Different Types Of Infections Research Articles

Effects of Obesity on Infections with Emphasis on Skin Infections and Wound Healing.

Obesity represents a serious health problem as it is rapidly increasing worldwide. Obesity is associated with reduced health span and life span, decreased responses to infections and vaccination and increased frequency of inflammatory conditions. In this review, we summarize published data showing that obesity increases the risk of different types of infections, with a special focus on skin infections. Obesity also induces skin changes and conditions (inflammation-based and hypertrophic) which are often associated with fungi or bacteria overgrowth. The association of obesity with the skin microbiome has been established in both mice and humans. Balance of commensal microbes controls skin homeostasis and the host immune response, while changes in normal physiologic skin microbiome composition and pathologic bacteria contribute to skin diseases. We also summarize the major steps in wound healing and how obesity affects each of them. The role that immune cells have in this process is also described. Although the studies summarized in this review clearly demonstrate the deleterious effects of obesity on wound healing, additional studies are needed to better characterize the cellular and molecular mechanisms involved and identify specific targets of intervention.

Antibiotic sensitivity of common bacterial pathogens against levofloxacin

Levofloxacin is a member of the fluoroquinolone class of antibacterial agents with a safe and effective treatment. The aim of this study is to evaluate the susceptibility and resistance pattern of clinical isolates causing different types of infections to Levofloxacin. In vitro antibacterial activity and resistance patterns of levofloxacin antibiotic were studied using disk diffusion method. A total 485 strains isolated from various clinical specimens from September 2020 to November 2020 in Al Saleem Medical Laboratory. This is for isolation and identification of pathogenic gram negative and gram positive bacteria. The samples were involving urine, semen, swabs, High vaginal swab, Blood, Stool, CSF, Body Fluid and Sputum. The isolates were identified by biochemical tests as well as the sensitivity and resistant were tested by levofloxacin antibiotic. In present study, gram negative bacteria were prevalent, 75.6% than gram positive bacteria 47.7%. In the four hundred eighty five clinical isolates comprising of Escherichia coli, Klebseilla spp, Staph Aureus, Enterobacter spp, Streptococcus pneumonia, Pseudmonas spp, Streptococcus pyogen, Citrobacter spp, proteus spp and Staph epidermidis were collected from different clinical specimens. The predominantly isolated bacteria were Escherichia coli, followed by Klebseilla spp, staph Aureus and Enterobacter spp. The levofloxacin antibiotic has sensitive against most of the isolates, E Coli (31%), Klebseilla spp (14%), Staph Aureus (8.7), Enterobacter spp (6%), strep pneumonia (5%), Pseudomonas spp (3%), Strep pyogen (1%) and Citrobacter spp (0.6%). Levofloxacin exhibited statistically significantly high bactericidal activity against all strains of gram positive and gram negative bacteria. Levofloxacin was shown to be active against both Gram-positive and Gram-negative bacteria.

Clinical features and management of 20 patients with hepatic portal venous gas.

The present study investigated the characteristics, diagnosis, treatment and prognosis of hepatic portal venous gas (HPVG) using the data of 20 patients from the Tongji University School of Medicine Affiliated with Yangpu Hospital (Shanghai, China). The aim of the present study was to optimize the management method and improve the prognosis of patients with HPVG. A total of 20 patients were selected using a CT scan to confirm HPVG. All patients were enrolled and identified via a search engine, which examined all CT radiology reports containing the words pneumatosis and/or portal venous gas/air. Data were collected and analyzed, including sex, age, laboratory evidence, etiologies at admission, therapeutic method and in-hospital mortality. The patients consisted of 14 women (mean age, 79.1 years) and six men (mean age, 67.8 years). The results demonstrated that HPVG indicated a higher inflammatory index. The etiologies of HPVG included abdominal infection, pulmonary infection and hemorrhage, whereas the comorbidities included hypertension, diabetes, coronary disease, cerebrovascular disease and renal insufficiency. The present study determined that intestinal obstruction, acute enteritis and pulmonary infection were the main causes of HPVG. Of the 20 patients enrolled in the present study, four patients received surgery and 16 patients received conservative treatment. The overall in-hospital mortality was 25%. The present study indicated that the causes of HPVG may be closely related to inflammation and blood vessel injury. It was also determined that hemodynamic disorders of the intestinal tract and the combination of different types of infection were important contributors towards patient mortality.

Antibiotic Sensitivity Pattern of Clinically Isolated Klebsiella Species in C. U. Shah Hospital, Surendranagar

Klebsiella, a gram-negative, rod-shaped bacteria that can cause different types of infections like enteritis, meningitis, urinary tract infections, bacteraemia, septicaemia etc. In humans Klebsiella pneumoniae is among the foremost common bacteria combatted by medical practitioners worldwide which are often resistant to several antibiotics and doesn’t get cured easily. To study the antibiotic resistance among patients, total 856 clinical isolates were collected from different clinical specimens of patients admitted in different wards of C. U. Shah Hospital, Surendranagar, Gujarat, India for a period of 3 years (2016 to 2018). The specimens were processed at Department of Microbiology, C. U. Shah Hospital, Surendranagar, with an objective to study the antibiotic resistance pattern of the Klebsiella Species. Antimicrobial resistance not only increases the healthcare costs, but it is also linked with the severity and death rates from certain infections.

Evaluation with E-test of the meropenem/vaborbactam association in carbapenem-resistant and sensitive negative control strains isolates of samples processed at the Laboratory of the Rivoli Hospital

Background and aims: Meropenem (Mer) and vaborbactam (Vab) is a combination of a carbapenem and a new β-lactamase inhibitor used in adults to treat different types of infections caused by Gram-negative bacteria. This combination is chosen as an alternative in infections caused by Gram-negative bacteria when carbapenem-only therapies are unsatisfactory.
 Materials and methods: Based on this, we report our assessment of such meropenem/vaborbactam association through the E-test and the Microscan routine automated system. This evaluation was performed on 22 samples, carbapenem-resistant strains of Gram-negative bacteria isolated from different types of biological material. Five E. coli and 1 P. mirabilis were respectively susceptible to both carbapenems and Mer/Vab, 6 P. aeruginosa and 2 A. baumannii were respectively resistant to both carbapenems and Mer/Vab and out of 8 K. pneumoniae which were resistant to carbapenems only one was resistant to the Mer/Var combination.
 Results and conclusions: From the data obtained, it can be seen that resistance to carbapenems is 72%, and drops to 36% with the combined use of Mer/Vab. However, this combination cannot be used in the treatment of patients with diseases caused by P. aeruginosa and Acinetobacter spp., resistant to meropenem.

Attitudes towards vaccination and knowledge about antibiotics: Analysis of Wellcome Monitor survey data

Vaccine hesitancy and antimicrobial resistance are biomedically connected public health challenges, but to date minimal research has examined social connections between the UK public’s attitudes towards vaccination and attitudes towards antibiotic use. Understanding the extent to which these issues are attitudinally parallel would be valuable for implementing and evaluating public health interventions.Using data from the Wellcome Trust Monitor Wave 4 this study examined social associations between these two areas. An ordinal logistic regression model predicting knowledge level about antibiotics was fitted using 2,654 observations, controlling for known outcome covariates, with perceptions of the risk of side-effects from vaccination and of the efficacy of vaccination as a preventative intervention as independent variables.Compared to the modal response category of ‘Fairly low’, respondents who rated the risk of serious side-effects from vaccination as ‘Very high’ (OR = 2.87, 95% CI = 1.71–4.89) or ‘Fairly high’ (OR = 1.51, 95% CI = 1.21–1.88) were more likely to have provided incorrect responses to questions about the utility of antibiotics for treating different types of infection. Conversely, respondents who felt there was ‘No risk at all’ (OR = 0.69, 95% CI = 0.50–0.95) were less likely to have provided incorrect responses about the utility of antibiotics. Compared to the modal category of ‘Almost always effective’, only respondents who felt that vaccines were ‘Sometimes effective’ (OR = 1.26, 95% CI = 1.05–1.51) or ‘Almost never or never effective’ (OR = 2.32, CI = 1.32–4.19) were more likely provide incorrect responses regarding antibiotics’ utility.Negative perceptions of vaccination and misperceptions about the role of antibiotics for treating infections are associated with one other within the general UK public. Qualitative research is needed to understand the nature of this association and identify areas of public understanding that are not exclusive to specific health interventions but that may be targeted to improve responsiveness to vaccine- and antibiotic-related public health interventions.

Ocular Surface Infection Mediated Molecular Stress Responses: A Review.

Infection mediated ocular surface stress responses are activated as early defense mechanisms in response to host cell damage. Integrated stress responses initiate the host response to different types of infections and modulate the transcription of key genes and translation of proteins. The crosstalk between host and pathogen results in profound alterations in cellular and molecular homeostasis triggering specific stress responses in the infected tissues. The amplitude and variations of such responses are partly responsible for the disease severity and clinical sequelae. Understanding the etiology and pathogenesis of ocular infections is important for early diagnosis and effective treatment. This review considers the molecular status of infection mediated ocular surface stress responses which may shed light on the importance of the host stress-signaling pathways. In this review, we collated literature on the molecular studies of all ocular surface infections and summarize the results from such studies systematically. Identification of important mediators involved in the crosstalk between the stress response and activation of diverse signaling molecules in host ocular surface infection may provide novel molecular targets for maintaining the cellular homeostasis during infection. These targets can be then explored and validated for diagnostic and therapeutic purposes.

Evaluation of Procalcitonin and Interleukin-6 as a Marker of Bacterial Urinary Tract Infection.

Urinary tract infection (UTI) is a major clinical problem in a wide age range that is associated with a high morbidity rate. Due to issues such as low specificity and the inability to differentiate between different types of infection in current diagnostic methods, there is a need to introduce novel UTI markers. The present study was conducted to evaluate the utility of Procalcitonin (PCT) and interleukin-6 (IL-6) as a marker of bacterial urinary tract infection. For this purpose, a cross-sectional study was conducted between November 2020 and February 2021 among 125 patients and 60 healthy volunteers (control) in Erbil Teaching Hospital. The concentration of PCT and IL-6 was quantified using the ELISA cloud immunoassay test. Between-group comparisons were assessed for the variables with analysis of variance. The results revealed that there was a significant difference between PCT levels in UTI patients (104.6±6.07) and control groups (54±2.24) (p <0.0001). The differences in IL-6 concentration in UTI patients (55.74±4.2) and control groups (24.56±2.4) were also significant (p <0.0001), implying that the level of both PCT and IL-6 increased due to bacterial infection in the urinary tract. As a whole, the findings of this study provide.

Emerging Fungal Pathogen Causing a Persistent Rash

Candida haemulonii is a rare, fungal organism. This emerging, multidrug resistant pathogen can cause many different types of infections. We present a case of a previously healthy, 16-year-old girl with a lower extremity rash.

Therapeutic Index of Herbal Medicine in Pandemic COVID-19: A Review

The study of this review focus on effective herbal medicine against COVID-19. There have been many such plants on which a lot of research has been done earlier, and these have been very good for health as we know that the current situation of the whole world is very serious with the novel COVID-19 virus epidemic. Hence, people consume a lot of herbal medicine to increase their immunity, such as kadha (brewing), and it is also very effective against this viral infection. If we take brewing in the proper dose, research should be done from clinical trials. We have been taking many medicines since old times and have been doing research on them which is Antiviral and useful in different types of infection caused by bacteria, viruses, microbes, etc. The plant's diversity included their chemical constituents, showing the promise of their therapeutic level against the antiviral activity, without any toxicity with plasma concentration. Many plants show effectively against viral infections that are Flavonoids, Glycosides, polyphenols, alkaloids, etc.. Still, any clinical trials on humans do not prove their proper research on them, but the Chinese system of medicine claimed that Traditional Chinese medicine improves the COVID-19 patient. According to this review, we aim to collate data of plants the various large in the quantity of natural active constituents from individual medicinal plant species that may have potential therapeutic efficacy. The continuing development of novel antiviral drugs needs to isolate and synthesize more new active constituents.

Physical activity in asthma control and its immune modulatory effect in asthmatic preschoolers.

BackgroundThe impact of physical activity on immune response is a hot topic in exercise immunology, but studies involving asthmatic children are scarce. Our aims were to examine whether there were any differences in the level of physical activity and daily TV attendance, to assess its role on asthma control and immune responses to various immune stimulants.MethodsWeekly physical activity and daily television attendance were obtained from questionnaires at inclusion of the PreDicta study. PBMC cultures were stimulated with phytohemagglutinin (PHA), R848, poly I:C, and zymosan. A panel of cytokines was measured and quantified in cell culture supernatants using luminometric multiplex immunofluorescence beads‐based assay.ResultsAsthmatic preschoolers showed significantly more TV attendance than their healthy peers (58.6% vs. 41.5% 1–3 h daily and only 25.7% vs. 47.2% ≤1 h daily) and poor asthma control was associated with less frequent physical activity (PA) (75% no or occasional activity in uncontrolled vs. 20% in controlled asthma; 25% ≥3 times weekly vs. 62%). Asthmatics with increased PA exhibited elevated cytokine levels in response to polyclonal stimulants, suggesting a readiness of circulating immune cells for type 1, 2, and 17 cytokine release compared to subjects with low PA and high TV attendance. This may also represent a proinflammatory state in high PA asthmatic children. Low physical activity and high TV attendance were associated with a decrease in proinflammatory cytokines. Proinflammatory cytokines were correlating with each other in in vitro immune responses of asthmatic children, but not healthy controls, this correlation was more pronounced in children with sedentary behavior.ConclusionAsthmatic children show more sedentary behavior than healthy subjects, while poor asthma control is associated with a substantial decrease in physical activity. Our results suggest that asthmatic children may profit from regular exercise, as elevated cytokine levels in stimulated conditions indicate an immune system prepared for responding strongly in case of different types of infections. However, it has to be considered that a hyperinflammatory state in high PA may not be beneficial in asthmatic children.

Lesson learned from the pandemic: Isolation and hygiene measures for COVID-19 could reduce the nosocomial infection rates in oncology wards

It was previously demonstrated that seasonal influenza incidence was significantly decreased during the COVID-19 pandemic, possibly due to respiratory and hygiene precautions. From this point, we hypothesized that the COVID-19 precautions could lead to a decrease in nosocomial infection rates in oncology inpatient wards. We evaluated the nosocomial infection rates in an inpatient palliative oncology ward in the first 3 months of the COVID-19 pandemic in our country and compared this rate with the same time frame of the previous year in our institution. The percentage of nosocomial infections complicating the hospitalization episodes were significantly reduced in the first 3 months of the pandemic compared to the previous year (43 vs. 55 nosocomial infection episodes; 18.6% vs. 32.2%, p = 0.002). The decrease in the nosocomial infections was consistent in the different types of infections, namely pneumonia (4.8% vs. 7.6%), urinary tract infection (5.2% vs. 7.6%), bacteremia (5.2% vs. 7%) and intraabdominal infections (2.6% vs. 3.5%). The median monthly disinfectant use was significantly increased to 98 liters (interquartile range: 82 - 114) in 2020 compared to 72 L (interquartile range: 36 - 72) in 2019 (p = 0.046). The continuation of the simple and feasible hygiene and distancing measures for healthcare workers and patient relatives and adaptations for earlier discharge could be beneficial for preventing nosocomial infections in oncology wards. These measures could be implemented routinely even after the COVID-19 pandemic for patient safety, especially in settings with higher nosocomial infection rates like inpatients palliative care units.

Molecular Diversity of Methicillin-Resistant and -Susceptible Staphylococcus aureus Detected in Animals: A Focus on Aquatic Animals

Staphylococcus aureus (S. aureus) are one of the best-known opportunistic pathogens capable of causing different types of infections in animals. Furthermore, it has the ability to acquire resistance to various antibiotics very easily. Methicillin-resistant S. aureus (MRSA) are currently of great concern as they are the leading cause of infections in humans and animals, with a major impact on health and the economy. Several studies already demonstrate that the spread of MRSA is constantly increasing due to its ability to form reservoirs in humans, animals and the environment. In fact, several works have already identified the presence of these bacteria in animals, including domestic animals, farm animals and even wild animals. Furthermore, the incidence of various S. aureus strains in aquatic animals has also been reported by different authors, although it is still a rarely discussed topic. Some of these strains have previously been associated with humans and other animals. Strain 398 is the strain that manages to infect a wider spectrum of hosts, having been identified in several different species. Aside from this strain, many others have yet to be identified. In addition, many of these strains have virulence factors and antibiotic resistance genes that worsen the situation. The present work is a review of studies that intend to investigate the epidemiology of this agent in samples of aquatic animals from different origins, in order to better understand its distribution, prevalence and the molecular lineages associated with these species.

A Green, Simple and Facile Way to Synthesize Silver Nanoparticles Using Soluble Starch. pH Studies and Antimicrobial Applications.

Along with the progress of nanoscience and nanotechnology came the means to synthesize nanometric scale materials. While changing their physical and chemical properties, they implicitly changed their application area. The aim of this paper was the synthesis of colloidal silver nanoparticles (Ag-NPs by ultrasonic disruption), using soluble starch as a reducing agent and further as a stabilizing agent for produced Ag-NPs. In this context, an important parameter for Ag-NPs preparation is the pH, which can determine the particle size and stability. The physical-chemical behavior of the synthesized Ag-NPs (shape, size, dispersion, electric charge) is strongly influenced by the pH value (experiment being conducted for pH values in the range between 8 and 13). The presence of a peak located at 412 nm into the UV-VIS spectra demonstrates the presence of silver nano-spheres into the produced material. In UV/VIS spectra, we observed a specific peak for yellow silver nano-spheres located at 412 nm. Samples characterization was performed by scanning electron microscopy, SEM, energy-dispersive X-ray spectroscopy, EDX, Fourier-transform infrared spectroscopy, and FT-IR. For all Ag-NP samples, we determined the zeta and observed that the Ag-NP particles obtained at higher pH and have better stability. Due to the intrinsic therapeutic properties and broad antimicrobial spectrum, silver nanoparticles have opened new horizons and new approaches for the control of different types of infections and wound healing abilities. In this context, the present study also aims to confirm the antimicrobial effect of prepared Ag-NPs against several bacterial strains (indicator and clinically isolated strains). In this way, it was confirmed that the antimicrobial activity of synthesized Ag-NPs was good against Staphylococcus aureus (ATCC 25923 and S. aureus MSSA) and Escherichia coli (ATTC 25922 and clinically isolated strain). Based on this observation, we conclude that the prepared Ag-NPs can represent an alternative or auxiliary material used for controlling important nosocomial pathogens. The fungal reference strain Candida albicans was more sensitive at Ag-NPs actions (zone of inhibition = 20 mm) compared with the clinically isolated strain (zone of inhibition = 10 mm), which emphasizes the greater resistance of fungal strains at antimicrobial agent’s action.

Mycobacterium-Induced Th1, Helminths-Induced Th2 Cells and the Potential Vaccine Candidates for Allergic Asthma: Imitation of Natural Infection.

Bronchial asthma is one of the most chronic pulmonary diseases and major public health problems. In general, asthma prevails in developed countries than developing countries, and its prevalence is increasing in the latter. For instance, the hygiene hypothesis demonstrated that this phenomenon resulted from higher household hygienic standards that decreased the chances of infections, which would subsequently increase the occurrence of allergy. In this review, we attempted to integrate our knowledge with the hygiene hypothesis into beneficial preventive approaches for allergic asthma. Therefore, we highlighted the studies that investigated the correlation between allergic asthma and the two different types of infections that induce the two major antagonizing arms of T cells. This elucidation reflects the association between various types of natural infections and the immune system, which is predicted to support the main objective of the current research on investigating of the benefits of natural infections, regardless their immune pathways for the prevention of allergic asthma. We demonstrated that natural infection with Mycobacterium tuberculosis (Mtb) prevents the development of allergic asthma, thus Bacille Calmette-Guérin (BCG) vaccine is suggested at early age to mediate the same prevention particularly with increasing its efficiency through genetic engineering-based modifications. Likewise, natural helminth infections might inhabit the allergic asthma development. Therefore, helminth-derived proteins at early age are good candidates for designing vaccines for allergic asthma and it requires further investigation. Finally, we recommend imitation of natural infections as a general strategy for preventing allergic asthma that increased dramatically over the past decades.

Biofilm Formation of Multidrug-Resistant MRSA Strains Isolated from Different Types of Human Infections.

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the main pathogens causing chronic infections, mainly due to its capacity to form biofilms. However, the mechanisms underlying the biofilm formation of MRSA strains from different types of human infections are not fully understood. MRSA strains isolated from distinct human infections were characterized aiming to determine their biofilm-forming capacity, the biofilm resistance to conventional antibiotics and the prevalence of biofilm-related genes, including, icaA, icaB, icaC, icaD, fnbA, fnbB, clfA, clfB, cna, eno, ebpS, fib and bbp. Eighty-three clinical MRSA strains recovered from bacteremia episodes, osteomyelitis and diabetic foot ulcers were used. The biofilm-forming capacity was evaluated by the microtiter biofilm assay and the biofilm structure was analyzed via confocal scanning laser microscopy. The antimicrobial susceptibility of 24-h-old biofilms was assessed against three antibiotics and the biomass reduction was measured. The metabolic activity of biofilms was evaluated by the XTT assay. The presence of biofilm-related genes was investigated by whole-genome sequencing and by PCR. Despite different intensities, all strains showed the capacity to form biofilms. Most strains had also a large number of biofilm-related genes. However, strains isolated from osteomyelitis showed a lower capacity to form biofilms and also a lower prevalence of biofilm-associated genes. There was a significant reduction in the biofilm biomass of some strains tested against antibiotics. Our results provide important information on the biofilm-forming capacity of clinical MRSA strains, which may be essential to understand the influence of different types of infections on biofilm production and chronic infections.

White blood cell type identification using multi-layer convolutional features with an extreme-learning machine

White blood cells (WBCs) are the main component of the immune system that have a major role in protecting the body against different types of infections arising due to viruses, bacteria, fungi, and so on. The WBCs are generally referred to as 5 main subtypes: lymphocytes, monocytes, neutrophils, eosinophils, and basophils. Recognizing and counting each type of WBC is important for diagnosing and treating various disorders, such as infectious diseases, autoimmune disorders, immune deficiencies, leukemia, etc. To this end, a fast and accurate WBC classification model is crucial. This study offers a new model that works with a deep neural network—namely, multi-layer (ML) convolutional features of the AlexNet architecture followed by a feature selection (FS) strategy (MLANet-FS) for WBC-type identification. The proposed model exploits multi-layer convolutional features from different layers of the AlexNet model to provide rich discriminative detail, because different convolutional layers contain different visual characteristics of WBCs, and thereafter, linear fusion of these features occurs automatically. FS strategy is used to select the most distinguishing features from the feature fusion pool. Next, an extreme-learning machine (ELM) is employed to learn a discriminative model of WBC type identification. The proposed MLANet-FS-ELM model was evaluated in extensive experiments on the WBC benchmark dataset. It achieved 99.99% training accuracy and 99.12% testing accuracy, demonstrating that the proposed model outperforms alternative methods in the literature developed for WBC identification.

Incidence of Infections and Second Cancers in Philadelphia Chromosome-Negative Patients with Myeloproliferative Neoplasms Treated with Ruxolitinib

Introduction:This is a retrospective, case-control study evaluating the incidence of infections and second cancers in Philadelphia-chromosome negative (Ph-) myeloproliferative neoplasm (MPN) patients treated with ruxolitinib, a JAK1/JAK2 tyrosine kinase inhibitor approved for treating patients with polycythemia vera (PV), primary myelofibrosis (PMF), post-essential thrombocythemia myelofibrosis (PET-MF), and post-polycythemia vera myelofibrosis (PPV-MF) [1]. These patients are at significant risk for infections and second cancers when treated with long-term ruxolitinib. Similar observations have been reported in the COMFORT-II clinical trial findings, which studied ruxolitinib use in myelofibrosis (MF) patients [2], and have real-world clinical implications.Methods:128 MPN patients treated with ruxolitinib were studied and matched with 122 control patients based on gender, disease subtype, and age at the beginning of an MPN treatment (± 5 years). All evidence of infections and second cancers during this treatment regimen were recorded.Results:MPN patients whose mean age was 67.2±11.2 years when starting ruxolitinib treatment were studied, among whom myelofibrosis (38.3%) and PV (33.6%) were the leading subtypes. Of patients in the ruxolitnib cohort, 60/128 (46.9%) presented with ≥1 infection and a second cancer occurred in 13/128 (10.2%) patients. Of patients in the control cohort, 37/122 (30.3%) presented with ≥1 infection and a second cancer occurred in 6/122 (4.9%) patients. The difference of these proportions was significant for both infections (p=0.0072, RR=1.5456) and second cancers (p=0.0006, RR=2.0651) (Graph 1). Types of infections and cancers are summarized in Table 1a, Table 1b, and Table 2 . Of note, 2 patients treated with ruxolitinib had tuberculosis (TB) reactivations and 1 patient had pulmonary aspergillosis. All 13 of the patients that were diagnosed with a second cancer after being treated with ruxolitinib were found to have ≥1 skin cancer.Stratification of the incidence of these events by gender shows a trend for females treated with ruxolitinib with a higher relative risk (RR) of developing cancer than males of the same cohort (RR: 6.8971 for females, 0.4385 for males) (Table 3) . Serial upper respiratory infections (URIs) and urinary tract infections (UTIs) were of higher incidence in the ruxolitinib cohort than in the control cohort. In the ruxolitinib cohort, 7/21 (33.3%) and 5/12 (41.7%) experienced serial URIs and UTIs, respectively. In the control cohort, 1/9 (11.1%) and 0/8 (0.0%) experienced serial URIs and UTIs, respectively. 29/128 (22.7%) of the ruxolitinib cohort and 14/123 (11.4%) of the control cohort developed ≥2 different types of infections (p=0.0217, RR=1.9905).When compared to the control cohort, patients in the ruxolitinib cohort were found to have a higher incidence of recurring neutropenia (ruxolitinib: 35/128 (27.3%), control: 22/123 (17.9%), p=0.0782, RR=1.5288). The ruxolitnib cohort had a higher incidence of elevated ferritin than the control cohort (ruxolitinib: 26/128 (20.3%), control: 6/123 (4.9%), p=0.0010, RR=4.1641). Elevated ferritin could be a factor contributing to the increased risk of developing certain types of infections owing to iron overload [3].Conclusions:Long-term ruxolitinib treatment in Ph- MPN patients has resulted in an increased risk of infections and second cancers when compared to a matched control cohort. Those patients also had significantly higher ferritin levels which may contribute to the increased risk of certain infections. The risk of secondary cancer was much higher in the ruxolitinib group and especially in females. The significant proportion of ruxolitinib-treated patients who developed skin cancer (13/128, 10.2%) emphasizes the importance of skin cancer screening in these patients. [Display omitted] DisclosuresRitchie:Astellas Pharma: Other: Research funding to my institution; NS Pharma: Other: Research funding to my institution; Bristol-Myers Squibb: Other: Research funding to my institution; Celgene: Consultancy, Other: Travel, Speakers Bureau; Pfizer: Consultancy, Other: Research funding to my institution; Incyte: Consultancy, Speakers Bureau; Novartis: Consultancy, Other: Research funding to my institution, and travel, Speakers Bureau. Roboz:Cellectis: Research Funding; AbbVie, Agios, Amgen, Amphivena, Array Biopharma Inc., Astex, AstraZeneca, Celator, Celgene, Clovis Oncology, CTI BioPharma, Genoptix, Immune Pharmaceuticals, Janssen Pharmaceuticals, Juno, MedImmune, MEI Pharma, Novartis, Onconova, Pfizer, Roche Pharmace: Consultancy. Lee:Amgen: Consultancy; Baxalta: Consultancy; Alexion Pharmaceuticals: Consultancy; Clinipace: Consultancy.

Mucormycosis: Pathogenesis, Diagnosis, and Management

Mucormycosis (black fungus) is caused by Mucor and Rhizopus. After getting affected such warning signs; pain and redness around the eyes and nose, fever, headache, coughing, shortness of brain, bloody vomit can see. It can suspect in COVID-19 patients, diabetics, or immunosuppressed individuals. Mucormycosis, if not cared it may be turned fatal. Mucormycosis can cause different types of infections: rhino-cerebral, pulmonary, cutaneous, gastrointestinal, and dissemination mucormycosis. In a study β- hydroxybutyrate (a representative of ketone bodies) and elevated serum iron levels were the major factors that enhanced expression of both CotH and GRP78, whereas lactic acidosis did not affect their expression. In addition, sodium bicarbonate reversed the effect of acidosis and protected β- hydroxybutyrate –treated mice from mucormycosis, implying the significance of correction acidosis as a treatment measure in patients with DKA and mucormycosis. The objective of this paper is screening, different pathogenesis, diagnosis, and management of Mucormycosis. An additional factor that significantly contributes to the poor prognosis of these infections is the inherent resistance of Mucorales to the most available antifungals, with amphotericin-B, posaconazole, and isavuconazole considered the most potent antifungals in vitro. According to the studies Rhizopus arrhizus is present in 85% of rhino-cerebral forms, compared with only 17% of non-rhino cerebral forms. However, recent data enlarge the antifungal armamentarium with the US Food and Drug Administration and European Medicines Agency’s approval of the new triazole isavuconazole, however, comparative clinical data are lacking, and the respective places of polyenes and different azoles need to be discussed.&#x0D;

Optimization of a Ligand Exchange Chromatography Method for the Enantioselective Separation of Levofloxacin and Its Chiral Impurity.

Levofloxacin is a third-generation fluoroquinolone that has several advantages over its (R) ofloxacin isomer. It is used to treat different types of infection, including urinary infection and prostatitis. A new HPLC method for the enantioselective separation of levofloxacin and its chiral impurity was developed and validated to improve the separation of the enantiomers of levofloxacin [impurity(R) and active principle (S)] by increasing the value of the resolution between the eutomer and the distomer. Chromatographic separation was performed on a Prodigy ODS -2, 5 µm 4.6 × 150 mm column, with a gradient of buffer solution and methanol (80:20, v/v). A Box-Behnken design was considered when optimizing the enantioseparation involving the effects of many factors such as the concentration of d-phenylalanine, the pH of the buffer, the percentage of organic modifier in the mobile phase, the flow rate, the temperature of the column, and the type of column. Chiral separation was achieved with an optimal resolution of 3.8. The method was successfully validated following the International Conference on Harmonization Q2 (R1) guideline, fulfilling the acceptance criteria for selectivity [no interference in the retention time of (S) levofloxacin and (R) levofloxacin], linearity (r ≥0.999 in the range 1.25-3.75 µg/mL for all enantiomers), and precision (RSD <2%). Accuracy was assessed by the application of the analytical method to an analyte of known purity, providing evidence for the usefulness of this monitoring system. The method was successfully used for the determination of levofloxacin impurity in raw material and pharmaceutical dosage forms. The following method is accurate and robust to quantify and characterize the presence of levofloxacin impurity in raw material for pharmaceutical compounds.