Cryptic aspergillosis: a rare entity and a diagnostic challenge.

Introduction: Cryptic aspergillosis, caused by cryptic species of Aspergillus, is increasingly reported in humans and causes significant morbidity and mortality in immunocompromised individuals. The main aim of this study was to describe the occurrence of this entity at a large tertiary care centre and analyse the challenges in identifying them in a routine diagnostic laboratory. Methods: This was a retrospective case review of all patients diagnosed with cryptic Aspergillus species from April 2019 to February 2020. The isolates were identified using conventional microbiological techniques, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI- TOF MS), 28S rRNA and internal transcribed spacer (ITS) sequencing. Results: The species identified were Aspergillus tamarii, Aspergillus lentulus and Aspergillus sydowii. Identification by MALDI- TOF MS and sequencing was concordant for all except A. sydowii, with MALDI- TOF MS misidentifying it as Aspergillus thermomutans. All isolates showed low minimum inhibitory concentrations (MICs) for the panel of antifungal drugs. Conclusion: Aspergillosis caused by cryptic Aspergillus species presents a diagnostic challenge. This study confirms the importance of molecular methods for accurate identification.

Microplastics in the environment and in commercially significant fishes of mud banks, an ephemeral ecosystem formed along the southwest coast of India.

Microplastic pollution and the impacts they generate on the marine ecosystem and its biota is a major global concern of recent decades. The present study was conducted to evaluate the spatio-temporal distribution of microplastics in the surface waters, sediments, and their subsequent ingestion by the commercially important fishes of Alappuzha Mud banks, a transient ecosystem formed in the littoral zones of the southwest coast of India exclusively during the Indian summer monsoon. Sampling conducted over three periods, Pre-mud bank (Pre-MB), Mud bank (MB), and Post mud bank (Post-MB) extending over three depths (2 m, 5 m and 18 m), along the semi-circular patch of mudbanks revealed marked spatio-temporal variability in microplastic distribution. In both surface water and sediments, microplastic concentration was comparatively high during MB than in Pre-MB and Post-MB periods. Spatially, during MB, the microplastic concentration was high at 5 m where the dampening of waves occurred concomitant to the thick fluid mud formation. In contrast, during Post-MB, with the subsequent dissipation of MB's and less wave dampening, the microplastics aggregated at 5 m were transported to both inshore (2 m) and offshore (18 m), thus raising their concentration at these depths. Likewise, the microplastic ingestion was more in fishes caught during MB (41%) than Post-MB (30%) and Pre-MB (29%) periods indicating increased uptake corresponding to the higher incidences in their ambient environment. Microplastic ingestion was more among pelagic planktivores, S. gibbosa (38%), A. chacunda (20%) and R. kanagurta (13%) compared to the demersal fishes. White coloured fragments of size 1-5 mm of polypropylene were the dominant microplastic in the surface waters, sediment and fishes analysed. The present study indicates the critical role of wind speed, rainfall, wave patterns, and the fluid muddy environment in regulating the microplastics distribution in a transient ecosystem formed along the southwest coast of India.

Efficacy of curcumin in treating palatal changes associated with reverse smoking / Eficácia da curcumina no tratamento de alterações do palato associadas ao fumo reverso

Objectives: To evaluate the efficacy of curcumin preparation on the palatal changes associated with reversesmoking. Materials and methods: The study sample was divided into two groups with ten reverse smokingpatients each. Group A patients were advised to use curcumin oral gel on an acrylic palatal plate whereasgroup B patients were instructed about the benefits of smoking cessation. Clinical and cytological smearexaminations were performed at the first visit and at the end of the third visit. Data obtained was subjectedto statistical analysis. Results: Evident improvement with reduction in size and severity of the clinical lesionwas observed among the study group at both first and third visits (p < 0.001, significant). However, thecytological appearances remained the same in all the cases, except for three cases from the study group,which demonstrated a transition from moderate dysplastic features to milder dysplastic features (p = 0.28,not significant). Conclusion: Due to its diverse array of molecular targets, curcumin affords great potentialas a therapeutic agent for precancerous and cancerous conditions. Results from our pilot study have clearlyshown that curcumin is effective in the treatment of the palatal changes associated with reverse smoking.

Objetivos: Avaliar a eficácia da curcumina sobre as alterações palatais associadas ao fumo reverso. Materiaise métodos: A amostra foi dividida em dois grupos com dez pacientes fumantes cada. No grupo A os pacientesforam aconselhados a usar o gel de curcumina oral em uma placa de acrílico palatina, enquanto os pacientesdo grupo B foram instruídos sobre os benefícios da cessação tabágica. Exames de esfregaço citológico e examesclínicos foram realizados na primeira visita e no fim da terceira visita. Os dados obtidos foram submetidosà análise estatística. Resultados: Observou-se evidente melhora na redução do tamanho e na gravidadeda lesão clínica no grupo de estudo em ambas as visitas (p < 0,001, significativo). No entanto, a aparênciacitológica permaneceu a mesma em todos os casos, exceto em três casos do grupo de estudo, os quais demonstraramuma transição de características displásicas moderadas para leves (p = 0,28; não significativo).Conclusão: A curcumina, em virtude de seu conjunto diversificado de alvos moleculares, proporciona umgrande potencial como agente terapêutico para as condições cancerosas e pré-cancerosas. Os resultados donosso estudo piloto mostraram claramente que a curcumina é eficaz no tratamento das alterações palataisassociadas ao fumo reverso.