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   Table of Contents - Current issue
Coverpage
September 2022
Volume 15 | Issue 9
Page Nos. 381-428

Online since Friday, September 30, 2022

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PERSPECTIVES  

The future of COVID-19 vaccination rates for children p. 381
Giao Huynh, Kimberly H. Nguyen, Han Thi Ngoc Nguyen, Tuan Diep Tran, Pham Le An
DOI:10.4103/1995-7645.356991  
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A looming twindemic of COVID-19 and dengue on post-flood scenario in the developing countries p. 383
Abdullah, Sher Ali, Muhammad Salman, Muddasir Khan
DOI:10.4103/1995-7645.356990  
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Recurrent Marburg virus disease outbreaks from 1967 to 2022: A perspective on challenges imposed and future implications p. 385
Yusra Mashkoor, Faryal Rafique, Amraha Zubair
DOI:10.4103/1995-7645.356989  
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REVIEW ARTICLE Top

Non-albicans candidemia in cancer patients as an increasing health problem: A comprehensive review and meta-analysis p. 387
Aynaz Ghojoghi, Maryam Erfaninejad, Ehsan Ahmadpour, Eisa Nazar, Aleksandra Barac, Mahnaz Fatahinia
DOI:10.4103/1995-7645.356992  
Objective: To evaluate the prevalence of Candida species in cancer patients with candidemia around the world, and to identify related risk factors and their antifungal resistance, with an emphasis on non-albicans Candida species (NACs). Methods: The published papers related to the subject were systematically searched in databases of MEDLINE (including PubMed), Web of Science, Scopus, Science Direct, and Google Scholar between the 1st January 2000 and 21st April 2021. Results: Among the 4 546 records, 69 studies met the inclusion criteria. The pooled prevalence of NACs in cancer patients with candidemia was 62% (95% CI 58%-67%; I2=94.85%, P=0.00). Based on type of cancer, the pooled prevalence of NACs in hematologic and solid cancer patients were 68% (95% CI 65%- 70%) and 52% (95% CI 49%-54%), respectively. Among NACs, Candida (C.) parapsilosis was the most frequently isolated organism followed by C. tropicalis and C. glabrata. In addition, the therapeutic usage of antibiotics was found as the most common risk factor, accounting for 85% (95% CI 81%-89%) and central venous catheter accounting for 69% (95% CI 62%-77%). Conclusions: The incidence of Candida bloodstream infections among cancer patients is a growing concern, especially when the etiologic agents of candidemia tend to shift towards NACs.
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ORIGINAL ARTICLES Top

The predictors of long–COVID in the cohort of Turkish Thoracic Society– TURCOVID multicenter registry: One year follow–up results p. 400
Serap Argun Baris, Oya Baydar Toprak, Pelin Duru Cetinkaya, Fusun Fakili, Nurdan Kokturk, Seval Kul, Ozgecan Kayalar, Yildiz Tutuncu, Emel Azak, Mutlu Kuluozturk, Pinar Aysert Yildiz, Pelin Pinar Deniz, Oguz Kilinc, Ilknur Basyigit, Hasim Boyaci, Ismail Hanta, Neslihan Kose, Gulseren Sagcan, Caglar Cuhadaroglu, Hacer Kuzu Okur, Hasan Selcuk Ozger, Begum Ergan, Mehtap Hafizoglu, Abdullah Sayiner, Esra Nurlu Temel, Onder Ozturk, Tansu Ulukavak Ciftci, Ipek Kivilcim Oguzulgen, Vildan Avkan Oguz, Firat Bayraktar, Ozlem Ataoglu, Merve Ercelik, Pinar Yildiz Gulhan, Aysegul Tomruk Erdem, Muge Meltem Tor, Oya Itil, Hasan Bayram
DOI:10.4103/1995-7645.354422  
Objective: To evaluate long-term effects of COVID-19, and to determine the risk factors in long-COVID in a cohort of the Turkish Thoracic Society (TTS)-TURCOVID multicenter registry. Methods: Thirteen centers participated with 831 patients; 504 patients were enrolled after exclusions. The study was designed in three-steps: (1) Phone questionnaire; (2) retrospective evaluation of the medical records; (3) face-to-face visit. Results: In the first step, 93.5% of the patients were hospitalized; 61.7% had a history of pneumonia at the time of diagnosis. A total of 27.1% reported clinical symptoms at the end of the first year. Dyspnea (17.00%), fatigue (6.30%), and weakness (5.00%) were the most prevalent long-term symptoms. The incidence of long-term symptoms was increased by 2.91 fold (95% CI 1.04-8.13, P=0.041) in the presence of chronic obstructive pulmonary disease and by 1.84 fold (95% CI 1.10-3.10, P=0.021) in the presence of pneumonia at initial diagnosis, 3.92 fold (95% Cl 2.29-6.72, P=0.001) of dyspnea and 1.69 fold (95% Cl 1.02-2.80, P=0.040) fatigue persists in the early-post-treatment period and 2.88 fold (95% Cl 1.52- 5.46, P=0.001) in the presence of emergency service admission in the post COVID period. In step 2, retrospective analysis of 231 patients revealed that 1.4% of the chest X-rays had not significantly improved at the end of the first year, while computed tomography (CT) scan detected fibrosis in 3.4%. In step 3, 138 (27.4%) patients admitted to face-to-face visit at the end of first year; at least one symptom persisted in 49.27% patients. The most common symptoms were dyspnea (27.60%), psychiatric symptoms (18.10%), and fatigue (17.40%). Thorax CT revealed fibrosis in 2.4% patients. Conclusions: COVID-19 symptoms can last for extended lengths of time, and severity of the disease as well as the presence of comorbidities might contribute to increased risk. Long-term clinical issues should be regularly evaluated after COVID-19.
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A cross–sectional study of post–COVID syndrome at a tertiary care center in Turkey p. 410
Efraim Guzel, Oya Baydar Toprak, Burak Mete, Yasemin Saygideger, Bengu Curuk, Sedat Kuleci
DOI:10.4103/1995-7645.356993  
Objective: To investigate long-term symptoms after acute COVID-19, the link between symptoms and respiratory function, radiological changes in the post-COVID period, and risk factors for post-COVID syndrome. Methods: In this cross-sectional study, 123 participants who were admitted within the first 3 months were categorized as group 1, and those who applied after 3 months were categorized as group 2. According to thoracic imaging and pulmonary function tests, patients were split into 3 groups as mild, moderate and severe. Results: At least one symptom was present in 91.9% and 61.8% in acute and post-COVID period, respectively. Pulmonary function tests were normal in 60 (70.6%) in the first three months, and 30 (78.9%) in 91-days to 1-year period after acute COVID-19 infection. After 3 months, 22.4% of chest X-rays and 7.9% of computerized tomography revealed progression. Patients who developed acute complications (OR 9.91, 95% Cl 1.93-50.87), had 2 or more symptoms at admission (OR 7.73, 95% CI 2.56-23.33), had 1% to 14% CT involvement (OR 3.05, 95% CI 1.06-8.79), or had 50% or more CT involvement (OR 14.68, 95% CI 1.24-172.55) had a higher risk of developing post-COVID syndrome. Conclusions: COVID-19 symptoms can last for long time. Severity of symptoms, acute complications, and the extent of radiological involvement may all contribute to elevated risk of post-COVID syndrome. As a result, patients with COVID-19 should be checked for long-term clinical difficulties on regular basis.
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Genetic diversity of Leishmania donovani isolates from cutaneous lesions of military personnel in the Mullaitivu and Kilinochchi districts of the Northern Province, Sri Lanka p. 418
Tharaka Wijerathna, Nayana Gunathilaka, Saveen Semege, Nishantha Pathirana, Wasana Rodrigo, Deepika Fernando
DOI:10.4103/1995-7645.354420  
Objective: To compare the DNA sequences of Leishmania (L.)donovani isolated from individuals in two districts of the Northern Province with other parts of Sri Lanka and neighboring countries. Methods: Samples were collected from military personnel at the Army Hospital, Narahenpita, Sri Lanka from November 2018 to March 2020. A portion of the samples was fixed, stained with Giemsa and observed under the light microscope. The genomic The DNA was extracted from the remaining portion of the samples using DNEasy blood tissue kit (Qiagen, Germany) and amplified using Leishmania genus-specific primers for molecular diagnosis initially. DNA was amplified using L. donovani species-specific primers by PCR and the amplified product was sequenced for comparison of nucleotide sequences. Results: Out of 76 suspected patients, at least one biological sample of 45 (59.2%) was positive for L. amastigotes upon microscopy. Overall, 33 (43.4%) were positive in Leishmania genus-specific PCR, but only 23 (30.3%) were positive in L. donovani specific PCR. The dendrogram indicates that the current sequences clustered together with those from Nepal and Gampaha districts (Western Province), Sri Lanka, while the Indian and Eastern African sequences clustered separately. Conclusions: The genetic diversity was low among the isolates, indicating a single and possibly a local point of origin. However, the similarity of Sri Lankan and Nepal strains indicate a possibility of a shared point of origin, which needs more extensive evidence to confirm.
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CASE REPORT Top

Acute motor axonal neuropathy following anti-rabies human diploid cell vaccine: A rare case and review p. 425
Tanushree Chawla, Jyoti Sehgal, Surekha Dabla, Vinay Goyal
DOI:10.4103/1995-7645.356994  
Rationale: Guillain Barre syndrome (GBS) is an acute neurological illness leading to quadriparesis with respiratory involvement. It can be triggered by infections, vaccinations, surgery, trauma, transplantation and drugs. Anti-rabies cell culture vaccines introduced to overcome the high rate of neurological complications associated with tissue based rabies vaccine, can be very rarely associated with GBS. Patient concerns: A 50-year-old female presented with acute severe upper back pain evolving into pure motor quadriparesis following administration of human diploid cell vaccine for rabies. Diagnosis: Acute motor axonal neuropathy variant of GBS following anti-rabies human diploid cell vaccine. Interventions: Intravenous high dose steroids. Outcomes: Patient recovered completely within 1 month. Lessons: Although anti-rabies cell culture vaccines are highly immunogenic and safe, they are rarely associated with GBS. Clinicians should be aware of this link because prompt diagnosis and treatment can result in complete recovery and avoid complications.
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LETTER TO EDITOR Top

An alarming scenario in developing world: A looming of viral outbreaks p. 427
Faheem Anwar, Abdullah , Shazma Wahab, Komal Aman, Ihteshamul Haq
DOI:10.4103/1995-7645.357201  
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