Primary Aortoenteric Fistula Due to Salmonella typhi-related Mycotic Aneurysm.

Primary aortoenteric fistulas (AEF) are rare. The majority of these are due to atherosclerotic aortic aneurysms. Mycotic aortic aneurysms leading to primary AEF are exceedingly uncommon. Here we report a rare case of primary AEF secondary to Salmonella-related mycotic aneurysm and discuss the diagnostic and therapeutic issues.

Antifungal activity of probiotic strain Lactiplantibacillus plantarum MYSN7 against Trichophyton tonsurans.

The primary objective of this study was to assess the probiotic attributes and antifungal activity of lactic acid bacteria (LAB) against the fungus, Trichophyton tonsurans. Among the 20 isolates screened for their antifungal attributes, isolate MYSN7 showed strong antifungal activity and was selected for further analysis. The isolate MYSN7 exhibited potential probiotic characteristics, having 75 and 70% survival percentages in pH3 and pH2, respectively, 68.73% tolerance to bile, a moderate cell surface hydrophobicity of 48.87%, and an auto-aggregation percentage of 80.62%. The cell-free supernatant (CFS) of MYSN7 also showed effective antibacterial activity against common pathogens. Furthermore, the isolate MYSN7 was identified as Lactiplantibacillus plantarum by 16S rRNA sequencing. Both L. plantarum MYSN7 and its CFS exhibited significant anti-Trichophyton activity in which the biomass of the fungal pathogen was negligible after 14 days of incubation with the active cells of probiotic culture (106 CFU/ml) and at 6% concentration of the CFS. In addition, the CFS inhibited the germination of conidia even after 72 h of incubation. The minimum inhibitory concentration of the lyophilized crude extract of the CFS was observed to be 8 mg/ml. Preliminary characterization of the CFS showed that the active component would be organic acids in nature responsible for antifungal activity. Organic acid profiling of the CFS using LC-MS revealed that it was a mixture of 11 different acids, and among these, succinic acid (9,793.60 µg/ml) and lactic acid (2,077.86 µg/ml) were predominant. Additionally, a scanning electron microscopic study revealed that CFS disrupted fungal hyphal structure significantly, which showed scanty branching and bulged terminus. The study indicates the potential of L. plantarum MYSN7 and its CFS to control the growth of T. tonsurans. Furthermore, in vivo studies need to be conducted to explore its possible applications on skin infections.

Probiotics and their postbiotics for the control of opportunistic fungal pathogens: A review.

During past twenty years the opportunistic fungal infections have been emerging, causing morbidity and mortality. The fungi belonging to Aspergillus, Mucor, Rhizopus, Candida, Fusarium, Penicillium, Dermatophytes and others cause severe opportunistic fungal infections. Among these Aspergillus and Candida spp cause majority of the diseases. The continuum of fungal infections will prolong to progress in the surroundings of the growing inhabitants of immunocompromised individuals. Presently many chemical-based drugs were used as prophylactic and therapeutic agents. Prolonged usage of antibiotics may lead to some severe effect on the human health. Also, one of the major threats is that the fungal pathogens are becoming the drug resistant. There are many physical, chemical, and mechanical methods to prevent the contamination or to control the disease. Owing to the limitations that are observed in such methods, biological methods are gaining more interest because of the use of natural products which have comparatively less side effects and environment friendly. In recent years, research on the possible use of natural products such as probiotics for clinical use is gaining importance. Probiotics, one of the well studied biological products, are safe upon consumption and are explored to treat various fungal infections. The antifungal potency of major groups of probiotic cultures such as Lactobacillus spp, Leuconostoc spp, Saccharomyces etc. and their metabolic byproducts which act as postbiotics like organic acids, short chain fatty acids, bacteriocin like metabolites, Hydrogen peroxide, cyclic dipeptides etc. to inhibit these opportunistic fungal pathogens have been discussed here.

Exploring biotechnological and functional characteristics of probiotic yeasts: A review.

Probiotics are vital and beneficial organisms which offers the health benefits to the host organisms. The fungal probiotic field is one of the developing fields nowadays. Yeast has an enormous and diverse group of microorganisms that is attracting and expanding the attention from researchers and industries. Saccharomyces boulardii, the only patented strain belonging to yeast genera for the human use, has been broadly evaluated for its probiotic effect. Yeasts belonging to the genera Debaryomyces, Pichia, Yarrowia, Meyerozyma, Kluyveromyces etc.., have attained more interest because of their beneficial and probable probiotic features. These yeast probiotics produce VOCs (Volatile organic compounds), mycocins and antimicrobials which shows the antagonistic effect against pathogenic fungi and bacteria. Additionally, those yeasts have been recorded as good plant growth promoting microorganisms. Yeast has an important role in environmental applications such as bioremediation and removal of metals like chromium, mercury, lead etc., from waste water. Probiotic yeasts with their promising antimicrobial, antioxidant, anticancer properties, cholesterol assimilation and immunomodulatory effects can also be utilized as biotherapeutics. In this review article we have made an attempt to address important yeast probiotic attributes.

Nutritional interventions for improving the endurance performance in athletes.

Endurance refers to the ability of skeletal muscles to perform continuously withstanding the hardships of exercise. Endurance exercises have three phases: pre-, during-, and post-workout phase. The nutritional requirements that drive these phases vary on intensity, type of workout, individual's body composition, training, weather conditions, etc. Generally, the pre-workout phase requires glycogen synthesis and spare glycogen breakdown. While workout phase, requires rapid absorption of exogenous glucose, insulin release to transport glucose into muscle cells, replenish the loss of electrolytes, promote fluid retention, etc. However, post-workout phase requires quick amino acid absorption, muscle protein synthesis, repair of damaged muscle fibres and tendon, ameliorate inflammation, oxidative stress, etc. Therefore, nutritional sources that can help these metabolic requirements is recommended. In this review, various dietary interventions including timing and amount of nutrient consumption that can promote the above metabolic requirements that in turn support in improving the endurance potential in athletes are discussed.HIGHLIGHTSReview article describes nutritional requirements of endurance exercises.It also describes nutritional interventions to enhance the endurance potential in athletes.

DoseCal: a virtual calculator for dosage conversion between human and different animal species.

CONTEXT: The scientists as well as pharmacologists frequently convert the dose of drugs or extracts between human and different animal species. According to the literature, the extrapolation of the dose by simple conversion based only on body weight is not an accurate method. The miscalculation of dosage conversion may result in adverse effects due to overdose or reduced potency due to underdose. AIM: To develop a conversion calculator with factual factor like Km factor. METHOD: The virtual calculator was developed as a web-based application using hypertext pre-processor programming language. My SQL software was used to store the data related to DoseCal. RESULTS: Based on the Km factor, dose conversion calculator called DoseCal was developed. The DoseCal would provide the dosage for both per kg and actual weight of the animal taken for the experiment. CONCLUSION: The DoseCal would assist scientists in the dosage conversion easily and accurately between species.

Probiotic properties of Lactobacillus casei - MYSRD 108 and Lactobacillus plantarum-MYSRD 71 with potential antimicrobial activity against Salmonella paratyphi.

A total of 130 isolates were screened, twelve isolates were characterized for probiotic attributes and two isolates with best probiotic features were evaluated in the study. Isolates MYSRD108 and MYSRD71 survived gastric conditions and were susceptible to tested antibiotics. Isolates showed more vital cell surface traits such as autoaggregation of 89.2 and 88.5% and cell surface hydrophobicity of 61 and 64%. PCR amplification followed by 16sRNA sequencing results confirmed that the isolates as Lactobacillus casei (MYSRD 108) and Lactobacillus plantarum (MYSRD 71). During this study, the Cells and their Cell Free Supernatant (CFS) were examined for antimicrobial activity. Both the isolates inhibited different bacterial pathogens in which the growth of S. paratyphi was significantly reduced. Further, their CFS also showed inhibitory effects against S. paratyphi with agar well diffusion and Minimum Inhibitory Concentration using Broth micro dilution method. The antimicrobial compounds in the CFS was characterized to different constraints such as pH neutralization, heat treatment, Hydrogen peroxide test and storage stability at -20> °C and represented that the antagonistic acitivity against Salmonella is due to the presence of organic acids in the supernatants that lowered the pH. These strains were further examined for the inhibition of S. paratyphi biofilm. The results indicated that CFS reduced S. paratyphi biofilm by more than 75% and the number of Salmonella biofilm was effectively reduced using 15% concentration of CFS. These strains may be used to produce antimicrobial compounds which can be a substitute for chemical preservatives in food industry.

A Randomised Controlled Trial to Assess the Analgesic Efficacy of Reduced Dose 0.2% Ropivacaine-Dexmedetomidine Combination Compared to Standard 0.375% Ropivacaine in USG Guided TAP Block for Paediatric Hernia Repair.

OBJECTIVE: Paediatric pain management has remained understated practice over a period of time. Recently ultrasound-guided (USG) guided techniques are gaining popularity for perioperative analgesia, especially in the paediatric population. So, the aim of the present study was to evaluate the efficacy of reduced dose ropivacaine-dexmedetomidine combination compared to standard 0.375% ropivacaine in USG guided transversus abdominis plane (TAP) block. METHODS: Sixty children of either sex, aged 2-10 years, posted for elective open herniotomy under general anaesthesia were randomly divided into two groups of 30 patients each. Group RD received 0.2% ropivacaine with dexmedetomidine 1 mg kg 1 while group R received 0.375% ropivacaine at 0.5mL kg 1. Meantime to first rescue and total analgesics, Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and Ramsay sedation score, haemodynamic parameters and adverse effects were noted. RESULTS: Time to first rescue analgesia in group RD and group R were 16.32 6 3.11 hours and 10.82 6 2.16 hours, respectively (P < .0001). Mean CHEOPS score were 4.48 6 1.1 and 6.3 6 1.74 (P < .024) in group RD and R. Post-op Ramsay sedation score was significantly greater in group RD. Heart rate and blood pressure remained similar in either of the group. No episode of respiratory depression, bradycardia or hypotension was noted perioperatively. CONCLUSION: Combination of 1 mg kg 1 dexmedetomidine with reduced concentration of ropivacaine (0.2%) produced significantly longer duration of post-operative analgesia and lowered post-operative CHEOPS pain score in comparison with 0.375% ropivacaine alone in USG guided TAP block for paediatric hernia repair.

Preeclampsia: Pathophysiology and management.

Preeclampsia is a pregnancy-related multisystem disorder, frequently encountered pregnancy-related medical complications next to gestational diabetes mellitus. It is the onset of hypertension during pregnancy. The preeclampsia can be of two types, placental or maternal preeclampsia. Among these two types former, i.e., placental preeclampsia is more severe than the latter. According to the recent survey by National Health Portal of India, the incidence of preeclampsia is about 8-10 % among pregnant women. Though our understanding of preeclampsia has improved in recent years, the development and interpretation of the clinical tests remain difficult for preeclampsia. Hence, we have made an attempt to understand the pathophysiology, associated conditions/consequences, treatment and management/prevention of the condition in this review.

Experimental models of polycystic ovary syndrome: An update.

Polycystic ovary syndrome (PCOS) is one of the major endocrine disorders in women. PCOS is a disorder with alterations in the structure as well as functions of female reproductive organs and is also associated with metabolic disorders. Studies on humans have limitations due to ethical issues, hence animal models are used to understand the different aspects of PCOS. Animal models of PCOS aids in studying various facts beginning from etiology to the treatment, hence, several animal models have been developed. Despite of the establishment of several models and a number of studies on PCOS, lacunae exist. This may be due to the failure in selecting a suitable animal model, as all animal models may not exhibit all the key features of the human PCOS condition or may exhibit traits similar to other diseased conditions in addition to the PCOS which should be excluded. Therefore, in this review, we have discussed the different animal models, features they exhibit, their merits and limitations which may aid in the selection of the relevant animal model of PCOS based upon the investigation's focus. In addition, a few nonmammalian models as an alternative to mammalian models have also been discussed which is to be validated further.

Chronic stress effects and their reversibility on the Fallopian tubes and uterus in rats.

The durational effects of chronic stress on the Fallopian tubes and uterus were studied by exposing rats to stressors in the form of restraint (1h) and forced swimming (15min) daily for 4, 8 or 12 weeks. One group of stressed rats from each time period was then maintained without exposure to stressors for a further 4 weeks to assess their ability to recover from stress. All time periods of stress exposure resulted in decreased weight of the body and Fallopian tubes; however, the relative weight of the uterus and serum concentrations of oestradiol and insulin increased significantly. The antioxidant potential was decreased with increased malondialdehyde concentrations in the Fallopian tubes following all durations of exposure and after 4 and 8 weeks of stress exposure in the uterus. Interestingly, rats stressed for 12 weeks showed an increase in serum testosterone concentration and antioxidant enzyme activities with a decrease in malondialdehyde concentration in the uterus. The antioxidant enzyme activities and malondialdehyde concentration in the Fallopian tubes of all recovery group rats were similar to stressed rats. However, in the uterus these parameters were similar to controls in recovery group rats after 4 weeks or 8 weeks of exposure, but after 12 weeks of stress exposure these parameters did not return to control levels following the recovery period. These results reveal, for the first time, that chronic stress elicits an irreversible decrease in antioxidant defence in the Fallopian tubes irrespective of exposure duration, whereas the uterus develops reversible oxidative stress under short-term exposure but increased antioxidant potential with endometrial proliferation following long-term exposure.

Splenic Abscess in Immunocompetent Patients Managed Primarily without Splenectomy: A Series of 7 Cases.

INTRODUCTION: Splenic abscesses are rare in immunocompetent adults. Despite advances in diagnosis and treatment, these abscesses are still potentially life threatening. Various factors have been reported to predispose otherwise immunocompetent adults to splenic abscesses. Splenectomy was once considered the "gold standard" treatment. However, the trend is shifting to a conservative approach. CASE DESCRIPTION: We describe seven cases of splenic abscess in immunocompetent adults, the cause of which ranged from tuberculosis to salmonella and was as rare as Plasmodium vivax. All the patients presented with fever (median duration = one month; range = one week to six years) and abdominal pain, and most also had weight loss. All patients were in their third to fifth decades of life. The patients were successfully treated with appropriate antibiotic therapy, after which they were clinically normal. DISCUSSION: A microbiological diagnosis of splenic abscess is of utmost importance. In this series, all patients underwent percutaneous aspiration. This was performed under radiologic guidance (either ultrasonography or computed tomography). Only one patient required diagnostic splenectomy. Irrespective of whatever surgical or nonsurgical drainage measures are employed, appropriate antibiotic therapy is the cornerstone of management. The dose and duration of antibiotic therapy depend on the causative organism and its sensitivity pattern.

The protective effect of the Vacha rhizome extract on chronic stress-induced immunodeficiency in rat.

CONTEXT: Chronic stress is an inevitable factor in the modern day society which affects cell mediated as well as humoral immunity. There is a need to prevent stress effects with traditionally used herbs. OBJECTIVE: The present study was undertaken to investigate the immunoprotective effect of Vacha (Acorus calamus L. Acoraceae) rhizome under stressful condition. MATERIALS AND METHODS: Soxlet extraction of Vacha rhizome was performed with increasing polarity of solvents, i.e., petroleum ether to ethanol. The extract was concentrated by distilling off the solvent in flash evaporator and dried in desiccators. The benzene extract was found to have anti-stress property in our earlier studies and hence it was used in the present experiment. Extract was administered every day for 4 weeks orally to adult female rats prior to exposure to stress, restraint (1 h) and forced swimming exercise (15 min). RESULTS: Vacha rhizome extract significantly prevented the stress induced reduction in total and differential leukocytes count, immunoglobulin content, bone marrow cellularity and viability, lymphocytes counts in lymphoid organs, islands of white pulp of spleen (ED50 = 10 mg, p < 0.001) and a significant increase in circulating immune complexes and apoptotic index of lymphoid organs (ED50 = 10 mg, p < 0.001) compared to controls. DISCUSSION AND CONCLUSION: The present study clearly indicates that Vacha extract not only prevents stress-induced suppression of immunity and structural involution of lymphoid organs, but also boosts immunity in normal rats. Therefore, it is suggested that Vacha extract administration maintains normal immunity despite the body experiencing stress.

Long-term chronic stress exposure induces PCO phenotype in rat.

Thus far the effects of chronic stress on the ovary were studied for shorter durations. However, responses of the ovary may vary with durations of exposure to stress. Hence, we investigated the responses of the ovary following exposure to different durations of chronic stress. Exposure of rats to restraint (1 h) and after a gap of 4 h to forced swimming (15 min) daily for 4 or 8 weeks resulted in significant decreases in the activities of the ovarian antioxidant enzymes, 3ß-hydroxysteroid dehydrogenase and percentage of healthy granulosa cells with concomitant increases in the number of atretic follicles, the percentage of apoptotic granulosa cells and ovarian malondialdehyde concentration. However, the response of the ovary to similar stress regime for 12 weeks was paradoxical as there were increases in the activities of ovarian antioxidant enzymes and 3ß-hydroxysteroid dehydrogenase, the number of healthy antral follicles, and decreases in ovarian malondialdehyde concentration and percentage of apoptotic granulosa cells. These changes were accompanied by hyperglycaemia and an increase in the serum levels of insulin, testosterone and oestradiol. In addition the cystic follicles were found in the ovaries of these rats. However, the number of oestrous cycles and active corpora lutea showed significant decrease in all the durations of stress exposure. The results demonstrate a differential response of ovary to short- and long-term exposure to chronic stress.

Enteric fever in India: current scenario and future directions.

Enteric fever is a major cause of morbidity and mortality in tropical areas worldwide. The Indian subcontinent bears the brunt of the disease, both in terms of absolute case numbers and drug-resistant strains. Recent phylogenetic studies suggest that the multidrug-resistant clade H58 originated in India and subsequently expanded through Asia and Africa. In Africa, it caused unrecognised outbreaks in areas previously considered free of the disease. In this study, we discuss the current status of enteric fever in India, the factors preventing its control and its future directions in this rapidly developing nation.

A Novel Variant of Bartter's Syndrome.

Bartter's syndrome, a rare disorder affecting the renal tubular potassium handling, is characterized by metabolic alkalosis, hypokalemia and renal salt wasting. Here we describe a patient with Bartter's syndrome with hitherto undescribed clinical features and also discuss the various possibilities leading to such variant of Bartter's syndrome.