ABSTRACT
Aim: To investigate the effects of Terpinen-4-ol on quorum sensing (QS)-regulated biofilm formation and virulence factors production in Pseudomonas aeruginosa. Materials & methods: QS inhibition, molecular docking analysis and gene expression studies were performed to check attenuation effect of Terpinen-4-ol on virulence of P. aeruginosa. Production of various virulence factors and biofilm formation were studied at sub-MIC of Terpinen-4-ol alone and in combination with ciprofloxacin. Results: Terpinen-4-ol at sub-MIC exhibited QS inhibition and downregulated all key QS genes. Molecular docking analysis showed high binding affinities of Terpinen-4-ol with QS receptors. Terpinen-4-ol exhibited synergistic interaction with ciprofloxacin and further reduced production of all the virulence factors and biofilms formation. Conclusion: Terpinen-4-ol could be developed into antivirulence drug after its in vivo evaluation for treatment strategies.
Subject(s)
Biofilms/drug effects , Ciprofloxacin/pharmacology , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/metabolism , Terpenes/pharmacology , Virulence/drug effects , Acyl-Butyrolactones/metabolism , Anti-Bacterial Agents/pharmacology , Bacterial Proteins/metabolism , Drug Synergism , Gene Expression Regulation, Bacterial , Microbial Sensitivity Tests , Molecular Docking Simulation , Quorum Sensing/drug effects , Virulence Factors/genetics , Virulence Factors/metabolismABSTRACT
: We report a 14-year-old girl who presented with subdural hematoma and a deranged coagulation profile suggestive of an inhibitor. Investigations revealed prothrombin deficiency along with positivity for antiphospholipid antibodies, which improved with steroid therapy. Bleeding diathesis in children and adolescents commonly results from thrombocytopenia, platelet function disorders, or coagulation factor deficiency; whereas bleeding because of coagulation factor inhibitors are extremely rare in this age group. This case also highlights the uncommon presentation of antiphospholipid antibody syndrome, as they often present with thrombosis or pregnancy complications rather than bleeding.
Subject(s)
Antiphospholipid Syndrome/complications , Hematoma, Subdural/complications , Hypoprothrombinemias/complications , Lupus Coagulation Inhibitor/blood , Adolescent , Antiphospholipid Syndrome/blood , Antiphospholipid Syndrome/drug therapy , Female , Hematoma, Subdural/blood , Hematoma, Subdural/drug therapy , Humans , Hypoprothrombinemias/blood , Hypoprothrombinemias/drug therapy , Steroids/therapeutic useABSTRACT
Factor V deficiency is a rare autosomal recessive coagulation disorder. We report a case with inherited factor V deficiency presenting as life-threatening recurrent hemoperitoneum, following bleeding from ruptured corpus haemorrhagicum. Prolonged prothrombin and activated partial thromboplastin times, normal thrombin time and a normal platelet count pointed towards a disorder of coagulation. Mixing studies with factor V deficient plasma and coagulation factor assay revealed markedly reduced plasma factor V clotting activity. The management included blood, plasma and tranexamic acid. Family screening revealed low factor V levels in her parents. Although her brother had significant Factor V deficiency and epistaxis, he did not need hospitalization or replacement, indicating the varied manifestation of this bleeding defect in this family.
Subject(s)
Corpus Luteum/abnormalities , Factor V Deficiency/blood , Hemoperitoneum/etiology , Adult , Factor V Deficiency/physiopathology , Female , Hemoperitoneum/complications , Humans , Young AdultABSTRACT
Bleeding in the neonates may be a result of thrombocytopenia, sepsis or vitamin K deficiency. Congenital bleeding disorders are a rare cause of bleeding. The umbilical cord bleed is an important clue to underlying bleeding disorders especially factor XIII deficiency and afibrinogenemia. In some laboratories, the routine workup for the bleeding neonate may not always include fibrinogen assays, which may then delay this diagnosis. We report a case of congenital afibrinogenemia in a neonate who presented with umbilical stump bleeding for its rarity and to re-emphasize the need for including fibrinogen assays while assessing a bleeding neonate.
