An innovative strategy for attaining efficient and high-throughput detection in a wide range of applications is the simultaneous detection of numerous chemicals from a single sample. Even though immunoanalytical techniques are well-established and favorable over alternative screening analytical platforms, multiplexing is one of the hurdles for immunoassays. While ELISA is still extensively used to characterize a single analyte, multiplex immunoassays are becoming more popular among laboratories and organizations. Furthermore, screening multiple analytes at the same time are advantageous for a quick, cost-effective, and reliable quantification. Feinberg and Wheeler developed the concept of immunoassay for clinical diagnostics when they developed a technique for detecting autoimmune antibodies and tissue antigens, in which, serum from autoimmune thyroiditis patients was treated with thyroglobulin immobilized in a microspot on cellulose acetate strips.[1] The capacity of the microspot assay to detect low quantities of autoantibody and antigen had the benefits of being simple, sensitive, objective, fast, and requiring only a small amount of blood and antigen. R. Ekins later proposed that immunoassays be shrunk (i.e., the capture antibody concentration should be reduced) and described the key microarray multiplex technology concepts, with an eye toward their potential applications in research and clinical diagnostics.[2] Assaying for disease biomarkers such as soluble antigens and antibodies has always been a useful diagnostic and research tool. In diagnosis and research, ELISA has the potential to replace agglutination, complement fixation, precipitation, and immunodiffusion. One of the primary reasons for switching from traditional serological tests to ELISA is the ability to automate the test procedure. However, to implement an optimized therapeutic regimen in more complex, multifactorial diseases such as cancer, autoimmune, and neurodegenerative diseases, multiple biomarkers must be analyzed.[3,4] In the postgenomic age, large-scale screening has been used for everything from identifying disease-related gene products, medication discovery, and clinical diagnostics to functional exploration of unknown genes.[4] High sensitivity, multiplexing capabilities, rapid turnaround time, low system complexity, and low manufacturing costs, and minimal user intervention are all desirable characteristics of an ideal device for emergency testing.[5] Multiplex immunoassays have become an important instruments for efficiently utilizing available data in disease observation, monitoring, and therapy. Simplex and multiplex ELISAs both use the same “sandwich” format (capture antibody-analyte-detection antibody). However, because enzymatic reporters are chemically incompatible with simultaneous analysis of multiple localized targets, multiplex ELISA uses chemiluminescent/fluorescent reporter systems. As a result, multiplexed diagnostic devices capable of high-throughput analysis of numerous parameters such as RNAs, metabolites, proteins, cells, and so on have become increasingly important.[5] Nonetheless, only a small number of protein multiplex immunoassays have been validated in clinical settings for in vitro diagnostics.[4] The rising need for novel biomarkers (e.g., aptamers) or targets (e.g., circulating RNAs and DNA, tumor cells, miRNAs, and so on) and their diagnostic, prognostic, and therapeutic applications, including therapeutic drug monitoring will have an impact on the future of multiplex systems.[3,5] PCR, ELISA, microarrays, gel electrophoresis, capillary electrophoresis, Sanger sequencing, and other modern technologies are required for multiplex assays. Fluorescence spectroscopy measurements are becoming increasingly common due to their compatibility with biochemical assays, small sample size, ease of conjugation to potential substances, affordability, stability, durability, and detection with less expensive optical instruments.[6] Without the need for separation, mass spectrometry (MS) can identify molecules. In hospitals, for example, matrix-assisted laser desorption/ionization (MALDI-MS) is used to characterize antigens. However, these bioanalyzers are large, expensive, and only detect a small amount or type of analyte. As a result, these systems still face numerous hurdles, such as cost and detecting capability.[4,7] Precision medicine combines genomes, epigenomics, proteomics, and metabolomics with specific patient clinical characteristics using modern omics technologies such as next-generation sequencing, protein and gene microarrays, and laser capture microdissection. Multiplex genotyping and high-throughput genomic profiling technologies have advanced to the point where the patient’s genome can be analyzed from peripheral blood or tissue samples.[8] In clinical diagnostics, multiplex assays have lately acquired prominence, with novel applications appearing in underdeveloped nations. Multiplex assays have a number of benefits, including the capacity to run many reactions on a single sample and deliver additional information from the sample in a timely and efficient manner. As a result, improvements in clinical science technology make it easier to identify analytes or biomolecules in pathological samples. 

Objective: Schistosoma mansoni (S. mansoni) is endemic in Africa, the Middle East, South America, and the Caribbean. This study investigated the modulation of immune response against S. mansoni through estimation of interleukin-4 (IL-4) (Th2 cytokine) and interferon-gamma (INF-γ) (Th1 cytokine) under the effect of anti-schistosomal drugs. Methods: Laboratory bred female albino mice (n = 120) were divided into the following groups: untreated mice, S. mansoni infected mice, S. mansoni infected mice treated with artemisinin (ART), arachidonic acid (ARA), nifedipine or praziquantel (PZQ). Levels of IL-4 and INF-γ cytokines in the serum samples of treated and untreated mice were determined by enzyme-linked immunosorbent assay and the results were further validated by measuring the mRNA levels IL-4 and INF-γ using quantitative real-time polymerase chain reaction. Results: Anti-schistosomiasis drugs ART and ARA increased the levels of Th2 cytokine IL-4 (P < 0.05), whereas PZQ drug decreased the response of IL-4 (P < 0.05). However, nifedipine was found to be ineffective in modulating the response of IL-4 (P > 0.05). As far as Th-1 cytokine IFN γ was concerned, only PZQ increased its levels (P < 0.05), whereas other tested anti-schistosomiasis drugs; ART, ARA, and nifedipine were found to be infective (P > 0.05). Conclusions: These findings indicated that anti-schistosomiasis drugs ART, ARA, and PZQ play a role in the modulation of expression of Th2 cytokines. Whereas, only PZQ may play a role in the modulation of Th1 cytokines. These findings provide a scope for the formulation of novel anti-schistosomal drugs as well as in the therapeutic management of patients infected with S. mansoni.

Objectives: The aim of the study was to determine the effectiveness of team-based learning (TBL) sessions as a learning tool and to assess the satisfaction level of medical students towards TBL in modular curriculum. Methods: Using the quasi-experimental study design, TBL sessions were conducted, involving students of 1st and 2nd year of Bachelor of Medicine and Bachelor of Surgery. The TBL infrastructure comprised of pre-class preparation, in-class individual readiness assurance pre-test and post-test, before and after group discussion, respectively. The responses of the students regarding TBL satisfaction were recorded through a structured questionnaire (5-point Likert-type scale) while Wilcoxon signed rank test was applied to measure the effectiveness of TBL sessions. Results: Out of 192 students, 85% agreed or strongly agreed that TBL helped them think critically, identify their knowledge gaps, boosted their confidence, and motivated them in group participation. Significantly better post-test scores were found in all modules where TBL was used as a teaching tool (Z range = -5.33 to -11.81, P < 0.00). Conclusion: TBL increases the post-test score in majority of the students, indicating improved learning process. It not only keeps students engaged throughout the learning process but incites critical thinking, problem solving skills, and confidence. Further studies are required to see long-term benefit of TBL in students’ learning.

Objective: Human papillomavirus (HPV) is a sexually transmitted virus which play a vital role to developing Cervical cancer. It is presumed and accepted that sexually exposed women will have occurred HPV infection at least once in their whole life. Hence, determined the actual cause of transmission of HPV infection in sexually active women with single sex partner that is married women and sexually active women with multiple sex partners that is female sex works (FSWs). Methods: A total 197 urine sample of FSWs and MW has been utilized through RT-PCR technique for HR-HPV detection. DNA extracted from urine samples and estimation and purification of DNA, used RT-PCR technique for HPV-16 and HPV-18 detection. Results: The overall prevalence of HR-HPV was detected to be 16.75% (33/197) and 83.25% (164 out 197) negative results reported in both studied subjects. The results analysis of HPV-16 and HPV-18 reveals in which prevalence of HPV-16 was 14.21% (28/197) and HPV-18 was detected 2.53% (5/197) in studied subjects in both study groups. The prevalence of HPV-16 and HPV-18 among MW was high (18.75%) and HPV-16 and HPV-18 was low (14.85%) in FSWs. It did not differ significantly of HR-HPV prevalence in MW who has single sex partner and FSWs who has multiple sex partners. Conclusion: The study indicates that oncogenic HPV prevalence did not different significantly in multiple sex partners, that is, FSWs and single sex partner, that is, MW. The probability of genital hygiene rather than multiple sexual partners stands more apt as a cause of HPV infection. This study advises to develop more awareness program about genital hygiene in women to reduce the HPV infection and can be prevented from cervical cancer. Hence, genital hygiene may be reducing the burden of HPV infection in women.

Objective: During the COVID-19 pandemic, there was a significant decrease in the number of operated elective cases due to the shutdown procedures. This situation created a substantial surgical backlog. Several visits are generally necessary before a surgical decision making and booking the surgery time. Improving patient access by creating “one-stop” clinics might help decrease the number of visits before the surgery. This study investigated the effect of one-stop clinic application as a new care model on COVID-19 surgical backlog clearance. Methods: We conducted a quasi-experimental, interrupted time-series, pretest-posttest study design in the northern areas of Saudi Arabia. The study outcomes were the number of surgeries and the time elapsed from the first seen day to the booked room day. Results: A total of 358 surgeries were included. Of them, 107 (29.9%) surgeries were performed before initiation of the one-stop clinic and 251 (70.1%) after initiation. The median (quartile Q1, Q3) time elapsed from the first seen day until the booked OR day post-one-stop clinic was 10 (6-17), which was significantly lower than pre-one-stop clinic 20 (11-33), P < 0.0001. Conclusion: One-stop clinics shortened the period between first visit and booking in the operating room. One-stop clinics may alleviate the surgical backlog resulting from the COVID-19 crisis.

Objectives: The time for PCR positivity to negativity is defined as nucleic acid conversion time (NCT) and is very important in terminating the isolation of patients and determining infectiousness in patients with COVID-19. The aim of this study is to determine the median NCT and to evaluate the clinical and laboratory parameters affecting it in patients with COVID-19. Methods: This study included 318 patients with mild to moderate COVID-19 diagnosed with PCR positivity retrospectively. Results: The median NCT was 11 days. Patients were divided into 2 groups as early (<11 days) and late conversion (≥11 days). Older age, sore throat, onset fever, fever 72 h after hospitalization, history of exposure to SARS-CoV-2 virus without a mask, and moderated disease were significantly more common in the late conversion group. In addition, favipiravir use was higher in early conversion group and hydroxychloroquine use was higher in late conversion group. In multivariate analysis, sore throat (OR = 2.570; 95% CI: 1.051–6.284, P = 0.039) and hydroxychloroquine use (OR = 3.518, 95% CI: 1.163–10.635, P = 0,026) were independent risk factors for late conversion. Favipiravir use (OR = 0.062, 95% CI: 0.021–0.184, P = 0.0001) negatively affected the late conversion. Conclusion: NCT was longer in patients with COVID-19 who had sore throat at admission and were treated with hydroxychloroquine instead of favipiravir.

Myxoinflammatory fibroblastic sarcoma (MIFS) is rare and malignant soft-tissue neoplasms that typically present in the extremities. In the literature, MIFS has been reported in the groin, back, neck, nose, and temporal regions in addition to the extremities. We report a case of MIFS presenting with the complaints of nasal bleeding, purulent nasal discharge, and swelling on the right side of his face. Polypoid tissues protruded from the middle meatus were observed and initial diagnosis was inverted papilloma. The painless tumor was initially mistaken for low-grade myxofibrosarcoma in biopsy. Maxillectomy was performed and made the rare diagnosis of MIFS. Fibroblastic proliferation with extensive local spread from subcutaneous tissue to the epithelium of the maxillary sinus mucosa, maxillary bone, and especially along the bone marrow was observed. To the best of our knowledge, this is the first reported case of MIFS involving the maxillary bone.