Prediction of esophageal varices in cirrhosis by using splenic stiffness measurement

Background: Predicting esophageal varices in cirrhosis using the measurement of splenic stiffness is an exciting area of study. Vein enlargement in the lower esophagus, known as varices, is a common symptom of cirrhosis caused by portal hypertension. These varicose veins are potentially fatal since they bleed easily. The present study aims to predict the OV in cirrhosis patients by splenic stiffness in and around this region. Methods: After receiving permission from the Institutional Ethics Committee, the study was performed. The present study authors measured splenic stiffness and liver stiffness by using FibroScan in 112 consecutive cirrhotic patients who met the inclusion criteria. Patients were also assessed by hepatic venous pressure gradient (HVPG), upper gastrointestinal endoscopy, liver stiffness, liver spleen diameter to platelet ratio score, and platelet count to spleen diameter ratio. Results: Among 112 patients enrolled, 64 patients had valid liver stiffness and splenic stiffness measurement, and 64 patients had EV (small, n=23 and large n=42). There was a significant difference in median liver stiffness (54.2 vs. 21.3 kPa, p<0.05), splenic stiffness (56.1 vs. 30 kPa, p<0.05), liver spleen diameter to platelet ratio score (6.3 vs. 2.7, p<0.05), and platelet count to spleen diameter ratio (798 vs 1,241, p<0.05) between patients with OV and those without OV. Conclusions: Non-invasive markers, such as splenic stiffness, may help identify individuals with cirrhosis who are at risk of having esophageal varices, especially large ones, and who are at risk of bleeding, the study's authors conclude.

Endophytic fungal communities associated with two ethno-medicinal plants of Similipal Biosphere Reserve, India and their antimicrobial prospective.

To study endophytic fungi associated with two plant species used as ethno-medicines by aboriginal tribes of Similipal Biosphere Reserve and evaluation for their antimicrobial potentials against some clinically significant human pathogens. A total of 458 endophytic isolates were obtained from leaf, stem and fruit tissues of Solanum rubrum and Morinda pubescence. The dominant endophytic fungi belong to genera Aspergillus, Colletotrichum, Curvularia and Mycelia sterilia. Maximum endophytic isolates were obtained from leaves segments followed by stem and fruit tissues. In both the plants class hypomycetes were dominant over other fungal classes. Shannon- Weiner and Simpson indexes showed rich diversity of endophytic fungi suggesting even and uniform occurrence of various species. The endophytic isolates showed varying degree of antimicrobial activity against 9 human pathogens. In S. rubrum 20% and 10% of the isolates inhibited all the Gram-positive and Gram-negative bacteria and 35% of the isolates displayed antifungal activity against all the test fungal pathogens. One of the isolate showed considerable antimicrobial activity against all the test pathogens. Endophytic isolates of M. pubescence showed 24% antibacterial activity against Gram-positive bacteria and 28% antifungal activity against all the test fungal pathogens. The study revealed that medicinal plants associated endophytes could be a rich source of antimicrobial agents.