TB had the highest mean rank (116.52) followed by EP-TB (99.48) and control had significantly less mean rank (40.16). At the cut-off point of 25 U/L; sensitivity, specificity, positive predictive value and negative predictive value were 90.7%, 100%, 90.66% and 100% respectively. It can be concluded from data that there were insignificant difference in mean rank among sex wise distribution with p=0.037 and sputum grading wise distribution with p=0.142.
Background The spread of SARS-CoV-2 has become a global public health crisis. Nepal is facing the second wave of COVID-19 pandemic but, there is still a limited data on the genomic sequence of SARS-CoV-2 variants circulating in Nepal. Objective The objective of this study is to sequence the whole genome of SARS-CoV-2 in Nepal to detect possible mutation profiles and phylogenetic lineages of circulating SARSCoV- 2 variants. Method In this study, swab samples tested positive for SARS-CoV-2 were investigated. After RNA extraction, the investigation was performed through real-time PCR followed by whole genome sequencing. The consensus genome sequences were, then, analyzed with appropriate bioinformatics tools. Result Sequence analysis of two SARS-CoV-2 genomes from patient without travel history (Patient A1 and A2) were found to be of lineage B.1.1. Similarly, among other four samples from subjects returning from the United Kingdom, genomes of two samples were of lineage B.1.36, and the other two were of lineage B.1.1.7 (Alpha Variant). The mutations in the consensus genomes contained the defining mutations of the respective lineages of SARS-CoV-2. Conclusion We confirmed two genomic sequences of variant of concern VOC-202012/01 in Nepal. Our study provides the concise genomic evidence for spread of different lineages of SARS-CoV-2 – B.1.1, B.1.36 and B.1.1.7 of SARS-CoV-2 in Nepal.
Background Acute Encephalitis Syndrome is characterised by acute onset of fever and altered sensorium followed by a rapidly worsening clinical condition and even death. The causative agents vary with season and geographic location, while the etiologies remain unknown in 68-75% of the cases. In Nepal, the cases of acute encephalitis syndrome are tested only for Japanese encephalitis, which constitutes about 15% of the cases globally. However, there could be several causative organisms, including vaccine-preventable etiologies that cause acute encephalitis, which upon identification could direct public health efforts for prevention, including expanded use of vaccines or address gaps in vaccine coverage. Objective This study employs metagenomic next generation sequencing in the exploration of infectious etiologies contributing to acute encephalitis syndrome in a low-and-middle-income setting. Methods In this study, we have investigated 90, Japanese encephalitis-negative, banked retrospective cerebrospinal fluid samples that were collected as part of a national surveillance network in 2016 and 2017. The randomisation was done to include three age groups of <5 years, 5-14 years, and >15 years. Only some metadata related to the subjects (age and gender) were known. The analysis was performed in two batches which included total nucleic acid extraction, followed by individual library preparation for DNA and RNA and sequencing on Illumina iSeq100. The generated genomic data were interpreted using CZID and confirmed with polymerase chain reaction. Results Human alphaherpesvirus 2 and Enterovirus B were seen in two of the ninety samples. These hits were confirmed by qPCR and seminested PCR respectively. Most of the other samples were marred by low sample quality, lack of clinical metadata, storage issues, and possible ambiguous collection procedures. Conclusion From this study, two documented, causative agents were revealed through metagenomic next generation sequencing. Insufficiency of clinical metadata, process controls, and absence of standard operating procedure to collect and store samples in nucleic acid protectants impeded the study and incorporated ambiguity while correlating the identified hits to infections. Therefore, there is dire need of implementing stringent collection procedures for sample collection, including proper process controls. Despite the challenging conditions, this study highlights the usefulness of mNGS to investigate diseases with unknown etiologies, such as AES, and guide the development of adequate clinical management algorithms and outbreak investigations in low-middle income settings. Keywords: acute encephalitis syndrome, enterovirus, Human alphaherpes virus, low-middle-income country, metagenomic next generation sequencing
Background The dolutegravir-based antiretroviral regimen is the preferred first-line regimen for the management of people living with human immunodeficiency virus in Nepal recently. It is considered safe to transition to a dolutegravir-based regimen for children and adults on Nevirapine and Efavirenz-based regimens. Objective To determine the virologic response following the transition to a Dolutegravir-based regimen in people living with human immunodeficiency virus previously taking Nevirapine and Efavirenz-based regimen. Method This is a retrospective cohort study including people living with human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) who were transitioned to Tenofovir/Lamivudine/Dolutegravir previously on other antiretroviral therapy regimens for at least 6 months and who had their viral load test done before transition. The medical records of patients were reviewed from records available at the antiretroviral therapy clinic of Dhulikhel Hospital. The viral load done at least 3 months after switching to the Dolutegravir-based regimen was recorded. Descriptive analysis of socio-demographic and clinical characteristics data was done. Result Fifty-seven people living with human immunodeficiency virus/ acquired immunodeficiency syndrome who transitioned to a Dolutegravir-based regimen previously on other antiretroviral therapy regimens for at least 6 months were included in this study. Tenofovir/Lamivudine/Efavirenz (47.4%), Zidovudine/ Lamivudine/Nevirapine (22.8%) and Zidovudine/Lamivudine/Efavirenz (17.5%) were the most common antiretroviral regimens before transition. The majority of the patients (86%) had suppressed viral load of fewer than 40 copies/mL before the switch. Following the transition, 96.5% of the patients had suppressed viral load of fewer than 40 copies/mL. Conclusion Dolutegravir-based antiretroviral regimen led to untransmittable viral load following a switch from Nevirapine and Efavirenz-based regimen.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.