Ahmed Abd El Wahed
Ahmed Abd El Wahed

Scientists Develop Test-in-a-Box for Chikungunya Virus

Ahmed Abd El Wahed
Ahmed Abd El Wahed

As mosquito-borne viruses like Zika, Dengue, and Chikungunya continue to spread across the globe, rapid diagnosis and treatment are more important than ever. In a recent paper published in the journal PLOS Neglected Tropical Diseases, German researchers describe an inexpensive, portable test that could help speed up Chikungunya diagnosis in remote areas.

The word “chikungunya” means “to become contorted” in the Kimakonde language of southeastern Africa, and refers to the curled-up posture of people in pain. The symptoms of Chikungunya virus (CHIKV)—joint pain, muscle pain, and fatigue—are similar to those of a bad flu and will generally resolve on their own after a few days or weeks. But they also look a lot like the initial symptoms of Dengue fever, which can be fatal unless it’s treated quickly. The two illnesses are carried by the same mosquito species, Aedes aegypti and Aedes albopictus, and are found in the same parts of the world. Identifying which of these viruses a patient has can be a matter of life and death.

Current CHIKV tests rely on polymerase chain reaction, or PCR, which chemically amplifies any traces of RNA or DNA in a sample to make them easier to identify. But PCR is time- and cost-intensive and requires refrigeration, which makes it an impractical choice in remote areas. An international team of researchers decided to see if they could do better.

They set PCR aside in favor of a technique called reverse transcriptase recombinase polymerase amplification (RT-RPA), which they hoped would also amplify the RNA of the Chikungunya virus (CHIKV). To test their assay, the team ran samples from 58 patients with suspected CHIKV infection and another 20 whose infection had been confirmed through both a PCR scan and their new RT-RPA.

The results were promising indeed. The patients’ samples had included 18 different CHIKV strains, and the RT-RPA spotted them all. The new test correctly diagnosed 36 patients, and didn’t return a single false positive. The RT-RPA was slightly less sensitive than the PCR, but it was also faster and more shelf-stable.

“The CHIKV RPA assay presented here is a promising tool for CHIKV diagnostics at the point of need,” the authors write in their paper.

Still, the test isn’t ready for primetime just yet. In its present incarnation, the assay requires a lot of steps and pipetting, and costs around $5. Ideally, the researchers say, the process would be even simpler and max out at $1. They’re continuing to refine their product, and recommend combining it with Dengue and Zika tests, which “…would improve outbreak investigations, since the three viruses induce the same clinical picture upon infection and increasingly co-circulate in many parts of the world.”
 
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Feeling Down? Lifting Weights Can Lift Your Mood, Too
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There’s plenty of research that suggests that exercise can be an effective treatment for depression. In some cases of depression, in fact—particularly less-severe ones—scientists have found that exercise can be as effective as antidepressants, which don’t work for everyone and can come with some annoying side effects. Previous studies have largely concentrated on aerobic exercise, like running, but new research shows that weight lifting can be a useful depression treatment, too.

The study in JAMA Psychiatry, led by sports scientists at the University of Limerick in Ireland, examined the results of 33 previous clinical trials that analyzed a total of 1877 participants. It found that resistance training—lifting weights, using resistance bands, doing push ups, and any other exercises targeted at strengthening muscles rather than increasing heart rate—significantly reduced symptoms of depression.

This held true regardless of how healthy people were overall, how much of the exercises they were assigned to do, or how much stronger they got as a result. While the effect wasn’t as strong in blinded trials—where the assessors don’t know who is in the control group and who isn’t, as is the case in higher-quality studies—it was still notable. According to first author Brett Gordon, these trials showed a medium effect, while others showed a large effect, but both were statistically significant.

The studies in the paper all looked at the effects of these training regimes on people with mild to moderate depression, and the results might not translate to people with severe depression. Unfortunately, many of the studies analyzed didn’t include information on whether or not the patients were taking antidepressants, so the researchers weren’t able to determine what role medications might play in this. However, Gordon tells Mental Floss in an email that “the available evidence supports that [resistance training] may be an effective alternative and/or adjuvant therapy for depressive symptoms that could be prescribed on its own and/or in conjunction with other depression treatments,” like therapy or medication.

There haven’t been a lot of studies yet comparing whether aerobic exercise or resistance training might be better at alleviating depressive symptoms, and future research might tackle that question. Even if one does turn out to be better than the other, though, it seems that just getting to the gym can make a big difference.

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The Best Way to Wipe Your Butt, According to the Experts
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Curtis Asbury, MD sees it all the time. A patient comes in with blotchy, red, irritated rectum and insists they’re not doing anything unusual. Peering into their sore bottom, Asbury nods solemnly, then delivers news most people never expect to hear.

“You’re not wiping correctly,” he says.

A dermatologist practicing in Selbyville, Delaware, Asbury has seen an uptick in the number of people coming in expressing dissatisfaction with their rectal hygiene. Whether it’s due to misguided parental instruction during toilet training or wiping on sheer instinct, some of us are simply not maintaining one of the most potentially dirty crevices of our body. And the consequences can be irritating.

“It’s called perianal dermatitis,” Asbury tells Mental Floss, describing the kind of topical irritation that afflicts people who are wiping poorly, infrequently, or overzealously. In an attempt to clean their rear end, some people scrub so violently that the American Society of Colon and Rectal Surgeons has given a name to the resulting tenderness: Polished Anus Syndrome, or PAS.

Fortunately, the key to avoiding PAS and other rectal misadventures is relatively easy. Here are some pro tips for a clean butt.

GIVE UP WET WIPES

For starters, Asbury recommends that people stop using the pre-moistened cloths, which are heavily marketed to promote a sparkling cavity. Use of the wipes has been associated with allergic reactions to methylisothiazolinone, a preservative used to inhibit bacterial growth while products are on store shelves. “Even the all-natural ones can cause problems,” he says, since any kind of chemical present in the wipes isn’t usually rinsed off right away.

Does that mean you should reach for dry toilet paper instead? Not quite. “It’s healthier, certainly, to clean your body with water," Asbury says. "Nobody takes a dry piece of paper, rubs it over their skin, and thinks they’re clean.” Even the Greco-Romans (332 BCE–395 CE) knew this, as one historical account from the philosopher Seneca revealed that they used a damp sponge affixed to a stick as a post-toiletry practice. Of course, some ancient cultures also wiped with pebbles and clam shells, among other poor ideas, so perhaps we should stick with contemporary advice.

INVEST IN A BIDET

A bidet sprays water out of a toilet
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Asbury is an advocate of the standalone or add-on toilet accessory that squirts a spray of water between your cheeks to flush out residual fecal matter. While bidets are common in Europe and Japan, the West has been slower to adopt this superior method of post-poop clean-up; others might be wary of tapping into existing home plumbing to supply fresh water, even though DIY installation is quite easy. For those patients, Asbury has developed an alternative method.

TRY PAPER TOWELS AND WATER

“What I tell people to use is Viva, a really soft, thick paper towel made by Kleenex,” he says. “You get a squirt bottle and you leave it near the toilet and moisten the paper towel.” Regular toilet paper is usually too flimsy to stand up to a soaking, while normal paper towels are too harsh for rectal purposes. Viva is apparently just right. (And no, Asbury is not a brand ambassador, nor does Kleenex endorse this alternative use.)

This advice does come with a major caveat: Viva wipes are not flushable and might very well clog your pipes if you try to send them down the drain. When Asbury recommends the technique, he advises people to throw used towels in the trash. If you find that idea appalling, and provided your butt is not already red from bad wiping strategy, lightly moistening a wad of durable toilet paper should do the job.

DRY THOROUGHLY BUT GENTLY

Once you’ve wiped enough to see clean paper, take a dry square and mop up any excess moisture. Whether it’s wet wipes or bidets, some people don’t bother with this step, but “it would be weird not to dry,” Asbury says. Occasionally, moisture can lead to intertrigo, which is irritation in skin folds, or a fungal infection.

You also want to have a soft touch. “I see people scrubbing hard,” Asbury says. “That just makes the problem worse.” Excessive wiping can lead to micro-tears in the anal tissue, causing bleeding and discomfort.

WIPE IN THE RIGHT DIRECTION

Make sure to go from front to back, pushing waste away from the groin. This has traditionally been advised for women to keep poop away from the vaginal canal and prevent urinary tract infections. While Asbury hasn't found specific studies to back up this advice, he still believes it's likely more hygienic. There’s also something to be said for sitting while wiping, since ergonomically, it may keep your perianal area open. But if you’re uncomfortable reaching into the toilet to wipe, standing should suffice.

Assuming you’ve done all that and you’re still feeling discomfort, Asbury warns it might be something else. “If you’re not feeling clean, there could be issues with your sphincter,” he says. Weakened muscles can cause leakage. But generally, it’s dry-wipers who have trouble getting everything they need to get. For the hard-to-clean, Asbury advises that they make the switch to a bidet.

“It’s cold at first,” he says. “But you get used to it.”

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