Mycobacterium abscessus: causing fatal endocarditis after cardiac catheterization

Mycobacterium abscessus is an unusual cause of infection in immunocompetent patients. The intrinsic and acquired resistance of this organism to multiple antibiotics is a major issue in planning treatment regimens. We report a case of M. abscessus endocarditis of the native aortic valve in an immunocompetent patient following coronary angiography with a fatal outcome. The case highlights an unfortunate intervention – related nosocomial infection and the difficulties in chemotherapeutic options for this organism, particularly in the presence of renal failure.

Preparation, characterization and in vitro antioxidative potential of synbiotic fermented dairy products

The present study, evaluates the antioxidative potential of two synbiotic dairy products viz. synbiotic lassi with honey and whey based synbiotic drink with inulin and orange juice, along with their physicochemical and microbiological activity during storage period. Antioxidative potential of raw ingredients and probiotic cultures used to prepare synbiotic products was also evaluated. Synbiotic lassi with honey was prepared using Streptococcus thermophilus MTCC 5460 (MD2) and Lactobacillus helveticus MTCC 5463 (V3) as probiotics and honey as prebiotic. For preparation of whey based synbiotic drink, Lactobacillus helveticus MTCC 5463 and inulin were used as probiotic and prebiotic, respectively and orange juice was also incorporated. Titratable acidity and pH of both synbiotic products followed a similar pattern of increase or decrease during storage. Furthermore, no major changes were observed in viability of probiotic cultures under storage conditions adapted. The hydroxyl radical scavenging activity of synbiotic lassi with honey was found to significantly decrease from 107.76 to 79.41 % at the end of storage whereas, the activity of whey based synbiotic drink was 100.32 % which declined sharply to 79.21 % on 7th day but further increased to 102.59 % on 14th day. The DPPH (α, α-Diphenyl-β-Picrylhydrazyl) radical scavenging activity of freshly prepared synbiotic lassi with honey was 28.43 % which decreased to 23.03 % on 7th day while for whey based synbiotic drink decreased from 26.85 % (0 day) to 17.12 % (7th day) and continued to decline. Moreover, probiotic strains used for synbiotic preparation also demonstrated good antioxidative activity.

Evaluation of anti-ulcerogenic and ulcer-healing activities of nevirapine in rats

BACKGROUND

Nevirapine is a very potent antiretroviral drug frequently used in the management of Human Immunodeficiency Virus (HIV). Opportunistic pathologies in HIV/AIDS patients include gastric ulcer and gastrointestinal haemorrhage. Hence, the impact of nevirapine on induced gastric ulcer was studied using Wistar rats.

METHODS

Anti-ulcer activity of nevirapine was evaluated using cold restraint stress-induced, ethanol-induced and pylorus ligation-induced gastric ulcer models for acute ulceration; and acetic acid-induced ulcer model for the chronic ulceration in Wistar rats.

RESULTS

Nevirapine (9 mg/kg, 18 mg/kg and 36 mg/kg) showed significant (P < 0.05) reduction in ulcer severity score and ulcer index as compared to the control in the models,.with corresponding increase in percentage inhibition. Histopathological studies showed that nevirapine has a positive effect on the healing of gastric ulcer in the groups treated with the nevirapine compared with the control. The induced ulcers healed up in all the groups administered with nevirapine compared to what was found in the omeprazole group where manifestations of ulcer like inflammatory cells infiltration is still present.

CONCLUSION

Nevirapine may possess highly therapeutic effect in the treatment and prevention of gastrointestinal complications that might come with the presence of HIV virus in patients.

Probiotics as potential antioxidants: a systematic review

Probiotics are known for their health beneficial effects and are established as dietary adjuncts. Probiotics have been known for many beneficial health effects. In this view, there is interest to find the potential probiotic strains that can exhibit antioxidant properties along with health benefits. In vitro and in vivo studies indicate that probiotics exhibit antioxidant potential. In this view, consumption of probiotics alone or foods supplemented with probiotics may reduce oxidative damage, free radical scavenging rate, and modification in activity of crucial antioxidative enzymes in human cells. Incorporation of probiotics in foods can provide a good strategy to supply dietary antioxidants, but more studies are needed to standardize methods and evaluate antioxidant properties of probiotics before they can be recommended for antioxidant potential. In this paper, the literature related to known antioxidant potential of probiotics and proposing future perspectives to conduct such studies has been reviewed.

Three-Body Abrasive Wear Behavior of Needle-Punch Nonwoven Jute Fiber Reinforced Epoxy Composites

Now-a-days, natural fiber based composites are emerging as a supplement to the synthetic fiber composites. The aim of the present work is to investigate the three-body abrasive wear behavior of needle-punch nonwoven jute fiber reinforced epoxy (NJFE) composites in an abrasive environment. Three-body abrasion studies have been done on composites using rubber wheel abrasion tester. The design of experiments approach using Taguchi methodology is employed for the parametric analysis of abrasive wear process. The effect of the factors such as sliding velocity, fiber loading, applied load, sliding distance and abrasive size on the specific wear rate and coefficient of friction of composite has been studied. Experimental results reveal the improvement of abrasive wear behavior of the composites with the addition of fiber as compared to neat epoxy. At steady state condition, it has been observed that composites with 36 wt% fiber loading shows minimum specific wear rate. From the statistical analysis it has been concluded that the factor combination with sliding velocity of 120 cm/s, fiber loading of 36 wt%, normal load of 10 N, sliding distance of 50 m and abrasive size of 400 μm gives minimum specific wear rate whereas sliding velocity of 144 cm/s, fiber loading of 36 wt%, normal load of 10 N, sliding distance of 70 m and abrasive size of 300 μm gives minimum coefficient of friction. Finally, the worn surfaces are examined by using scanning electron microscopy (SEM) and possible abrasion wear mechanisms are discussed.

Huge critical current density and tailored superconducting anisotropy in SmFeAsO₀.₈F₀.₁₅ by low-density columnar-defect incorporation

Iron-based superconductors could be useful for electricity distribution and superconducting magnet applications because of their relatively high critical current densities and upper critical fields. SmFeAsO₀.₈F₀.₁₅ is of particular interest as it has the highest transition temperature among these materials. Here we show that by introducing a low density of correlated nano-scale defects into this material by heavy-ion irradiation, we can increase its critical current density to up to 2 × 10⁷ A cm⁻² at 5 K--the highest ever reported for an iron-based superconductor--without reducing its critical temperature of 50 K. We also observe a notable reduction in the thermodynamic superconducting anisotropy, from 8 to 4 upon irradiation. We develop a model based on anisotropic electron scattering that predicts that the superconducting anisotropy can be tailored via correlated defects in semimetallic, fully gapped type II superconductors.

Electrical property sensing biopsy needle for prostate cancer detection

BACKGROUND

Significant electrical property differences have been demonstrated to exist between malignant and benign prostate tissues. We evaluated how well a custom designed clinically deployable electrical property sensing biopsy needle is able to discriminate between these tissue types in an ex vivo prostate model.

METHODS

An electrical impedance spectroscopy (EIS) sensing biopsy (Bx) needle was developed to record resistive (ρR) and reactive (ρX) components of electrical impedance from 100 Hz to 1 MHz. Standard twelve-core biopsy protocols were followed, in which the EIS-Bx device was used to gauge electrical properties prior to extracting tissue cores through biopsy needle firing from 36 ex vivo human prostates. Histopathological assessment of the cores was statistically compared to the impedance spectrum gauged from each core.

RESULTS

The magnitudes of the mean resistive and reactive components were significantly higher in cancer tissues (P < 0.05). ROC curves showed that ρR at 63.09 kHz was optimal for discriminating cancer from benign tissues; this parameter had 75.4% specificity, 76.1% sensitivity, and ROC AUC of 0.779. Similarly, 251.1 kHz was optimal when using ρX to discriminate cancer from benign tissues; this parameter had a 77.9% specificity, 71.4% sensitivity, and ROC AUC of 0.79.

CONCLUSION

Significant electrical property differences noted between benign and malignant prostate tissues suggest the potential efficacy an EIS-Bx device would provide for cancer detection in a clinical setting. By sensing a greater fraction of the prostate's volume in real-time, the EIS-Bx device has the potential to improve the accuracy of cancer grading and volume estimation made with current biopsy procedures.

Electrical impedance spectroscopy for prostate cancer diagnosis

Electrical impedance was recorded at 21 discrete frequencies (1 to 100 kHz) from 27 ex vivo human prostates. These electrical properties were measured by using custom designed Electrical Impedance Spectroscopy (EIS) sensing biopsy (Bx) needles. EIS-Bx needles gauge the electrical properties of tissue in tandem with the tissue extraction (used for histopathological assessment). The EIS-Bx probe has a signal-to-noise ratio (SNR) of 65 dB across the frequency range (1 kHz to 100 kHz). A total of 36 cancers and 288 benign regions were sampled from 27 human prostates. Mean resistance (R) of prostate decreased from 537.27 Ω to 126.74 Ω for benign tissues and 999.52 Ω to 340.67 Ω for malignant tissues across the 1 kHz - 100 kHz spectral range. Likewise, mean reactance (X) ranged from -391.41 Ω to -62.6 Ω for benign and -675.09 Ω to -162.28 Ω for cancer tissues over the same frequency range. Both R and X values are found to be significantly lower in normal prostate tissues than in malignant tissue (p<0.001). Further testing to evaluate the clinical efficacy of this coupled device is underway.

Development of freeze dried synbiotic formulation using a probiotic strain of Lactobacillus plantarum

Synbiotics offer potential in the prophylactic management of gastrointestinal disorders. Therefore, present study evaluates the effect of prebiotics (inulin and gum acacia) on Lactocaillus plantarum for developing a freeze-dried synbiotic product from the selected culture. L. plantarum exhibited the highest specific growth rate (0.23/h) in presence of inulin followed by gum acacia (0.22/h) and glucose (0.22/h). Preparation of the lyophilized synbiotic powder incorporating inulin or gum acacia and using non fat dry milk as base material was standardized. Throughout refrigerated storage for 90 days, viable counts (i. e. 8 to 9 log cfu/g) of the probiotic bacteria in the product remained high, while a considerable reduction in the counts was observed in the product stored at room temperature (25 ± 1 °C).

Extra-anatomical complications of antegrade double-J insertion

Introduction:

Insertion of a double-J (JJ) stent is a common procedure often carried out in the retrograde route by the urologists and the antegrade route by the radiologists. Reported complications include stent migration, encrustation, and fracture. Extra-anatomic placement of an antegrade JJ stent is a rare but infrequently recognized complication.

Materials and Methods:

We performed a retrospective audit of 165 antegrade JJ stent insertions performed over three consecutive years by a single interventional radiologist. All renal units were hydronephrotic at the time of nephrostomy. All procedures were performed under local anaesthetic with antibiotic prophylaxis.

Results:

Antegrade stent insertion was carried out simultaneously at the time of nephrostomy in 55 of the 165 cases (33%). The remainder were inserted at a mean of 2 weeks following decompression. In five (3%) patients, who had delayed antegrade stenting following nephrostomy, the procedure was complicated by silent ureteric perforation and an extra-anatomic placement of the stent. These complications had delayed manifestations, which included two retroperitoneal abscesses, a pelvic urinoma, a case each of ureterorectal fistula, and ureterovaginal fistula. Risk factors for ureteric perforation include previous pelvic malignancy, pelvic surgery, pelvic radiation, and a history of ureteric manipulation.

Conclusion:

Antegrade ureteric JJ stenting is a procedure not without complications. Extra-anatomic placement of the antegrade stent is a hitherto the infrequently reported complication but needs a high index of suspicion to be diagnosed. Risk factors for ureteric perforation at the time of stent insertion have to be considered to prevent this potential complication.

Potential allergens of green gram (Vigna radiata L. Millsp) identified as members of cupin superfamily and seed albumin

BACKGROUND

No systematic study on allergenicity of green gram seed proteins have been performed so far, although incidences of IgE-mediated reaction to green gram seedlings have been reported.

OBJECTIVE

We sought to investigate the allergenic potential of green gram, followed by identification and characterization of its relevant allergens using proteomic approaches.

METHODS

BALB/c mice were sensitized intraperitoneally with green gram proteins, and levels of specific Igs, Th2 cytokines, histamine, anaphylactic symptoms and histopathological responses were studied. Twelve naso-bronchial allergic patients with a history of sensitization to green gram were selected on the basis of positive skin prick test and elevated specific IgE levels. Green gram allergens were identified and characterized by their ability to endure pepsin, by IgE immunoblot of two-dimensional (2D) gels in combination with mass spectrometry and by bioinformatics approaches.

RESULTS

Increased specific IgE, IgG1, Th2 cytokine and histamine levels, high anaphylactic scores and histological changes in lungs and spleen of green gram crude protein extract-treated mice are indicative of its sensitization ability. Four proteins (molecular weights: 52, 50, 30 and 18 kDa) showed pepsin resistance and IgE-binding capability with sensitized human and mice sera. The four proteins tentatively named as Vig r2 (52 kDa, pI 5.7), Vig r3 (50 kDa, pI 5.8), Vig r4 (30 kDa, pI 6.6) and Vig r5 (18 kDa, pI 5.5) showed significant sequence similarity with known allergens of soybean, lentil, pea, lupin, etc. Mass spectrometric analysis identified Vig r2 as 8S globulin β-isoform precursor, Vig r3 as 8S globulin α-isoform precursor and Vig r4 as seed albumin.

CONCLUSION AND CLINICAL RELEVANCE

Green gram seeds contain at least four clinically relevant allergenic proteins, namely Vig r2, Vig r3, Vig r4 and Vig r5 that were capable of inducing strong IgE-mediated reactions. One of the most important steps towards diagnostic and therapeutic approaches to deal effectively with food allergy is continued identification of newer food allergens and their characterization. The significance of this study can be enormous as the data generated may work as basic biology data in developing a green gram species modified genetically that may have reduced allergenicity.

The four-variable modification of diet in renal disease formula underestimates glomerular filtration rate in obese type 2 diabetic individuals with chronic kidney disease

AIMS/HYPOTHESIS

GFR is commonly estimated using the four-variable Modification of Diet in Renal Disease (MDRD) formula and this forms the basis for classification of chronic kidney disease (CKD). We investigated the effect of obesity on the estimation of glomerular filtration rate in type 2 diabetic participants with CKD.

METHODS

We enrolled 111 patients with type 2 diabetes mellitus in different stages of CKD. GFR was measured using (51)Cr-labelled EDTA plasma clearance and was estimated using the four-variable MDRD formula.

RESULTS

The bias between estimated and measured GFR was -22.4 (-33.8 to -11.0) p < 0.001 in the obese group compared with -6.04 (-17.6 to -5.5) p = 0.299 in the non-obese group. When GFR was indexed to body surface area of 1.73 m(2), the bias remained significant at -9.4 (-13.4 to -5.4) p < 0.001 in the obese participants.

CONCLUSIONS/INTERPRETATION

This study suggests that the four-variable MDRD formula significantly underestimates GFR in obese type 2 diabetic participants with CKD.

Epidemiology and microbiology of nosocomial pediatric candidemia at a northern Indian tertiary care hospital

The availability and aggressive use of chemotherapeutic and immunosuppressive agents as well as broad-spectrum antibacterial agents have created a large population of patients who are at increased risk of acquiring infections with fungal organisms, especially Candida species. Present work was undertaken to study the epidemiology and microbiology of candidemia and Candida colonization in hospitalized children. A total of 323 suspected cases of septicemia were enrolled, of which blood culture from 7.4% subjects was positive for Candida species. In total, 57.3% subjects were colonized by Candida species at least at one of the tested sites. Of 337 isolates, 24.3, 71.5, 2.9, 0.59, and 0.59% were Candida albicans, Candida tropicalis, Candida krusei, Candida kefyr, and Candida lusitaniae, respectively. Antifungal susceptibility results show that fluconazole, itraconazole, and amphotericin B resistance is prevalent in 18.2, 2.4, and 3.6% of C. albicans isolates, and 21.1, 4.6, and 0.04% of C. tropicalis isolates, respectively. In a large number of cases, source of blood infection was patient's own colonizers, as shown by genetic matching. It was also noted that some strain types are circulating within the ward. High prevalence of non-albicans candidemia with high resistance to fluconazole is prevalent in North Indian hospitalized children.