Novel approach to water-efficient bulk industrial textile printing production of cotton fabric

Water scarcity poses a global threat in climate change era, and regrettably, the textile processing industry is squandering a significant volume of water during bulk production. This research focused on a sustainable water-saving approach in the printing of cotton fabric by modifying the reactive printing recipe and methodology. Three modified recipes (X, Y, Z) and one controlled recipe (C) were tested using reactive dyes. The conventional reactive printing recipe (Control) includes sodium alginate, urea, mild oxidizing agent, and sodium bicarbonate. In contrast, the modified recipe trials incorporated an acrylic-based synthetic thickener in the replacement of sodium alginate (alone and in combination with sodium alginate). A total of four recipes (one controlled conventional and three modified recipes) were examined using three reactive dyes at two dose levels (2 % and 4 %). Various characterization techniques, including shade variation, color penetration into the fabric, sharpness of the edges, color tinting on the adjacent white fabric, perspiration fastness (both acidic and alkaline), washing fastness, rubbing fastness, and fabric hardness, affirmed that Y recipe yielded the best results in fabric testing, cost reduction, and water conservation. This research represents a pioneering contribution to the printing industry with novel recipes.

Green synthesis of Eucalyptus globulus zinc nanoparticles and its use in antimicrobial insect repellent paint formulation in bulk industrial production

Mitigating climate change can be achieved by opting for sustainable, plant-based materials instead of relying on hazardous chemicals that come with various side effects. Various natural plant extracts find widespread application in synthesizing insect-repellent coatings, particularly in industries such as paint manufacturing. The increasing demand for these coatings has led us to find out the effects of different plant extracts for the efficient preparation of paints with more advanced impacts and low cost. For this purpose, zinc nanoparticles of Eucalyptus globulus L. and its extracts were used in this study due to their remarkable biocidal and antimicrobial activities. The extract was prepared by the process of oven-drying and heating followed by their filtration. Then, they were subjected to different phytochemical tests that were performed in which plant material did not contain flavonoids and glycol. The comparison of the size of nanoparticles was visible during the weighing which was found to be 4.451 mg. Advanced characterization techniques like FTIR, UV visible spectroscopy, and particle size analysis were adopted for the analysis of nanoparticles of plant extract. The FTIR analysis of the plant material was reported to lie in the range of 1000-1800 cm-1. On the other hand, the results of UV visible spectroscopy of nanoparticles of plant extract showed absorption peaks around 300 nm. The produced material was integrated into paint formulations to impart insect-repellent and antibacterial characteristics. Painted panels exhibited notable antibacterial efficacy, presenting an inhibition zone of 0.7 cm for Escherichia coli and 0.3 cm for Staphylococcus aureus when utilizing biocide. Plant nanoparticles yielded inhibition zones of 1 and 1.2, while aqueous extract resulted in zones of 0.2 and 0.5, respectively. A thorough evaluation of the paint's color attributes, including ΔL, Δa, Δb, and ΔE, indicated noteworthy differences. The CMC ΔE values from the trials exceeded 1, indicating a substantial change in shade. The batches of paints containing E. globulus extracts and nanoparticles were found to be lighter in color specifically green and yellow colors. Their antimicrobial and insect repellant activity was tested using the mosquitos of Aedes aegypti with an age of 4-5 weeks, revealing that formulations with plant extracts exhibited a 61 % effective period, greater than the 7 % observed in non-biocidal formulations. The paint responded best towards these mosquitoes in terms of repellency and the ultimate target of this study was achieved.

Bulk industrial production of sustainable cellulosic printing fabric using agricultural waste to reduce the impact of climate change

In this research paper, a novel process was developed for reactive printing of cotton fabric, with the objective of producing a high-quality printed fabric that is sustainable, eco-friendly, and low-cost which will ultimately reduce the impact of climate change. The study incorporated substituted tamarind polysaccharide (STP) obtained from agricultural waste, trichloro-ethanoic acid (TCEA), and polyethylene glycol (PEG-400) in the reactive printing paste. Tamarind starch was extracted from the seeds having 72 % yield, and substitution was performed to use it as a thickener in the printing paste. The conventional printing system was formulated with sodium alginate, urea, and sodium bicarbonate at dose levels of 2 %, 15 %, and 2.5 %, respectively, while the modified recipe was formulated with STP and TCEA at 5 % and 3 % dose levels, respectively along with varying doses of PEG-400 (0 %, 1 %, and 2 %) in novel prints. Various factors such as shade comparison, penetration, staining on the white ground, washing, rubbing, light and perspiration fastness, sharpness of edges, and fabric hardness were evaluated for all the recipes. The study demonstrated that the optimal outcomes were obtained with a 2 % PEG-400 dose level. This study represents a significant contribution to sustainable textile production, as tamarind agriculture waste was used as a raw material, which is an environmentally friendly alternative of sodium alginate that reduces the wastewater load. Additionally, PEG-400 was utilized as a nitrogen-free solubilizing moisture management substitution of urea for printing, while TCEA dissociated at high temperature to make alkaline pH during curing of the printed fabric to replace sodium bicarbonate. This research is a novel contribution to the printing industry, as these three constituents have not been previously used together other than this research group, in the history of reactive printing.

Oncology care in the era of pandemics

Since the declaration by the World Health Organization on 11 March 2020 of a global pandemic from sars-cov-2, the public health impact on broader society has been unprecedented. [...]

Chemical mismanagement and skin burns among hospitalized and outpatient department patients

Purpose. This article attempts to elucidate the nature of chemicals causing major and minor skin burns, and their associated characterization across different industries, using Fujian provincial hospitals' admission and outpatient department records. Materials and methods. Data were collected from the provincial hospitals of Fujian through a questionnaire, sent via email, from June 1, 2017 to November 30, 2017. The collected responses were statistically analyzed using SPSS version 19 through the interquartile range, median, Mann-Whitney U test and Fisher's exact test with two-tailed significance. Results and conclusions. The results of 306 collected responses reveal that the majority of skin burn cases are due to a lack of technical education and professional training among workers handling chemicals. This study suggests that management's effective supervision and governmental regulations may help to prevent chemical skin burns at work, and can further be controlled by hiring professional workers alongside providing training to them in chemical handling as well as using protective equipment and developing appropriate management policies to improve victims' well-being and quality of life. Findings will help workers, doctors, hospitals, industries, government and other stakeholders to understand and control chemical hazards on site to minimize the risks of chemical skin burn incidents.

Replacement of sodium alginate polymer, urea and sodium bicarbonate in the conventional reactive printing of cellulosic cotton

The objective of this study is to replace sodium alginate (bio composite polymer), urea and sodium bicarbonate (alkalinity) in the conventional reactive printing of cotton with carboxymethyl tamarind plolysaccharide (bio polymer), polyethylene glycol 400 (PEG-400) and trichloroacetic acid respectively. This study was motivated by the goal of coming up with a low-cost, eco-friendly printing process. The results were evaluated on two reactive dyes (color index numbers: Reactive Violet 01 and Reactive Blue 21) at two dose levels (2% and 4% of the printing paste weight). In the conventional recipe, sodium alginate, urea and sodium bicarbonate were added at dose levels of 2%, 15% and 2.5%, respectively; in the modified recipe, the dose levels of the substituted tamarind polysaccharide and trichloroacetic acid were 6% and 4%, respectively. The different dose levels of PEG-400 (0%, 1%, 2%, 3%) were accessed in each modified recipe. Results showed that the Sum K/S and shade strength, dye penetration, staining on white ground of the fabric, rubbing fastness (dry and wet), washing fastness, perspiration fastness (acidic and alkaline), light fastness, sharpness of the edges and fabric softness all improved in the modified recipe with 2% PEG-400. However, the increase in PEG-400 only increased the dye penetration and did not give any significant benefit with the increase in concentration.

Fatal myocarditis and rhabdomyositis in a patient with stage IV melanoma treated with combined ipilimumab and nivolumab

Combination immune checkpoint blockade with concurrent administration of the anti-ctla4 antibody ipilimumab and the anti-PD-1 antibody nivolumab has demonstrated impressive responses in patients with advanced melanoma and other diseases. That combination has also been associated with increased toxicity, including rare immune-related adverse events. Here we describe a case of fatal steroid-refractory myocarditis and panmyositis associated with the use of this combination in a patient with metastatic melanoma. Correlative studies indicated increased levels of serum interleukin 6 in this patient at the onset of toxicity, suggesting a possible role for anti-interleukin 6 receptor antibodies in the treatment of subsequent cases of this rare, but fatal, toxicity.

Survivorship and long-term outcome of a consecutive series of 200 Scandinavian Total Ankle Replacement (STAR) implants

AIMS

We report the long-term clinical and radiological outcomes of a consecutive series of 200 total ankle arthroplasties (TAAs, 184 patients) at a single centre using the Scandinavian Total Ankle Replacement (STAR) implants.

PATIENTS AND METHODS

Between November 1993 and February 2000, 200 consecutive STAR prostheses were implanted in 184 patients by a single surgeon. Demographic and clinical data were collected prospectively and the last available status was recorded for further survival analysis. All surviving patients underwent regular clinical and radiological review. Pain and function were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot scoring system. The principal endpoint of the study was failure of the implant requiring revision of one or all of the components. Kaplan-Meier survival curves were generated with 95% confidence intervals and the rate of failure calculated for each year.

RESULTS

A total of 84 patients (87 ankles) were alive by the end of this study. Of the surviving 84 patients (87 ankles; rheumatoid arthritis (RA), n = 40; OA, n = 47), 45 were women and 39 were men, with a mean age of 54 years (18 to 72 years) at the time of surgery. A total of 32 implants failed (16%), requiring revision surgery. The mean time to revision was 80 months (2 to 257). The implant survival at 15.8 years, using revision as an endpoint, was 76.16% (95% confidence interval (CI) 64.41 to 87.91). We found a steady but low decrease in survival over the study period. The mean AOFAS score improved from 28 (10 to 52) preoperatively to 61 (20 to 90) at long-term follow-up.

CONCLUSION

STAR prostheses in the United Kingdom have now been largely superseded by newer design TAAs, potentially with improved characteristics and surgical techniques. The long-term survivorship for the STAR prosthesis can provide a benchmark for these later designs of ankle arthroplasty.

Total ankle arthroplasty: what are the risks?: a guide to surgical consent and a review of the literature

AIMS

Total ankle arthroplasty (TAA) surgery is complex and attracts a wide variety of complications. The literature lacks consistency in reporting adverse events and complications. The aim of this article is to provide a comprehensive analysis of each of these complications from a literature review, and to compare them with rates from our Unit, to aid clinicians with the process of informed consent.

PATIENTS AND METHODS

A total of 278 consecutive total ankle arthroplasties (251 patients), performed by four surgeons over a six-year period in Wrightington Hospital (Wigan, United Kingdom) were prospectively reviewed. There were 143 men and 108 women with a mean age of 64 years (41 to 86). The data were recorded on each follow-up visit. Any complications either during initial hospital stay or subsequently reported on follow-ups were recorded, investigated, monitored, and treated as warranted. Literature search included the studies reporting the outcomes and complications of TAA implants.

RESULTS

There were wound-healing problems in nine ankles (3.2%), superficial infection in 20 ankles (7.2%), and deep infection in six ankles (2.2%). Intraoperative fractures occurred in medial malleoli in 27 ankles (9.7%) and in lateral malleoli in four ankles (1.4%). Aseptic loosening and osteolysis were seen 16 ankles (5.8%). Fracture of the polyethylene component occurred in one ankle (0.4%) and edge-loading in seven ankles (2.5%). We observed medial gutter pain in 31 ankles (11.1%). The incidence of thromboembolism occurred in two ankles (0.7%). The results were found to be comparable to the previously reported complications of total ankle arthroplasty in the literature.

CONCLUSION

Total ankle arthroplasty continues to evolve and improve the ankle function. Despite high overall complication rates with TAA surgery, most complications appear to be minor and do not affect final clinical outcome. Our results and literature review will help in the consent process and provide detailed complication rates for an informed consent. Cite this article: Bone Joint J 2018;100-B:1352-8.

Abstract P3-12-04: Efficacy of extended adjuvant aromatase inhibitors in subgroups of women with early breast cancer

Background: Randomized trials (RCTs) have reported improvements in breast cancer outcomes from extending treatment with aromatase inhibitors (AIs) beyond the initial 5 years after diagnosis. It is uncertain whether this effect is consistent in different subgroups.

Methods: We identified RCTs that compared extended AIs to placebo or no treatment using a systematic search of MEDLINE. The search was supplemented by a review of abstracts from the American Society of Clinical Oncology and San Antonio Breast Cancer Symposium meetings between 2013 and 2016. Hazard ratios (HRs) and 95% confidence intervals (CI) for disease-free survival (DFS) were extracted or estimated from forest plots and included in a meta-analysis using generic inverse variance and random effects modelling. Pre-specified subgroups included age (<60 ± 5 years vs. ≥60 ± 5 years), tumor size (≤2 cm vs. >2 cm), nodal status (positive vs. negative), hormone receptor status (estrogen [ER] and progesterone receptor [PR] positive vs. ER or PR positive) and administration of adjuvant chemotherapy (yes vs. no).

Results: Seven trials comprising 16,349 patients were analyzed. Studies designs and prior endocrine therapy are shown in Table 1

Table 1: Characteristics of included studies.TrialTreatment ArmsSample sizePrior endocrine treatmentABCSG 6aAnastrozole 3 years vs. none387/ 469Tamoxifen± aminoglutethimide: 100%, 5 yearsMA 17Letrozole 5 years vs. placebo2572/ 2577Tamoxifen: 100%, ∼5 yearsNSABP B-33Exemestane 5 years vs. placebo783/ 779Tamoxifen: 100%, ∼5 yearsDutch DATAAnastrozole 6 years vs,. anastrozole 3 years827/ 833Tamoxifen: 100%, 2-3 yearsIDEALLetrozole 5 years vs. letrozole 2.5 years903/ 898Any endocrine treatment (tamoxifen/AIs/sequence of tamoxifen+ AIs): 100%, 5 yearsMA.17RLetrozole 5 years vs. placebo959/ 959AIs: 100%, ∼5 years Prior tamoxifen: 79.3%NSABP B-42Letrozole 5 years vs. placebo1959/ 1964Any endocrine treatment (AIs/sequence of tamoxifen+ AIs): 100%, 5 years

. The pooled effect of prolonged treatment with AIs in different subgroups is shown in the Table 2.

Table 2: Intra-subgroup comparison of longer AIs treatment effect by subgroupsSubgroup ASubgroup BHR (95% CI) Subgroup AHR (95% CI) Subgroup BP for differenceAge <60 ± 5Age ≥60 ± 50.83 (0.70-0.99)0.85 (0.74-0.97)0.64T >2 cmT ≤2 cm0.77 (0.55-1.06)0.88 (0.68-1.13)0.44N positiveN negative0.72 (0.63-0.83)0.83 (0.64-1.08)0.22ER and PR positiveER or PR positive0.68 (0.44-1.04)1.03 (0.53-2.02)0.27Adjuvant chemotherapyNone0.71 (0.59-0.86)0.80 (0.65-0.98)0.51

Overall, the effect of prolonged AIs was similar in all subgroups. However, non-significantly greater effect sizes were seen in patient with larger tumors, nodal involvement, presence of both ER and PR expression and those treated with adjuvant chemotherapy.

Conclusions: Extended treatment with adjuvant AIs is associated with similar relative improvements in DFS in all subgroups analyzed. The greater effect size seen in node positive and large tumor subgroups and the higher baseline risk of recurrence will likely translate to a higher absolute benefit from extended AIs in these groups.

Citation Format: Goldvaser H, Algorashi I, Ribnikar D, Majeed H, Ocana A, Seruga B, Templeton AJ, Amir E. Efficacy of extended adjuvant aromatase inhibitors in subgroups of women with early breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-12-04.

Nuclear spatial and spectral features based evolutionary method for meningioma subtypes classification in histopathology

Meningioma subtypes classification is a real-world multiclass problem from the realm of neuropathology. The major challenge in solving this problem is the inherent complexity due to high intra-class variability and low inter-class variation in tissue samples. The development of computational methods to assist pathologists in characterization of these tissue samples would have great diagnostic and prognostic value. In this article, we proposed an optimized evolutionary framework for the classification of benign meningioma into four subtypes. This framework investigates the imperative role of RGB color channels for discrimination of tumor subtypes and compute structural, statistical and spectral phenotypes. An evolutionary technique, Genetic Algorithm, in combination with Support Vector Machine is applied to tune classifier parameters and to select the best possible combination of extracted phenotypes that improved the classification accuracy (94.88%) on meningioma histology dataset, provided by the Institute of Neuropathology, Bielefeld. These statistics show that computational framework can robustly discriminate four subtypes of benign meningioma and may aid pathologists in the diagnosis and classification of these lesions.

Amplification of the Atlantic Multidecadal Oscillation associated with the onset of the industrial-era warming

North Atlantic sea surface temperatures experience variability with a periodicity of 60–80 years that is known as the Atlantic Multidecadal Oscillation (AMO). It has a profound imprint on the global climate system that results in a number of high value societal impacts. However the industrial period, i.e. the middle of the 19th century onwards, contains only two full cycles of the AMO making it difficult to fully characterize this oscillation and its impact on the climate system. As a result, there is a clear need to identify paleoclimate records extending into the pre-industrial period that contain an expression of the AMO. This is especially true for extratropical marine paleoclimate proxies where such expressions are currently unavailable. Here we present an annually resolved coralline algal time series from the northwest Atlantic Ocean that exhibits multidecadal variability extending back six centuries. The time series contains a statistically significant trend towards higher values, i.e. warmer conditions, beginning in the 19th century that coincided with an increase in the time series’ multidecadal power. We argue that these changes are associated with a regional climate reorganization involving an amplification of the AMO that coincided with onset of the industrial-era warming.

Tertiary syphilis in the cervical spine: a case report and review of the literature

As the prevalence of syphilis rises, an increase in tertiary syphilis with spinal involvement is predicted. We report what we believe to be the first case of compressive cervical spine syphilitic gummata, with central cord compression signs. We also review the relevant literature to date. The diagnosis of syphilis in the spine relies on the physician to be aware of it as part of the differential diagnosis. Treponemal laboratory tests are an important aid in establishing a diagnosis.

Accuracy of prognostic scores in decision making and predicting outcomes in metastatic spine disease

INTRODUCTION

Management of metastatic spinal disease has changed significantly over the last few years. Different prognostic scores are used in clinical practice for predicting survival. The aim of this study was to assess the accuracy of prognostic scores and the role of delayed presentation in predicting the outcome in patients with metastatic spine disease.

METHODS

Retrospectively, four years of data were collected (2007-2010). Medical records review included type of tumour, duration of symptoms, expected survival and functional status. The Karnofsky performance score was used for functional assessment. Modified Tokuhashi and Tomita scores were used for survival prediction.

RESULTS

A total of 55 patients who underwent surgical stabilisation were reviewed. The mean age was 63 years (range: 32-87 years). The main primary sources of tumours included myeloma, breast cancer, lymphoma, lung cancer, renal cell cancer and prostate cancer. Of the cases studied, 29 patients had posterior instrumented stabilisation alone, 10 patients had an anterior procedure alone and 16 patients (with an expected survival of more than one year) had both anterior and posterior procedures performed. Twenty-three patients presented with spinal cord compression. The mean follow-up duration was 9 months (range: 1-39 months). Patients who were treated within one week of referral survived longer than anticipated. Patients were divided into three groups based on their expected survival. Actual survival was better in all three groups after surgery. Discrepancies in scores were prominent in patients with myeloma, breast and prostate cancers. Functional outcome was better in patients under 65 years of age.

CONCLUSIONS

The prognostic scoring systems are not uniformly effective in all types of primary tumours. However, they are useful in decision making for surgical intervention, taking other factors into account, in particular the age of the patient, the type and stage of the primary tumour and general health.

Accuracy of prognostic scores in decision making and predicting outcomes in metastatic spine disease

INTRODUCTION

Management of metastatic spinal disease has changed significantly over the last few years. Different prognostic scores are used in clinical practice for predicting survival. The aim of this study was to assess the accuracy of prognostic scores and the role of delayed presentation in predicting the outcome in patients with metastatic spine disease.

METHODS

Retrospectively, four years of data were collected (2007-2010). Medical records review included type of tumour, duration of symptoms, expected survival and functional status. The Karnofsky performance score was used for functional assessment. Modified Tokuhashi and Tomita scores were used for survival prediction.

RESULTS

A total of 55 patients who underwent surgical stabilisation were reviewed. The mean age was 63 years (range: 32-87 years). The main primary sources of tumours included myeloma, breast cancer, lymphoma, lung cancer, renal cell cancer and prostate cancer. Of the cases studied, 29 patients had posterior instrumented stabilisation alone, 10 patients had an anterior procedure alone and 16 patients (with an expected survival of more than one year) had both anterior and posterior procedures performed. Twenty-three patients presented with spinal cord compression. The mean follow-up duration was 9 months (range: 1-39 months). Patients who were treated within one week of referral survived longer than anticipated. Patients were divided into three groups based on their expected survival. Actual survival was better in all three groups after surgery. Discrepancies in scores were prominent in patients with myeloma, breast and prostate cancers. Functional outcome was better in patients under 65 years of age.

CONCLUSIONS

The prognostic scoring systems are not uniformly effective in all types of primary tumours. However, they are useful in decision making for surgical intervention, taking other factors into account, in particular the age of the patient, the type and stage of the primary tumour and general health.

Fc24-01 - Ego defense mechanisms in pakistani medical students: a cross sectional analysis

Background

Ego defense mechanisms, defined by Freud as unconscious resources used by the ego to reduce conflict between the id and superego, are a reflection of how an individual deals with conflict and stress. Vaillants’ proposed Hierarchy of Defenses states that mature defenses are associated with better adaptive functioning and health, as opposed to immature defense which are correlated negatively with measures of adaptive adult functioning.

Objectives

This study assesses the prevalence of various ego defense mechanisms employed by medical students of Karachi, which is a group with higher stress levels than the general population.

Methods

A questionnaire based cross-sectional study was conducted on 682 students from five major medical colleges of Karachi in November 2006. Ego defense mechanisms were assessed using the Defense Style Questionnaire(DSQ-40) individually and as grouped under Mature, Immature, and Neurotic factors.

Results

Neurotic defenses had a higher mean score(5.62) than Mature(5.60) and Immature(4.78) mechanisms. Immature mechanisms were more commonly employed by males whereas females employed more Neurotic mechanisms than males. Neurotic and Immature defenses were significantly more prevalent in first and second year students. Mature mechanisms were significantly higher in students enrolled in Government colleges than Private institutions (p< 0.05).

Conclusions

Neurotic mechanisms are more commonly encountered than Mature or Immature mechanisms among medical students of Karachi, and this could reflect greater stress levels than the general population. Employment of these mechanisms was associated with female gender, enrollment in a private medical college, and students enrolled in the first 2 years of medical school.

Prediction of the warfarin maintenance dose after completion of the 10 mg initiation nomogram: do we really need genotyping?

INTRODUCTION

Initiation of warfarin therapy is complicated by its narrow therapeutic index and inter-patient dose-effect variability. A '10-mg nomogram' warfarin initiation protocol permits safe therapeutic anticoagulation in outpatients started on warfarin. We aimed to develop a safe and effective warfarin maintenance dose prediction tool in these patients.

METHODS

Baseline potential predictor variables were collected on a retrospective cohort of outpatients initiated on warfarin for venous thromboembolism treatment. The primary outcome was the warfarin maintenance dose, defined as mean warfarin dose over the last 10 days of the first month of warfarin treatment. Univariate and multivariate analyses were performed to determine which baseline variables were warfarin maintenance dose predictors. An independent cohort of patients validated the derived warfarin maintenance dose prediction rule.

RESULTS

Patient's age and weight, cumulative dose of warfarin over the first week of induction and international normalized ratio (INR) on days 3, 5 and 8 were statistically significant predictors of the warfarin maintenance dose. Our final prediction rule reads: maintenance dose (in mg) = 2.5 + 10% of the first week cumulative dose - INR value at day 8 + 1.5 if INR was below 2.0 at day 5. In the validation cohort, the predicted dose was strongly correlated with the actual maintenance dose (r = 0.88, P < 0.0001). The mean difference between observed and predicted dose was not clinically significant: -0.1 +/- 1.1 mg.

CONCLUSION

In outpatients initiated on warfarin using a '10-mg nomogram', a simple prediction rule can accurately predict warfarin maintenance dose. Prospective studies employing the rule are indicated.

Sensitivity pattern and beta-lactamase production in clinical isolates of Aeromonas strains

Of the 43 Aeromonas spp. isolated from various clinical samples 94% isolates were Beta-lactamase producers. The isolates were tested for sensitivity by disc diffusion method which is commonly used in Pakistan. MIC was determined by using Epsilometer test (E-test) method. More than 80% isolates were sensitive to cephalosporins and quinolones. However, resistance to commonly used antibiotics was very high, 94% isolates were resistant to ampicillin which corresponds to the betalactamase production. More than 60% of the isolates were resistant to cotrimoxazole and 40% to chloramphenicol, hence quinolones and cephalosporins appear to be the drugs of choice for treating serious Aeromonas infections. The MIC range of Aeromonas was best for cefotaxime < 0.06 - 1.0 ug/ml. MIC 90 for cefotaxime was 0.50 ug/ml, for imipenem 0.25 ug/ml and for ciprofloxacin 2.0 ug/ml.

Antibodies to a streptococcal cell wall adjuvant structure persist in patient with chronic rheumatic heart disease

Sera from 50 patients with chronic rheumatic heart disease were analysed by an enzyme linked immunosorbent assay for the presence of antibodies to the streptococcal minimal adjuvant moiety, muramyl dipeptide (MDP). The T-cell responsiveness to this structure was also studied in vitro, using the lymphocyte transformation test. Fifty four percent of the patients possessed anti-MDP antibodies in their sera when examined 5 to 25 years after the initial rheumatic attack. Such antibodies were found only in 5 to 6% of sera from healthy controls or from patients with cardiac disease of non-rheumatic origin. There was neither antigenic nor mitogenic stimulation by MDP of the T-cells from peripheral blood of chronic rheumatic heart disease patients or controls. The results point to a lifetime persistence of anti-MDP antibodies in rheumatic fever and rheumatic heart disease. Possible mechanisms by which detectable levels of such antibodies are maintained in rheumatic heart disease are discussed.