Differential gene expression analysis in germinating and dormant teliospores of Tilletia indica using RNA seq approach

Karnal bunt of wheat is an important quarantine disease that interrupts India’s wheat trade in the international market. The whole transcriptome of germinating and dormant teliospores of Tilletia indica was performed using the RNA Seq approach to identify germination-related genes. Approximately 63 million reads were generated using the RNA sequencing by the Illumina NextSeq500 platform. The high-quality reads were deposited in NCBI SRA database (accession: PRJNA522347). The unigenes from the pooled teliospores were 16,575 having unigenes length of 28,998,753 bases. The high-quality reads of germinating teliospores mapped on to 21,505 predicted CDSs. 9,680 CDSs were common between dormant and germinating teliospores of T. indica. 11,825 CDSs were found to be in germinating teliospores while only 91 were unique in dormant spores of pathogen. The pathway analysis showed the highest number of pathways was found in germinating spores than dormant spores. The highest numbers of CDSs were found to be associated with translation (431 in number), transport and catabolism (340), signal transduction (326), and carbohydrate metabolism (283). The differential expression analysis (DESeq) of germinating and dormant teliospores showed that 686 CDS were up-regulated and 114 CDS were down-regulated in the germinating teliospores. Significant germination-related genes in the spores were validated using qPCR analysis. Ten genes viz. Ti3931, Ti6828, Ti7098, Ti7462, Ti7522, Ti 9289, Ti 8670, Ti 7959, Ti 7809,and Ti10095 were highly up-regulated in germinated teliospores which may have role in germination of spores.Further, these differentially expressed genes provide insights into the molecular events. This first study of transcriptome will be helpful to devise better management strategies to manage Karnal bunt disease.

Effect of Supplementation of Vitamin C and Thiamine on the Outcome in Sepsis: South East Asian Region

Introduction: The global burden of sepsis is overwhelming and novel therapeutic agents is the need of the hour. The present study was designed to understand the role of Malondialdehyde as a marker of the oxidative stress in sepsis, as well as the effect of supplementation of Vitamin C and Thiamine in patients of sepsis. Methods: 80 patients of sepsis were randomly divided into 4 groups of 20 each. Twenty age-sex matched healthy volunteers were chosen as controls. The first group received Vitamin C, the second group received Thiamine, the third group received both and the fourth group received neither. Vitamin C (2g 8 hourly) and Thiamine (200 mg 12 hourly) were given intravenously for five days. The outcome was recorded in terms of mortality in the various groups as well as by the improvement in SOFA scores (?SOFA). The serum levels of Vitamin C, Thiamine and Malondialdehyde were estimated. Results: Among the 80 patients, 17 (21%) were in septic shock. The mortality rate was 10% overall, and 47% among patients of septic shock. No additional mortality benefit was observed in the groups supplemented with Vitamin C and Thiamine. However, the ?SOFA score in patients who received both Vitamin C and Thiamine was significantly higher as compared to the other groups. The mean malondialdehyde level was higher in patients of sepsis (1.81±1.18 ?mol/l) as compared with healthy controls (0.78 ± 0.36 ?mol/l). The Vitamin C level and Thiamine level (estimated indirectly by TPP effect), at presentation were 5.14±4.19 ng/ml and 52.99±28.45 % in patients of sepsis, which was significantly lower than that in healthy controls, in whom the levels were 14.64±5.51 ng/ml and 27.55±13.67% respectively. Conclusion: Vitamin C and Thiamine supplementation is a cost-effective approach with a good safety profile. Additional studies including a larger population is required to study the mortality benefits and reaffirm our findings.

Study of Urinary Tract Infection in Patients with Diabetes Mellitus

Introduction: Urinary tract infection is one of the most common types of bacterial infection in patients with diabetes mellitus.Aim: The aim of the study was to assess the prevalence of urinary tract infection among hospitalized diabetic patients.Materials and Methods: A hospital-based prospective study was carried out from June 2018 to May 2019. A total of 100 patientsof diabetes mellitus with urinary tract infection were included in this study.Results: Of 100 patients, 54 were male and 46 were female, the most common age group was 46–55 years. Most patientshad a fever with rigor (48%) followed by dysuria (22%), suprapubic pain (20%), increased frequency of urine (18%), flank pain(10%), pyuria (6%), and hematuria (4%). Urine culture analysis revealed that Escherichia coli (29%) was the most commonorganism responsible of urinary tract infection. The majority of isolated organisms were sensitive to antimicrobial agents suchas amikacin, nitrofurantoin, and levofloxacin.Conclusion: Urinary tract infection is frequent in diabetic patient and the urine culture should be performed in all hospitalizedpatients with diabetes mellitus. Early diagnosis, knowledge of common predisposing factors, and appropriate clinical managementare important to improve prognosis.

Level of C-reactive Protein in Obese and Overweight Individuals at Indira Gandhi Institute of Medical Sciences: A Tertiary Care Center of Bihar

Introduction: Human adipose tissue releases interleukin-6 which is a pro-inflammatory cytokine that causes low-grade systemicinflammation. Acute-phase C-reactive protein (CRP) is a sensitive marker for systemic inflammation. Low-grade systemicinflammation in overweight and obese can be measured by serum CRP level.Objective: The objective of this study was to find out the prevalence of raised serum CRP level among the obese and overweightperson.Materials and Methods: Overweight and obese persons were screened for raised CRP (≥3.0 mg/L) after excluding comorbidity.Results: The prevalence of raised CRP among obese and overweight is 23%, the female has higher prevalence of 25.45% ascompared to male 20%. The prevalence among overweight and obese participants is 18.88% and 60%, respectively.Conclusions: The finding suggest a higher prevalence of low-grade systemic inflammation in obese as compared to anoverweight person.

Nonkeratinizing squamous cell carcinoma: A rare case report with oral involvement

Transitional cell carcinoma also known as nonkeratinizing carcinoma (NKCa) of sinonasal tract comprises 15%–20% of malignant sinonasal carcinoma. We are reporting the case of 48-year-old male with a history of tooth extraction. A computed tomography was done which showed opacity in the right nasal cavity. Incisional biopsy was taken which revealed NKCa (transitional type). Very few reported cases of this type of malignancy were found. A possible reason could be multiple synonyms such as cylindrical cell carcinoma, Schneiderian carcinoma, and transitional cell carcinoma

Assessment of Influence of Basal Metabolic Rate on Blood Pressure Among Adult Patients: An Institutional Based Study

Background: Basal Metabolic Rate (BMR) represents thelargest component of total energy expenditure and is a majorcontributor to energy balance. Hypertension is an importantglobal health issue and is currently increasing at a rapid pacein most industrializing nations. Hence; under the light of abovementioned data, the present study was planned for assessingthe influence of basal metabolic rate on blood pressure amongadult patients.Materials & Methods: A total of 100 subjects were included inthe present study. Complete demographic details of all thesubjects were obtained. Assessment of smoking status,residence details and past medical history was done.Hemodynamic parameters of all the patients were recorded.Weight and height of all the patients was calculated. BMR wasassessed on the basis of these parameters.Results: Mean age of the patients of the present study was53.4 years. 60 patients in the present study were males whilethe remaining 40 patients were females. Significant correlationwas observed in between BMR and blood pressure.

Study of Clinical Profile of Acute Undifferentiated Fever in a Tertiary Care Hospital

Introduction: Major aetiology of acute undifferentiated fevershows wide variation, especially in developing countriesincluding India. Acute undifferentiated fever poses a diagnosticand therapeutic challenges to health care workers, particularlyin limited resources. It is one of the commonest presentingproblem in hospital. It is necessary to know the cause, whichwill be useful to give proper treatment to the patients. Thisstudy was aimed to find out the acute undifferentiated feveraetiologies and clinical pattern.Material and Methods: This study was conducted onhundred patients of acute undifferentiated fever, admittedin Indira Gandhi institute of Medical Science, Patna fromFebruary 2018 to January2019.Result: Acute undifferentiated fever affected all age groupbut most common in 26 to 35 years of age group (29%).One hundred patients were included, 78male and 22female.In this study, Typhoid (41%) was leading cause of acuteundifferentiated fever followed by Malaria (23%), DengueFever (20%), Leptospirosis (5%), Scrub Typhus (3%) andChikungunya (1%). Common symptom was fever (100%),Headache (64%), Vomiting (48%), Rigor and chills (42%)whereas common sign was hepatosplenomegaly (55%).Typhoid fever (41%) was the commonest cause of acuteundifferentiated fever followed by malaria (23%), denguefever (20%), urinary tract infection (5%), scrub typhus (3%)and chikungunya (1%).Conclusion: It is important to know the aetiology andclinical pattern of acute undifferentiated fever for theirproper management and it will help to prevent morbidity andmortality.

A comprehensive review on phytopharmacological investigations of Acacia auriculiformis A.Cunn.ex Benth

Acacia auriculifornis A.Cunn.ex Benth.is a perennial shrub having a wide range of medicinal potentials and is widely distributed throughout the world.It is being used traditionally to overcome various medical complications like sore eyes,aches,rheumatism,allergy,itching,and rashes.Besides,Acacia auriculifromis has been proven for many pharmacological activities like central nervous system depressant activity,antioxidant,antimicrobial,antimalarial,anti-filarial,cestocidal,antimutagenic,chemopreventive,spermicidal,wound healing,hepatoprotective and antidiabetic activity due to its low toxicity (LD50 =3 741.7 mg/kg) and high efficacy.In addition,various phytochemical investigations reveal the presence of chief constituents as flavonoids (Auriculoside) and triterpenoid saponin glycosides (acaciasides-acaciaside A & B) in different parts of this plant.Since many years researchers have been carrying out various studies on this medicinal important shrub to elicit the various biological activities.This review attempts to highlight the pharmacognostical,phytochemical and pharmacological observations from 1965 to 2018 retrieved from SciFinder,Scientific journals,books,Google Scholar,and botanical electronic database websites.The various plant extracts evaluated for different pharmacological activities showed significant efficacy.Bioactive phytoconstituents isolated from various parts of the plant are highlighted.Pharmacognostical standardization of the plant done with various standard parameters is also reported.The low toxicity of this plant and the presence of major bioactive phytoconstituents like flavonoids and triterpenoid saponin glycosides are responsible for a therapeutic remedy for various diseases and pharmacological activities respectively.This review provides exhaustive information about the pharmacognostical,phytochemical,and pharmacological investigations of Acacia auriculiformis till date.

Association of condylar angle with incisal wear and myofunctional therapy – Original Research

Introduction: In any normal dentition there is stable relationship between the morphology of the occlusal facets and the movement of the condyles. Change in one of these are compensated by reactive adaptation of another. In the present study, the relation between the incisal wear facets and the condylar inclination were evaluated by checking the changes in condylar angle measurements in patients with incisal wear and those without it. The effect of myofunctional therapy on condylar angle and its correlation pre and post treatment was also established. Materials and Methods: The case group included 50 patients with incisal wear (attrited mandibular incisors) and the control group included 50 patients without incisal wear. 44 samples were taken to evaluate the changes in condylar angle pre and post myofunctional therapy. The posterior slope of articular eminence was marked in the lateral cephalogram and the horizontal condylar angle was drawn by tangent method. Results and Conclusion: The steepness of the condylar angle was found, directly proportional to the mandibular incisal wear. There was decrease in the values of condylar angle in patients after treatment with myofunctional therapy when compared with the pre-treatment values.

Prevalence of non-alcoholic fatty liver disease in type 2 diabetes mellitus patients in a tertiary care hospital of Bihar

Background: Macrovesicular fat accumulation in more than 5% of hepatocytes without significant alcohol consumption is the defining criteria of Non-alcoholic fatty liver disease (NAFLD). Nonalcoholic fatty liver disease is often associated with diabetes mellitus which is associated with a 60- 70% of frequency of Non-alcoholic fatty liver disease. The prevalence of NAFLD among the Type 2 Diabetes mellitus (T2DM) patients is higher compared to non-diabetics. Type 2 Diabetes mellitus and Non-alcoholic fatty liver disease are common conditions that commonly co-exist and can act reciprocally to bring adverse outcomes. Aim and objectives: The aim of this study was framed to determine the prevalence of Non-alcoholic fatty liver disease in Type 2 Diabetes mellitus patients and also to study the risk factors. Material and methods: The present cross sectional, prospective study was conducted at Indira Gandhi Institute of Medical Sciences, Patna, a tertiary care hospital of Bihar, over a period of 5 months. A total of 140 patients with Type 2 Diabetes mellitus that satisfied inclusion criteria were included in the study. All patients included in the study were subjected to ultrasonography and relevant history, thorough clinical examinations and biochemical tests were performed and recorded. Results: Out of 140 patients participated in the study, 44 (31.43%) were found to have Non-alcoholic fatty liver disease (NAFLD). The most common ultrasonographic grade of NAFLD was grade I (mild) fatty liver disease 30(21.43%), followed by grade II (moderate) fatty liver disease 13 (9.29%). The grade III (severe) fatty liver disease was found in 1 (0.71%) of the diabetic patients. NAFLD patients were compared with those with normal liver ultrasonographic findings. The risk factors of NAFLD Naresh Kumar, Jyoti Kumar Dinkar, Chandrakishore. Prevalence of non-alcoholic fatty liver disease in type 2 diabetes mellitus patients in a tertiary care hospital of Bihar. IAIM, 2017; 4(9): 54-58. Page 55 were also evaluated. The highest prevalence of NAFLD was recorded in the age group of 51-60 years and it was more prevalent among females than males. Conclusion: An observation into the predisposing factors of Non-alcoholic fatty liver disease, revealed a higher prevalence of obesity, hypertension, hyperlipidemia, hyperglycemia and sedentary lifestyle in the subjects with NAFLD. Type 2 Diabetes mellitus patients having non-alcoholic fatty liver disease are at increased risk of developing progressive forms of the disease. The liver disorder constitutes another potential complication in T2DM patients that requires early and prompt intervention in the associated risk factors and prevents the emergence of chronicity of NAFLD.

A comparative study of Widal test and Typhidot (IgM and IgG specific assay) test in the diagnosis of enteric fever

Background: Enteric fever (Typhoid fever) is a common systemic infectious disease worldwide, especially in developing countries like India and continues to be one of the leading causes of morbidity and mortality. It is caused by the bacterium Salmonella typhi or Salmonella paratyphi serotypes A, B and C. The clinical diagnosis of Enteric fever traditionally depends on Blood culture and Widal tests. However limitations such as longer time for Blood culture results and difficulties in the interpretation of Widal tests make them unpractical for screening patients in endemic regions and lead to misdiagnosis and missed diagnosis. Aim and objectives: Purpose of the study was to compare the sensitivity and specificity of Widal test and Typhidot based IgM and IgG assay with the Blood culture (taken as gold standard) in the diagnosis of Enteric fever. Materials and methods: This comparative study was done on 120 patients in the General Medicine Department of Indira Gandhi Institute of Medical Sciences, Patna. All patients above 11 years of age of either sex with acute febrile illness suspected to have Enteric fever were included in this study. Febrile patients with other diagnosis were excluded. Blood culture, Widal test, Typhidot (IgM and IgG) test and other routine investigations were performed in all patients. Typhidot tests and Widal tests were compared for sensitivity and specificity. Results: Out of 120 clinically diagnosed cases of Enteric fever, 18(15%) patients were Blood culture positive for Salmonella typhi, 27(22.5%) patients were positive on Widal tests and 36(30%) were Typhidot positive. Out of 18 Blood culture positive patients for Salmonella typhi, 10 patients were Jyoti Kumar Dinkar, Naresh Kumar, Chandrakishore. A comparative study of Widal test and Typhidot (IgM and IgG specific assay) test in the diagnosis of enteric fever. IAIM, 2017; 4(7): 126-130. Page 127 positive and 8 were negative on Widal testing. Out of 36 Typhidot positive patients 16 patients were positive and 20 were negative on Blood culture. Conclusions: Traditionally Blood culture and Widal test are used in the diagnosis of Enteric fever. However Typhidot (IgM & IgG assay) tests are simple and rapid screening tests that simultaneously detect and differentiate between IgM and IgG antibody to Salmonella typhi and paratyphi produced in response to infection, thus aiding in determination of current or previous exposure. It offers the advantage of early and rapid diagnosis and helps in early institution of therapy. Preliminary data have shown sensitivity and specificity of 95% and 86% respectively of Typhidot tests.

A Modified Technique for Umbilical Arterial Catheterization.

A modified technique for umbilical artery catheterization was assessed in babies in whom conventional method failed or if the cord was dry. Success rate attained with the modified technique was 90% (19/21). This modified technique could provide an easier and faster method for successful umbilical arterial catheterization.

Fluconazole-induced Stevens-Jonson syndrome.

A 25-year-old girl self-administered tab fluconazole for vulvovaginal candidiasis and developed fever, myalgia and erythematous papular eruptions with itching at both upper and lower lip, mucous membrane of the mouth, vaginal region, which subsequently changed into blister and multiple ulcers. She also had difficulty in swallowing due to painful erosions of the mouth and oropharynx and severe burning pain at vulval and vaginal region. There was bilateral conjunctival hemorrhage. Investigation report revealed leukocytosis and elevated C-reactive protein, which was suggesting the diagnosis of Stevens-Johnson syndrome. She was treated mainly by corticosteroids, antihistamines and antimicrobials and improved. Time taken for resolution of the lesion was 14 days. Rechallenge with the offending drug was not done in the interest of the patient and due to ethical constraints.

Solitary giant molluscum contagiosum presenting as lid tumor in an immunocompetent child.

We report the case of a three-year-old male child who presented with a single painless subcutaneously located upper lid mass of 1.2 × 1.5 cm with a central depression. The mass could be easily separated from overlying skin on complete excision biopsy and showed a never described before whitish brain like appearance consisting of multiple lobes and gyri, which histopathologically proved to be molluscum contagiosum (MC). Tests to investigate underlying immunodeficiency did not show any evidence of immunocompromised state.

Induced mild hypothermia in post-cardiopulmonary bypass vasoplegia syndrome.

The state of vasoplegia in immediate post-cardiopulmonary bypass period is characterized by severe hypotension, supranormal cardiac output, low systemic vascular resistance (SVR), and resistance to vasoconstrictors. We could successfully use induced mild hypothermia to increase SVR, and could avoid very high doses of nor-epinephrine (>0.3 mcg/kg/min) in the background of severe pulmonary hypertension (systolic pulmonary pressure> 90 mmHg). Its effects such as decreased oxygen demand, positive inotropy and better right ventricle performance probably helped to improve oxygenation in presence of pulmonary oedema.

Biomanagement of sago-sludge using an earthworm, Lampito mauritii.

In the present study vermicomposting was carried out at three different concentrations of sago-sludge namely 50, 75 and 100% with an indigenous earthworm, Lampito mauritii for a period of 50 days. The fecundity of earthworm Lampito mauritii was found to be high in 50%. At the end of 50 days composting period. There were about 12 cocoons, 5 juveniles and 2 nonclitellates appeared at 50% sago-sludge concentration. The microbial analysis showed that after 40 days of composting their population stabilized and further increase in composting period did not increase their population size. Chemical analysis of Lampito mauritii worked substrates showed there is a step wise increase of nitrogen and phosphorus. The fold increase of phosphorus and nitrogen were found to be high for sago-sludge undergoing vermicomposting than the control. From the initial value of 1.8, 1.4 and 0.5 mg kg(-1) total nitrogen increased in a stepwise manner and reached a value of 5.8, 3.9 and 2.3 mg kg(-1), respectively for vermicomposting at 50, 75 and 100%. During composting the organic carbon decreased from its initial value of 56, 74 and 107 mg kg(-1) to 15, 25 and 58 mg kg(-1) for vermicomposting and 34, 45 and 72 mg kg(-1) for 50, 70 and 100% control, respectively. The results indicate that 50% and 75% concentration of sludge mixed with bedding material was ideal for the vermicomposting.

Biomanagement of sago-sludge using an earthworm, Eudrilus eugeniae.

Sago, the tapioca starch is manufactured by over 800 small-scale units located in the Salem district, Tamil Nadu, India. During the processing of sago it generates huge quantities of biodegradable solid waste, as crushed tubers. In present study an attempt was made to convert these biodegradable solid sago tubers into value added compost using an exotic earthworm, Eudrilus eugeniae. The experiments were carried out in a plastic tray at various concentrations of sago-sludge (50% 75% and 100%) for a period of 90 days. During the vermicomposting, data were collected on life form (cocoon, non clitellates, clitellates) of earthworm and it was found to be high in 50% followed by 75% and 100% concentrations. Chemical analysis of worked substrates showed a step wise increase of nitrogen and phosphorus. The fold increase of phosphorus and nitrogen were found to be high for sago-sludge undergoing vermicomposting than the control. During the composting period the organic carbon decreased from its initial value of 58, 76 and 107 mg/kg to 21, 24 and 65 mg/kg for 50, 70 and 100%, respectively The microbial analysis showed that after 75 days of composting, their population stabilized and further increase in composting period did not increase their population size. The results indicate that 50% and 75% concentration of sludge mixed with bedding material was ideal for the vermicomposting.

Pulmonary artery catheter insertion in a patient of dextrocardia with anomalous venous connections.

In a young adult patient having situs solitus with dextrocardia the attempted pulmonary artery catheter placement for emergency mitral valve replacement required an unduly long length (50cm) of catheter insertion to get into right ventricle and then into pulmonary artery. Although catheter coiling was suspected initially, chest x-ray taken after successfully placement revealed an uncommon congenital anomalous venous connection i.e. right internal jugular opening into left sided superior vena cava then into inferior vena cava after running all along the left border of the heart. With the result, it required to pass 50cm of PA catheter to get into right ventricle in our patient. This emphasizes the need to look for abnormal venous connections during echocardiography and x-ray screening in congenital heart disease. Fluoroscopy is recommended when an unusual length of pulmonary artery catheter insertion is required to enter the pulmonary artery.