ObjectivesThere is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS) infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis.MethodsChildren and adults patients clinically diagnosed with meningitis or encephalitis were enrolled at four reference health centers. Cerebrospinal fluid (CSF) was collected for bacterial culture, and in-house and multiplex RT-PCR testing was conducted for herpes simplex virus (HSV) types 1 and 2, mumps virus, enterovirus, varicella zoster virus (VZV), Streptococcus pneumoniae, HiB and Neisseria meningitidis.ResultsOut of 140 enrolled patients, the mean age was 23.9 years, and 58% were children. Bacterial or viral etiologies were determined in 51% of patients. Five Streptococcus pneumoniae cultures were isolated from CSF. Based on in-house PCR analysis, 25 patients were positive for S. pneumoniae, 6 for N. meningitidis, and 1 for H. influenzae. Viral multiplex PCR identified infections with enterovirus (n = 26), VZV (n = 4), and HSV-1 (n = 2). No patient was positive for mumps or HSV-2.ConclusionsStudy findings indicate that S. pneumoniae and enteroviruses are the main etiologies in this patient cohort. The utility of molecular diagnostics for pathogen identification combined with the knowledge provided by the investigation may improve health outcomes of CNS infection cases in Georgia.

Coronavirus has posed a great challenge to the whole world, including Georgia. The restrictions have taken a heavy toll on the tourism industry worldwide. It has been clear since the spring of the current year that the mass recovery of international tourism will not be possible by 2020. Consequently, the necessity has led to changes, especially in the direction of domestic tourism. Countries apply different strategies. This review article is based on the results of a mini-survey and data from the National Statistics Office. It is analyzed what impact COVID-19 had on local tourism in Georgia, what is the public mood, which places were visited, where did the epidemic break out after the restrictions were lifted, what are the statistics of international tourists in Georgia, etc. Besides, tourism support measures developed around the world are discussed.

BACKGROUNDAmyotrophic lateral sclerosis (ALS) is a fatal progressive neurodegenerative disorder that affects the upper and lower motor neurons. Several genetic risk factors have been identified in the past decade with a hexanucleotide repeat expansion in the C9orf72 gene being the most significant. However, the presence of c9orf72 repeat expansion has not been examined in the Transcaucasian region, therefore we aimed to analyze its frequency in Georgian patients with ALS.MethodsWe included 47 self-reported Georgian patients with ALS from different parts of the country, fulfilling the Gold Coast criteria. To investigate the presence of an expanded GGGGCC hexanucleotide repeat in the non-coding region of the C9orf72 gene, we performed Repeat-Primed PCR. Results45 sporadic and 2 familial ALS cases were identified. Patients were aged 26 to 84 years with a mean age of 58.3 years at disease onset. Bulbar onset was observed in 21.3%, upper limb onset in 38.3%, and lower limb onset in 40.4% of the patients. Frontotemporal dementia (FTD) fulfilling the Strong criteria was diagnosed in 6 patients (12.7%). C9orf72 repeat expansion could not be detected in any of the cases using RP-PCR. ConclusionsOur results indicate that c9orf72 hexanucleotide expansion does not belong to the genetic risk factors of ALS in Georgian patients. Further genetic studies in a bigger study population are needed to reveal the genetic causes of ALS in the Transcaucasian population. As part of this research, Whole Exome Sequencing testing will be performed for identifying other gene mutations that might contribute to developing ALS in those patients.

Coronavirus has posed a great challenge to the whole world, including Georgia. The restrictions have taken a heavy toll on the tourism industry worldwide. It has been clear since the spring of the current year that the mass recovery of international tourism will not be possible by 2020. Consequently, the necessity has led to changes, especially in the direction of domestic tourism. Countries apply different strategies. This review article is based on the results of a mini-survey and data from the National Statistics Office. It is analyzed what impact COVID-19 had on local tourism in Georgia, what is the public mood, which places were visited, where did the epidemic break out after the restrictions were lifted, what are the statistics of international tourists in Georgia, etc. Besides, tourism support measures developed around the world are discussed.

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