This review aims to fill the voids and to update the checklist of sandfly fauna along with its spatial distribution in India. Resource databases i.e. either online or offline were searched to deduce the information to systematize the Indian sandfly fauna. Articles/data retrieved were screened and analysed to further update the available latest checklist. The species name and authorship were given in accord with the International Code for Zoological Nomenclature. We compiled an updated checklist of reported Indian sandfly species along with their state-wise distribution till 2022 as per published literature. Kerala has maximum number of species reports when compared to other endemic states and states with pockets of transmission. Phlebotomus argentipes is the most widely distributed, recorded so far, followed by other Sergentomiya and Phlebotomus species in India. In this review, we have also described the vector and non-vector species of sandfly prevalent in different parts of the country. Phlebotoiella eoindianensis, an amber fossil sandfly species recorded from Gujarat might be older than other records of Indian sandfly fauna. So far 69 species (4 genera and 15 subgenera/groups) of Phlebotomine sandflies have been recorded in India. Proper knowledge of species diversity and its distribution is a prerequisite for planning a systematic vector control strategy and disease management.

Objective: To identify the association between serum albumin levels and disease severity among adult patients with dengue in mainland China. Methods: This retrospective cohort study analyzed the data of adult patients (aged ≥ 18 years) hospitalized with laboratory-confirmed dengue in a tertiary center for infectious diseases from 2013 to 2019 in mainland China. Serum albumin levels were estimated and compared between patients with severe dengue and non-severe dengue. Additionally, the association between serum albumin levels and severe dengue was evaluated using a generalized linear model [relative risks (RR)]. Multivariate logistic regression analysis was performed to identify the potential predictors of severe dengue. Results: Overall, 1 568 patients were included in this study. Of these patients, 34 (2.17%) developed severe dengue. The median serum albumin levels were significantly lower in patients with severe dengue than that in those with non-severe dengue (33 g/L vs. 37 g/L, P<0.001). After adjustment for age, sex, and comorbidities, hypoalbuminemia (RR 4.877, 95% CI 2.193-11.461, P<0.001) was found to be a predictor of severe dengue. Serum albumin levels (OR 1.303, 95% CI 1.161-1.462, P<0.001)] and age (OR 1.038, 95% CI 1.017-1.061, P<0.001) were significant risk factors for severe dengue. The area under the curve for serum albumin levels to distinguish severe dengue was 0.787. Conclusions: Lower serum albumin levels were significantly associated with disease severity in adult patients with dengue. Hypoalbuminemia on admission resulted in at least a four-fold increased risk of severe dengue.

Objective: To evaluate hepatitis B virus (HBV) vaccine coverage and its associated factors among health science students in Vietnam. Methods: This cross-sectional study involving 459 health science students at Tra Vinh University was conducted between April and June 2022. Data were collected using a structured questionnaire with items on sociodemographic characteristics, knowledge and attitude about HBV, and vaccination status. A multivariable logistic regression model was used to explore the factors associated with vaccination status. Results: The majority of participants were female (65.8%) and enrolled at the medical school (56.2%). A total of 30.3% participants received the full dose of the HBV vaccine. The percentages of participants with sufficient knowledge and positive attitudes toward HBV infection were 75.2% and 43.4%, respectively. Vaccination was 11.8 times higher in sixth-year medical students than any healthcare student in their first-year [adjusted odds ratio (aOR) 11.8, 95% CI 3.1-45.1, P<0.001], and the coverage was also significant higher in those who had sufficient knowledge (aOR 2.0, 95% CI 1.1-3.9, P<0.05) and positive attitudes (aOR 3.0, 95% CI 1.9-4.8, P<0.05) than in their counterparts. Conclusions: The majority of students were not fully vaccinated against HBV, indicating they were vulnerable to the disease. Administrators and authorities should reinforce health education messages aimed at encouraging all students to get vaccinated with the HBV vaccine, enhance their awareness and knowledge of HBV, and improve attitudes toward HBV infection prevention.

Objective: To determine the antibiotic resistance profile (ARP) of Staphylococcus ( S.) aureus isolates and molecular typing of the methicillin-resistant S. aureus (MRSA) isolates from Tuanku Mizan Armed Forces Hospital (TMAFH), Kuala Lumpur. Methods: The ARP and presence of the pvl gene were determined for 209 S. aureus isolates from clinical specimens. Of these, 123 were methicillin-susceptible S. aureus (MSSA) isolates and 86 were MRSA isolates. All MRSA isolates were characterized using SCC mec typing and spa typing. Descriptive analysis was performed to compare the demographic data with the phenotypic and genotypic variables of the S. aureus isolates. Results: No vancomycin-intermediate and -resistant S. aureus (VISA and VRSA, respectively) were detected among the study isolates. The MSSA isolates showed low resistance rates to all tested antibiotics, were commonly invasive (28/42, 66.7%), and mostly harboured pvl (35/42, 83.3%). Meanwhile, MRSA isolates showed high resistance to penicillin (86/86, 100%), ampicillin (86/86, 100%), sulbactam/ampicillin (86/86, 100%), cefuroxime (81/86, 94.19%), cefoperazone (76/86, 88.37%), azithromycin (56/86, 65.12%), and erythromycin (54/86, 62.79%). The majority of MRSA isolates were of SCC mec type IVh (65/86, 75.58%), spa type t032 (55/85, 63.95%), and grouped into spaCC-t022 (66/85, 77.65%). The t032 type was found to be associated with resistance traits to azithromycin and erythromycin (P<0.05). We also found several spa types that are typically associated with hospital-, community-, and livestock-associated MRSA co-existing in our MRSA population. Conclusions: This study reflected the consistent absence of VISA and VRSA and corroborated the clonal shifting of MRSA isolates in the Malaysian MRSA isolates.

Objective: To report the neurologic prognosis and autoimmune complications of 16 cases of childhood herpes simplex virus encephalitis. Methods: The study was conducted at Şanlıurfa Training and Research Hospital, Turkey from June 2017 to August 2019. The study included 16 pediatric patients aged between 6 months and 17 years (median age 77.7 months) who were diagnosed with herpes simplex virus type 1 encephalitis by pediatric infectious disease and pediatric neurology clinics. Patients were followed using patient records, and interviews at the pediatric neurology clinic or via the telephone. Clinical and demographic data, received therapies, neurologic prognosis and complications were evaluated. Results: Patients with and without autoimmune encephalitis were compared in terms of age, sex, symptom duration before treatment, initial cerebrospinal fluid protein, glucose, red blood count and white blood count but no significant difference was found. Autoimmune complications were seen in four patients. N-methyl-D-aspartate encephalitis was observed in three patients and choreoathetosis was seen in one patient. The average follow-up period was 48.3 months. Twenty-five percent of the patients were receiving multiple antiepileptic drug (AED) treatment, 43.8% were receiving single AED treatment and 31.3% were not receiving AED treatment at the end of the follow-up. Motor disability was observed in 12.5% and drug-resistant epilepsy was observed in 6.3% who had autoimmune complications. Conclusions: Seizures and movement disorders were controlled with immunotherapy and autoantibodies should be studied routinely. Treatment should be started early upon recognition of autoimmune complications through follow-up by measuring autoantibody levels and clinical examination results. Effective prevention and curative treatment modalities are needed to avoid herpes simplex virus encephalitis complications.

Dengue fever (DF) is one of the most commonly prevalent viral diseases in the world, primarily affecting tropical countries. It is transmitted by the bite of female Aedes (Ae.) aegypti mainly and Ae. albopictus mosquito infected with the virus. Dengue virus is a flavivirus, arbovirus. There are four strains of dengue virus (DENV1, DENV2, DENV3, DENV4). The clinical spectrum of the disease ranges from mild to severe forms with complications. It may be asymptomatic or symptomatic. Most of the symptomatic infections present as self-limiting fever, whereas few cases may progress to dengue haemorrhagic fever (DHF) and dengue shock syndrome[1-3]. Of the various systems known to be affected by DF, cardiovascular system is one of them. Cardiac complications of DF though uncommon, are being increasingly reported in various studies. A variety of cardiac complications have been reported, the most common being myocarditis, though conduction defect and arrhythmia have also been reported[4]. The pathophysiology of cardiac involvement in dengue, though not fully understood, is postulated to be caused either by direct viral invasion of cardiac muscle cells-myocytes or cytokine induced immune damage or both. It may be either focal or diffuse myocarditis[5]. Keeping this in view, a cross-sectional study tried to explore the changes in electrocardiogram (ECG) in dengue patients in an outpatient and inpatient set-up of a tertiary care centre in eastern India over a period of 12 months. The study included adult DF cases of either sex, diagnosed by NS1Ag or Dengue IgM reactive (by MAC ELISA). Known cases of cardiac, pulmonary and thyroid complications were excluded. Patients on medications affecting heart rate/rhythm and those showing electrolyte imbalances at the time of admission that may affect ECG, were excluded. Included patients were interviewed for basic demographics and detailed medical history, and subjected to physical examination and laboratory investigations including hemogram, liver function, urea, creatinine, electrolytes like sodium, potassium, lactate dehydrogenase (LDH). Each patient was subjected to 12 lead ECG. For selected cases, 2D echocardiography, troponin T, creatinine phosphokinase (CPK) were done. Thyroid screening was done in symptomatic cases. With a prevalence of 50% and 10% marginal error, a minimum sample size of 97 was estimated. For the 100 patients finally included in the study, the mean age of study population was (31.88 ± 8.85) years, with 53% male representation and rest females. Of the 100 cases, 82 were classified as DF and 18 were DHF according to the World Health Organization (WHO) staging. Of the total DHF cases, only one was of dengue shock syndrome. Most common clinical manifestations included fever (97%), followed by myalgia (89%), headache (88%), retro-orbital pain (76%), skin rash (74%), nausea (45%), vomiting (35%), abdominal pain (28%), haemorrhagic manifestations (18%), shortness of breath (7%) and palpitation (6%). ECG was done in all cases, which revealed abnormalities in 71% of the total cases. A total of 68.3% of the DF cases had ECG changes, while 83.3% of DHF cases revealed ECG abnormalities. Three most common ECG changes were sinus tachycardia (noted in 28.04% DF cases and 22.22% DHF cases), sinus bradycardia (noted in 10.97% DF cases), non-specific ST & T changes (noted in 20.73% DF and 11.11% DHF cases). The 1st degree heart block was seen in 3.66% DF cases and 11.11% DHF cases, Mobitz Type 1 2nd degree block (Wenckebach phenomenon) was seen in 1.22% DF and 5.55% DHF cases. Right bundle branch block was noted in 5.55% DHF cases. ST segment elevation suggestive of pericarditis was also seen in 1.22% DF cases and 11.11% of DHF cases. Low voltage complex was seen in 1.22% DF and 11.11% DHF cases. Raised CPK could be documented in 3 cases. LDH was found to be raised in 23 cases with values more than 1 000 U/L noted in 5 cases. However, troponin T was not found to be positive in any case with arrhythmia or ST segment changes. None of the patients developed any cardiac complications like angina, myocardial infarction during the course of the disease. The rhythm abnormalities as noted in 12 lead ECG, developed during the course of illness in febrile and convalescent phases and they reverted back to normal as the patients became afebrile. Follow-up ECG was normal in all the cases of rhythm disturbances.