Neurological features of COVID-19 have been reported in addition to the respiratory manifestations, but cognitive dysfunction has been scarcely described. And cognitive assessment has not been studied in asymptomatic subjects. We compared the cognitive assessment scores between asymptomatic SARS-CoV-2 infected subjects with that of controls to detect mild cognitive impairment by the Montreal Cognitive Assessment test. Asymptomatic COVID-19 subjects secured lower scores in certain domains of the MoCA in comparison with the controls. The domains were visuoperception (2.4 ± 0.7 vs2.8 ± 0.7,
p
= 0.032), naming (3.6 ± 0.5 vs3.9 ± 0.2,
p
= 0.016) and fluency (0.9 ± 0.6 vs1.6 ± 0.7,
p
= < 0.001). Also, older aged COVID-19 positive subjects scored lower in the MoCA when compared to the younger people. Our study shows that even otherwise asymptomatic COVID-19 subjects have cognitive deficits in certain subdomains and suggests the need for a detailed psychometric assessment especially in the elderly population.
Supplementary Information
The online version of this article (10.1007/s13337-021-00663-w).
BackgroundThe Brugia malayi Bm-103 and Bm-RAL-2 proteins are orthologous to Onchocerca volvulus Ov-103 and Ov-RAL-2, and which were selected as the best candidates for the development of an O. volvulus vaccine. The B. malayi gerbil model was used to confirm the efficacy of these Ov vaccine candidates on adult worms and to determine whether their combination is more efficacious.Methodology and Principle FindingsVaccine efficacy of recombinant Bm-103 and Bm-RAL-2 administered individually, concurrently or as a fusion protein were tested in gerbils using alum as adjuvant. Vaccination with Bm-103 resulted in worm reductions of 39%, 34% and 22% on 42, 120 and 150 days post infection (dpi), respectively, and vaccination with Bm-RAL-2 resulted in worm reductions of 42%, 22% and 46% on 42, 120 and 150 dpi, respectively. Vaccination with a fusion protein comprised of Bm-103 and Bm-RAL-2 resulted in improved efficacy with significant reduction of worm burden of 51% and 49% at 90 dpi, as did the concurrent vaccination with Bm-103 and Bm-RAL-2, with worm reduction of 61% and 56% at 90 dpi. Vaccination with Bm-103 and Bm-RAL-2 as a fusion protein or concurrently not only induced a significant worm reduction of 61% and 42%, respectively, at 150 dpi, but also significantly reduced the fecundity of female worms as determined by embryograms. Elevated levels of antigen-specific IgG were observed in all vaccinated gerbils. Serum from gerbils vaccinated with Bm-103 and Bm-RAL-2 individually, concurrently or as a fusion protein killed third stage larvae in vitro when combined with peritoneal exudate cells.ConclusionAlthough vaccination with Bm-103 and Bm-RAL-2 individually conferred protection against B. malayi infection in gerbils, a more consistent and enhanced protection was induced by vaccination with Bm-103 and Bm-RAL-2 fusion protein and when they were used concurrently. Further characterization and optimization of these filarial vaccines are warranted.
BACKGROUND: Measurement of oxygen saturation with a handheld pulse oximeter is widely practiced as a surrogate to invasive arterial blood gas analysis. Oxygen saturation is an important parameter in cases of COPD, but there are insufficient data on the role of pulse oximetry in patients with COPD, moreso in diseases across its spectrum, such as chronic bronchitis and emphysema. We assessed the performance of pulse oximetry in acute respiratory failure of patients with COPD. METHODS: This was a cross-sectional, observational study. We studied 50 subjects with COPD admitted to the Government General Hospital, a 1,000-bed tertiary referral center in Guntur, India, from June 2013 to July 2013. Simultaneous reading of S pO 2 by a handheld pulse oximeter and S aO 2 by an automated arterial blood gas analyzer were taken. RESULTS: Pulse oximetry was sufficiently sensitive (84.60%) to hypoxemia in respiratory failure to be used in clinical situations. The mean difference (bias) between S aO 2 and S pO 2 was ؊3.98 (95% CI ؊4.68 to 3.28). There was less sensitivity (82% vs 85%) and positive predictive value (69% vs 85%) of the pulse oximeter to respiratory failure in subjects with chronic bronchitis versus emphysema. CONCLUSIONS: Pulse oximetry performed poorly in comparison with the invasive arterial blood gas analysis. The variability of the readings was greater in the subjects with chronic bronchitis than in those with emphysema.
Parasitic nematodes produce an unusual class of fatty acid and retinol (FAR)-binding proteins that may scavenge host fatty acids and retinoids. Two FARs from Brugia malayi (Bm-FAR-1 and Bm-FAR-2) were expressed as recombinant proteins, and their ligand binding, structural characteristics, and immunogenicities examined. Circular dichroism showed that rBm-FAR-1 and rBm-FAR-2 are similarly rich in α-helix structure. Unexpectedly, however, their lipid binding activities were found to be readily differentiated. Both FARs bound retinol and cis-parinaric acid similarly, but, while rBm-FAR-1 induced a dramatic increase in fluorescence emission and blue shift in peak emission by the fluorophore-tagged fatty acid (dansyl-undecanoic acid), rBm-FAR-2 did not. Recombinant forms of the related proteins from Onchocerca volvulus, rOv-FAR-1 and rOv-FAR-2, were found to be similarly distinguishable. This is the first FAR-2 protein from parasitic nematodes that is being characterized. The relative protein abundance of Bm-FAR-1 was higher than Bm-FAR-2 in the lysates of different developmental stages of B. malayi. Both FAR proteins were targets of strong IgG1, IgG3 and IgE antibody in infected individuals and individuals who were classified as endemic normal or putatively immune. In a B. malayi infection model in gerbils, immunization with rBm-FAR-1 and rBm-FAR-2 formulated in a water-in-oil-emulsion (®Montanide-720) or alum elicited high titers of antigen-specific IgG, but only gerbils immunized with rBm-FAR-1 formulated with the former produced a statistically significant reduction in adult worms (68%) following challenge with B. malayi infective larvae. These results suggest that FAR proteins may play important roles in the survival of filarial nematodes in the host, and represent potential candidates for vaccine development against lymphatic filariasis and related filarial infections.
Vaccination of Mongolian gerbils with Brugia malayi cysteine protease inhibitor-2 in which the amino acid Asn66 was mutated to Lys66 (Bm-CPI-2M) resulted in reduced parasite numbers of 48.6% and 48.0 % at 42 and 90 days p.i. with B. malayi L3s. Fertility of female worms was also affected at 90 days p.i. In vitro killing of L3s observed in the presence of gerbil peritoneal exudate cells and anti-Bm-CPI-2M sera suggests antibody-dependent cell-mediated cytotoxicity as a putative protective mechanism. These observations suggest that Bm-CPI-2M is a promising prophylactic and anti-fecundity vaccine candidate.
BackgroundCysteine protease inhibitors of Brugia malayi have been ascribed to be involved in parasite development as well as to immunomodulate the host’s immune response. In Onchocerca volvulus, Onchocystatin has been shown to induce partial protection in the mouse diffusion chamber vaccination model. In the present study we investigated the impact of vaccination with recombinant Bm-CPI-1 and Bm-CPI-2 proteins on protection against a subcutaneous challenge of B. malayi third stage larvae in gerbils.FindingsVaccination with E. coli derived recombinant B. malayi cysteine protease inhibitors (Bm-CPI-1 or -2) did not confer protection against B. malayi L3 challenge infection in gerbils but altered the homing of a significant number of adult worms from the lymphatics to the heart and lungs.ConclusionBm-CPI vaccination-induced alteration in worm migration is consistent with our previous observations in gerbils vaccinated with B. pahangi excretory-secretory (ES) proteins, which resulted in delayed migration of the L3s and altered the final location of adult worms. Similar observations have also been made in dogs vaccinated with Ancylostoma caninum proteins; an increased number of worms were recovered in the colon and not the expected small intestine. A change in the final niche was also reported in immune versus non-immune hosts of two other gut dwelling nematodes. Vaccination induced alteration of the parasite’s final homing might be a rare or a common phenomenon, which unfortunately is rarely recorded. The reason for the alteration in the final niche selection by adult nematode worms following vaccination is unknown and necessitates further investigation.
Context:
Coronavirus disease 2019 (CoViD 19) pandemic has induced the government to initiate strict control measures. Improvements to these measures and shortcomings could be gleaned with the understanding of the knowledge, attitude and practices (KAP) of the public.
Aims:
The aim of this study the CoViD 19 KAP of a south Indian state population.
Settings and Design:
This was a Cross-sectional observational study.
Subjects and Methods:
We conducted an online survey to elicit this information.
Statistical Analysis Used:
Mean, Standard deviation, Binomial and Multinomial logistic regression.
Results:
Of the 1837 subjects who answered the survey, 70% were youth (16–29 years), 54% were postgraduates and 47.8% were desk jobholders. The mean knowledge score was 9.92 ± 2.37/14 and 94.44% secured at least above-average score. The subjects had a positive (70%) attitude towards the CoViD 19 situation and 77% of subjects followed good preventive practices. However, we found that women, people with low education and nonmedical background were associated with poor knowledge and practices. The attitude was poor in subjects occupant in physical works.
Conclusions:
The health policy would better serve the purpose of the groups with poor scores are targeted.
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