Host-related Risk Factors Research Articles

Exploring Anticitrullinated Antibodies (ACPAs) and Serum-Derived Exosomes Cargoes

Background: Autoantibodies such as rheumatoid factor (RF) and anticitrullinated protein autoantibodies (ACPAs) are useful tools for rheumatoid arthritis (RA). The presence of ACPAs against citrullinated proteins (CPs), especially citrullinated fibrinogen (cFBG), seems to be a useful serological marker for diagnosing RA. RA patients’ sera were found to be enriched in exosomes that can transmit many proteins. Exosomes have been found to express citrullinated protein such as cFBG. Objective: We conducted this study in two stages. In the first phase, we aimed to evaluate the association between autoantibodies and risk factors. In the next step, ACPA-positive serum samples from the first phase were subjected to exosomal studies to explore the presence of cFBG, which is a frequent target for ACPAs. Methods: We investigated the autoantibodies in one hundred and sixteen Saudi RA patients and correlated with host-related risk factors. Exosomes were extracted from patients’ sera and examined for the presence of cFBG using monoclonal antibodies. Results: The study reported a high female-to-male ratio of 8:1, and seropositive RA (SPRA) was more frequent among included RA patients. The frequency and the levels of ACPAs were similar in both genders. Autoantibodies incidences have a direct correlations with patient age, while the average titers decreased as the age increased. Further, the highest incidence and levels of autoantibodies were reported in patients with RA duration between 5 and 10 years. Smoking and family history have no impact on autoantibody, except for ACPAs titers among smokers’ RA. Our analysis of serum exosomes revealed that about 50% of SPRA patients expressed cFBG. Conclusions: The female-to-male ratio is 8:1, which is higher than the global ratio. We can conclude that patients’ age and disease duration contribute to the autoantibodies, particularly RF and anti-MCV, whereas smoking and family history had no effects on autoantibodies. We detected cFBG in all exosomes from SPRA patients; thus, we suggest that the precise mechanism of exosomes in RA pathogenesis can be investigated to develop effective treatment strategies.

Refinement of post-COVID condition core symptoms, subtypes, determinants, and health impacts: A cohort study integrating real-world data and patient-reported outcomes

Post-COVID-19 condition (PCC) affects millions of people, and is an essential component of the long-term impact of COVID-19 during the post-pandemic era. Yet, consensus on clinical case definition and core components of PCC remains lacking, affecting our ability to inform research and evidence-based management. Our study aims 1) to identify the most specific symptoms for PCC, and identify clinical subtypes; 2) to evaluate both virus- and host-related determinants of PCC, and 3) assess the impact of PCC on physical and mental health. We studied participants from UK Biobank who completed a health and wellbeing survey between June and September 2022. Participants reported the current conditions of the presence, duration, and functional limitations of 45 symptoms, using an online questionnaire designed specifically for COVID-19 research. SARS-CoV-2 infection status and disease history were obtained through linkage to surveillance data and electronic medical records, respectively. Participants reporting symptoms within 30 days after infection (acute phase) were excluded. The most specific PCC symptoms were defined using two criteria: statistical significance (P<0.05 after Bonferroni correction) and clinical relevance (absolute risk increase > 5%). Propensity score weighting was used to control for confounding. Subtypes of PCC were then defined based on the specific symptoms among the COVID-19 infected individuals. A multivariable regression was used to study pathogen- and host-related risk factors for PCC, and its impact on 13 physical and 4 mental health patient-reported functional outcomes. 172,303 participants (mean age 68.9, 57.4% female) were included in the analysis, of whom 43,395 had PCR-confirmed COVID-19. We identified 10 most specific symptoms and classified four PCC subtypes: ENT subtype (30.1%), characterized by alterations in smell, taste, and hearing loss; cardiopulmonary subtype (10.4%), characterized by shortness of breath, postural tachycardia, chest tightness, and chest pressure; neurological subtype (23.5%), characterized by brain fog and difficulty speaking; and general fatigue subtype (38.0%), characterized by mild fatigue. A higher PCC risk was observed for patients with Wild-type variant, multiple infections, and severe acute COVID-19 illness, consistently across the four PCC subtypes. In addition, a range of factors, including socioeconomic deprivation, higher BMI, unhealthy lifestyle, and multiple chronic health conditions, were associated with increased PCC risk, except for age and sex. Conversely, vaccination was associated with a largely reduced PCC risk, particularly for the cardiopulmonary subtypes. Individuals with PCC experienced a much worse physical and mental health. Specifically, the cardiopulmonary subtype had the most pronounced adverse impact on function impairments, followed by neurological, mild fatigue, and ENT subtype. The most affected functions included the ability to concentrate, participate in day-to-day work, and emotional vulnerability to health problems. PCC can be categorized into four distinct subtypes based on ten core symptoms. These subtypes appeared to share a majority of pathogen and host-related risk factors, but their impact on health varied markedly by subtype. Our findings could help refine current guidelines for precise PCC diagnosis and progression, enhance the identification of PCC subgroups for targeted research, and inform evidence-based policy making to tackle this new and debilitating condition. NIHR Senior Research Fellowship (grant SRF-2018-11-ST2-004).

The Risk Factors Contributing to The Occurrence of Pulmonary Tuberculosis in The Small Island of South Sulawesi, Indonesia

Background:Pulmonary tuberculosis (PTB) has emerged as the leading cause of death among infectious diseases globally. This is attributed to a complex interaction of factors, including host-related risk factors, infecting agents, and environmental conditions. The Southeast Asia and West Pacific regions account for 58% of all tuberculosis cases, with Indonesia reporting the second highest prevalence of tuberculosis globally (10%), following India, which accounts for 23% of global cases. Objective:This study aimed to investigate the risk factors associated with the incidence of pulmonary tuberculosis on small islands in South Sulawesi, Indonesia. Methods:This research employed a case-control study design. Several explanatory variables were considered: age, gender, knowledge, nutritional status, occupant density, ventilation area, humidity levels, and type of flooring. The occurrence of pulmonary tuberculosis was designated as the dependent variable. The study sample consisted of 240 respondents, with 120 cases and 120 controls, all residing on three small islands—Sembilan Island, Balang Lompo Island, and Salemo Island—all sharing similar characteristics. Results:The study identified several factors associated with an increased risk of pulmonary tuberculosis. These factors included gender (OR = 1.71, 95% CI 0.61-4.77), knowledge (OR = 3.143, 95% CI 1.06-9.26), occupant density (OR = 1.52, 95% CI 0.42-5.47), area of ventilation (OR = 6.00, 95% CI 1.17-30.72), humidity (OR = 3.763, 95% CI 1.03-13.64), and type of floor (OR = 1.144, 95% CI 0.41-3.16). In contrast, age and nutritional status were not identified as risk factors for pulmonary tuberculosis. Conclusion:Environmental factors such as occupant density, area of ventilation, humidity, and type of floor were found to be significant risk factors for the incidence of pulmonary tuberculosis in small islands of South Sulawesi. These findings highlight the need for targeted interventions addressing these modifiable environmental conditions to reduce the burden of tuberculosis. Keywords:risk factors; incidence; pulmonary tuberculosis; nutritional status; environmental factors; Indonesia

RADT-03. CONTRAST-ENHANCING LESIONS INDUCED BY CNS-DIRECTED INTENSITY MODULATED PROTON THERAPY: DEMOGRAPHIC AND CARDIOVASCULAR RISK FACTORS ANALYSIS

Abstract INTRODUCTION Lesions exhibiting radiation-induced contrast enhancement (RICE) may develop following cranial intensity modulated proton therapy (IMPT). The mechanisms underlying their development may be shared or amplified by existing patient comorbidities. The objective of this study was to assess a potential relationship between individual or composite cardiovascular risk criteria and RICE development, independent of dosimetric considerations. METHODS Data were reviewed for patients treated at a single tertiary care institution between 2017-2023. Time to RICE development was assessed using Kaplan-Meier. Cox regression analysis was used to determine hazard ratios (HRs) with 95% confidence intervals (CIs). Host-related risk factors for RICE development were assessed in a univariable analysis (UVA). A binary logistic regression model was built to ascertain the effects of age and cardiovascular risk factors on the likelihood of developing RICE (expressed as QRISK3 relative risk). RESULTS The study cohort included 137 patients; the median age was 40 years (range: 1-85), 51% female, and 53% Hispanic. Cardiovascular risk factors included smoking (18% past, 6% current), diabetes (7%), hypertension (22%), dyslipidemia (15%) and high body mass index (BMI, 50% were obese with BMI&amp;gt;25). At a median follow-up of 3 years, RICE developed in 36 (26%) patients. On UVA, RICE development was only associated with age ≥18 compared to &amp;lt;18 (HR 3.3, 95% CI: 1.2-9.4, p=0.024). None of the other evaluated risk factors were significantly associated with RICE (p&amp;gt;0.05). Additionally, logistic regression analysis showed increasing age was associated with likelihood of developing RICE (χ2=6.95, p=0.031), while QRISK3 score was not. CONCLUSIONS In this contemporary series of patients treated with IMPT, age was the only host factor associated with RICE, while other cardiovascular risk factors, evaluated individually or using established composite risk scores (QRISK3) were not associated with RICE. Additional research is needed to identify potential patient characteristics associated with RICE.

Epidemiology and Risk Determinants of Drug-Induced Liver Injury: Current Knowledge and Future Research Needs.

Drug-induced liver injury (DILI) is a major global health concern resulting from adverse reactions to medications, supplements or herbal medicines. The relevance of DILI has grown with an aging population, the rising prevalence of chronic diseases and the increased use of biologics, including checkpoint inhibitors. This article aims to summarise current knowledge on DILI epidemiology and risk factors. This review critically appraises available evidence on DILI frequency, outcomes and risk determinants, focusing on drug properties and non-genetic host factors that may influence susceptibility. DILI incidence varies across populations, with hospitalised patients experiencing notably higher rates than outpatients or the general population. Increased medication use, particularly among older adults and women, may partly explain age- and sex-based disparities in DILI incidence and reporting. Physiological changes associated with aging likely increase susceptibility to DILI in older adults, though further exposure-based studies are needed for definitive conclusions. Current evidence does not strongly support that women are inherently more susceptible to DILI than men; rather, susceptibility appears to depend on specific drugs. However, once DILI occurs, older age and female sex are associated with greater severity and poorer outcomes. Other less-studied host-related risk factors are also discussed based on available evidence. This article summarises existing data on DILI frequency, outcomes, drug properties affecting hepatotoxicity and non-genetic host risk factors while identifying critical knowledge gaps. Addressing these gaps through future research could enhance understanding and support preventive measures.

The Ability of Indigenous Plants in Alleviating Rheumatoid Arthritis: A Comprehensive Review.

Rheumatoid Arthritis is a long-lasted, inflammatory, systemic autoimmune disease that predominantly manifests in people between the ages of 30 and 50 Rheumatoid arthritis is characterized by more than a half-hour of morning stiffness in the affected joints, fever, soreness, swelling, weight loss, tiredness, warm joints, and subcutaneous rheumatoid nodules. Hormonal, genetic, epigenetic, reproductive, and neuroendocrine risk factors, as well as comorbid host variables, are the categories of host-related risk factors associated with the evolution of RA. Additional risk variables that have been linked to RA include food, environmental variables, socioeconomic status, smoking, microbiome, infection agents, and other airborne exposures. The objective of RA therapies is to minimise joint deformity and destruction, minimise discomfort and inflammation in the joints, and maximise joint function.Growing data suggests that the course of Rheumatoid Arthritis is affected by the minimisation of disease activity caused by disease-modifying medications, and that patients may benefit from early antirheumatic medication delivery that modifies illness. While numerous herbs have been explored for their anti-inflammatory properties, it is important to note that not all herbs have been thoroughly researched. This review focuses on seventeen native plant species that have shown either promising or established anti-arthritic effects based on preclinical and clinical studies where available. The review highlights the biochemical and immunological attributes of these herbs, summarizing their therapeutic potential for RA management while also acknowledging the limitations and gaps in current research. This examination provides insights into the potential of these herbal treatments for RA and calls for further research to explore their efficacy and safety in greater depth.

SARS-COV-2 breakthrough infection and its covariates among healthcare providers of a hospital in Bangladesh during the omicron wave

Breakthrough infection by SARS-COV-2 virus among vaccinated individuals has been reported from all over the world and it has created a substantial challenge in designing strategies to live with the virus in the post-pandemic era. Factors affecting the extent and nature of breakthrough infection are still not fully understood and those are known to vary depending on host and agent factors. Health Care Workers (HCWs), especially in hospital settings, are front-liners in combating the epidemic and, consequently, they are more vulnerable to breakthrough infection by SARS-COV-2. Like most of the countries of the world, Bangladesh went through several waves of COVID-19 and the last (3rd wave) was the widespread Omicron wave during the winter of 2022. HCWs in Bangladesh have been disproportionately affected by the virus. Under this context, the aim of the present study was to explore breakthrough infection (BTI) and its host-related covariates among HCWs of a COVID-dedicated city-based hospital during the Omicron wave in Bangladesh. An observational cross-sectional study was conducted on 267 HCWs of the Narayanganj Tertiary (300-bed) hospital during February-March 2022 which coincided with the terminal part of the 3rd wave. Data were collected by trained Field Assistants using Interviewer-administered Data Collection Forms with Questionnaires as instruments. Previous COVID-19 status (any time after the onset of the pandemic and within last 3 months) was explored by the history of specific symptoms as well as by the confirmatory rtPCR test reports from DGHS approved laboratories Anti-nucleocapsid antibody (Anti-N-Ab) in venous blood samples, assayed by a chemiluminescent ELISA technique, was used as a seroprevalence-based marker of breakthrough infection during the preceding few months. Data were analyzed by bivariate as well as multivariate statistics using the IBM-SPSS software. The median age (range) of the HCWs was 38 (21-65) years; Body Mass Index (BMI, kg/m2) 25 (15-49); and Waist-Hip Ratio (WHR) was 0.92 (0.46-1.21). The male subjects had significantly higher median age (p=0.01) and higher WHR (p=0.001) as compared to the female subjects. As per the BMI category, subjects with overweight and obesity constituted 83.3% of the male subjects as compared to 61.6% of the female subjects (p=0.001). The time lapse between receiving of 3rd dose and blood sampling was significantly higher among females compared to males (median days 60 vs 49, p<0.02) indicating earlier vaccination with 1st booster dose among females. A proportion of 51.85% male and 49.68% female subjects showed Anti-N-Ab positivity; there was no significant difference between the gender groups. Also, there was no significant difference among male and female subjects regarding the Ab levels. On Spearman correlation analysis, a tendency of association of WHR with Ab level was observed among the male subjects; however, the association did not show statistical significance (p=0.09). On binary logistic regression Ab positivity was found to be independently associated with WHR (p=0.03), and prior SARS-COV-2 infection within the last 3 months (p=0.02) among males. When all the subjects were considered together, COVID symptom positivity during the last 3 months (p=0.067) and receiving the 1st booster dose (p=0.07) showed a tendency of association with Ab positivity. On multiple regression analysis, Ab levels showed a negative association with WHR (p=0.035) among males. More than 50% of the vaccinated hospital-based HCWs in Bangladesh suffered from BTI during the winter of 2022 when the Omicron wave (the 3rd wave) of COVID-19 was at its peak. The data also indicate that overweight and obesity are major host-related risk factors underlying BTI. Inadequate coverage by a booster dose seems to be another determinant of BTI and the level of immune response in this population.

Incidence of infections related to cardiac implantable electronic devices in Germany

Abstract Background Worldwide, the risk of cardiovascular implantable electronic device (CIED) infection is increasing. Publications of contemporary big data regarding CIED infections for Germany are lacking. This investigation is providing rates of CIED, hospital admission for CIED infection and related mortality in Germany. Methods Data from the biggest healthcare insurance fund was screened for CIED procedures, including placement, revision with aim to up- or downgrade, generator substitution, early revision and partial or complete extraction using specific procedure codes for reimbursement in Germany during 2015. Among the total population of beneficiaries with CIED placement in that year international Classification of Diseases, 10th revision German modification codes were used to identify CIED infections and lead related endocarditis. Results In 2015 altogether 60,296 patients (57.3% male) underwent a CIED procedure. 1129 (1.9%) patients underwent at least one procedure related to CIED infection and 466 (0.77%) participants underwent at least one procedure for treatment of a lead related endocarditis. CIED infection was associated with a mortality rate of 8.4%. Lead related endocarditis was associated with a mortality rate of 15.4% in 2015. Patients presenting with CIED infection and lead related endocarditis were younger (69.5 and 67.3 vs 73.5 years) and more often male (69.4 and 70.2 vs 57.3%) 2.22 procedures in case of hospital admission with CIED infection and 1.93 procedures in case of lead related endocarditis were conducted in 2015. Conclusions Our observational study shows that the rate of CIED infection is greater than has been reported by large randomised trials. Mortality rates for CIED infection and lead related endocarditis are in line with published rates. Younger age and male gender are host related risk factors for an increased risk for CIED infection and lead related endocarditis.

Epigenetic Peculiarity of Alphapapillomavirus Genus Based on the CpG Dinucleotides’ Island Variability

Background: Methylation plays a crucial role in genome regulation, serving as an essential epigenetic mechanism. CpG islands, which are regions of DNA rich in CpG dinucleotides, are ubiquitous epigenetic regulatory features that can modulate the functional dynamics of genes, thereby influencing the pathophysiology of pathogenic organisms within a host. Objectives: In this study, we aimed to investigate the distribution of CpG islands on Papillomavirus genomes and assess their potential impact on the neoplastic progression of different Alphapapillomavirus genera within host cells. Methods: We conducted an analysis of dinucleotide frequencies in DNA sequences from various Alphapapillomavirus genera. The sequences for our analysis were sourced from the specialized HPV (human papillomavirus) database (pave.niaid.nih.gov). Following a comprehensive comparative examination of entire genomes from different HPV species, we specifically focused on 63 genomes belonging to the Alphapapillomavirus genus to identify internal CpG island profiles. These investigations were conducted using online bioinformatics software (DBCAT), and statistical analysis was performed using GraphPad Prism v. 8.0.1. Results: Our preliminary findings revealed that 76.1% of the viruses in our study had fewer than 3 CpG islands but multiple CpG sites, while fewer than 25% of the viruses possessed at least 3 CpG islands. High-risk viruses were identified in 68.42% of genotypes with fewer than 3 CpG islands, whereas low-risk genotypes were observed in 15.7% of cases. Notably, some oncogenic viruses lacked CpG islands entirely, and this pattern was also observed in viruses with a single CpG island, occurring in 50% of cases. Based on the absence of CpG islands, genotypes such as HPV 67, HPV 97, and HPV 34 could potentially be classified as carcinogenic. Additionally, the distribution of CpG islands across HPV genes did not appear to be random. Genes like L2 and E2 contained a CpG island in 50% of cases, whereas oncogenes E6 and E7 consistently had a CpG island in 100% of cases in high-risk genotypes. Conclusions: Our findings suggest that the loss of 1 or more CpG islands could potentially transform an HPV genotype into a high-risk genotype. This process may be accelerated in the presence of host-related risk factors. Further research is required to validate whether CpG island distribution can aid in identifying oncogenic viruses.

Predictive factors of postoperative anastomotic leakage after bowel surgeries, retrospective chart review

Objective: This study aimed to identify host-related and operation-related risk factors and recognize factors that can help in predicting postoperative anastomotic leakage. Methods: It was a retrospective analytical study, conducted in King Fahad Specialist Hospital, Saudi Arabia. Data were collected from medical records. Results: The current study revealed male predominance (57.8%) with 35.9% aged over 60 years. Most participants had no Crohn\&amp;apos;s Disease (81.4%). Hemicolectomy was the common procedure (50.8%), with tumor resection as the primary cause (49.5%). Anastomotic leakage (36.9%) was prominent, and associated with lower albumin levels. Surgery site, reason, and Crohn\&amp;apos;s Disease did not significantly correlate. Bowel resection/anastomosis and emergent surgeries showed notable associations with anastomotic leakage. Conclusion: The study highlighted male predominance and a significant occurrence of anastomotic leakage, correlated with lower albumin levels. Surgery site, reason, and Crohn\&amp;apos;s Disease did not show significant associations, contrasting with bowel resection/anastomosis and emergent surgeries.

On-farm molecular epidemiology and therapeutic insights into multidrug-resistant Staphylococcus aureus isolated from bubaline mastitis

Staphylococcus aureus (S. aureus) is a pathogen of veterinary and public health concern; majorly responsible for bubaline mastitis and huge farm economic losses. The current study, aimed to investigate the on-farm epidemiology, associated antibiotic resistance and possible resistance modulation strategies against S. aureus isolated from bubaline mastitis. S. aureus methicillin and vancomycin-resistant (MRSA and VRSA) from buffalo (n = 384) herds of district Bahawalpur and Rahim yar khan, Pakistan were identified based on bacteriological, biochemical, and molecular confirmation of nuc, mecA, and vanb genes, respectively. The antibiotic susceptibility profiling of S. aureus isolates was done by Kirby-Bauer’s disc diffusion method. The resistant antibiotics were combined with non- antibiotics (NSAIDs and ivermectin) using well diffusion method and checkerboard assay to evaluate resistance modulation. The risk factor analysis was done by chi-square and logistic regression analysis to find out the potential risk factors associated with mastitis in buffalo herds. The results found 50.26% and 38.02% samples positive for subclinical mastitis and S. aureus, respectively. Among local isolates, 62.5% and 20.83% isolates were confirmed MRSA and VRSA, respectively. The final logistic regression analysis revealed that host-related risk factors like (udder depth, teat pathology) and farm management risk factors (udder hygiene during milking, hock score, post-milking disinfection, and dry cow therapy) were significantly associated with the occurrence of sub-clinical mastitis in buffaloes. Antibiotic resistance profiling of local isolates showed significantly (p&lt;0.05) higher resistance to gentamicin, oxytetracycline, and cotrimoxazole. The antimicrobial effects of non-antibiotics against study isolates showed higher zones of inhibition for meloxicam followed by flunixin, ketoprofen, and ivermectin. The combinations of resistant antibiotics with non-antibiotics showed that the combinations of amoxicillin/ meloxicam, cotrimoxazole/flunixin, cotrimoxazole/ketoprofen, and gentamicin/flunixin on well diffusion method and cotrimoxazole/flunixin, amoxicillin/ketoprofen, and gentamicin/flunixin on checkerboard assay revealed synergistic interactions. The study concluded that S. aureus, MRSA, and VRSA is anemerging and prevailing causes of bubaline mastitis in dairy farms in Pakistan. The increasing antibiotic resistance in S. aureus can be modulated by combining the resistant antibiotics with NSAIDs, especially flunixin and ketoprofen.

An overview of the detection of bovine respiratory disease complex pathogens using immunohistochemistry: emerging trends and opportunities.

The bovine respiratory disease complex (BRDC) is caused by a variety of pathogens, as well as contributing environmental and host-related risk factors. BRDC is the costliest disease for feedlot cattle globally. Immunohistochemistry (IHC) is a valuable tool for enhancing our understanding of BRDC given its specificity, sensitivity, cost-effectiveness, and capacity to provide information on antigen localization and immune response. Emerging trends in IHC include the use of multiplex IHC for the detection of coinfections, the use of digital imaging and automation, improved detection systems using enhanced fluorescent dyes, and the integration of IHC with spatial transcriptomics. Overall, identifying biomarkers for early detection, utilizing high-throughput IHC for large-scale studies, developing standardized protocols and reagents, and integrating IHC with other technologies are some of the opportunities to enhance the accuracy and applicability of IHC. We summarize here the various techniques and protocols used in IHC and highlight their current and potential role in BRDC research.

Synchronous and metachronous multiple primary cancers in melanoma survivors: a gender perspective.

Long-term survivors of cutaneous malignant melanoma (CMM) risk subsequent malignancies due to both host-related and environmental risk factors. This retrospective population-based study differentially assesses the risk of synchronous and metachronous cancers in a cohort of CMM survivors stratified by sex. The cohort study (1999-2018) included 9,726 CMM survivors (M = 4,873, F = 4,853) recorded by the cancer registry of all 5,000,000 residents in the Italian Veneto Region. By excluding subsequent CMM and non-CMM skin cancers, the incidence of synchronous and metachronous malignancies was calculated according to sex and tumor site, standardizing for age and calendar year. The Standardized Incidence Ratio (SIR) was calculated as the ratio between the number of subsequent cancers among CMM survivors and the expected number of malignancies among the regional population. Irrespective of the site, the SIR for synchronous cancers increased in both sexes (SIR = 1.90 in males and 1.73 in females). Both sexes also demonstrated an excess risk for synchronous kidney/urinary tract malignancies (SIR = 6.99 in males and 12.11 in females), and women had an increased risk of synchronous breast cancer (SIR = 1.69). CMM male survivors featured a higher risk of metachronous thyroid (SIR = 3.51, 95% CI [1.87, 6.01]), and prostate (SIR = 1.35, 95% CI [1.12, 1.61]) malignancies. Among females, metachronous cancers featured higher SIR values than expected: kidney/urinary tract (SIR = 2.27, 95% CI [1.29, 3.68]), non-Hodgkin's lymphoma (SIR = 2.06, 95% CI [1.24, 3.21]), and breast (SIR = 1.46, 95% CI [1.22, 1.74]). Females had an overall increased risk of metachronous cancers in the first 5 years after CMM diagnosis (SIR = 1.54 at 6-11 months and 1.37 at 1-5 years). Among CMM survivors, the risk of metachronous non-skin cancers is higher than in the general population and differs significantly by sex. These results encourage sex-tailored interventions for metachronous secondary cancer prevention.

Identification, prevalence, distribution of ectoparasites and associated host-related risk factors on domestic animals in district Dera Ismail Khan, KPK, Pakistan

Identification, prevalence, distribution of ectoparasites and associated host-related risk factors on domestic animals in district Dera Ismail Khan, KPK, Pakistan

Spatial-Temporal Variations in Parasitological Prevalence and Host-Related Risk Factors of Camel Trypanosomiasis and Its Vectors in North Eastern Kenya: A Repeated Cross-Sectional Study.

Camel trypanosomiasis (Surra) is endemic in the Horn of Africa. Understanding the spatiotemporal variations in Surra prevalence, vector dynamics, and host-related risk factors is important in developing effective control strategies. A repeated cross-sectional study was conducted to determine the Surra parasitological prevalence, livestock reservoirs, vector density/diversity, and host-related risk factors in Kenya. Random samples of 847, 1079, and 824 camels were screened at the start of the dry season, peak dry season, and during the rainy season, respectively. Blood samples were examined using the dark ground/phase contrast buffy-coat technique, and Trypanosoma species were identified based on their movement and morphology in wet and stained thin smears. Reservoir status for Trypanosoma evansi was assessed in 406 cattle and 372 goats. A rainy and dry seasons entomological surveys were conducted to determine the Surra vector abundance/diversity and spatiotemporal density changes. Surra prevalence was 7.1%, 3.4%, and 4.1% at the start of the dry season, peak dry season, and rainy season, respectively. Camel co-infections by Trypanozoon (T. evansi or Trypanosoma brucei brucei) and Trypanosoma vivax were recorded. Spatial variations in Surra prevalence were recorded at the beginning of dry (X (7, N = 846) 2 = 110.9, p ≤ 0.001), peak dry (X (7, N = 1079) 2 = 42.2, p ≤ 0.001), and rainy (X (7, N = 824) 2 = 29.1, p ≤ 0.001) seasons. The screened cattle and goats tested negative for Trypanozoon (T. evansi or T. b. brucei), while two cattle tested positive for Trypanosoma congolense. Biting fly catches were composed of a single species from Tabanus, Atylotus, Philoliche, Chrysops, and Stomoxys genera. The total catches for Philoliche, Chrysops, and Stomoxys were higher in the rainy than dry season consistent with the prevalence results. Surra remains an important camel disease in the region with its prevalence varying in space and time. Camel co-infections by Trypanozoon (T. evansi or T. b. brucei) and T. vivax necessitate proper diagnosis of suspected cases and targeted therapy.

INCIDENCE AND RISK FACTORS OF SURGICAL SITE INFECTION FOLLOWING CESAREAN SECTION IN A TERTIARY CARE CENTRE IN NORTH KERALA, INDIA

Objectives: To objectives of the study were to study 1) the incidence and maternal determinants (host related) risk factors on post cesarean surgical site infection (SSI) and 2) the influence of labor related and procedure related risk factors on post cesarean SSI. Methods: This study was conducted in the Department of Obstetrics and Gynaecology, KMCT Medical College, Kozhikode from April 1 to August 31 2021 after clearance from ethical committee in which 153 cases of SSI post cesarean were included in the study. Results: Educational status of patients had statistically significant association with the development of SSI incidence of SSI (44.4%) and is highest among overweight women. Patients with diabetes and hypertension had increased risk of developing SSI. 72.2% with SSI had duration of ruptured membrane for &gt;8 h and duration of rupture of membrane were significantly associated with development of wound infection. Significant linear association was found between number of prior cesarean and risk of development of SSI (p=0.019). Cesarean with mean operative time &gt;45 min had statistically significant risk of developing SSI. Intraoperative complication like adhesions was a predictor of SSI (p=0.001) Conclusions: Medical morbidities and increased body mass index being predictors along with prolonged operative time can be properly identified and awareness ensured to prevent and identify post cesarean SSI.

Coinfection of pulmonary tuberculosis with other lower respiratory tract infections: A retrospective cross-sectional study.

Little attention has been given to the development of lower respiratory tract infections (LRTIs) in patients with pulmonary tuberculosis (PTB) during their anti-tuberculosis (anti-TB) treatment and how that might affect patients' health status. Here, the prevalence and etiologies of other LRTIs in a cohort of PTB patients were determined, and the clinical features and outcomes were described. Adult patients with PTB between 2015 and 2020 were recruited and monitored during their anti-TB treatment for the presence of LRTIs. Clinical data were retrospectively collected from patients' medical records. Data from 76 PTB patients (57 [75%] males) were reviewed. The median age was 61.0 (interquartile range 83.5-35.5) years, and other LRTIs were detected in 45 (59.2%) PTB patients. Of the 126 episodes of LRTIs, 84 (66.7%) were due to bacterial infections, 37 (29.4%) were due to fungal infections, and 5 (3.9%) were due to viral infections. The development of LRTIs was significantly more common in older (P = 0.012) and hypertensive patients with PTB (P = 0.019). Patients with PTB and LRTIs experienced significantly more frequent extrapulmonary infections (P = 0.0004), bloodstream infections (P = 0.001), intensive care unit stays (P = 0.001), and invasive mechanical ventilation use (P = 0.03) than patients who did not develop LRTI. The identification of host-related risk factors for LRTI development among patients with PTB could be used to develop a prediction model for LRTI development. Hence, initiating antimicrobials early, in parallel with appropriate anti-TB treatment, may mitigate PTB-related health and economic consequences.

Risk Factors Associated with Surgical Site Infection following Cesarean Section in Tertiary Care Hospital, Nepal.

Background Cesarean section (CS) is one of the most performed surgeries in obstetrics. Surgical site infection is the major cause of morbidity and mortality causing an increase in the duration of hospitalization as well as the cost of admission for the patient. Objective To determine incidence of surgical site infection following cesarean section, classify them according to CDC criteria, and identify the different risk factors. Methodology. This is a case-control study conducted at the Department of Obstetrics and Gynecology at Tribhuvan University Teaching Hospital (TUTH), main campus of Institute of Medicine (IOM), Kathmandu, Nepal. Surgical site infections (SSI) in patients who underwent cesarean sections from February 2019 to August 2019 were taken as cases, while the patients who underwent cesarean section before or after the procedure and did not develop SSI comprised the controls. Visual inspection during ward rounds, reports from laboratory, and postprocedure follow-ups for up to 30 days formed the basis of identifying infections on the patients. Risk factors were identified by bivariate and multivariate logistic regression. Results Out of 1135 cases of cesarean sections, 97 of them developed SSI with incidence rate of 8.54%. Among them, 94.85% were superficial incisional and 5.15% were deep incisional type of SSI with no organ space type. Cases had higher mean age 26.88 ± 4.38 years compared to 24.81 ± 5.08 years in controls. Host-related risk factors which led to higher odds of developing surgical site infection (SSI) were obesity with adjusted odds ratio (AOR) 15.72 (confidence interval (CI): 4.60-53.67), diabetes/hypertension in pregnancy with AOR 4.75(CI 1.69-13.32), and other medical diseases with AOR 9.38 (CI 2.89-30.46). Duration of the rupture of membrane for more than 18 hours with AOR 8.38 (CI 1.48-47.35), more than five per vaginal (PV) examination with AOR 1.93 (95% CI 1.03-3.64), and in labor status with AOR 6.52 (CI 1.17-36.38) were some procedure-related factors resulting into higher odds of infection. Conclusion Multiple risk factors like age, obesity, medical complications during pregnancy, occurrence of labor status during cesarean section, prolonged duration of rupture of membrane for more than 18 hours, and more than five vaginal examinations before the procedure increases the chance of surgical site infection (SSI) following cesarean section.

Study on Bovine Trypanosomiasis and Associated Risk Factors in Benatsemay District, Southern Ethiopia.

Trypanosomosis is an endemic livestock disease in Ethiopia that hinders livestock production and productivity, especially in fertile agricultural western and southwestern areas. A cross-sectional questionnaire-based and parasitological studies were conducted from October 2020 to July 2021 in the Benatsemay district, southern Ethiopia to assess the knowledge of livestock owners about trypanosomosis, its prevalence, and host-related risk factors associated with bovine trypanosomosis in the area. According to the questionnaire survey, trypanosomosis was the main bottleneck to cattle in two of the selected study Sites in the Benatsemay district. The parasitological survey revealed that 11.46% (44/384) of the cattle were infected with trypanosomosis. Moreover, Trypanosoma congolense (9.11%) is the leading trypanosome species in the area, followed by T. vivax (31.8%). The adult age group (16.15%), poor-conditioned cattle (22.22%), and black-skinned cattle (34.24%) were significantly associated (P < .05) with trypanosomosis infection in the study area. Furthermore, the mean packed cell volume (PCV) of parasitaemic cattle (22.75%) was significantly (P < .05) lower than that of aparasitaemic cattle (29.23%). Therefore, the present study revealed that the prevalence of bovine trypanosomosis in the study area and participatory vector control and the rational use of trypanocidal drugs should be implemented to control trypanosomosis in the area.

Study on the Prevalence and Host-Related Risk Factors of Bovine Trypanosomosis in Selected Kebeles of Konta Zone District, South Western Ehiopia

Trypanosomosis is a disease caused by several species of protozoa parasites called trypanosomes found in the blood and other tissues of vertebrates including livestock, wildlife &amp; people. The objective of this cross sectional study was to determine the prevalence of bovine trypanosomosis, identify species of trypanosomes involved and access associated risk factor in Ameya Zuria Woreda. In this study, over all prevalence of 12.8 % (49/ 384) bovine trypanosomosis was recorded. Prevalence of 9.4 % and 16.9 % was observed in female and malecattle respectively. Bovine trypanosomosis with prevalence of 18.5%, 11.8%, 10.4%, 10.8% &amp; 11.8% was recorded in Chebera, Cheta, Dupa, Serishewa and Yora peasant associations respectively. The prevalence of 5.6%, 14.3 6% and 16.7 were recorded in cattle of young, adult and old respectively. Two species of trypanosomosis T.congulense and Brucei were detected with a prevalence of 11.2% and 1.7 % respectively. In the current study, the prevalence of trypanosomosisbased on body condition scores were recorded as good, medium, and poor as 6.8 %, 9.9 % and 21.3 % respectively. Based on coat color, prevalence of 26.4%, 15.8%, 8.5% and 5.8 were recorded in black, grey, red and white color respectively. Based on Hematological finding to PCV &lt;25 and PCV ≥ 25 78.6% were recorded anemic while 21.4 % were normal. In conclusion, this study indicated that trypanosomosis was the major constraint of livestock production in the Ameya Zuria Woreda *20therefore; concerned individuals should strengthen and continue the effort against this parasitic disease.