Binding interaction of laccases from Bacillus Subtilis after industrial dyes exposure: Molecular docking and molecular dynamics simulation studies

Dyes are becoming more widely used around the world wide, but there is no effective bioremediation approach for removing them completely from the environment. Several dyes are mentioned to be degraded through bacteria; however, it's still unknown how the particular enzymes act throughout the dye degradation. The behavior and function of these enzymes in the biodegradation of azo dyes (Textile dyes) had been investigated experimentally by the numbers of the researchers, however, the molecular mechanisms remain unclear. Therefore, the interaction mechanisms of textile dye (methyl orange) with laccase from B. subtilis were explored through molecular docking and molecular dynamics simulations, the three selected dyes (methyl orange, malachite green, and acid blue 62) that interact positively with laccase on the basis of their maximum binding energy, molecular docking results indicate that one of the three dyes is more stable as a target for degradation through Bacillus subtilis laccase. Therefore, subsequent research focused solely on one substrate: methyl orange. Molecular Dynamics simulation study was applied after the molecular docking to determine the interaction between laccases and methyl orange dyes. The trajectory was proved with root mean square deviation and root mean square fluctuation analysis. According to the molecular dynamics simulation results, laccase-methyl orange complexes remain stable during the catalytic reaction. So, this study demonstrates how laccase is involved in methyl orange bioremediation.

Antifungal stewardship: What we need to know

Antimicrobial stewardship refers to a well-coordinated program which promotes the scientific and rational use of antimicrobials, reduces the chances of drug resistance and improves patient outcomes. A comprehensive English language literature search was done across multiple databases (PubMed, EMBASE, MEDLINE and Cochrane) for the period 1990–2022, revealing a large volume of reports of growing resistance to established antifungal therapies, against a backdrop of irrational and unscientific prescriptions. As a result of this, antifungal stewardship, a new kid on the block, has recently garnered attention. This review article is an attempt to summarise the basic concept of stewardship programs, highlighting the dire need to implement the same in the present situation of antifungal resistance and treatment failure

Parallelism between hypovitaminosis D3 and recently detected myopia in children with amplified screen use in the COVID-19 era—A preliminary study

Purpose: This introductory study aims to analyze the association of serum vitamin D3 levels with recently detected myopia in Indian children following home confinement post?COVID?19 pandemic. Methods: Children aged 5–15 years who had not attended physical school in the past 1 year and visited the ophthalmology department with various ocular symptoms were divided into two groups: the myopic group with recently detected myopia and the non?myopic group with ocular ailments other than myopia. All children underwent basic ophthalmic evaluation and a general physical examination. Blood samples were collected for serum vitamin D3 levels. A pretested questionnaire inquiring about the duration of exposure to a digital screen, outdoor activities, and socioeconomic status was filled out for all children. Results: The mean serum vitamin D3 level in the myopic group was 28.17 ± 15.02 ng/dl in comparison to 45.36 ± 17.56 ng/dl in the non?myopic group (P value < 0.05). Linear regression of the data establishes that myopia is associated with hypovitaminosis D3 (OR? 13.12, 95% CI 2.90–50.32, a P value of 0.001). The correlation between spherical equivalent and vitamin D3 levels was significant (Pearson correlation value: 0.661). In the myopic group, 63.3% of children had screen use >6 hours against 43.3% of children in the non?myopic group. In the myopic group, 33.3% of the children had an outdoor activity duration of <2 hours against 6.6% of children in the non?myopic group. Conclusion: This study proposes hypovitaminosis D3 as a strong factor associated with the development of myopia in children. Although it is a preliminary study, it suggests that the trial for vitamin D3 supplementation in young children to delay or cease the development of myopia is warranted.

Antifertility activity of Oroxylum indicum (L.) Kurz:In vitro and in vivo study on human sperm and male wistar rats

Oroxylum indicum (L.) Kurz, commonly called as Broken bones tree or Indian trumpet flower, belonging to Fam. Bignoniaceae, is traditionally used as a contraceptive by ethnic people of Tripura, North-East India. Here, we investigated the scientific basis for use of O. indicum as male antifertility agent by folklore healers. In vitro spermicidal activity of aqueous (AEOI) and methanolic (MEOI) extracts of O. indicum stem bark were studied on human sperm. The in vivo activity was experimented on male albino rats. The treated animals were allowed to mate and the pups delivered by female rat partners were counted. Phytochemical estimation of test samples was done using HPLC. The AEOI and MEOI treatments significantly decreased human sperm motility and viability. Test extracts have increased the hypo-osmotic swelling of sperm. Both the extracts were significantly declined the weight of reproductive organ. The MEOI treated rats have shown significant decrease in sperm motility and sperm counts. AEOI and MEOI treatment significantly reduced level of testosterone, but sharply raised dihydrotestosterone and prostaglandin in rats. Results testified the traditional claim for use of O. indicum as a male contraceptive agent, where MEOI have shown reversible action on male reproductive system leading to contraception without harming the libido.

Adherence and Cost Effectivity of Home-Based Prophylaxis Over Institutionalized Prophylaxis in Patients with Hemophilia

Purpose: Home-based prophylaxis in hemophilia facilitates the treatment of patients with hemophilia (PwH) at home resulting in an improved quality of life, experiencing less pain and greater flexibility in daily activities. This literature studies the cost effectivity and adherence to prophylaxis treatment after the implementation of home-based prophylaxis therapy in PwH registered under the Hemophilia Treatment Centre (HTC) of Assam Medical College and Hospital. Materials and Methods:?PwH and their parents were advised for self/home infusion after being trained by a medical professional for 6 months. Data were collected on the skip in prophylaxis treatment by PwH and their traveling cost to access the prophylaxis treatment before and after the implementation of home infusion, through questionnaire and telephonic interview. Results:?The mean number of days of skip in prophylaxis was significantly reduced from 25 (±11) to 4 (±2) days after implementation of home infusion. The mean transportation cost was also found to be significantly decreased from Rs. 3297 (±2251) to 440 (±279). Before home/self-infusion, 77% of the registered PwH were found to skip prophylaxis doses more than 12 times a year but after home infusion, no PwH were found to skip more than 12 doses a year. Conclusion:?Home therapy facilitates the PwH to strictly adhere to the prophylaxis regime significantly reducing the skipping of doses to be administered to the PwH. The risks of regular traveling and the burden of transportation expenditure to avail the prophylaxis treatment was also found to be reduced significantly.

Achromobacter Spp.: A retrospective review of rare and emerging pathogen

Background: Achromobacter spp. is a rare nosocomial pathogen known to cause many serious infections like bloodstream infection, osteomyelitis, meningitis, urinary tract infections, corneal ulceration, peritonitis, and endocarditis. Materials and Methods: In this study, we retrospectively analyzed all the bacteriological sample records from the bacteriology database from January 2021 to December 2021 to determine the prevalence of Achromobacter spp. Result: Nine patients with Achromobacter xylosoxidans causing bacterial infection were identified, from whom five blood samples, two pus, one respiratory sample, one central venous pressure (CVP), and one cerebrospinal fluid were found positive for Achromobacter spp., among whom one was a 6-year-old patient having the same organism from two different body sites—CVP line and cerebrospinal fluid. Five patients had coinfection with another organism, whereas acute kidney injury was the most common comorbidity. Conclusion: In our single-center experience, approximately 50% of the cases with Achromobacter denitrificans bacteremia suffered from chronic kidney disease and had a history of antibiotic therapy, hospitalization, and the presence of devices. Active research on rising trends of Achromobacter spp. needs to be promoted.

Infections and immunity: associations with obesity and related metabolic disorders

About one-fourth of the global population is either overweight or obese, both of which increase the risk of insulin resistance, cardiovascular diseases, and infections. In obesity, both immune cells and adipocytes produce an excess of pro-inflammatory cytokines that may play a significant role in disease progression. In the recent coronavirus disease 2019 (COVID-19) pandemic, important pathological characteristics such as involvement of the renin-angiotensin-aldosterone system, endothelial injury, and pro-inflammatory cytokine release have been shown to be connected with obesity and associated sequelae such as insulin resistance/type 2 diabetes and hypertension. This pathological connection may explain the severity of COVID-19 in patients with metabolic disorders. Many studies have also reported an association between type 2 diabetes and persistent viral infections. Similarly, diabetes favors the growth of various microorganisms including protozoal pathogens as well as opportunistic bacteria and fungi. Furthermore, diabetes is a risk factor for a number of prion-like diseases. There is also an interesting relationship between helminths and type 2 diabetes; helminthiasis may reduce the pro-inflammatory state, but is also associated with type 2 diabetes or even neoplastic processes. Several studies have also documented altered circulating levels of neutrophils, lymphocytes, and monocytes in obesity, which likely modifies vaccine effectiveness. Timely monitoring of inflammatory markers (e.g., C-reactive protein) and energy homeostasis markers (e.g., leptin) could be helpful in preventing many obesity-related diseases.

Rehabilitation Professionals’ Perspectives on Psychosocial Needs of Family Caregivers of Persons with Spinal Cord Injury: A Qualitative Study from India / 가정의학회지

Background@#This study explored the psychosocial needs of family caregivers of persons with spinal cord injuries from the perspective of rehabilitation professionals. @*Methods@#An exploratory qualitative approach was used, and a total of 14 rehabilitation professionals from various backgrounds participated in face-to-face interviews. All interviews were audio recorded, and session notes were added to the existing data and later transcribed. Thematic analysis was used to identify key themes. @*Results@#Nine need themes emerged: informational, psychological, personal care, financial, social support, welfare, vocational, telemedicine, and referral. @*Conclusion@#The findings of this study will aid the design or development of need-based customized psychosocial interventions for family caregivers of persons with spinal cord injuries in India. Multiple stakeholders involved in spinal cord injury management should understand the importance of meeting the needs of family caregivers of persons with spinal cord injuries and the timely delivery of customized psychosocial interventions.

Immunohistochemical Analysis of the Expression of Cytokeratins in Acquired Cholesteatoma and Its Clinico-Radiological Correlation

Background and Objectives@#Cholesteatomatous chronic otitis media acquires epithelial proliferation and differentiation characteristics, which render it able to erode the underlying bone and cause complications. We attempt to characterize the cholesteatoma epithelium by observing the expression of cytokeratins (such as 34ße12, CK17, and CK13) and Ki67 among patients with cholesteatoma with different aggressiveness as compared to disease-free controls. @*Subjects and Methods@#In this prospective study (2017-2021), we enrolled all consenting consecutive patients with cholesteatomatous chronic otitis media. They were staged in accordance with the staging guidelines of the European Academy of Otology and Neurotology and the Japanese Otological Society. Bony external auditory canal (EAC) skin specimens of the patients undergoing tympanoplasty were chosen as controls. We did an immunohistochemical analysis of the cholesteatoma specimens and normal bony EAC controls by observing the expression of 34ße12, CK17, CK13, and Ki67 across the layers of the epithelium. Fisher’s exact test and chi-square test were used to evaluate any statistical significance between the cases and the controls, and the subgroups were made based on the clinical stage. @*Results@#An increased expression of CK17 (p<0.001), CK13 (p<0.03), and Ki67 (p<0.001) was observed in cholesteatoma specimens when compared to normal bony EAC controls. Also, there was a loss of expression of 34ße12 in a subset of cholesteatoma specimens, all of which showed full-thickness expression of CK13. There was no difference in the expression of cytokeratin among specimens from patients belonging to different subgroups based on clinical stage, age, sex, duration of ear symptoms, or type of hearing loss (conductive vs. sensorineural). @*Conclusions@#The majority of cholesteatoma specimens significantly overexpressed CK17, CK13, and Ki67 when compared to normal bony EAC skin controls, while a subset showed loss of expression of 34ße12, which provides some insight into its pathogenesis.

Cerebral visual impairment in children: Multicentric study determining the causes, associated neurological and ocular findings, and risk factors for severe vision impairment

Purpose: To evaluate the causes, associated neurological and ocular findings in children with cerebral visual impairment (CVI), and to identify risk factors for severe vision impairment. Methods: A multicenter, retrospective, cross?sectional analysis was carried out from January 2017 to December 2019 on patients less than 16 years of age with a diagnosis of CVI. Results: A total of 405 patients were included of which 61.2% were male and 38.8% were female. The median age at presentation was 4 years (range 3 months to 16 years). Antenatal risk factors were present in 14% of the cases. The most common cause of CVI was hypoxic?ischemic encephalopathy (35.1%), followed by seizure associated with brain damage (31.3%). The most common neurological finding was seizure (50.4%), followed by cerebral palsy (13.6%). Associated ophthalmological findings were significant refractive error (63.2%), esotropia (22.2%), exotropia, (38%), nystagmus (33.3%), and optic nerve atrophy (25.9%). Severe visual impairment (<20/200) was associated with optic atrophy (odds ratio: 2.9, 95% confidence interval: 1.4–6.0; P = 0.003) and seizure disorder (odds ratio: 1.9, 95% confidence interval: 1.2–3.3; P = 0.012). Conclusion: The various ophthalmic, neurological manifestations and etiologies could guide the multidisciplinary team treating the child with CVI in understanding the visual impairment that affects the neuro development of the child and in planning rehabilitation strategies

Mortality of Elderly Patients Supported by Mechanical Ventilation at a General Critical Care Unit in a Tertiary Care Centre

Background : There has been a steady rise in the geriatric population in India and increasing number of elderly patients are being admitted in Critical Care Unit (CCU). They need mechanical ventilation during their hospital stay. Hence, there is continued need for evaluation and research to develop a validating scoring systems used to predict the outcome of CCU patients supported by mechanical ventilation. Objective : Analysis to predict the outcome (survival or mortality) of mechanically ventilated elderly patients in different age groups at the CCU. Material and Method : A Prospective observational study was done in CCU for a period of one year. A group of 40 elderly ventilated patients greater than 60 years of age (Group 1-elderly case group) and another group of 40 ventilated patients less than 60 years of age (Group-2- control group) were included in the study. A clinical database was collected which included age, sex, Acute Physiology and Chronic health Evaluation II (APACHE II) score and an Sequential Organ Failure Assessment (SOFA) scores were calculated in the first 24 hours of ventilation,indication of mechanical ventilation, co-morbidity, according to the Charlson Comorbidity Index (CCI), functional capacity according to the Barthel Index (BI). Patients outcome (survival or mortality) were analyzed. All the patients in two groups were on ventilation support. Result : In case group (n=40), mortality was 55%. In control group (n=40), mortality was 52.5%. On comparison of outcome between two groups (case with control group) the difference was not statistically significant (p= 0.8225). In case group, association of outcome to different age groups (60-65 years, 66-75years, more than75years) (p=0.3357) andto gender (p=0.3854) was not statistically significant. Multivariate logistic regression analysis of the study variables showed APACHE II score to be statistically significant for outcome (p=0.0229). Conclusion : Mortality of elderly patients supported by mechanical ventilation at CCU were slightly higher(55%) than in mechanically ventilated younger populations (52.5%) though the difference was not statistically significant between two groups (p=0.82). APACHE II, score measured within 24 hours of ventilation was a significant predictor of mortality in the patients on mechanical ventilation.

Skin as an endocrine organ: A narrative review

Skin being the largest organ of the body, is equipped with numerous functional properties. Over the past few years, intricate research into the biology of skin has led to a gamut of discoveries. Skin is now regarded as one of the most vital endocrine organs. The skin contains equivalents of the hypothalamo-pituitary-adrenal axis, hypothalamo-pituitary-thyroid axis and the appendages produce multiple hormones such as Vitamin D, sex steroids, retinoids and opioids. In this article, we will explore the role of skin as a target and source of some of the hormones of the human body, and briefly touch on the clinical applications

Complete response in metastatic breast cancer with visceral crisis using a combination of cyclin-dependent kinase 4/6 inhibitor and aromatase inhibitor: A case report from the eastern region of India

Patients with metastatic breast cancer (MBC) in visceral crisis require systemic chemotherapy. However, a coexisting cardiac failure that contradicts the use of systemic chemotherapy often demands an alternative treatment. Here, we report a case of hormone-receptor-positive MBC with cardiological comorbidities. She was treated with a combination treatment of tablet Ribociclib (600 mg once daily for 21 days followed by 7 days gap) and tablet Letrozole (2.5 mg once daily). The patient had a complete metabolic response in 18-Fluorodeoxyglucose Positron Emission tomography-Computed Tomography (18F-FDG PET/CT), after 6 months of treatment. Combination treatment with Ribociclib and Letrozole is beneficial in postmenopausal females with hormone receptor-positive and human epidermal growth factor receptor 2 neu-negative MBC in visceral crisis who have a contraindication to chemotherapy.

Arrhythmia occurring as the sole presenting feature in Covid-19

Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infection is observed to be associated with several cardiac complications. Cardiac arrhythmias are frequently observed in critically ill patients and are usually associated with myocarditis. We report two patients with Covid-19, in whom serious arrhythmias were the sole presenting feature, in the absence of any of the known manifestations of the disease. Further research is required into this yet unknown mechanism of the effect of Covid-19 on the conduction system. Thus, managing patients with acute-onset arrhythmias of unexplained aetiology, even when they present without known clinical features of Covid-19, should be done with care.

An Observational Study Comparing the Adverse Effect Profiles of Sputnik V and Covaxin COVID-19 Vaccines in Adult General Population of Eastern India

Aim : Currently no data is available on the safety profile of COVID-19 Vaccines like Covaxin and Sputnik V from Eastern India. Our aim was to evaluate the safety profiles of Covaxin and Sputnik V Vaccine in Eastern India. Methods : 0.5 ml of Covaxin and Sputnik V given to 701 adults in a two-dose regimen at a private tertiary care Hospital, Kolkata, with the doses separated by 4-7 weeks in Covaxin and 3 weeks in Sputnik V. Data regarding local and systemic Adverse Event Following Immunizations (AEFIs) was collected 30 minutes after vaccination and also on the first- and seventh-day following vaccination after each dosage. Results : Incidence of AEFI was 65% and 59% following the first dose of vaccination in Covaxin and Sputnik V groups, respectively. Incidence of AEFI was 83% and 70% after the second dose in Covaxin and Sputnik V groups. Pain in the injection site was the most common adverse effect. Body-ache, fever and tiredness were other systemic side effects. Adverse effects were noticeably more after the second dose. Over half of the reactions were mild in nature. Covaxin had a higher number of moderate adverse reactions after both doses. Adults with age >40 years, Comorbidities, Hypertension and Diabetes had a smaller number of side effects following the first dose of vaccination. People with previous COVID-19 infections had noticeably fewer adverse effects after the second dose. Allergic adults were associated with more systemic side effects, whereas Hypertensive adults had less total AEFI. Conclusion : Both Covaxin and Sputnik V had favorable safety profiles. Sputnik V vaccine had significantly fewer AEFIs compared to Covaxin. Age, co-morbidities, specifically hypertension, Diabetes, Allergy and previous history of COVID-19 infection, were important variables observed in the prevalence of side effects.