Endophytic fungi mediates production of bioactive secondary metabolites via modulation of genes involved in key metabolic pathways and their contribution in different biotechnological sector

Endophytic fungi stimulate the production of an enormous number of bioactive metabolites in medicinal plants and affect the different steps of biosynthetic pathways of these secondary metabolites. Endophytic fungi possess a number of biosynthetic gene clusters that possess genes for various enzymes, transcription factors, etc., in their genome responsible for the production of secondary metabolites. Additionally, endophytic fungi also modulate the expression of various genes responsible for the synthesis of key enzymes involved in metabolic pathways of such as HMGR, DXR, etc. involved in the production of a large number of phenolic compounds as well as regulate the expression of genes involved in the production of alkaloids and terpenoids in different plants. This review aims to provide a comprehensive overview of gene expression related to endophytes and their impact on metabolic pathways. Additionally, this review will emphasize the studies done to isolate these secondary metabolites from endophytic fungi in large quantities and assess their bioactivity. Due to ease in synthesis of secondary metabolites and their huge application in the medical industry, these bioactive metabolites are now being extracted from strains of these endophytic fungi commercially. Apart from their application in the pharmaceutical industry, most of these metabolites extracted from endophytic fungi also possess plant growth-promoting ability, bioremediation potential, novel bio control agents, sources of anti-oxidants, etc. The review will comprehensively shed a light on the biotechnological application of these fungal metabolites at the industrial level.

Resistive Index of Intrarenal Artery in Evaluation of Diabetic Nephropathy

Diabetes mellitus is one of the systemic diseases affecting the kidneys. Diabetic nephropathy is a serious microvascular complication of diabetes mellitus. It is the most important,cause of death in type I diabetic patients, of whom 30%-40% eventually develop end-stage renal failure and 40% of type II diabetics are at risk of developing diabetic nephropathy. So, diagnosis of diabetic nephropathy is paramount for the survivability of the diabetic patients not only because of the consequences of renal progression but also because of the strong association with the risk of developing cardiovascular disease. A total number of 53 subjects were enrolled in this present cross sectional study in the department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration of Nephrology and Medicine of the same institution during two years (2011-13) aim to evaluate the diagnostic usefulness of renal resistive index (RI) by duplex Doppler ultrasonography for detection of renal dysfunction in diabetic patients. Clinically diagnosed diabetic patients having diabetic nephropathy referred to the department of Radiology and Imaging in BSMMU for ultrasonography of Kidneys, Ureters and Bladder (KUB) region or whole abdomen were selected as sample. Biochemical reports (Serum creatinine and Urinary albumin) and the RI value of intrarenal artery were correlated and analyzed. Only those patients biochemically were diagnosed as having diabetic nephropathy was included. Those with incomplete data, hydro nephrosis and renal calculus were excluded. Both the kidneys were visualized by commercially available real time scanner (GE Voluson) equipped with a curvilinear transducer operating at 3.5 MHz First Gray scale ultrasonography was done followed by Color Doppler of intra renal artery and then RI was measured. Majority (45.3%) patients were in 6th decade with the mean age was of 52.66±7.4 years and ranging from 38 to 65 years in patients. Male was found to be 54.7% of diabetic patients with male to female ratio 1.2:1. Resistive index of (≥ 0.7) was found in 73.6% patients with diabetes with the mean resistive index of 0.71±0.04. Positive correction between resistive index with serum creatinine (r=0.581, p<0.01) and albuminuria (r-0.725, p<0.01) were observed. It can be concluded that Resistive Index measured by duplex Doppler ultrasonography is useful diagnostic modality for detection of renal dysfunction in diabetic nephropathy patients. Resistive Index has value in identifying diabetic patients who are developing nephropathy and can be used as an additional diagnostic tool. Also it is well correlated with Serum Creatinine and Albuminuria which are the biochemical parameters to diagnose diabetic nephropathy.

Comparative Study of Prevalence of Cataract at High Altitude and Kathmandu Valley

BACKGROUND

Cataract is the leading cause of avoidable blindness in the world. Many etiological and risk factors for age related cataract has been documented. The present study is conducted to compare the prevalence of cataract at high altitude and Kathmandu valley.Many etiological and risk factors for age related cataract has been documented.

METHODS

A cross sectional comparative study was conducted at Jomsom, Kagbeni, Jharkot and Muktinath of Mustang district and Balaju and Jawalakhel of Kathmandu valley of Nepal in 2009 to 2011 . There were 222 participants at Mustang and186 participants at Kathmandu. The prevalence of cataract was studied among the Tibetans and Thakali population at Mustang and Tibetans at Jawalakhel and Thakali population at Balaju of Kathmandu valley.

RESULTS

Prevalence of cataract at high altitude was 31.5% and 10.2% at Kathmandu valley. The prevalence of cataract is 4.05 times more at high altitude as compared to Kathmandu valley (p value < 0.001).

CONCLUSIONS

The prevalence of cataract was significantly high at high altitude as compared to lower altitude.

Exhaled Breath Analysis in Tuberculosis Case Detection: The New Horizon

Sixty years ago, Nobel Prize winner Linus Pauling proposed the concept that human breath is a complex and dynamic gaseous mixture of more than 200 different endogenous volatile organic compounds (VOCs) that are continually being released in different quantities within the internal environment during health and disease. The researchers estimate that more than a thousand chemicals produced in different organ-systems as metabolic end products come out every minute through the respiratory tract. Volatile organic compounds and other products of oxidative stress are a big chunk among these exhaled breath elements.DOI: http://doi.dx.org/10.3126/nje.v3i2.8509

Effective control of hypertension in adults with chronic kidney disease

INTRODUCTION: Adequate control of hypertension in Chronic Kidney Disease patients is difficult to achieve. This study was designed to analyze the adequacy of Hypertension control in adults with CKD using different classes of antihypertensive drugs. METHODS: A cross-sectional observational study was done that included 85 patients with CKD admitted to our Medicine Department over a period of two years (2006-2008 A.D.). Presence of CKD was defined as glomerular filtration rate <60 ml/min per 1.73 m2 for more than three months or presence of albuminuria (albumin:creatinine ratio >30ug/mg). Adequate blood pressure control was defined as systolic blood pressure less than or equals to 130 and diastolic blood pressure less than or equals to 80 mm Hg. Data and Statistical analysis was done using SPSS Version 12 for Windows. RESULTS: Of all the CKD patients, 51.4% required three Anti-Hypertensive drugs combination for the effective control of Hypertension, while only 21% of CKD patients with hypertension was controlled on two drugs. CONCLUSION: Adequate control of blood pressure in CKD patient was shown to be most effective on combination of three antihypertensive drugs. A poor control was seen on patients taking less than three antihypertensive drugs. Keywords: antihypertensive drug; chronic kidney disease; glomerular filtration rate; hypertension.

Effective control of hypertension in adults with chronic kidney disease

INTRODUCTION

Adequate control of hypertension in Chronic Kidney Disease patients is difficult to achieve. This study was designed to analyze the adequacy of Hypertension control in adults with CKD using different classes of antihypertensive drugs.

METHODS

A cross-sectional observational study was done that included 85 patients with CKD admitted to our Medicine Department over a period of two years (2006-2008 A.D.). Presence of CKD was defined as glomerular filtration rate <60 ml/min per 1.73 m2 for more than three months or presence of albuminuria (albumin:creatinine ratio >30ug/mg). Adequate blood pressure control was defined as systolic blood pressure less than or equals to 130 and diastolic blood pressure less than or equals to 80 mm Hg. Data and Statistical analysis was done using SPSS Version 12 for Windows.

RESULTS

Of all the CKD patients, 51.4% required three Anti-Hypertensive drugs combination for the effective control of Hypertension, while only 21% of CKD patients with hypertension was controlled on two drugs.

CONCLUSION

Adequate control of blood pressure in CKD patient was shown to be most effective on combination of three antihypertensive drugs. A poor control was seen on patients taking less than three antihypertensive drugs.

Toxicity of antibiotics and antifungals on cultured human corneal cells: effect of mixing, exposure and concentration

Toxic effects of topical drugs may be masked by manifestations of the disease they cure. The toxicity of drug mixtures has not been thoroughly studied. We therefore investigated cytopathic effects on primary cultures of human corneal cells of six topical antimicrobials singly and in combinations of any two, to determine the combined toxicity ranking and the interaction between duration of exposure and concentration. Preconfluent cultures were exposed to fixed dilutions of single drugs, or to equal-dilution mixtures of two drugs, for 7 and 14 days. Diminishing concentrations of single drugs were applied sequentially to cultures for 14 days. The number of metabolically competent cells was assessed by measuring hexosaminidase and total protein. Toxic effects depended on substance, concentration and exposure. The scale of toxicity determined for single drugs after 7 days of exposure was: gentamicin > econazole > or = methicillin > or = clotrimazole > or = miconazole > or = chloramphenicol. After 14 days this order changed: in particular chloramphenicol showed a highly increased toxicity. The order of diminishing effects was: gentamicin > chloramphenicol > or = methicillin > miconazole > econazole > clotrimazole. A clear reduction in cytopathic effects was observed when drug concentration was decreased progressively only in cultures treated with gentamicin or methicillin. All drug combinations were more toxic than their components at equal dilution. Combinations containing chloramphenicol ranked most toxic overall, those containing econazole least. A tapering off combination regime did not improve cell survival. These in vitro toxicity data complement clinical studies and suggest ways in which topical drugs can be chosen to minimise toxic effects to corneal surface.

Visual outcome of conventional extracapsular cataract extraction with posterior chamber intraocular lens implantation versus manual small-incision cataract surgery

Background: An effective method for cataract surgery should be identified to combat cataract blindness. Aim: To study the surgical outcome of conventional extracapsular cataract extraction versus manual small-incision cataract surgery. Materials and methods: A randomized clinical trial was carried out including one hundred eyes (88 patients) which were divided into two groups using systematic randomization: groups of conventional extracapsular cataract extraction with posterior chamber intraocular lens (ECCE with PCIOL) implantation and manual small-incision cataract surgery (MSICS). The postoperative parameters/variables studied were the unaided and best-corrected visual acuity and astigmatism. Statistics: Epi info 2000 version statistical software was used for data analysis and calculation of relative risk, 95% CI and p value. The p value of less than 0.05 was considered as significant. Results: In the immediate postoperative period, unaided visual acuity of =/> 6/18 was achieved in 24 subjects in MSICS group versus 7 in ECCE with PCIOL group (RR=2.05, 95% CI=1.44 - 2.94, p = 0.0002), whereas the same at 6 - 8 weeks postoperatively was found in 28 and 22 subjects in those groups respectively (RR=1.27, 95% CI=0.86-1.89, p=0.23). The astigmatism of =/> 2 at 6 - 8 weeks was found in 35 and 17 subjects from the conventional and MSICS groups respectively ( R=2.28, 95% CI = 1.39-3.73, p=0.0002). Conclusion: Both MSICS and conventional ECCE with PCIOL are safe and effective techniques for treatment of cataract patients. A more rapid recovery of good vision can be achieved with MSICS than with conventional ECCE with PCIOL in the immediate postoperative period. Key words: ECCE; MSICS; visual acuity; astigmatism DOI: 10.3126/nepjoph.v1i1.3668 Nep J Oph 2009;1(1):13-19

Pattern of Ophthalmological Diseases in the Patients of Shree Birendra Hospital

Introduction: Blindness is one of the most tragic yet often avoidable disabilities in the developing world. The pattern of ocular diseases varies in different parts of Nepal due to differences in socioeconomic and geographic factors. This retrospective study likely reflects the pattern of ocular diseases in Kathmandu Valley. Aim: To assess the patterns of ocular disease in the patients attending the outpatient department of Ophthalmology from 14th April 2009 to 13th April 2010 at the Army Hospital. Methods: This is a retrospective study and all the new cases which attended the department of Ophthalmology of Shree Birendra Hospital in the year 2066 were included. The diseases were divided into 11 groups i.e. lid & adenexal disorder, disease of conjunctiva & sclera, corneal diseases, lens associated disorders, diseases of uveal tract, refractive error, glaucoma & its associations, posterior segment diseases, ocular & systemic neoplastic disorders, Nekebadi (annual medical check up) and others. Result: The total number of patients recorded in the department of Ophthalmology is 16709. Among them 4473 were regular serving army personnel and 12236 were ex-army and army families. Conclusion: The pattern of eye disease varies in different age groups. In younger age group conjunctival, scleral disease and refractive error were commonly seen whereas in elder age group lens disorder was frequently seen. The number of blind patients was more in females than in male patients. Key words: Conjunctivitis; Cataract; Blindness. DOI: http://dx.doi.org/10.3126/mjsbh.v9i2.5023 Medical Journal of Shree Birendra Hospital Vol.9(2) 2010: 30-37