Video-tube thoracostomy in trauma resuscitation: A pilot study

BACKGROUND

Complications related to incorrect positioning of tube thoracostomy (TT) have been reported to be as high as 30%. The aim of this study was to assess the feasibility of flexible videoscope guided placement of a pre-loaded chest tube, permitting direct intrapleural visualization and placement (Video-Tube Thoracostomy [V-TT]).

METHODS

A prospective, single centre, phase 1 pilot study with a parallel control group was undertaken. The population studied were adult thoracic trauma patients requiring emergency TT who were haemodynamically stable. The intervention performed was VTT. Patients in the control group underwent conventional TT. The primary outcome was tube position as defined by a consultant radiologist's interpretation of chest x-ray (CXR) or CT. The trial was registered with ANZCTR.org.au (ACTRN: 12,615,000,870,550).

RESULTS

There were 37 patients enrolled in the study - 12 patients allocated to the VTT intervention group and 25 patients allocated to conventional TT. Mean age of participants was 48 years (SD 15) in intervention group and 46 years (SD 15) years in the control group. In the VTT group all patients were male; the indications were pneumothorax (83%), haemothorax (8%) and haemopneumothorax (8%). The median injury severity score was 23 (16-28). There were 1 positional and 1 insertional complications. In the control group 72% of patients were male, the indications were pneumothorax (56%), haemothorax (4%) and haemopneumothorax (40%). The median injury severity score was 24 (14-36). There were 8 (32%) positional complications and no insertional complications.

CONCLUSION

V-TT was demonstrated to be a feasible alternative to conventional thoracostomy and merits further investigation.

An In Vitro Comparative Evaluation of Shear Bond Strengths of Veneering Porcelain and Different Core Materials

AIM

The aim of the present study was to evaluate and compare the bond strengths of different core structures to veneering porcelain.

MATERIALS AND METHODS

Sixty specimens were divided into 4 groups of 15 each. Specimen fabrication was done according to the International Organization for Standardization (ISO) specifications 9693:1999. Group 1 comprised core structure made of cast alloy, group 2 from sintered metal, group 3 from milled zirconia and group 4 milled zirconia without liner at the interface. The shear bond strengths were recorded and the values obtained were statistically examined.

RESULTS

Highest values were recorded in group 3 and there were significant differences between groups 1 and 3 while groups 3 and 4 were not statistically different. This led us to imply that zirconia as a core structure provided maximum strengths and laser sintered metal came second. The results also pointed out that the role of the zirconia liner is not that crucial to attaining adequate strength.

CONCLUSION

The present study concluded that zirconia and laser sintered metal are excellent core materials and feasible alternatives to cast alloy. We also concluded from our study that a zirconia liner did not affect the bond strength significantly and is not absolutely essential.

CLINICAL SIGNIFICANCE

This study helps us to understand the role of materials used as core structures in enhancing the shear bond strength to veneer porcelains and also clarifies the role of a zirconia liner in the process.

Endophytic Phomopsis sp. colonization in Oryza sativa was found to result in plant growth promotion and piperine production

Endophytic fungi have been reported to have the acquired ability to synthesize host plant specific medicinal natural products. Many fungi with such properties have been characterized and optimized for the conditions which favor maximal production of desired products. However, the inherent plant colonization property of promising endophytic fungi is least studied. Exploiting the transgenome functioning of these fungi have immense applications to add beneficial features to nonhost plants. In the present study, the endophytic fungus Phomopsis sp. isolated from Piper nigrum was confirmed for piperine production by HPLC and LCMS/MS. Further, the fungal isolate was studied for its colonization ability in Oryza sativa. Interestingly, the fungi treated plants were found to have significant plant growth enhancement when compared to the control. Further screening of extract from treated plants by HPLC and LCMS/MS resulted in the confirmation of presence of piperine. The observed result is extremely significant as it opens up novel applications of endophytic fungal colonization in taxonomically diverse plants.

Bioengineering of Dioscorea nipponica with rhizospheric Proteus spp. for enhanced tuber size and diosgenin content

Rhizobacterial production of plant hormones, ACC deaminase, fixation of nitrogen, solubilization of phosphate and antimicrobial metabolites play very important role in the health and growth of plants. Hence exploration of plant probiotic prospectives of promising rhizobacterial isolates from biodiversity rich areas can have enormous applications to engineer both the biomass and active ingredients of plants. In the present study, rhizospheric Proteus spp. R6 and R60 isolated from Pseudarthria viscida and Glycosmis arborea were analyzed for tuber and diosgenin enhancement effects in Dioscorea nipponica under field conditions for 1 year. Among the two Proteus spp. selected, both were positive for ACC deaminase, siderophore, nitrogen fixation, IAA and ammonia production. However, the isolate R6 was found to have additional phosphate solubilizing activity. Quantitative analysis of IAA by HPTLC showed its maximum production by Proteus sp. R60 (714.47 ± 8.7 µg/mL) followed by Proteus sp. R6 (588.06 ± 7.0 µg/mL). The tubers formed from the Proteus sp. R6 treated samples were identified to have significant enhancement in size, root number and diosgenin content when compared to control. Interestingly, HPLC analysis has confirmed twofold higher diosgenin content in Proteus sp. R6 treated samples than control during 1 year period of its field growth. The obtained results are of great importance as it involved the utilization of rhizospheric bacteria to improve tuber size which suggests its potential use in developing cost-effective, eco-friendly and multifunctional biofertilizer.

Single-tube tetradecaplex panel of highly polymorphic microsatellite markers < 1 Mb from F8 for simplified preimplantation genetic diagnosis of hemophilia A

Essentials Preimplantation genetic diagnosis (PGD) of severe hemophilia A relies on linkage analysis. Simultaneous multi-marker screening can simplify selection of informative markers in a couple. We developed a single-tube tetradecaplex panel of polymorphic markers for hemophilia A PGD use. Informative markers can be used for linkage analysis alone or combined with mutation detection.

SUMMARY

Background It is currently not possible to perform single-cell preimplantation genetic diagnosis (PGD) to directly detect the common inversion mutations of the factor VIII (F8) gene responsible for severe hemophilia A (HEMA). As such, PGD for such inversion carriers relies on indirect analysis of linked polymorphic markers. Objectives To simplify linkage-based PGD of HEMA, we aimed to develop a panel of highly polymorphic microsatellite markers located near the F8 gene that could be simultaneously genotyped in a multiplex-PCR reaction. Methods We assessed the polymorphism of various microsatellite markers located ≤ 1 Mb from F8 in 177 female subjects. Highly polymorphic markers were selected for co-amplification with the AMELX/Y indel dimorphism in a single-tube reaction. Results Thirteen microsatellite markers located within 0.6 Mb of F8 were successfully co-amplified with AMELX/Y in a single-tube reaction. Observed heterozygosities of component markers ranged from 0.43 to 0.84, and ∼70-80% of individuals were heterozygous for ≥ 5 markers. The tetradecaplex panel successfully identified fully informative markers in a couple interested in PGD for HEMA because of an intragenic F8 point mutation, with haplotype phasing established through a carrier daughter. In-vitro fertilization (IVF)-PGD involved single-tube co-amplification of fully informative markers with AMELX/Y and the mutation-containing F8 amplicon, followed by microsatellite analysis and amplicon mutation-site minisequencing analysis. Conclusions The single-tube multiplex-PCR format of this highly polymorphic microsatellite marker panel simplifies identification and selection of informative markers for linkage-based PGD of HEMA. Informative markers can also be easily co-amplified with mutation-containing F8 amplicons for combined mutation detection and linkage analysis.

Strain-specific variation in plant growth promoting volatile organic compounds production by five different Pseudomonas spp. as confirmed by response of Vigna radiata seedlings

AIM

Analysis of a blend of volatile organic compounds (VOCs) released by Pseudomonas spp. with growth-promoting effect in Vigna radiata seedlings.

METHODS AND RESULTS

Plant growth-promoting activity of VOCs produced by five different Pseudomonas spp. was investigated by I-plate technique. VOCs produced by different organisms were extracted by various solvents (methanol, ethyl acetate, hexane and butanol) and were identified by gas chromatography-mass spectrometric analysis. The major VOCs identified were undecane, nonadecane, hexacosane, tetradecane, heptacosane, pentadecane, dodecane and tetratetracontane. The cultural conditions for the production of VOCs with plant growth enhancement effect were optimized and further confirmed using pure pentadecane as a candidate VOC.

CONCLUSIONS

The study provides insight into plant beneficial effect of VOCs produced by Pseudomonas spp. Remarkable modulation in the production of VOCs with plant growth-promoting effect by rhizobacteria was found to be dependent on the bacterial strain and its concentration.

SIGNIFICANCE AND IMPACT OF THE STUDY

The study describes the requirement to consider bacterial VOC production also for preparing plant probiotic formulations. As VOCs are least considered for preparation of commercial plant growth-promoting rhizobacterial strain formulation, the results of the study is highly significant.

Evidence of enhanced photocurrent response in corannulene films

Experimental optical absorption and photoconductivity spectra of thin films with GW–BSE theoretical predictions provide evidence for diffuse super atomic molecular orbitals (SAMOs) in corannulene, C₂₀H₁₀.

Identification of endophytic Bacillus mojavensis with highly specialized broad spectrum antibacterial activity

Biosynthetic adaptation of endophytic bacteria to chemically support host plant is very remarkable. Hence these organisms from medicinal plants are considered as highly valuable sources for natural products with diverse bioactivity. Their metabolite diversity and biosynthetic versatility have been increasingly explored for drug discovery. In this study, an endophytic Bacillus mojavensis with broad spectrum antibacterial properties has been analyzed for the chemical basis of its activity. By LC-MS/MS the organism was identified to have the biosynthetic ability to produce lipopeptides surfactin and fengycin. The impressive antibacterial activity of B. mojavensis as reported in the study indicates its broad antimicrobial applications.

Studies on coexistence of mec gene, IS256 and novel sasX gene among human clinical coagulase-negative staphylococci

Methicillin-resistant coagulase-negative staphylococci (MRCoNS) are major nosocomial pathogens which cause device-related infections. Presence of various virulence factors along with methicillin resistance favor improved CoNS pathogenicity and their dissemination among population. In the present study, mec gene prevalence was analyzed along with SCC mec diversity among 55 human clinical CoNS isolates. PCR screening of insertion sequence (IS256) was also conducted to elucidate their association with methicillin resistance among selected CoNS species. In addition to this, PCR screening and sequence analysis of novel colonization-associated gene sasX was also carried out. High incidences of mec gene, IS256 and their association have been noted among all of the CoNS species tested. Interestingly, eight CoNS isolates were found to harbor sasX gene including S. epidermidis, S. hemolyticus and S. saprophtyicus species. Remarkably they were also found to have the coexistence of mec gene and IS256 in their genome. Increased SCC mec diversity with non-typeable elements was also observed among CoNS isolates. Presence of sasX gene in CoNS with mec gene and insertion sequence 256 and also the identification of non-typeable SCC mec element make the study novel and interesting.

Factors influencing local control in patients undergoing breast conservation surgery for ductal carcinoma in situ

BACKGROUND

The aim of our study was to assess various predictors for local recurrence (LR) in patients undergoing breast conservation surgery (BCS) for ductal carcinoma in situ (DCIS).

MATERIALS AND METHODS

An audit was performed of 582 consecutive patients with DCIS between Jan 1975 to June 2008. In patients undergoing BCS, local guidelines reported a margin of ≥10 mm during the above period. Guideline with regard to margin of excision changes soon after this period. We retrospectively analysed clinical and pathological risk factors for local recurrence in patients undergoing BCS. Statistical analysis was carried out using SPSS version 19, and a cox regression model for multivariate analysis of local recurrence was used.

RESULTS

Overall 239 women had BCS for DCIS during the above period. The actuarial 5-year recurrence rate was 9.6%. The overall LR rate was 17% (40/239. LR was more common in patients ≤50 years: (10/31 patients, 32%) compared to patients > 50 years (30/208, 14%, P = 0.02). Forty three per cent of patients (6/14) with <5 mm margin developed LR which was significantly higher compared to patients with 5-9 mm margin (12%, 3/25) and with ≥10 mm margin (14%, 27/188, P = 0.01). On multivariate analysis age ≤50 years, <5 mm pathological margin were independent prognostic factors for local recurrence.

CONCLUSION

Our study shows that younger age (≤50 years) and a margin < 5 mm are poor prognostic factors for LR in patients undergoing breast conservation surgery for DCIS.

Plant growth and diosgenin enhancement effect of silver nanoparticles in Fenugreek (Trigonella foenum-graecum L.)

Various methods have been used to enhance production of chemically diverse phytochemicals especially medicinal natural products. With the advancement in nanotechnology, nanoparticles have been reported to have varying impact in plant growth and inducibility of phytochemical composition. Major objective of the study was to study the secondary metabolite modulatory effect of silver nanoparticles. In the current study, treatment of fenugreek seedlings with biosynthesized silver nanoparticles (Ag-NPs) was found to have significant impact on its growth parameters such as leaf number, root length, shoot length and wet weight. On HPLC based analysis, Ag-NPs treated seedlings showed an enhancement in the production of major phytochemical diosgenin to a level of 214.06 ± 17.07 μg/mL. An untreated control gave an yield of only 164.44 ± 7.67 μg/mL of diosgenin, and the observed phytochemical enhancement effect induced by Ag-NP was very significant. Most remarkably, the Ag-NP used in the study was found to play dual role of enhancement of both plant growth and diosgenin synthesis. Hence the study is of immense application as it opens up development of new methods based on nanoelicitors to enhance the biosynthesis of medicinal natural products in plants.

Favorable Waitlist and Posttransplant Outcomes in Children and Adolescent Patients Supported With Durable Continuous-Flow Ventricular Assist Devices

Pediatric centers are implanting durable adult continuous-flow ventricular assist devices (CFVADs) in children who are smaller than the industry-recommended size. Waitlist and posttransplant outcomes data in pediatric patients supported with CFVADs as a bridge to transplant are limited. We analyzed the United Network of Organ Sharing and Organ Procurement and Transplantation Network registry to identify patients aged ≤18 years with a CFVAD at the time of listing or transplantation. Patients were stratified by body surface area (BSA; >1.5 vs. ≤1.5 m(2) ) at time of listing. We identified 138 patients with a durable CFVAD during the listing period (100 with BSA >1.5 m(2) , 38 with BSA ≤1.5 m(2) ). Patients with BSA ≤1.5 m(2) were more likely to have a noncardiomyopathy diagnosis (18% vs. 4%, p = 0.007) and to be implanted with a centrifugal-flow rather than an axial-flow device (74% vs. 30%, p = 0.001). There was no difference in failure-free waitlist survival between BSA groups (p = 0.99) among patients with a CFVAD at listing. Posttransplantation survival was 100% and 88% at 1 and 5 years, respectively, for the entire cohort and did not differ by BSA group (p = 0.99). Consequently, waitlist and posttransplant outcomes are favorable for pediatric CFVAD recipients. Small patients (≤1.5 m(2) ) had pre- and posttransplant outcomes similar to those of larger patients that met the industry-recommended size for implantation.

Surfactin, Iturin, and Fengycin Biosynthesis by Endophytic Bacillus sp. from Bacopa monnieri

Endophytic microorganisms which are ubiquitously present in plants may colonize intracellularly or intercellularly without causing any diseases. By living within the unique chemical environment of a host plant, they produce a vast array of compounds with a wide range of biological activities. Because of this, natural products of endophytic origin have been exploited for antimicrobial, antiviral, anticancer, and antioxidant properties. Also, they can be considered to function as an efficient microbial barrier to protect plants from various pathogens. In the present study, endophytic bacterium BmB 9 with antifungal and antibacterial activity isolated from the stem tissue of Bacopa monnieri was studied for the molecular and chemical basis of its activity. PCR-based genome mining for various biosynthetic gene clusters proved the presence of surfactin, iturin, and type I polyketide synthase (PKS) genes in the isolate. The LC-MS/MS based analysis of the extract further confirmed the production of surfactin derivatives (M + H(+)-1008.6602, 1022.6755), iturin (M + H(+)-1043.5697), and fengycin (M + H(+)-1491.8195, 1477.8055) by the selected bacterial isolate. The 16S rDNA sequence similarity based analysis identified the isolate BmB 9 as Bacillus sp. with 100 % identity to Bacillus sp. LCF1 (KP257289).

Adverse Drug Reactions in Hospitalized Pediatric Patients: A Prospective Observational Study

OBJECTIVES

To determine the incidence, pattern, causality, preventability, severity and predictors of adverse drug reactions (ADRs) in pediatric population.

METHODS

It was a prospective, observational study that included patients of either sex, of any age treated in the pediatric wards of a tertiary care hospital. Study patients were followed throughout their hospital stay. Whenever an ADR was detected, all the required data was collected and analyzed. Data was analyzed for incidence, causality (by using WHO Probability scale and Naranjo's algorithm), preventability (by using Modified Shumock and Thornton scale), severity (by using Modified Hartwig and Siegel scale) and predictors of ADRs.

RESULTS

Of the 1775 children admitted in the pediatrics ward, 1082 patients met study criteria and were enrolled into the study. A total of 64 ADRs were identified from 54 patients. The incidence of ADRs was 4.99 %. Male patients experienced majority (68.52 %) of ADRs. Drugs most commonly implicated in ADRs were amoxicillin + clavulanate (21.87 %) followed by ceftriaxone (20.31 %). Most (51.56 %) of the ADRs reported belonged to the system organ class, gastrointestinal system disorders. Among the ADRs reported, 82.85 % of ADRs were mild. Majority (87.5 %) of the ADRs were of 'probable' causality category and 96.9 % were not preventable. There was a significant association between occurrence of ADRs and the use of ≥4 number of medications, age (infants) and gender (male).

CONCLUSIONS

Among the pediatric population, infants, male gender and those receiving ≥4 number of medications are at risk of developing ADRs. Constant monitoring is required to address the safety issue in pediatric population especially in infants and patients receiving ≥4 drugs.

Ganoderma lucidum total triterpenes attenuate DLA induced ascites and EAC induced solid tumours in Swiss albino mice

G. lucidum total triterpenes were assessed for its apoptosis-inducing and anti-tumour activities. The ability of the total triterpenes to induce apoptosis was evaluated in Dalton's lymphoma ascites (DLA) and Ehrlich's ascites carcinoma (EAC) cell lines. Total triterpenes were found to be highly cytotoxic to DLA and EAC cell lines with IC50 values 5 ± 0.32 and 7.9 ± 0.2 µg/ml respectively. Total triterpenes induced apoptosis in both cell lines which is evident from the DNA fragmentation assay. Anti-tumour activity was accessed using DLA induced solid and EAC induced ascites tumour models in Swiss albino mice. Administration of 10, 50 and 100 mg/kg b. wt. total triterpenes showed 11.86, 27.27 and 40.57% increase in life span of animals in ascites tumour model. Treatment with 10, 50 and 100 mg/kg b. wt. total triterpenes exhibited 76.86, 85.01 and 91.03% inhibition in tumour volume and 67.96, 72.38 and 77.90% inhibition in tumour weight respectively in the solid tumour model. The study reveals the significant dose-dependent anti-tumour activity of total triterpenes in both models. Total triterpenes were more active against the solid tumour than the ascites tumour. The anti-oxidant potential and ability to induce cell-specific apoptosis could be contributing to its anti-tumour activities.

Studies on prevalence of biofilm associated genes and primary observation on sasX gene in clinical isolates of coagulase negative staphylococci (CoNS)

Coagulase negative staphylococci (CoNS) are nosocomial pathogens that cause indwelling medical device associated infections due to its biofilm forming potential and multiple antibiotic resistance. The current study focused on species identification, antibiotic resistance profile and molecular basis of biofilm formation and attachment of CoNS isolated from clinical samples. Along with this, molecular screening for mecA and newly identified surface colonization protein encoded by sasX gene was also conducted. S. epidermidis (n = 19, 47%) was identified as the most prevalent CoNS species and very interestingly two biofilm forming, mecA positive S. epidermidis isolates were found to carry all the biofilm associated genes screened in this study, which indicates its potential to form the strong biofilm. Another novel observation of the study is the detection of sasX gene in one biofilm positive S. epidermidis isolate. The study also identified one doxycycline resistant mecA positive, multidrug resistant S. haemolyticus isolate. In conclusion, the study signifies the existence of multiple biofilm related genes, multidrug resistance and the presence of sasX gene among clinical isolates of CoNS.

Olefin hydrosilylation catalyzed by cationic nickel(ii) allyl complexes: a non-innocent allyl ligand-assisted mechanism

Cationic nickel allyl complexes catalyse selective monohydrosilylation of α-olefins with sec-silanes via a unique mechanism assisted by a non-innocent allyl ligand.

Electrospun Polycaprolactone Membrane Incorporated with Biosynthesized Silver Nanoparticles as Effective Wound Dressing Material

Biosynthesized silver nanoparticles (AgNPs) incorporated polycaprolactone (PCL) nanomembrane was prepared by electrospinning as a cost-effective nanocomposite for application as an antimicrobial agent against wound infection. The nanocomposite membrane was characterized by Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD) analysis and Scanning Electron microscopy (SEM). The hydrophilicity analysis of electrospun membranes as evaluated by water contact angle measurement showed the change of hydrophobicity of PCL to hydrophilic upon incorporation of silver nanoparticles. Better mechanical properties were also observed for PCL membrane due to the incorporation of silver nanoparticles and are highly supportive to explore its biomedical applications. Further antibacterial analysis of silver nanoparticle-incorporated PCL membrane against common wound pathogens coagulase-negative Staphylococcus epidermidis and Staphylococcus haemolyticus showed remarkable activity. As biosynthesized AgNPs are least explored for clinical applications, the current study is a promising cost-effective method to explore the development of silver nanoparticle-based electrospun nanocomposite to resist wound-associated infection.

Lasers: The Magic Wand in Esthetic Dentistry!!

In this era of fast developing technologies and innovative ideas, the need for faster treatment has become a necessity. Treatment with lasers that is much less time-consuming and painless is accepted and appreciated by the patient. Use of Lasers is not new; they have been in use for decades since their development by Maiman in 1960. Lasers have travelled a long way from ruby lasers to erbium lasers and are being fondly used in every aspect of dental treatment. This article aims at elaborate the use and applications of lasers in the field of esthetic dentistry.

Inhibitory effect of silver nanoparticle fabricated urinary catheter on colonization efficiency of Coagulase Negative Staphylococci

Multiple antibiotic resistance and diverse mechanisms for biofilm formation make Coagulase Negative Staphylococci (CoNS) to cause infections associated with insertion of medical devices. As the infectious life style of CoNS pose difficult to treat conditions, materials with multitargeted antimicrobial effect can offer promising ways to modify the surface of devices to limit microbial growth. The broad spectrum of antimicrobial properties shown by silver nanoparticles (AgNPs) make it as an excellent candidate to act on device surface as persistent antimicrobial structures. In the current study, AgNPs assembled by soil bacteria under visible light at room temperature were analysed for its physical properties by UV-Vis spectroscopy, FTIR, SEM, HR-TEM and EDS and they also showed significant antimicrobial and antibiofilm properties against selected members of CoNS like Staphylococcus epidermidis and Staphylococcus haemolyticus. Very interestingly, further analysis on antibacterial mechanism of AgNPs showed their remarkable ability to cause disorganization of bacterial cell membrane. Further, surface engineering application of AgNPs on urinary catheter showed its excellent potential to prevent the attachment and colonization of CoNS which make result of study with significantly novel medical applications.

Antibacterial properties of silver nanoparticles synthesized by marine Ochrobactrum sp

Metal nanoparticle synthesis is an interesting area in nanotechnology due to their remarkable optical, magnetic, electrical, catalytic and biomedical properties, but there needs to develop clean, non-toxic and environmental friendly methods for the synthesis and assembly of nanoparticles. Biological agents in the form of microbes have emerged up as efficient candidates for nanoparticle synthesis due to their extreme versatility to synthesize diverse nanoparticles with varying size and shape. In the present study, an eco favorable method for the biosynthesis of silver nanoparticles using marine bacterial isolate has been attempted. Very interestingly, molecular identification proved it as a strain of Ochrobactrum anhtropi. In addition, the isolate was found to have the potential to form silver nanoparticles intracellularly at room temperature within 24 h. The biosynthesized silver nanoparticles were characterized by UV-Vis spectroscopy, transmission electron microscope (TEM) and scanning electron microscope (SEM). The UV-visible spectrum of the aqueous medium containing silver nanoparticles showed a peak at 450 nm corresponding to the plasmon absorbance of silver nanoparticles. The SEM and TEM micrographs revealed that the synthesized silver nanoparticles were spherical in shape with a size range from 38 nm – 85 nm. The silver nanoparticles synthesized by the isolate were also used to explore its antibacterial potential against pathogens like Salmonella Typhi, Salmonella Paratyphi, Vibrio cholerae and Staphylococcus aureus.

Denture Adhesives in Prosthodontics: An Overview

The use of denture adhesives is common among denture wearers, and it is also prescribed by many dentists. Prescribing denture adhesives has been viewed by many prosthodontists as a means of compensating for any defects in the fabrication procedures. Denture adhesives add to the retention and thereby improve chewing ability, reduce any instability, provide comfort and eliminate the accumulation of food debris beneath the dentures. Consequently, they increase the patient's sense of security and satisfaction. However, obtaining the advice of the dental practitioner prior to the use of adhesives is a must.

Acute kidney injury after ex vivo lung perfusion (EVLP)

BACKGROUND

Ex vivo lung perfusion (EVLP) identifies viability for marginal organs but complicates and lengthens lung transplantation surgery. Preliminary evidence supports equivalency for EVLP-assisted versus traditional (non-EVLP) procedures regarding graft function, postoperative course, mortality, and survival. However, acute kidney injury (AKI), a common serious complication of lung transplantation, has not been assessed. We tested the hypothesis that EVLP-assisted and non-EVLP lung transplantations are associated with different AKI rates.

METHODS

Demographic, procedural, and renal data were gathered for 13 EVLP-viable lung transplantations and a non-EVLP group matched 4:1 for single versus double, pulmonary disease, and age. AKI was defined by AKI Network (AKIN) criteria and peak creatinine rise relative to baseline (Δ%Cr) during the 1st 10 postoperative days. Chi-square was performed for AKIN and 2-tailed t test for %ΔCr.

RESULTS

Patient and procedural characteristics were similar between the groups. One non-EVLP patient required postoperative dialysis. AKI rates were also similar, as assessed by both AKIN (EVLP 7/13 (54%) vs non-EVLP 32/52 (62%); P = .61) and %ΔCr (EVLP 91 ± 81% vs non-EVLP 72 ± 62%; P = .63).

CONCLUSIONS

We did not observe different AKI rates between EVLP-assisted and traditional lung transplant procedures. Although 1 non-EVLP patient required dialysis, AKI rates were otherwise similar. These findings further support EVLP as a strategy to expand the organ pool and reduce concerns for high-renal risk recipients. The small sample size and retrospective design are limitations. However, our sample size is similar to other reports, and it is the first to analyze AKI after EVLP-assisted lung transplantation. Larger multicenter prospective studies are needed.

Pilot randomised study of early intervention based on tumour markers in the follow-up of patients with primary breast cancer

BACKGROUND

This pilot study aimed to test the possibility of therapeutic benefit imparted by early intervention based on sequential tumour marker (TM) measurements during follow-up of primary breast cancer (PBC) patients.

METHODS

Patients with oestrogen receptor positive PBC with no clinical and/or radiological evidence of metastases were recruited and followed-up 3-monthly with clinical assessment and TM (CA15.3 and CEA) measurements. The clinical team was blinded to the TM results. Asymptomatic patients who developed raised TMs (based on pre-defined cut-offs) were randomised to either 'treatment change' (either start or change of adjuvant endocrine agent to another agent) or 'no change' (control). Patients who developed symptomatic metastases came off the study. The primary and secondary endpoints were intervals from randomisation to symptomatic metastases and to last follow-up/death respectively.

RESULTS

Eighty-five patients (median age = 54 years (30-72)) were recruited with a median follow-up of 81 months (1-124). Sixteen patients were randomised as described. There was no significant difference (treatment change versus no change) with regards to interval from randomisation to symptomatic metastases - 23 (2-62) and 22 (1-63) months respectively (p = 0.9), as well as interval from randomisation to last follow-up/death - 36 (7-63) and 37 (10-63) months respectively (p = 0.9).

CONCLUSIONS

Despite long follow-up (up to 10+ years), this small study has thus far shown no significant difference in outcome. However, we have confirmed the feasibility of this study design but a larger study will be required to show if there is a benefit to this approach.

Antibacterial activity and synergistic effect of biosynthesized AgNPs with antibiotics against multidrug-resistant biofilm-forming coagulase-negative staphylococci isolated from clinical samples

Silver nanoparticles form promising template for designing antimicrobial agents against drug resistant pathogenic microorganisms. Thus, the development of a reliable green approach for the synthesis of nanoparticles is an important aspect of current nanotechnology research. In the present investigation, silver nanoparticles synthesized by a soil Bacillus sp. were characterized using UV-vis spectroscopy, FTIR, SEM, and EDS. The antibacterial potential of biosynthesized silver nanoparticles, standard antibiotics, and their conjugates were evaluated against multidrug-resistant biofilm-forming coagulase-negative S. epidermidis strains, S. aureus, Salmonella Typhi, Salmonella Paratyphi, and V. cholerae. Interestingly, silver nanoparticles (AgNPs) showed remarkable antibacterial activity against all the test strains with the highest activity against S. epidermidis strains 145 and 152. In addition, the highest synergistic effect of AgNPs was observed with chloramphenicol against Salmonella typhi. The results of the study clearly indicate the promising biomedical applications of biosynthesized AgNPs.

Extracellular synthesis of silver nanoparticles by the Bacillus strain CS 11 isolated from industrialized area

Biological synthesis of silver nanoparticles using microorganisms has received profound interest because of their potential to synthesize nanoparticles of various size, shape and morphology. In the current study, synthesis of silver nanoparticles by a bacterial strain (CS 11) isolated from heavy metal contaminated soil is reported. Molecular identification of the isolate showed it as a strain of Bacillus sp. On treating the bacteria with 1 mM AgNO₃, it was found to have the ability to form silver nanoparticles extracellularly at room temperature within 24 h. This was confirmed by the visual observation and UV-Vis absorption at 450 nm. Further characterization of nanoparticles by transmission electron microscopy confirmed the size of silver nanoparticles in 42-92 nm range. Therefore, the current study is a demonstration of an efficient synthesis of stable silver nanoparticle by a Bacillus strain.

Isolation and characterization of plant growth promoting endophytic bacteria from the rhizome of Zingiber officinale

Endophytes, by residing within the specific chemical environment of host plants, form unique group of microorganisms. Microbially unexplored medicinal plants can have diverse and potential microbial association. The rhizome of ginger is very remarkable because of its metabolite richness, but the physiological processes in these tissues and the functional role of associated microorganisms remain totally unexplored. Through the current study, the presence of four different endophytic bacterial strains were identified from ginger rhizome. Among the various isolates, ZoB2 which is identified as Pseudomonas sp. was found to have the ability to produce IAA, ACC deaminase and siderophore. By considering these plant growth promoting properties, ZoB5 can expect to have considerable effect on the growth of ginger.

MELAS syndrome presenting as an acute surgical abdomen

MELAS (mitochondrial cytopathy, encephalomyopathy, lactic acidosis and stroke-like episodes) is a syndrome in which signs and symptoms of gastrointestinal disease are uncommon if not rare. We describe the case of a young woman who presented as an acute surgical emergency, diagnosed as toxic megacolon necessitating an emergency total colectomy. MELAS syndrome was suspected postoperatively owing to persistent lactic acidosis and neurological symptoms. The diagnosis was later confirmed with histological and genetic studies. This case highlights the difficulties in diagnosing MELAS because of its unpredictable presentation and clinical course. We therefore recommend a high index of suspicion in cases of an acute surgical abdomen with additional neurological features or raised lactate.

Symmetrisation procedures in breast reconstruction patients constitute a rising workload in our DGH

INTRODUCTION

In breast cancer patients undergoing reconstructive surgery, achieving symmetry is of considerable importance. The aim of our study was to identify the proportion of breast cancer patients undergoing reconstructive surgery requiring contralateral symmetrisation procedures.

PATIENTS AND METHODS

This is a retrospective review of consecutive patients undergoing reconstructive procedures following cancer surgery from April 2005 to April 2012.

RESULTS

One hundred and fifty three patients had symmetrisation procedure of the opposite side during this period. The median age was 53 years (22-79). Reduction mammoplasty was the commonest procedure (94 patients), followed by mastopexy (34 patients) and augmentation mammoplasty (25 patients). Overall, it represent approximately one third of (153/489; 31.2%) of all the major reconstruction procedures in this unit.

CONCLUSION

Almost half the number of patients (153/336) undergoing breast reconstruction as a part of breast cancer surgery had a symmetrisation procedure performed on the opposite side which constitutes a significant reconstructive workload in our unit. Consideration should be given to the above when planning departmental work force and training.

Antibacterial properties of silver nanoparticles synthesized by marine Ochrobactrum sp

Metal nanoparticle synthesis is an interesting area in nanotechnology due to their remarkable optical, magnetic, electrical, catalytic and biomedical properties, but there needs to develop clean, non-toxic and environmental friendly methods for the synthesis and assembly of nanoparticles. Biological agents in the form of microbes have emerged up as efficient candidates for nanoparticle synthesis due to their extreme versatility to synthesize diverse nanoparticles with varying size and shape. In the present study, an eco favorable method for the biosynthesis of silver nanoparticles using marine bacterial isolate has been attempted. Very interestingly, molecular identification proved it as a strain of Ochrobactrum anhtropi. In addition, the isolate was found to have the potential to form silver nanoparticles intracellularly at room temperature within 24 h. The biosynthesized silver nanoparticles were characterized by UV-Vis spectroscopy, transmission electron microscope (TEM) and scanning electron microscope (SEM). The UV-visible spectrum of the aqueous medium containing silver nanoparticles showed a peak at 450 nm corresponding to the plasmon absorbance of silver nanoparticles. The SEM and TEM micrographs revealed that the synthesized silver nanoparticles were spherical in shape with a size range from 38 nm - 85 nm. The silver nanoparticles synthesized by the isolate were also used to explore its antibacterial potential against pathogens like Salmonella Typhi, Salmonella Paratyphi, Vibrio cholerae and Staphylococcus aureus.

Femtosecond laser fluorescence and propagation in very dense potassium vapor

Femtosecond (fs) laser propagation and fluorescence of dense potassium vapor was studied, and the spectral region around the first and the second doublets of the principal series lines of potassium atoms was investigated. In our search we did not observe the conical emission in the far field, although it was previously observed in the case of rubidium. We discuss the possible reason of this unexpected result. The fluorescence spectrum revealed Rb impurity resonance lines in emission due to the collisional redistribution from the K(4p) levels into the Rb(5p) levels. In the forward propagation of 400 nm femtosecond light we observed the molecular band red shifted from potassium second doublet. However, no molecular spectrum was observed when the mode-locked fs laser light was discretely tuned within the wings of the first resonance lines, at 770 nm.

SU-E-T-649: Evaluation of RapidArc- Based Stereotactic Cranial Radiotherapy Plans with MU Objective Using Multiple Non Coplanar Arcs in Comparison with Conventional Dynamic Conformal Arc Technique

PURPOSE

Previous researches reported that RapidArc plans for stereotactic cranial radiotherapy have two to three times more MUs as compared to Conventional Dynamic Conformal Arc (DCA) Technique. This study aims to evaluate RapidArc plans using multiple non- coplanar arcs, developed with MU objective constraint in the optimization stage.

METHODS

Five single brain metastasis and three multiple metastases cases previously planned using DCA techniques in BrainLab iPlan Version 4.1 were investigated in this study. For each case, the target was defined on CT-MR fused images in iPlan. The CT images and contours of these patients were exported from iPlan to Varian Eclipse TPS Version 8.6. For each case, a DCA plan and a RapidArc plan with multiple non-coplanar arcs with and without using MU objective in the optimization stage were generated using Varian Trilogy machine with Millennium 120 MLC keeping the same prescription and critical structure dose limits. All plans were evaluated according to Conformity Index (CI-modified Paddick) Homogeneity Index (HI), and the normal tissue volume receiving various dose levels (V80%, V50%, V25% and V10%).

RESULTS

In all the plans, the target objectives were met and dose to OARs was within tolerance dose constraints. RapidArc plans with and without MU objective showed better CI and HI as supposed to DCA plans. V80%, V50%, V25% and V10% of normal tissue for RapidArc plans are equal or lesser than DCA plans. Single isocentre RapidArc plan for closely spaced multiple metastases cases showed better dose fall off between the lesions as supposed to DCA plans. RapidArc plans with MU objective resulted in comparable MUs as that of DCA plans.

CONCLUSIONS

Our study showed RapidArc plans done with and without MU objective have no significant dosimetric difference in plan objectives. Therefore, multiple non-coplanar RapidArc plans with MU objective is clinically feasible and can provide better treatment plans than conventional DCA plans, especially for complicated cases.