Evaluation of interleukin-33 & sST2 levels in type-2 diabetic mellitus patients with or without metabolic syndrome

Background & objectives: Diabetes mellitus (DM) is characterized by increase in blood glucose levels due to defective insulin secretion or insulin sensitivity. Interleukins (ILs) are known to play an important role in the pathogenesis of DM. The aim of this study was to investigate the serum concentration of IL-33 and its receptor soluble ST2 (sST2) in patients with diabetes and draw a correlation between their serum levels and different standard glycaemic indices of patients affected with type-2 diabetes with or without metabolic syndrome. Methods: Thirty type-2 diabetic individuals and 30 healthy controls were recruited for this study. Serum and plasma were separated by centrifugation of blood for quantitative measurement of IL-33, sST2 and other biochemical parameters. Results: It was observed that serum IL-33 levels were significantly less and sST2 levels were significantly high in type-2 diabetic individuals as compared to healthy controls. A significant correlation between the serum IL-33 concentration and fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) levels were also found. Additionally, data also elucidated that serum levels of high-density lipoprotein, low-density lipoprotein or triglyceride in type-2 diabetics did not influence the serum levels of IL-33 and sST2, thereby excluding these factors as the major drivers of changes in serum IL-33 and sST2 concentration. Interpretation & conclusions: This study demonstrated alteration in serum levels of IL-33 and sST2 in type-2 diabetic individuals. Further mechanistic studies, focusing on the progression of type-2 diabetes could elucidate the involvement of IL-33 in the cellular acquisition of insulin resistance as observed in type-2 diabetics

Perforated isolated jejunal diverticulum: a rare cause of acute abdomen

A 45-year-old female presented with pain in peri-umbilical region for past one day along with history of non-bilious vomiting and non passage of stool and flatus for past one day. On physical examination, patient was afebrile, mild dehydration was present, tachycardia of 102 beats per minute with normal blood pressure. On clinical examination, the abdomen was diffusely tender with rebound tenderness. Bowel sounds were absent. Laboratory investigations revealed leucocytosis. An erect plain chest X-ray was done, didn’t reveal any gas under the diaphragm. Contrast enhanced computed tomography abdomen was done which showed a hollow viscus perforation with intra-abdominal free air and pelvic free fluid. Patient was resuscitated with IV fluid, broad-spectrum antibiotics were started and immediately taken up for exploratory laparotomy. Three jejunal diverticula identified at mesenteric border, with pin-head perforation in one of the diverticula. Small bowel resection including the three diverticula and primary end-to-end anastomosis was performed. Post-operative period was uneventful. Patient discharged on satisfactory conditions. This case stresses the importance to consider this entity in cases of unexplained gastrointestinal symptoms because any treatment delay may lead to unsuccessful clinical outcome.

Assessment of acid phosphatase enzyme and influence of potassium iodide on its production in the yeast form of Sporothrix schenckii

Background: Sporotrichosis is caused by a dimorphic fungal species, Sporothrix schenckii (S. schenckii). The enzyme acid phosphatase is pervasive among yeast and yeast like fungi. It has been studied in various fungi like Aspergillus oryzae, Candida albicans etc. but in S. schenckii little is known about enzyme acid phosphatase. The present study depicts the in-vitro influence of Potassium Iodide (KI) on the enzyme acid phosphatase produced by the S. schenckii (yeast form).Methods: A master culture was prepared by incorporating the standard strain of S. schenckii in YNB (Yeast Nitrogen Base) medium and was incubated at 37ºC. After preparing the increasing concentrations with KI in YNB medium, 1.0 mL suspension of master culture was inoculated into each bottle and incubated at 37ºC for different time period 6th, 12th, 18th day (early, mid, peak of log period) respectively. After centrifuging, a 5% homogenate was prepared, which was used for acid phosphatase enzyme assay.Results: The mean acid phosphatase level of control specimen was 20.9±2.01, 50.0±2.25, 45.0±5.10 μg and test specimens was ranged from 14.9±4.89 to 20.2±3.49, 10.2±4.19 to 40.0±6.39 and 10.0±1.81 to 34.7±6.08 μg on day 6, 12 and 18 respectively. The mean value was lower significantly for all the test concentrations as compared to control (p<0.05).Conclusions: The low activity of the enzyme acid phosphatase indicates that KI has inhibitory effect on the growth of S. schenckii that has led to decrease in the activity of the enzyme.

A new uranium bioremediation approach using radio-tolerant Deinococcus radiodurans biofilm

Deinococcus radiodurans is the most radiation-tolerant organism ever known. It has gained importance in recent years as apotential candidate for bioremediation of heavy metals, especially the radioactive type. This study investigates the efficiency of a recombinant D. radiodurans (DR1-bf?) strain with an ability to form biofilm for uranium remediation. Themodified Arsenazo III dye method was used to estimate the uranium concentration. Uranyl nitrate aqueous solution wasgenerated during the operation of nuclear fuel reprocessing. The D. radiodurans biofilm (DR1-bf?) grown in the presenceof 20 mM Ca2? showed remarkable ability of uranyl ion removal. DR1-bf? (?Ca2?) biofilm removed *75±2% of1000 mg/L uranium within 30 min post-treatment from uranyl nitrate aqueous solution. Uranium removal rate was alsofound to be directly proportional to biofilm age. This study discusses the ability of D. radiodurans biofilm in uraniumremoval.

Microbiota of spent nuclear fuel pool water with emphasis on their biofilm forming ability on stainless steel (SS-304L)

Spent nuclear fuel (SNF) pool is an essential unit of a nuclear power plant infrastructure, where radioactive fuel rods arekept for cooling and shielding, before reprocessing. This study explored the presence of bacteria in SNF pool water withemphasis on their capability to form biofilms on pool wall cladding material stainless steel (SS-304L). Bacteria wereisolated from SNF pool water and were characterized using 16S rRNA gene sequencing. The six bacterial isolates (Bacillussubtilis, Staphylococcus sps., S. arlettae, S. epidermidis, S. auricularis and Chryseobacterium gleum) can grow and formbiofilms at very low nutrient condition as well as in chronic radioactivity. The bacterial isolates formed biofilm on SS-304Land glass. However, the biofilm parameters assessed by CLSM microscopy showed that the strains preferred SS-304Lsurface for biofilm formation. On SS-304L, the maximum biomass (0.45 lm3/lm2) was formed by S. arlettae whencompared to maximum biomass (0.054 lm3/lm2) by Staphylococcus sp., on glass. Maximum biofilm thickness on SS304L was observed by Staphylococcus sp. (8.81 lm) when compared to that of S. epidermidis (4.16 lm) on the glasssurface. The biofilm formation on SS-304L surface suggests the possible risk of microbial-induced corrosion of SNF poolcladding material. This study highlights the need for mandatory monitoring of microbial biofilm formation in an extremeenvironment such as SNF pool.

Parkinson's Disease: The Emerging Role of Gut Dysbiosis, Antibiotics, Probiotics, and Fecal Microbiota Transplantation

The role of the microbiome in health and human disease has emerged at the forefront of medicine in the 21st century. Over the last 2 decades evidence has emerged to suggest that inflammation-derived oxidative damage and cytokine induced toxicity may play a significant role in the neuronal damage associated with Parkinson's disease (PD). Presence of pro-inflammatory cytokines and T cell infiltration has been observed in the brain parenchyma of patients with PD. Furthermore, evidence for inflammatory changes has been reported in the enteric nervous system, the vagus nerve branches and glial cells. The presence of α-synuclein deposits in the post-mortem brain biopsy in patients with PD has further substantiated the role of inflammation in PD. It has been suggested that the α-synuclein misfolding might begin in the gut and spread “prion like” via the vagus nerve into lower brainstem and ultimately to the midbrain; this is known as the Braak hypothesis. It is noteworthy that the presence of gastrointestinal symptoms (constipation, dysphagia, and hypersalivation), altered gut microbiota and leaky gut have been observed in PD patients several years prior to the clinical onset of the disease. These clinical observations have been supported by in vitro studies in mice as well, demonstrating the role of genetic (α-synuclein overexpression) and environmental (gut dysbiosis) factors in the pathogenesis of PD. The restoration of the gut microbiome in patients with PD may alter the clinical progression of PD and this alteration can be accomplished by carefully designed studies using customized probiotics and fecal microbiota transplantation.

An outbreak of hand–foot–mouth disease: A report from the hills of northern India.

Background. Hand–foot–mouth disease (HFMD) is known to cause outbreaks around the world as well as in India. We report the clinical characteristics of an outbreak in Dehradun, Uttarakhand. Methods. The study was done in the Department of Paediatrics of a tertiary care referral teaching hospital in northern India. Children (<18 years of age) presenting with vesicular skin lesions distributed over the hand, foot and mouth were prospectively enrolled between August 2013 and October 2013. The diagnosis of HFMD was made clinically, and laboratory investigations were done for clinical care. Children were managed with supportive measures and followed for 6 weeks after discharge. No virological investigations were done to identify the offending agent. Results. Thirty-three children (18 boys, 54.5%; median [range] age 4 [1–17 years]) were enrolled. The majority of children were <5 years of age (75.8%), who presented with prodromal symptoms (93.9%), mostly milder (80.6%) in severity. The most common prodromal symptoms were fever (93.9%), cough (72.7%) and malaise (54.5%). All children had rash on their hands and feet whereas the majority (85%) had oral lesions as well. All children recovered completely and had no complications during 6 weeks of follow-up. Conclusion. HFMD was milder and all children (mostly <5 years of age) recovered completely without complications. Natl Med J India 2015;28:126–8

Pharmacognostical standardization of leaves of Cupressus macrocarpa Hartweg. ex Gordon.

Cupressus macrocarpa Hartweg. ex Gordon belongs to family Cupressaceae. It is commonly known as Monterey Cypress. Traditionally the decoction of leaves is used in rheumatism. The species of genus Cupressus are used to improve bladder tone and coadjuvant in therapy of urinary incontinence and enuresis. The present study was carried out to establish the pharmacognostical study along with preliminary phytochemical screening of petroleum ether, chloroform, ethanol and aqueous extracts of Cupressus macrocarpa. The macroscopical and microscopical characters of leaves were studied. The transverse section of leaves indicated the arrangement of various cells in epidermis, sunken stomata, hypodermis, spongy parenchyma and vascular bundles. The physicochemical parameters such as total ash, acid insoluble ash, water soluble ash and sulphated ash value, loss on drying, extractive values, fluorescence analysis of extracts and powder treated with different chemical reagents were studied under ordinary light, short and long UV light. The foaming and swelling index of leaves were also studied. Preliminary phytochemical screening of various extracts revealed the presence of glycosides, flavonoids, sterols, phenolic compounds, carbohydrates and amino acids. These studies will be helpful in developing standards for quality, purity and sample identification of this plant.

Performance characteristics of bisulfite conversion and SYBR green based quantitative PCR for DNA methylation analysis.

Genomic DNA methylation is one of the most important epigenetic modifications in eukaryotes play vital role in development of severe disease like cancer. Many techniques used for assessment of DNA methylation, bisulfite treatment followed by methylation specific polymerase reaction (MSP) are one of them, which introduce conversion of unmethylated cytosine into uracil. The significant level of bisulfite treated DNA degradation results in the failure of methylation detection. Therefore, this step is to be properly controlled to avoid the degradation of DNA. In the present study, an attempt has been made to access the incubation time of DNA with bisulfate treatment at three time points i.e. 2.5, 4 and 16 hrs to get complete conversion of cytosine to uracil. Currently, the experiments were undertaken using oral cancer tissue, with varying incubation time of bisulfite treatment and 2 representative genes viz MGMT and p16 were selected for the quantitative assessment of methylation by real time PCR. Both genes are frequently methylated at promoter region in carcinogenesis. The short term incubation for 4hrs indicated better real time threshold value for p16 and MGMT gene methylation (Ct 25.55, 27.25) and unmethylation (Ct 18.82, 25.84) in tissue whereas it was 28.16, 37.35 and 21.98, 26.19 in blood sample, respectively as compared to other incubation time which shows less degradation of full length DNA.

Comparative study of laparoscopic surgery and open surgery in regards to surgical-site infections.

Background: Surgical site infections (SSI) formerly termed surgical wound infection, are one of the most frequent post-operative infectious complication. Patients with SSI had longer and costlier hospitalization than patients who didn't have such infection. Laparoscopic surgery as a minimally invasive surgery have good outcome regarding SSI as compared to open procedure. Aims & Objective: To compare infection rate after laparoscopic versus open surgery. Material and Methods: A retrospective analysis of large number of cases in SMIMER Hospital was conducted. Patients who underwent laparoscopic (n=4500) or open (n=1500) appendicectomy, cholecystectomy, anti-reflux surgery, or gastric bypass from 2009 to 2012 were included in the analysis. The main outcome measure was inpatient diagnosis of SSI (Surgical Site Infection) after laparoscopic and open surgery. Results: During 36 month of study period total of 6000 patient underwent one of four selected procedure. Overall, the incidence of SSI was significantly lower in laparoscopic (100 of 4500, 2.0%) than in open (150 of 1500, 10%) surgery (P<0.01). Largely, laparoscopic techniques offer a protective effect against SSI. Patient treated with laparoscopy were 76% less likely to experience SSI. Odds Ratio (OR), 0.30; 95% Confidence Interval (CI), 0.28-0.34. Conclusion: Patient treated with laparoscopic procedure is less likely to experience SSI. After stratification by severity of illness, wound classification & admission status, laparoscopic techniques shows a protective effect against SSI.

Clinical predictors of fulminant colitis in patients with clostridium difficile infection

Clostridium difficile infection [CDI] can affect up to 8% of hospitalized patients. Twenty-five percent CDI patients may develop C. difficile associated diarrhea [CDAD] and 1-3% may progress to fulminant C. difficile colitis [FCDC]. Once developed, FCDC has higher rates of complications and mortality. A 10-year retrospective review of FCDC patients who underwent colectomy was performed and compared with randomly selected age- and sex-matched non-fulminant CDAD patients at our institution. FCDC [n=18] and CDAD [m=49] groups were defined clinically, radiologically, and pathologically. Univariate analysis was performed using Chi-square and Student's t test followed by multivariate logistic regression to compute independent predictors. FCDC patients were significantly older [77 +/- 13 years], presented with triad of abdominal pain [89%], diarrhea [72%], and distention [39%]; 28% had prior CDI and had greater hemodynamic instability. In contrast, CDAD patients were comparatively younger [65 +/- 20 years], presented with only 1 or 2 of these 3 symptoms and only 5% had prior CDI. No significant difference was noted between the 2 groups in terms of comorbid conditions, use of antibiotics, or proton pump inhibitor. Leukocytosis was significantly higher in FCDC patients [18.6 +/- 15.8/mm[3]us 10.7 +/- 5.2/mm[3], P=0.04] and further increased until the point of surgery. Use of antiperistaltic medications was higher in FCDC than CDAD group [56% vs 22%; P=0.01]. Our data suggest several clinical and laboratory features in CDI patients, which may be indicative of FCDC. These include old age [>70 years], prior CDI, clinical triad of increasing abdominal pain, distention and diarrhea, profound leukocytosis [>18,000/mm[3]], hemodynamic instability, and use of antiperistaltic medications

Antioxidant and antimicrobial activity of ethanol and water extracts of Cymbopogon jwarancusa (Jones.) leaves.

The Cymbopogon jwarancusa (Jones.) leaves extracts were explored for their antioxidant and antimicrobial activity. The ethanol extract showed highest antioxidant activity in DPPH (31.99 ± 0.50 % inhibition) and FRAP (38.79 ± 0.54 Fe (II) micromole per litre) assay while water extract showed highest antioxidant activity in βCL (54.76 ± 1.37 %) at 1mg/10ml concentration. BHT and ascorbic acid were used as standards. During antimicrobial assay, the ethanol extract found was very effective against Fusarium oxyporium f.sp-lini (85.31 ± 0.25 mm) and Staphylococcus aureus (94.37 ± 0.28 mm) at 500 ppm while water extract was found less effective against Aspergillus flavus (03.72 ± 0.19 mm) at 100 ppm concentration. The ethanol extract can be used for the applications such as food preservation as a remedy and against dental diseases.

Feasibility of Self-Assessment of Acute Mania: Comparison of Self-Rated and Observer-Rated Scales of Mania in Naturalistic Setting.

Mania is one of the commonest psychiatric disorders causing severe social and functional disturbances and thus requiring immediate intervention. Rating scales of mania are limited, especially the self-rating scales. Aim: To study correlation between the self-rated and observer rated scales of mania over 4 weeks period; To study the resolution and persistence of symptoms of mania with respect to clinical characteristics and treatment in the naturalistic ward setting over 4 weeks period. Methods: 40 consecutive hospitalized patients of either sex between 15-55 years with diagnosis of Mania (ICD-10 – Diagnostic criteria for research) were recruited for the study. The subjects were assessed using semistructured Performa covering socio-demographic and clinical characteristics of patient and his/her illness and by using following rating scales: Clinician Administered Rating Scale for Mania (CARS-M) [Altman et al, 1994]; Altman Self-Rating Mania scale (ARSM) [Altman et al 1997]; Hamilton Rating Scale for Depression (HAM-D) [M Hamilton 1960]; Clinical Global Impression Scale (CGI) (modified by Brandit et al, 1996). Results: The scores of the CARSM, ARSM, HAM-D, CGIS-S AND CGIS-1 showed the decreasing trends in the subsequent weekly assessments. This indicated improvement in the illness in the due course of treatment, which is an expected phenomenon. The reliability analysis scale (alpha) among the respective ARSM and CARSM scores showed the value as 0.8846 indicating that each self-rating is significantly reliable enough with the respective objective ratings. There are similar correlation patterns among CGI-S scores vs. the ASRM scores. However the correlation between the scores of CGI-I vs. ARSM in the first week does not seem to correlate significantly (p=.568), but the subsequent scores from 2nd through 4th week do correlate significantly. The HAM-D scores do not seem to correlate with the ARSM scale at any point except on the third week of the symptoms that resolved first were the hallucinations and disorientations. Insomnia and disordered thinking (incoherence/ extreme pressure of speech) disappeared nearly at the end of 2 weeks, followed subsequently by distractibility, excess energy and the delusions. Lack of insight and judgment, and euphoric/irritable mood were among the last to disappear.

Antisense expression of a gene encoding a calcium-binding protein in transgenic tobacco leads to altered morphology and enhanced chlorophyll.

Entamoeba histolytica contains a novel calcium-binding protein like calmodulin,which was discovered earlier,and we have reported the presence of its homologue(s)and a dependent protein kinase in plants.To understand the functions of these in plants,a cDNA encoding a calcium-binding protein isolated from Entamoeba histolytica (EhCaBP)was cloned into vector pBI121 in antisense orientation and transgenic tobacco plants were raised.These plants showed variation in several phenotypic characters,of which two distinct features,more greenness and leaf thickness,were inherited in subsequent generations.The increase in the level of total chlorophyll in different plants ranged from 60% to 70%.There was no major change in chloroplast structure and in the protein level of D1,D2,LHCP and RuBP carboxylase.These morphological changes were not seen in antisense calmodulin transgenic tobacco plants,nor was the calmodulin level altered in EhCaBP antisense plants.

Carotid artery stenting prior to coronary artery bypass graft surgery inpatients with left-main-coronary-artery disease.

Patients with concomitant carotid and left main or left main equivalent coronary artery disease are at high risk of both cardiac and cerebrovascular complications when they undergo revascularization procedures. Here, we present case reports of three patients who successfully underwent elective carotid stenting prior to coronary artery bypass surgery. Any sort of intervention in these patients is fraught with high risk due to the severity of their carotid and coronary artery disease.

In vitro evaluation of sulfadrugs against fungi causing otomycosis.

The efficacy of four sulfadrugs i.e., sulfadiazine, sulfamethoxazole, sulfaguanidine and sulfamoxole were taken in different doses (500, 1000, 1500, 2000 and 2500 ppm) to test their effectiveness against five pathogenic organisms for the control of mycelial growth and sporulation. Amongst the drugs tested sulfamethoxazole seems to be most effective against most of the test fungi showing 96.78, 90.53, 86.62, 54.16 and 43.91 percent inhibition in mycelial growth of P. nigricans, A. flavus, A. corymbifera, A. niger and C. albicans, respectively at its 2500 ppm dose in the basal medium. Gradual reduction in sporulation in all the test organisms almost in all the sulfadrugs have caused inhibition in sporulation, in comparison to their respective controls. Maximum inhibitory effect of sulfadiazine was recorded in A. niger showing 77.26 percent inhibition in the mycelial growth at a dose of 2500 ppm. Sulfaguanidine at its higher dose i.e., 2500 ppm proved to be most toxic against A. corymbifera causing 56.39 percent inhibition in the mycelial growth, while the same dose could not be found much effective against other test fungi. Sulfamoxole was found to be quite effective against most of the test fungi causing 47.16 to 85.86 percent inhibition in the mycelial growth. A gradual inhibition in the vegetative growth and sporulation or budding in all the test fungi was noted by increasing the concentrations of the test sulfadrugs.

Purification and some properties of buffalo spleen cathepsin Β.

Purification of cathepsin Β from buffalo-spleen, a hitherto unstudied system has been achieved by a simple procedure developed by incorporating suitable modifications in the existing methods for isolation of the enzyme from other sources. The purified enzyme has a molecular weight of 25 KDa and its Stokes radius was found to be 2·24 nm. Effects of several reducing agents, urea and thiol-protease inhibitors such as leupeptin and antipain, have been studied and the data unequivocally support the contention that the buffaloenzyme is similar to cathepsin Β from other tissues with respect to these properties.

Mean frontal QRS axis and pulmonary artery pressures in rheumatic mitral stenosis.

The relationship between the mean frontal QRS axis calculated from the scalar 12 lead ECG, and the pulmonary artery (PA) pressures obtained by cardiac catheterisation in 64 cases of isolated rheumatic mitral stenosis (MS), was analysed. An overall trend of rightward axis shift with increasing PA pressures was observed; the best correlation was seen with systolic PA pressures (r = 0.51). It was possible to recognise 3 categories of patients: (1) With an axis of 70 degrees and below, systolic PA pressures were below 70 mm Hg in 82.4% of cases and below 80 mm Hg in 94% of cases; diastolic pressures were below 40 mm Hg in 88.2%; mean PA pressures were below 50 mm Hg in 88.2% cases. (2) With an axis of 71 degrees to 100 degrees, systolic PA pressures ranged from 30 to 120 mm Hg, diastolic PA pressures from 12 to 60 mm Hg and mean PA pressures from 19 to 80 mm Hg. (3) With an axis of above 100 degrees, systolic PA pressures were over 70 mm Hg in 95.5% of cases, diastolic PA pressures more than 30 mm Hg in 90.9%, and mean PA pressures more than 45 mm Hg in 90.9% cases. It was therefore possible to predict, with reasonable accuracy, the range of PA pressures in patients with isolated MS, except in those cases with an axis between 71 and 100 degrees.

Domain II + III of bovine serum albumin: Isolation and its characterization.

Some properties of a fragment of bovine serum albumin containing residues 184-582 of the protein sequence, produced by cyanogen bromide cleavage, have been reported. Urea-induced difference spectra of the fragment showed considerable exposure of aromatic chromophores by 8 Μ urea. Reversible unfolding of the fragment by urea, as followed by difference spectral measurements at 30°C, pH 7·0, occurred in two distinct steps involving at least 3 major conformational states, namely the native (N), intermediate (X) and completely denatured (D) states. The co-operativity values for the two transitions, N X and X Dwere found to be 4·0 and 16·4, respectively. Analysis of the data on bilirubin binding to bovine serum albumin and its fragment suggested that the fragment retains significant amount of its native structure. However, hydrodynamic parameters such as Stokes radius (3·14 nm), diffusion coefficient (6·98 × 10-7cm2/s) and frictional ratio (1·32) obtained by analytical gel chromatography as well as intrinsic viscosity (4·31 ml/g) indicates some asymmetry in the fragment molecule.