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The emerging pandemic of COVID-19 caused by the novel pathogenic human coronavirus SARS-CoV-2 has caused significant morbidity and mortality across the globe, prompting the scientific world to search for preventive measures to interrupt the disease process. Demographic data indicates gender-based differences in COVID-19 morbidity with better outcome amongst females. Disparity in sex-dependent morbidity and mortality in COVID-19 patients may be attributed to difference in levels of sex steroid hormones -androgens and estrogens. Evidence suggests that apart from the regulation of viral host factors, immunomodulatory and cardioprotective roles exerted by estrogen and progesterone may provide protection to females against COVID-19. Exploring the underlying mechanisms and beneficial effects of these hormones as an adjuvant to existing therapy may be a step towards improving the outcomes. This article aims to review studies demonstrating the role of sex steroidal hormones in modulating SARS-CoV-2 host factors and summarize plausible biological reasons for sex-based differences seen in COVID-19 mortality.

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Objective: To determine the prevalence and associated factors of intestinal parasitic infections in migrant workers in Nakhon Ratchasima Province, Northeast Thailand. Methods: A cross-sectional study was conducted from August 2017 to July 2018 in 600 Myanmar migrant workers. Questionnaires were employed for collecting the demographic data of participants. Stool samples were collected and examined using the formalin-ether concentration technique. Risk factors for intestinal parasitic infections were determined using multiple logistic regressions analyses. Results: The overall infection rate of intestinal parasitic infections was 27.67% (166/600). Among the intestinal helminthes observed, hookworm was most abundant (8.67%) followed by Trichuris trichiura (8.50%), Opisthorchis viverrini(4.17%), Ascaris lumbricoides(1.50%), Strogyloides stercoralis(1.17%) and Hymenolepis nana(0.5%). Meanwhile, Entamoeba coli was the most prevalent intestinal protozoa (4.33%, 26/600) followed by Endolimax nana (1.33%), Entamoeba histolytica complex (1.17%), Blastocystis sp. (1.0%) and Giardia duodenalis (0.17%). The study found significant associations between gender and Strogyloides stercoralis infection (OR_adj=5.61, 95% CI=1.18–26.70, P=0.03), workers aged 30 years old were likely to have a lower risk of the T. trichiura infection (OR_adj=0.45, 95% CI= 0.23–0.89). Moreover, the history of consuming raw or undercooked cyprinoid fish was a risk factor of Opisthorchis viverrini infection (OR_adj=2.82, 95% CI=1.22–6.49, P=0.015). Conclusions: There remains a high prevalence of intestinal parasitic infections among Myanmar migrant workers in the study area and therefore health screenings for all migrant workers in Thailand are required.

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Objective: To screen phytochemicals in ethanolic leaf extracts of Phyllanthus amarus collected from three different geographical zones in Nigeria and evaluate their effects on larva and adult of Anopheles gambiae. Methods: The sample extracts of Phyllanthus amarus prepared with ethanol solvent were tested against Anopheles gambiae at two important developmental stages of its life cycle using slightly modified WHO protocols. Results: Alkaloids, saponins, tannins, flavonoids, glycosides, phenols, and terpenes were detected in each extract. Among these samples, the extract from northwest exhibited the highest larvicidal activity (LC₅₀=263.02 ppm), followed by southeast and southwest extracts (LC₅₀=288.40 and 295.12 ppm, respectively after 48 h), while the extract from southwest exhibited the highest adulticidal activity (LC₅₀=275.42 ppm), followed by northwest and southeast extract (LC₅₀=301.99 and 316.22 ppm, respectively after 24 h). A 50% larva mortality was almost attained at 600 ppm after 48 h duration of exposure to the northwest extract. Conclusions: The tested samples possess strong larvicidal and adulticidal property against Anopheles gambiae which depends on their chemical composition and localities of collection. Further studies are needed to explore the insecticidal activity against a wider range of mosquito species, and to identify active ingredient(s) of the extract responsible for such activity.

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Objective: To evaluate the potential of Gracilaria changii extract in ameliorating the potential adverse effects of bisphenol A. Methods: The antioxidant capacity of Gracilaria changii extracted using different solvents (methanol, ethanol, and aqueous) was studied. The mice were administered by oral gavage with bisphenol A (60 mg/kg body weight) for 6 weeks with or without Gracilaria changii aqueous extract. Thereafter, the mice were either euthanized for histology and immunohistochemistry studies or mated to evaluate the pregnancy rate. Results: Gracilaria changii aqueous extract showed the highest antioxidant properties compared with extract using methanol and ethanol. The aqueous extract of Gracilaria changii improved the uterus index and uterine lipid peroxidation after bisphenol A exposure, although the uterine expressions of estrogen receptors and complement C3 were not improved. Histological evaluation of the uterus during the estrus stage has revealed that the extract could mitigate bisphenol A-induced adverse effects in the uterus as there was a lower percentage of mice showing abnormalities like decreased eosin staining in the myometrium, and decrease in the number of eosinophil and endometrial glands in the endometrium. Besides, Gracilaria changii aqueous extract improved the pregnancy rate of mice administered with bisphenol A. Conclusions: Gracilaria changii extract protects against bisphenol A-induced female reproductive abnormalities in mice which may be mediated via modulation of eosinophil migration, endometrial gland formation, and protein expressions associated with prostaglandins in the myometrium.

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Rational: Brucellosis is a globally prevalent zoonotic disease. Any part of the body can be affected by active brucellosis but osteoarticular involvement are the most common symptoms which was reported to vary from 10% to 85%. The spine is the most common site of brucellosis in the bones. However, noncontiguous brucellar spondylitis is rare, only few cases have been reported in the literature. Patient concerns: A 62-year-old woman with brucellar spondylitis presented with lower back pain and pain in the right lower extremity for six months. Diagnosis: Brucella agglutination test (1:320) and the result of polymerase chain reaction (PCR) confirmed the diagnosis of noncontiguous brucellar spondylitis. Intervention: During hospital stay, the women received intravenous treatment for brucellosis (A combination of doxycycline 200 mg/d, rifampicin 900 mg/d, levofloxacin 0.5 g/QD, and ceftriaxone 2 g/QD was administered for 1 week), The L4-S1 vertebral body was fixed by posterior lumbar debridement. Outcome: Six months after discharge, the follow-up radiographic images showed stable vertebral height and good lumbar stability. She complained no discomfort. Lessons: Multi-level involvement is an exceptional form of brucellar spondylitis. To the best of our knowledge, only few similar cases have been reported. PCR and bacterial culture is necessary for confirmed diagnosis.

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Objective: To determine the seroprevalance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in the general population of Mazandaran province in Iran and to estimate the percentage of asymptomatic, mild, and severe infections. Methods: We chose 1 588 inhabitants of Mazandaran province with cluster sampling. We measured their SARS-CoV-2 immunoglobulin M (IgM) and immunoglobulin G (IgG) serum levels. Demographics, risk factors, and symptoms were collected. The seroprevalence of SARS-CoV-2 was calculated by age and city and the World Health Organization (WHO) protocol and further stratified by demographic variables and risk factors. Finally, we identified the symptoms and factors related to COVID-19 with logistic regression. Results: Two hundred subjects (12.59%) were tested positive for either IgG or IgM. Until May 23, 2020, the prevalence of COVID-19 was 15.26% (95% CI: 12.97%-17.79%) based on direct standardization and WHO’s standardized age groups. Based on multivariate logistic regression, the incidence of getting an infection increased by an average of 11.6% for every 10-year increase in age (OR=1.116, 95% CI: 1.008-1.236, P=0.035). Furthermore, those in contact with COVID-19 patients had a 66.1% higher risk of developing the disease (OR=1.661, 95% CI: 1.104-2.497, P=0.015). In addition, the chance of getting SARS-CoV-2 infection was almost four times higher in people who had consulted a doctor during the pandemic than those who had not (OR=3.942, 95% CI: 2.813-5.524, P<0.001). Conclusions: The prevalence of COVID-19 in Mazandaran province could be higher than the officially reported statistics based on diagnostic tests and clinical cases. There seems to be more asymptomatic or mild symptom cases than what was previously reported.

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