Renewed Focus on the Threat of Cross-Contamination in Molecular Laboratories: Notes from the COVID-19 Testing Experience in Bangladesh

Rapid and accurate laboratory diagnosis of SARS-CoV-2 infection is crucial for the management of COVID-19 patients and control of the spread of the virus. At the start of the COVID-19 pandemic, Bangladesh had only one government molecular laboratory where real-time RT-PCR would be performed to diagnose SARS-CoV-2 infection. With the increasing number of suspected cases requiring confirmation diagnostic testing, there is a requirement to expand capacity for large-scale testing quickly. The government of Bangladesh established over 100 molecular laboratories within one year to test COVID-19. To expand the testing capacity, the government was compelled to recruit laboratory staff with limited experience and technical expertise, especially in molecular assays, to process specimens, interpret results, troubleshoot. As a result, the risk of diagnostic errors, such as cross-contamination, increased, potentially undermining the efficacy of public health policies, public health response, surveillance programs, and restrictive measures aimed toward containing the outbreak. In this piece, we discuss the different sources of cross-contamination in the COVID-19 RT-PCR laboratories and proffer practical preventive measures to avoid them.

The Assessment of Platelet Indices Levels in Patients with Generalized Anxiety Disorder

Background: The prevalence of anxiety disorders is increasing in the world. Studies revealed that generalized anxiety disorder may lead to change in platelet size, volume and functions. Thus, the changes in platelet indices may increase the future risk of thrombotic diseases in patients with Generalized Anxiety Disorder (GAD). Aim: To evaluate platelet indices (total count of platelet, mean platelet volume, platelet distribution width, plateletcrit) levels in patients with generalized anxiety disorder. Material and Methods: A cross-sectional study was performed in the Department of Physiology, Dhaka Medical College, Dhaka from July 2019 to June 2020. After obtaining ethical clearance, a total of 144 individuals were selected based on inclusion and exclusion criteria with ages ranging from 18 - 50 years. Group A was the study group selected from Out Patient Department of Psychiatry of Dhaka Medical College Hospital, Dhaka, diagnosed by an experienced psychiatrist. Group B was the control group who were apparently healthy adults selected from different areas of Dhaka city. The subjects were interviewed and detailed history regarding personal, family, medical and drug history were taken. Prior to sample collection, informed written consent was taken from the participants. Platelet indices (total count of platelet, mean platelet volume, platelet distribution width, plateletcrit) were measured in the Department of Laboratory Medicine, Dhaka Medical College Hospital, Dhaka. Statistical Analysis: For statistical analysis, the Unpaired Student’s “t” test was considered using SPSS 25.0 version. Results: Mean platelet volume of generalized anxiety disorder patients was significantly higher (p < 0.001) than the control group. Platelet distribution width and plateletcrit were higher in the study group than the control group. Conclusion: It can be concluded that generalized anxiety disorder patients may have more chance of thrombotic diseases due to significantly higher mean platelet volume and higher platelet distribution width, plateletcrit than healthy adults.

The Possibility of Nucleic Acids to Act as Anti-Viral Therapeutic Agents—A Review

For just about 30 years, researchers have considered the likelihood to utilize nucleic acids as antiviral therapeutics. In principle, small single-stranded nucleotide sequence (oligonucleotide) could hybridize to a particular gene or messenger RNA and diminish transcription or translation, respectively, in this manner decreasing the amount of protein that is synthesized. Until now, an incredible number of antisense oligonucleotides, double-stranded oligonucleotides, aptamers, ribozymes, deoxyribozymes, interfering RNAs, chimeric RNA-DNA molecules, antibody genes has been created artificially and applied effectively for comprehension and manipulating biological processes and in clinical preliminaries to treat a variety of diseases. Their versatility and potency make them similarly fit candidates for fighting viral infections. However, troubles with their efficiency, off-target effects, toxicity, delivery, and stability halted the development of nucleic acid-based therapeutics that can be utilized in the clinic. The potential for nucleic acid therapeutic agents is significant and is quite recently beginning to be realized. In this review, we have summarized some of the recent advancements made in the area of nucleic acid based therapeutics and focused on the methods of their delivery and associated challenges.