The primate gut mycobiome-bacteriome interface is impacted by environmental and subsistence factors

The gut microbiome of primates is known to be influenced by both host genetic background and subsistence strategy. However, these inferences have been made mainly based on adaptations in bacterial composition - the bacteriome and have commonly overlooked the fungal fraction - the mycobiome. To further understand the factors that shape the gut mycobiome of primates and mycobiome-bacteriome interactions, we sequenced 16 S rRNA and ITS2 markers in fecal samples of four different nonhuman primate species and three human groups under different subsistence patterns (n = 149). The results show that gut mycobiome composition in primates is still largely unknown but highly plastic and weakly structured by primate phylogeny, compared with the bacteriome. We find significant gut mycobiome overlap between captive apes and human populations living under industrialized subsistence contexts; this is in contrast with contemporary hunter-gatherers and agriculturalists, who share more mycobiome traits with diverse wild-ranging nonhuman primates. In addition, mycobiome-bacteriome interactions were specific to each population, revealing that individual, lifestyle and intrinsic ecological factors affect structural correspondence, number, and kind of interactions between gut bacteria and fungi in primates. Our findings indicate a dominant effect of ecological niche, environmental factors, and diet over the phylogenetic background of the host, in shaping gut mycobiome composition and mycobiome-bacteriome interactions in primates.

Experimental safety testing shows that the NSAID tolfenamic acid is not toxic to Gyps vultures in India at concentrations likely to be encountered in cattle carcasses

Population declines of Gyps vultures across the Indian subcontinent were caused by unintentional poisoning by the non-steroidal anti-inflammatory drug (NSAID) diclofenac. Subsequently, a number of other NSAIDs have been identified as toxic to vultures, while one, meloxicam, is safe at concentrations likely to be encountered by vultures in the wild. Other vulture-safe drugs need to be identified to reduce the use of those toxic to vultures. We report on safety-testing experiments on the NSAID tolfenamic acid on captive vultures of three Gyps species, all of which are susceptible to diclofenac poisoning. Firstly, we estimated the maximum level of exposure (MLE) of wild vultures and gave this dose to 40 Near Threatened Himalayan Griffons G. himalayensis by oral gavage, with 15 control birds dosed with benzyl alcohol (the carrier solution for tolfenamic acid). Two birds given tolfenamic acid died with elevated uric acid levels and severe visceral gout, while the remainder showed no adverse clinical or biochemical signs. Secondly, four G. himalayensis were fed tissues from water buffaloes which had been treated with double the recommended veterinary dose of tolfenamic acid prior to death and compared to two birds fed uncontaminated tissue; none suffered any clinical effects. Finally, two captive Critically Endangered vultures, one G. bengalensis and one G. indicus, were given the MLE dose by gavage and compared to two control birds; again, none suffered any clinical effects. The death of two G. himalayensis may have been an anomaly due to i) the high dose level used and ii) the high ambient temperatures at the time of the experiment. Tolfenamic acid is likely to be safe to Gyps vultures at concentrations encountered by wild birds and could therefore be promoted as a safe alternative to toxic NSAIDs. It is manufactured in the region, and is increasingly being used to treat livestock.

Optical coherence tomography versus angiography to guide percutaneous intervention: a real-world single center propensity-matched analysis

Funding Acknowledgements

Type of funding sources: None.

Background

Optical coherence tomography (OCT) with its superior resolution has several benefits over coronary angiography (CA) to guide percutaneous coronary intervention (PCI).  Despite the benefits of OCT in comparison with angiography, it is not widely used in developing countries like India data is limited in India specifically in all comer population to meet unmet need.

Objective

Here we aim to determine the clinical efficacy and safety outcomes of OCT versus CA alone in guiding PCI in all-comer patients.

Methods

This was a retrospective study which included 434 all comer patients which were propensity matched. These patients underwent PCI at our center between December 2018 and June 2020.  The primary endpoint was MACE, a composite of cardiovascular death, repeat revascularization, stent thrombosis, recurrent ischemia and target vessel myocardial infarction (TV-MI) at 6 months. Secondary endpoint was target lesion failure (TLF), composite of stent thrombosis and in-stent restenosis. Safety endpoints were post-PCI s. creatinine and hospital stay and other outcome includes post PCI rise in CK-MB.

Results

A total of 217 patients were included in each group: the OCT group and conventional angiography guided PCI (angio group) after propensity matching. Compared to angio group, patients presenting with unstable angina, NSTEMI were significantly higher in the OCT group (55.7% vs 43.3%, p = 0.0095; 17.5% vs 10%, p = 0.02, respectively) while patients with STEMI were significantly low in the OCT (23.5% vs 41.5%, p = 0.00005). Number of balloons, maximum balloon size and left main interventions and contrast volume were more in OCT group than angio group (4.21 ± 1.67 vs 3.86 ± 1.76, P= 0.0034; 3.77 ± 0.63 mm vs 3.51 ± 0.52 mm,P < 0.0001; 24.52% vs 13.36 %,P = 0.003 and 202.53 ± 73.15 ml vs 161.91 ± 69.23 ml, P< 0.0001 respectively). The incidence of MACE at 6 months was numerically lower in the OCT group vs angio group but the difference was not statistically significant (15 [6.9%] vs 21 [9.7%]; p = 0.2964). No cases of TV-MI, TLF (stent thrombosis or in-stent restenosis) is observed in both the groups. Post procedure rise in CKMB was more in Angio group in comparison to OCT group (6.16 ± 31.28 ng/ml vs 39.5 ± 108.71 ng/ml, p < 0.001). Optimal stent expansion (>80%) was seen in 71.5% patients in post OCT-guided PCI. In OCT guided PCI group, OCT identified stent underexpansion in 28.5%, stent malapposition in 3.7%, stent edge dissection in 4.1%, and tissue prolapse in 10% of the patients.

Conclusion

In this large retrospective study, OCT guided PCI is feasible and OCT-guided PCI has tendency to improve clinical outcomes at six months follow up compared to conventional angiography guided PCI in all comer patients. Abstract Figure. central illustration  Abstract Figure. Identification of PCI complications

Assessing the Effect of Smokeless Tobacco Consumption on Oral Microbiome in Healthy and Oral Cancer Patients

Oral cancer is a globally widespread cancer that features among the three most prevalent cancers in India. The risk of oral cancer is elevated by factors such as tobacco consumption, betel-quid chewing, excessive alcohol consumption, unhygienic oral condition, sustained viral infections, and also due to dysbiosis in microbiome composition of the oral cavity. Here, we performed an oral microbiome study of healthy and oral cancer patients to decipher the microbial dysbiosis due to the consumption of smokeless-tobacco-based products and also revealed the tobacco-associated microbiome. The analysis of 196 oral microbiome samples from three different oral sites of 32 healthy and 34 oral squamous cell carcinoma (OSCC) patients indicated health status, site of sampling, and smokeless tobacco consumption as significant covariates associated with oral microbiome composition. Significant similarity in oral microbiome composition of smokeless-tobacco-consuming healthy samples and OSCC samples inferred the possible role of smokeless tobacco consumption in increasing inflammation-associated species in oral microbiome. Significantly higher abundance of Streptococcus was found to adequately discriminate smokeless-tobacco-non-consuming healthy samples from smokeless-tobacco-consuming healthy samples and contralateral healthy site of OSCC samples from the tumor site of OSCC samples. Comparative analysis of oral microbiome from another OSCC cohort also confirmed Streptococcus as a potential marker for healthy oral microbiome. Gram-negative microbial genera such as Prevotella, Capnocytophaga, and Fusobacterium were found to be differentially abundant in OSCC-associated microbiomes and can be considered as potential microbiome marker genera for oral cancer. Association with lipopolysaccharide (LPS) biosynthesis pathway further confirms the differential abundance of Gram-negative marker genera in OSCC microbiomes.

Socio-demographic features and quality of life post burn injury

Introduction:

Burn injury is a highly devastating injury accounting for the major cause of disability-adjusted life years (DALYs) lost mostly in developing countries. Physical trauma, body disfigurement, the social stigma associated with injury completely shatter an individual’s life.

Aim:

To study the quality of life among burn injury patients.

Methodology:

A cross-sectional hospital-based descriptive study was done on 150 burn injury patients. During the initial recruitment from Burns and Plastic Surgery Ward, socio-demographic profile and burn incident-related data were collected, whereas the WHO QoL-BREF tool was applied after 3 months of discharge during a follow-up visit in the outpatient department of Burns and Plastic Surgery to assess the quality of life among subjects. Data were compiled in MS Excel and statistical analysis was done using SPSS 20 version.

Results:

The study revealed poor quality of life among four domains of QoL; it was most inferior in the psychological domain followed by the physical health domain, environment domain, and social relationship domain.

Conclusion:

Advancement in the medical field has improved the survival rate in victims although the patients recover from the acute painful phase of physical trauma. However, the psychological and social impacts of injury remain unaddressed leading to a poor QoL. There is a need for an integrated approach for prevention and enhancement of the quality of care for the victims in all four domains of life. More emphasis is needed on rehabilitative care for long-term improvement in the QoL of the affected person.

Simultaneous adsorptive removal of conventional and emerging contaminants in multi-component systems for wastewater remediation: A critical review

The rapid growth of population and industrialization results in pollution of freshwater sources which leads to the water stress conditions on the world in future. Adsorption is a low cost and popular technique for the removal of contaminants from water bodies. Most of the reports till date are on removal of a single component from aqueous solutions using this technique, but the real-world effluent contains multiple contaminants such as dyes, heavy metals, pesticides, antibiotics and many more. Therefore, a study on simultaneous removal of contaminants is highly needed to obtain a suitable adsorbent that can be used commercially. This critical review provides a detailed study on the removal of contaminants in the presence of other contaminant/s i.e., from a multi-component system (MCS). The different possible interaction mechanisms in MCS like synergism, antagonism and non-interaction are discussed. The MCS containing the mixture of conventional contaminants such as heavy metals and dyes, and other emerging contaminants such as antibiotics, organic contaminants, pesticides and personal care products are explained in depth. This review article will be helpful for researchers working in the field of simultaneous removal of contaminants from MCSs for wastewater remediation.

Western and non-western gut microbiomes reveal new roles of Prevotella in carbohydrate metabolism and mouth-gut axis

The abundance and diversity of host-associated Prevotella species have a profound impact on human health. To investigate the composition, diversity, and functional roles of Prevotella in the human gut, a population-wide analysis was carried out on 586 healthy samples from western and non-western populations including the largest Indian cohort comprising of 200 samples, and 189 Inflammatory Bowel Disease samples from western populations. A higher abundance and diversity of Prevotella copri species enriched in complex plant polysaccharides metabolizing enzymes, particularly pullulanase containing polysaccharide-utilization-loci (PUL), were found in Indian and non-western populations. A higher diversity of oral inflammations-associated Prevotella species and an enrichment of virulence factors and antibiotic resistance genes in the gut microbiome of western populations speculates an existence of a mouth-gut axis. The study revealed the landscape of Prevotella composition in the human gut microbiome and its impact on health in western and non-western populations.

Advances in decontamination of wastewater using biomass-basedcomposites: A critical review

Contaminant removal from wastewater using natural biosorbents has been widely studied as a suitable and environmentally benign alternative for conventional techniques. Currently, researchers are working on various biomass-based composites for wastewater remediation to improve the performance of natural biosorbents. This review takes into focus a wide range of biomass-based composites like hydrogel composites, metal oxide composites, magnetic composites, polymer composites, carbon nanotubes (CNTs) and graphene composites, metal organic framework composites (MOFs) and clay composites for the removal of various contaminants from wastewater. It is evident from the literature survey that the composite fabrication involves the modification of morphological and textural features of the biomass which results in significant enhancement of adsorption capacity. Apart from this, regeneration of the used biomass-based composite is also studied in depth in order to overcome the problem of solid waste generation. This review would prove to be beneficial for researchers who are currently focusing on the development of cost-effective, easily available, recyclable biomass-based composites with enhanced adsorption capacities for wastewater treatment.

Multi-drug resistant (MDR), extended spectrum beta-lactamase (ESBL) producing and carbapenem resistant Escherichia coli in rescued Sloth bears (Melursus ursinus), India

The study reports the multi-drug resistant (MDR), extended spectrum beta-lactamase (ESBL) producing and carbapenem resistant Escherichia coli (CRE) isolated from rescued sloth bear (Melursus ursinus), India. Non-duplicate faecal samples from 21 adult rescued sloth bears were collected at once during 2015-2016 and processed for isolation of E. coli and antibacterial susceptibility pattern. From 21 samples, 45 E. coli were isolated and on phenotypic screening, 23 were MDR, 17 were ESBL producers, and five were carbapenem-resistant (CR). Three E. coli isolates (6.67%, 3/45) showed no resistance, however 42 isolates (93.33%, 42/45) exhibited resistant to at least one antibiotics. The MDR isolates carried beta-lactamase, chloramphenicol, aminoglycosides, tetracycline, fluroquinolone, and sulphadimidine resistance genes. All the phenotypic ESBL producing isolates harbored blaCTX-M genes. On genotypic screening, three CRE (60.0%, 3/5) were positive for blaNDM carbapenemase gene and efflux pump-mediated carbapenem resistance was detected in two CRE isolates (40.0%, 2/5) which were negative for carbapenemase genes. The CRE isolates (n = 5) also co-harbored AMR genes like blaTEM-1, blaAmpC, qnrA, qnrB, qnrS, tetA, tetB and sulI. Virulence screening of the resistant isolates detected the presence of Stx1(n = 1), Stx2 (n = 3), eaeA (n = 4) and hlyA (n = 3) genes. Plasmid incompatibility (Inc) typing revealed that two isolates harboured blaNDM-5 gene on Incl1 and one isolate on IncF plasmid. Apart from the NDM gene, the plasmids also carried tetracycline, beta-lactamase and quinolone resistance genes. The plasmid multilocus sequence typing (pMLST) of the E. coli Incl1 plasmid showed the Sequence Type (ST) 297. This appears to be the first report of MDR, ESBL producing and blaNDM-5 genes on Incl1 and IncF plasmids from rescued sloth bear.

Outcome of Trabeculectomy with Collagen Matrix Implant versus Mitomycin C in Primary Glaucoma: A Comparative Study

Background:

Glaucoma is a serious vision-threatening condition appropriately called as the silent killer of sight. The effect of postoperative fibrosis on success of filtration surgeries requires modulation of the wound healing process.

Aim:

The aim of the study was to compare trabeculectomy augmented with collagen matrix implant with mitomycin C in primary glaucoma.

Materials and Methods:

This prospective, longitudinal, hospital-based, analytical, and interventional study was conducted on 36 eyes of 36 patients. Group 1 included 18 patients who underwent trabeculectomy combined with subconjunctival collagen matrix implant and Group 2 included 18 patients who underwent trabeculectomy augmented with intraoperative mitomycin C (0.04 mg/ml) for 2 min. Each patient underwent detailed ocular examination and comparison was drawn by recording intraocular pressure (IOP), bleb characteristics, and postoperative complications.

Results:

The cumulative success rates at the end of our study were similar in two groups, 94.44% in Group 1 and 88.89% in Group 2 (P = 1.000). The mean reduction in IOP at 24 weeks in Group 1 was 18.67 ± 7.59 mmHg and in Group 2 was 21.32 ± 5.84 mmHg. The reduction in IOP was similar between the two groups (P = 0.290). The mean fall in IOP was 56.46% in Group 1 and 64.70% in Group 2 at 24 weeks. Mean bleb score in Group 1 was 10.33 ± 1.23 and in Group 2 was 8.89 ± 1.41, and the difference was statistically significant (P = 0.002). Shallow anterior chamber, overfiltration, and hypotony were statistically higher in Group 2 than in Group 1 (P = 0.041, 0.041, and 0.046, respectively).

Conclusion:

Collagen matrix implant as an adjuvant to trabeculectomy is noble, safe, and effective option as compared to mitomycin C.

Porous Hydrophobic-Hydrophilic Composite Hollow Fiber and Flat Membranes Prepared by Plasma Polymerization for Direct Contact Membrane Distillation

High water vapor flux at low brine temperatures without surface fouling is needed in membrane distillation-based desalination. Brine crossflow over surface-modified hydrophobic hollow fiber membranes (HFMs) yielded fouling-free operation with supersaturated solutions of scaling salts and their precipitates. Surface modification involved an ultrathin porous polyfluorosiloxane or polysiloxane coating deposited on the outside of porous polypropylene (PP) HFMs by plasma polymerization. The outside of hydrophilic MicroPES HFMs of polyethersulfone was also coated by an ultrathin coating of porous plasma-polymerized polyfluorosiloxane or polysiloxane rendering the surface hydrophobic. Direct contact membrane distillation-based desalination performances of these HFMs were determined and compared with porous PP-based HFMs. Salt concentrations of 1, 10, and 20 wt% were used. Leak rates were determined at low pressures. Surface and cross-sections of two kinds of coated HFMs were investigated by scanning electron microscopy. The HFMs based on water-wetted MicroPES substrate offered a very thin gas gap in the hydrophobic surface coating yielding a high flux of 26.4-27.6 kg/m2-h with 1 wt% feed brine at 70 °C. The fluxes of HFMs on porous PP substrates having a long vapor diffusion path were significantly lower. Coated HFM performances have been compared with flat hydrophilic membranes of polyvinylidene fluoride having a similar plasma-polymerized hydrophobic polyfluorosiloxane coating.

Dual trace inter-pulse interferometer for measurement of phase stability of ultra short laser pulse train

A dual trace intra-pulse and inter-pulse spatio-spectral interferometer has been set up to study the temporal stability of a ∼200 fs duration laser pulse train from a cw mode-locked laser oscillator. Simultaneous recording of twin interferograms helps identify the phase error in inter-pulse interferograms due to the diagnostic setup kept in a standard laboratory environment. Applicability of inter-pulse tilted pulse-front interferograms has been demonstrated to constitute an alternative inexpensive method for visual detection and estimation of phase slippage and pulse repetition frequency of an ultra short pulse train. The effect of pump beam intensity on the repetition rate of pulses due to accumulated intra-cavity non-linear phase shifts is also presented.

Effects of treatment with a microRNA mimic or inhibitor on the developmental competence, quality, epigenetic status and gene expression of buffalo (Bubalus bubalis) somatic cell nuclear transfer embryos

Expression levels of 13 microRNAs (miRNAs) were compared between buffalo blastocysts produced by somatic cell nuclear transfer through hand-made cloning and IVF to improve cloning efficiency. Expression of miR-22, miR-145, miR-374a and miR-30c was higher, whereas that of miR-29b, miR-101, miR-302b, miR-34a, miR-21 and miR-25 was lower, in nuclear transferred (NT) than IVF embryos; the expression of miR-200b, miR-26a and miR-128 was similar between the two groups. Based on these, miR-145, which is involved in the regulation of pluripotency, was selected for further investigation of NT embryos. miR-145 expression was lowest at the 2-cell stage, increased through the 4-cell stage and was highest at the 8-cell or morula stage in a pattern that was similar between NT and IVF embryos. miR-145 expression was higher in NT than IVF embryos at all stages examined. Treatment of reconstructed embryos 1h after electrofusion with an inhibitor of miR-145 for 1h decreased the apoptotic index and increased the blastocyst rate, total cell number, ratio of cells in the inner cell mass to trophectoderm, global levels of acetylation of histone 3 at lysine 18 and expression of Krueppel-like factor 4 (KLF4), octamer-binding transcription factor 4 (OCT4) and SRY (sex determining region Y)-box 2 (SOX2) in blastocysts. Treatment with an miR-145 mimic had the opposite effects. In conclusion, treatment of NT embryos with an miR-145 inhibitor improves the developmental competence and quality, and increases histone acetylation and expression of pluripotency-related genes.

PSVI-22 Rumen microbiome of beef cattle is modulated by backgrounding systems

Backgrounding (BKG) segment in beef production systems is characterized by utilization of different forages which affect growth performance and carcass characteristics. However, it is unclear how BKG systems impact rumen microbiome. We investigated rumen microbiome dynamics of beef calves under different BKG systems. At weaning, Angus and Angus x Simmental beef calves (n = 38) were stratified by age, weight, and sex in a completely randomized design into 1 of 3 BKG treatments for 55 d: 1) perennial pasture (PP; quackgrass, orchardgrass; smooth bromegrass, red clover, and alfalfa); 2) summer annual cover crop (CC; cereal oats, purple top turnips, hunter forage brassica, and graza forage radish); and 3) dry lot (DL; haylage, corn, and DDGS). After BKG, all calves were assigned to a high energy ration in a feedlot. Rumen sample was collected via esophageal tubing at weaning, BKG and feedlot. A total of 190 rumen fluid samples were used to sequence the hypervariable V4 region of the 16S rRNA bacterial gene on an Illumina MiSeq platform. The results showed that BKG systems largely influenced rumen bacterial communities. Specifically, microbiome composition and diversity were not different at weaning, diverged significantly during BKG (Shannon index, Bray Curtis distance metrics; P < 0.001) and homogenized during feedlot. During the BKG segment, the bacterial genera Agrobacterium, Coprococcus, and Ruminococcus were dominant in CC whereas Fibrobacteraceae and Mycoplasmataceae was most dominant in DL. Moreover, rumen microbiome patterns of CC and DL calves showed increased plasticity in early stages of development but not during feedlot with PP showing fewer changes over time. These results indicate that BKG systems significantly modulate the rumen microbiome of beef cattle and, underscore the importance of early developmental stages as potential targets for feeding interventions that can impact the animal microbiome to enhance animal performance.

Mesenchymal stem cell tailored bioengineered scaffolds derived from bubaline diaphragm and aortic matrices for reconstruction of abdominal wall defects

Bioengineered scaffolds derived from the decellularized extracellular matrix (ECM) obtained from discarded animal organs and tissues are attractive candidates for regenerative medicine applications. Tailoring these scaffolds with stem cells enhances their regeneration potential making them a suitable platform for regenerating damaged tissues. Thus, the study was designed to investigate the potential of mesenchymal stem cells tailored acellular bubaline diaphragm and aortic ECM for the repair of full-thickness abdominal wall defects in a rabbit model. Tissues obtained from bubaline diaphragm and aorta were decellularized and bioengineered by seeding with rabbit bone marrow derived mesenchymal stem cells (r-BMSC). Full-thickness abdominal wall defects of 3 cm × 4 cm size were created in a rabbit model and repaired using five different prostheses, namely, polypropylene sheet, nonseeded diaphragm ECM, nonseeded aorta ECM, r-BMSC bioengineered diaphragm ECM, and r-BMSC bioengineered aorta ECM. Results from the study revealed that biological scaffolds are superior in comparison to synthetic polymer mesh for regeneration in terms of collagen deposition, maturation, neovascularization, and lack of any significant (P > 0.05) adhesions with the abdominal viscera. Seeding with r-BMSC significantly increased (P < 0.05) the collagen deposition and biomechanical strength of the scaffolds. The bioengineered r-BMSC seeded acellular bubaline diaphragm showed even superior biomechanical strength as compared to synthetic polymer mesh. Tailoring of the scaffolds with the r-BMSC also resulted in significant reduction (P < 0.01) in antibody and cell mediated immune reactions to the xenogeneic scaffolds in rabbit model.

Silver embellished PANI/CNT nanocomposite for antimicrobial activity and sequestration of dye based on RSM modelling

Silver doped PANI/CNT (Ag-PANI/CNT) nanocomposite was synthesized and investigated as adsorbent for its possible application in the elimination of organic dye Brilliant Blue G (BBG). The morphological characteristics of Ag-PANI/CNT were studied using Fourier transform infrared, scanning electron microscopy, elemental mapping, transmission electron microscopy and X-ray diffraction. The response of operational parameters given as adsorbent dosage, concentration, pH and contact time for dye removal were investigated by using Response Surface Methodology (RSM). The results from RSM suggested that the efficiency of BBG elimination is 98.7 under the optimum conditions of experimental factors. The adsorption studies showed that the equilibrium data fitted well with Langmuir isotherm model compared to Freundlich. Finally, the antimicrobial activities of Ag-PANI/CNT were tested against bacterial strain Escherichia coli and Salmonella typhi and fungal strains Aspergillus niger.

Genetic characterization and phylogenetic analysis of Sarcocystis suihominis infecting domestic pigs (Sus scrofa) in India

A total of 57 tissue samples of domestic pigs (Sus scrofa) were collected from the meat outlets of five north Indian states and examined for sarcocystosis by histological and molecular methods. The genomic DNA extracted from five representative positive isolates was subjected to PCR amplification of the partial 18S rRNA gene followed by cloning and sequencing. Sequence analysis of the newly generated Indian isolates recorded 96.9-100.0% identity with published sequences of Sarcocystis suihominis. Two new haplotypes that have not been previously described manifested 99.5-100.0% nucleotide homology within themselves. In the phylogenetic analysis, Indian isolates of S. suihominis grouped together with S. suihominis originating from Italy, and they collectively formed a sister clade with Sarcocystis miescheriana within a clade containing various Sarcocystis spp. of ruminants having felids as final hosts. At the same time, this clade separated from a sister clade containing Sarcocystis spp. of bovid or cervid ruminants using canids as known or surmised definitive host. The current study established the phylogenetic relationship of Indian isolates of S. suihominis with various Sarcocystis spp. as well as with other taxa of Sarcocystidae family based on 18S rRNA gene for the first time.

Use of knotless barbed sutures for closure of intraoral incisions for maxillofacial trauma: a randomised controlled trial

The objective of this study was to assess the efficacy of knotless barbed sutures in intraoral wound closure for maxillofacial trauma in comparison with conventional (vicryl) sutures. This was a randomised controlled clinical trial involving 40 patients with isolated mandibular angle fractures who required intraoral incisions for open reduction and internal fixation (ORIF). The sample was randomised into the study group (20 patients) and control group (20 patients). Following fracture fixation by a standardised surgical protocol, the wound closure was done with bidirectional knotless barbed suture and vicryl for the study and control groups, respectively. The wounds were closed in layers (periosteum and mucosa). All operations were performed by a single surgeon. Outcome parameters measured were intraoperative wound closure time and wound healing using 'Landry's wound healing index' on the first, third, and seventh postoperative days. Statistically significant difference in suturing time was noted between the study and control group (p value <0.001). The study group demonstrated a mean (SD) suturing time of 9.46 (2.01) minutes, compared with the 17.61 (2.57) minutes in the control group. Wound healing was found to be better and statistically significant in the study group than the control group (p value<0.001). Knotless barbed suture is a promising alternative to vicryl for intraoral wound closure.

Efficacy and safety of a single-tablet regimen containing tenofovir disoproxil fumarate 300 mg, lamivudine 300 mg and efavirenz 400 mg as a switch strategy in virologically suppressed HIV-1-infected subjects on nonnucleoside reverse transcriptase inhibitor-containing first-line antiretroviral therapy in Pune, India

OBJECTIVES

As per National AIDS Control Organization (NACO) estimates, there are 2.1 million people living with HIV (PWH) in India, of whom 1.2 million are on first-line antiretroviral therapy (ART). This study explored the use of a single-tablet regimen containing tenofovir disoproxil fumarate 300 mg + lamivudine 300 mg + efavirenz 400 mg (TLE400 STR) as a first-line switch strategy in PWH in Pune, India.

METHODS

This retrospective cohort study was conducted in private sector ART clinics in three tertiary-level hospitals in Pune, India. PWH > 12 years of age (n = 502) who initiated first-line ART (predominantly TLE600 STR), completed ≥ 6 months of follow-up and achieved virological suppression [plasma viral load (VL) < 1000 HIV-1 RNA copies/mL] were identified and switched to TLE400 STR. The virological and immunological efficacy of TLE400 STR at 6 and 12 months of follow-up were noted. Grade 3/4 adverse events (especially efavirenz-related neuropsychiatric adverse events) leading to regimen discontinuation were also noted.

RESULTS

Of 502 PWH who switched to TLE400 STR, complete virological suppression (VL < 20 copies/mL) was maintained in more than 97% of patients at follow-up. TLE400 STR was successful in maintaining CD4 counts within the range observed at the start of the regimen. Grade 3/4 adverse events leading to TLE400 STR discontinuation were seen in 11 (2.2%) patients. Virological failure (VL > 1000 copies/mL) and treatment regimen failure were seen in six (1.2%) and 49 (9.8%) subjects, respectively.

CONCLUSIONS

TLE400 STR exhibits excellent efficacy and safety as a switch strategy and should be introduced in the Indian National ART Program, especially for PWH who are virologically suppressed on TLE600 STR.

Primary malignant melanoma of the gastroesophageal junction: A rare and unusual disease

Malignant melanoma, an aggressive tumor of skin, is also seen rarely in extra cutaneous sites like the gastrointestinal tract (GIT). Primary melanoma of the GIT by itself is a rare tumor; often metastatic at presentation and if found non-metastatic, it is rarely resectable. We are reporting a histopathologically confirmed case of primary malignant melanoma affecting the 'gastroesophageal junction', which we operated on.