Probiotic potential of a novel endophytic Streptomyces griseorubens CIBA-NS1 isolated from Salicornia sp. against Vibrio campbellii infection in shrimp

A novel endophytic Streptomyces griseorubens CIBA-NS1 was isolated from a salt marsh plant Salicornia sp. The antagonistic effect of S. griseorubens against Vibrio campbellii, was studied both in vitro and in vivo. The strain was validated for its endophytic nature and characterized through scanning electron microscopy, morphological and biochemical studies and 16SrDNA sequencing. The salinity tolerance experiment has shown that highest antibacterial activity was at 40‰ (16 ± 1.4 mm) and lowest was at 10 ‰ salinity (6.94 ± 0.51 mm). In vivo exclusion of Vibrio by S. griseorubens CIBA-NS1 was studied in Penaeus indicus post larvae and evaluated for its ability to improve growth and survival of P. indicus. After 20 days administration of S. griseorubens CIBA-NS1, shrimps were challenged with V. campbellii. The S. griseorubens CIBA-NS1 reduced Vibrio population in test group when compared to control, improved survival (60.5 ± 6.4%) and growth, as indicated by weight gain (1.8 ± 0.05g). In control group survival and growth were 48.4 ± 3.5% and 1.4 ± 0.03 g respectively. On challenge with V. campbellii, the S. griseorubens CIBA-NS1 administered group showed better survival (85.6 ± 10%) than positive control (64.3 ± 10%). The results suggested that S. griseorubens CIBA-NS1 is antagonistic to V. campbellii, reduce Vibrio population in the culture system and improve growth and survival. This is the first report on antagonistic activity of S. griseorubens isolated from salt marsh plant Salicornia sp, as a probiotic candidate to prevent V. campbellii infection in shrimps.

Updated S2 K guidelines for the management of bullous pemphigoid initiated by the European Academy of Dermatology and Venereology (EADV)

BACKGROUND

Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and presents with itch and localized or, most frequently, generalized bullous lesions. A subset of patients only develops excoriations, prurigo-like lesions, and eczematous and/or urticarial erythematous lesions. The disease, which is significantly associated with neurological disorders, has high morbidity and severely impacts the quality of life.

OBJECTIVES AND METHODOLOGY

The Autoimmune blistering diseases Task Force of the European Academy of Dermatology and Venereology sought to update the guidelines for the management of BP based on new clinical information, and new evidence on diagnostic tools and interventions. The recommendations are either evidence-based or rely on expert opinion. The degree of consent among all task force members was included.

RESULTS

Treatment depends on the severity of BP and patients' comorbidities. High-potency topical corticosteroids are recommended as the mainstay of treatment whenever possible. Oral prednisone at a dose of 0.5 mg/kg/day is a recommended alternative. In case of contraindications or resistance to corticosteroids, immunosuppressive therapies, such as methotrexate, azathioprine, mycophenolate mofetil or mycophenolate acid, may be recommended. The use of doxycycline and dapsone is controversial. They may be recommended, in particular, in patients with contraindications to oral corticosteroids. B-cell-depleting therapy and intravenous immunoglobulins may be considered in treatment-resistant cases. Omalizumab and dupilumab have recently shown promising results. The final version of the guideline was consented to by several patient organizations.

CONCLUSIONS

The guidelines for the management of BP were updated. They summarize evidence- and expert-based recommendations useful in clinical practice.

Addition of oral Fexofenadine to topical therapy leads to a significantly greater reduction in the serum IL-31 levels in mild to moderate pediatric atopic dermatitis

BACKGROUND

Recent evidence has suggested that oral antihistamines could have a beneficial role in atopic dermatitis (AD) due to their anti-inflammatory action. Hence, we aimed to evaluate the effectiveness of adding an oral second generation, non-sedating, H1 antihistamine (Fexofenadine) to topical treatment in AD.

MATERIALS AND METHODS

In this prospective randomized study, a total of 50 patients with a diagnosis of mild to moderate atopic dermatitis were recruited and randomized into two groups A (appropriate topical treatment combined with oral fexofenadine) and B (appropriate topical treatment without oral fexofenadine). Both groups received the respective treatments for a duration of 8 weeks.

RESULTS

There was no significant difference between the two groups in terms of SCORAD and the 5-D Itch Score at any of the time points (2 weeks, 4 weeks, 8 weeks). However, the serum IL-31 (ng/ml) decreased significantly from baseline in the fexofenadine group after 8 weeks of treatment.

CONCLUSIONS

Although we could not conclusively confirm the clinical efficacy of adding oral fexofenadine to topical treatment in AD, serological evaluation indicates that fexofenadine treatment can lead to significant lowering of serum IL-31 levels in AD patients.

S2k guidelines (consensus statement) for diagnosis and therapy of dermatitis herpetiformis initiated by the European Academy of Dermatology and Venereology (EADV)

INTRODUCTION

Dermatitis herpetiformis (DH) is a chronic, pruritic, gluten-induced skin disorder characterized by subepidermal granular IgA deposition and a variable degree of enteropathy identical to that seen in coeliac disease. So far, there has been no European consensus about the management of DH.

METHODS

The guidelines were created by small subgroups of a guideline committee consisting of 26 specialists from various medical fields and one patients' representative. The members of the committee then discussed the guidelines and voted for the final version at two consensus meetings. The guidelines were developed under the support of the European Academy of Dermatology and Venereology (EADV) and in collaboration with the European Dermatology Forum (EDF).

RESULTS

The guidelines summarize evidence-based and expert-based recommendations (S2 level) for the management of DH (see Appendix).

CONCLUSION

These guidelines will improve the quality of management of DH and support dermatologists in their diagnostic and therapeutic decisions.

Severe epidermolysis bullosa/Kindler syndrome-like phenotype of an autoinflammatory syndrome in a child

A 5-year-old boy presented with generalized cutaneous erosions, severe scarring, depigmentation and contractures affecting major joints. The lesions had initially affected his ears, nose, feet, and the genital and ocular mucosa, leading to significant depigmentation, scarring, contractures and mutilation. The whole of the trunk and limbs were involved at the time of presentation, with the exception of some islands of spared skin on the proximal thighs, legs, nipples and external genitalia. Electron microscopy revealed a split in the sublamina densa with the absence of anchoring fibrils, suggestive of dystrophic epidermolysis bullosa (EB). Immunofluorescence antigen mapping demonstrated a broad reticulate pattern of staining with collagen IV, VII, and laminin 332 in the floor of the blister, suggestive of Kindler syndrome. Next-generation sequencing revealed a de novo heterozygous missense mutation (a variant of unknown significance) in exon 22 of the phospholipase-C gamma 2 gene (PLCG2), which resulted in a substitution of serine by asparagine at codon 798 (p.Asp798Ser), a result that was validated using Sanger sequencing. The child was diagnosed with PLCG2-associated antibody deficiency and immune dysregulation (PLAID)/autoinflammation and PLCG2-associated antibody deficiency and immune dysregulation (APLAID) syndrome. The cutaneous and corneal erosions, inflammation and scarring of this magnitude, and the eventual result of death have not been described previously for the PLAID/APLAID spectrum previously. In conclusion, this was an unusual acquired autoinflammatory severe EB-like disease that may be associated with de novo PLCG2 mutation.

Paediatric morphoea: a holistic review. Part 1: epidemiology, aetiopathogenesis and clinical classification

Morphoea, also known as localized scleroderma, is a debilitating fibrosing disorder of uncertain aetiology, affecting the skin and subcutaneous tissues. Paediatric-onset disease is not uncommon and is associated with frequent relapses. The disease has complex pathogenetic mechanisms and multiple clinical subtypes, and affects children of all ages. Recent research has focused on elucidating the disease pathophysiology and identifying measures of disease activity. We performed a literature search on PubMed, MEDLINE and Google Scholar, using keywords such as 'pediatric morphea', 'juvenile localised scleroderma' and 'juvenile systemic sclerosis'. Relevant studies, including randomized trials, reviews of standard current guidelines and original research articles, were selected, and results were analysed before being summarized. In the first of this two-part review, we provide a bird's-eye view of the current literature concerning the epidemiology, aetiopathogenesis and clinical classification of paediatric morphoea; in Part 2, we review the diagnosis, markers of disease activity, management and natural history.

Paediatric morphoea: a holistic review. Part 2: diagnosis, measures of disease activity, management and natural history

Paediatric morphoea is a debilitating fibrosing disorder of uncertain aetiology, affecting the skin and subcutaneous tissues. Defining optimum management strategies in paediatric morphoea remains an ongoing challenge, owing to the varied presentations and a relative paucity of paediatric-specific studies. We performed a literature search on PubMed, MEDLINE and Google Scholar, using keywords such as 'pediatric morphea', 'juvenile localised scleroderma' and 'juvenile systemic sclerosis'. Relevant studies, including randomized trials, reviews of standard current guidelines and original research articles, were selected and results analysed before summarizing them. In Part 1 of this review, we described the epidemiology, aetiopathogenesis and clinical classification; in this part, we discuss the diagnosis, markers of disease activity, management and natural history in paediatric morphoea.

Performance and stability analysis of curcumin dye as a photo sensitizer used in nanostructured ZnO based DSSC

Environmental friendly natural dye curcumin extracted from low-cost Curcumina longa stem is used as a photo-sensitizer for the fabrication of ZnO-based dye-sensitized solar cells (DSSC). Nanostructured ZnO is fabricated on a transparent conducting glass (TCO), using a cost-effective chemical bath deposition technique. Scanning electron microscopic images show hexagonal patterned ZnO nano-towers decorated with several nanosteps. The average length of ZnO nano-tower is 5μm and diameter is 1.2μm. The UV-Vis spectroscopic study of the curcumin dye is used to understand the light absorption behavior as well as band gap energy of the extracted natural dye. The dye shows wider absorption band-groups over 350-470nm and 500-600nm with two peaks positioned at 425nm and 525nm. The optical band gap energy and energy band position of the dye is derived which supports its stability and high electron affinity that makes it suitable for light harvesting and effortless electron transfer from dye to the semiconductor or interface between them. FTIR spectrum of curcumin dye-sensitized ZnO-based DSSC shows the presence of anchoring groups and colouring constitutes. The I-V and P-V curves of the fabricated DSSC are measured under simulated light (100mW/cm²). The highest visible light to electric conversion efficiency of 0.266% (using ITO) and 0.33% (using FTO) is achieved from the curcumin dye-sensitized cell.

Identification of factors associated with treatment refractoriness of oral lesions in pemphigus vulgaris

BACKGROUND

The oral mucosal lesions of patients with pemphigus vulgaris are known to show more treatment refractoriness than skin lesions.

OBJECTIVES

To identify which clinical and laboratory parameters may indicate treatment refractoriness of oral lesions in pemphigus vulgaris.

METHODS

This was a prospective study of 50 adults with pemphigus vulgaris and oral lesions; patients were given treatment appropriate for overall disease severity. Treatment refractoriness was defined arbitrarily as less than 75% reduction in oral objective Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) after treatment for 6 months.

RESULTS

Of 46 patients who completed the study, 17 (37%) were treatment refractory whereas 29 (63%) were treatment responsive. At baseline, the treatment refractory group had a significantly longer mean duration of disease (P = 0·02) and mean duration of oral lesions (P = 0·01), a higher percentage of lesions in the retromolar trigone (P = 0·05) and on the occlusion line along the buccal mucosa (P = 0·04), a higher percentage of deep/crateriform ulcers (P < 0·001) and erosions with a lichenoid hue (P < 0·001). Herpes simplex virus (HSV) DNA positivity, assessed by polymerase chain reaction in oral tissue scrapings (P = 0·02), was also significantly higher in the treatment refractory group. No other factors we tested for were statistically significant.

CONCLUSIONS

Treatment refractoriness of oral lesions was significantly associated with duration of disease/oral lesions; specific morphology and location of oral lesions; and the presence of HSV DNA in the oral cavity. These factors may forewarn the treating physician about a refractory course of oral lesions that may help with counselling patients.

Correlation between salivary and serum anti-desmoglein 1 and 3 antibody titres using ELISA and between anti-desmoglein levels and disease severity in pemphigus vulgaris

ELISA for anti-desmoglein antibodies (Dsg) is commonly used for diagnosis and assessment of treatment response in pemphigus vulgaris (PV). The present study was conducted to assess the relationship between salivary and serum Dsg1 and Dsg3 levels, and whether salivary Dsg1 and Dsg3 levels correlate with clinical disease severity of oral mucosal lesions in PV. In total 43, patients with PV with predominantly mucosal involvement were recruited. Both serum and salivary samples were collected from the cases, and salivary samples were also collected from five controls. There was a statistically significant correlation between serum and salivary Dsg1 levels and between serum and salivary Dsg3 levels. There was no correlation between serum or salivary Dsg1 and Dsg3 levels with the objective component of the oral mucosal Autoimmune Bullous Skin Disorder Intensity Score (ABSIS). Serum Dsg1 levels significantly correlated with cutaneous ABSIS, but there was no correlation between cutaneous ABSIS and either salivary Dsg1, salivary Dsg3 or serum Dsg3. As salivary Dsg titres correlate with serum levels, saliva can serve as a simple and noninvasive alternative to serum for Dsg ELISA.

Magnetoelectric Coupling, Ferroelectricity, and Magnetic Memory Effect in Double Perovskite La3Ni2NbO9

We observe ferroelectricity in an almost unexplored double perovskite La3Ni2NbO9. Ferroelectricity appears below ∼60 K, which is found to be correlated with the significant magnetostriction. A reasonably large value of spontaneous electric polarization is recorded to be ∼260 μC/m(2) at 10 K for E = 5 kV/cm, which decreases signifi- cantly upon application of a magnetic field (H), suggesting considerable magnetoelectric coupling. The dielectric permittivity is also influenced by H below the ferroelectric transition. The magnetodielectric response scales linearly to the squared magnetization, as described by the Ginzburg-Landau theory. Meticulous studies of static and dynamic features of dc magnetization and frequency dependent ac susceptibility results suggest spin-glass state below 29 K. Intrinsic magnetic memory effect is observed from zero-field cooled magnetization and isothermal remanent magnetization studies, also pointing spin-glass state below 29 K. Appearance of ferroelectricity together with a significant magnetoelectric coupling in absence of conventional long-range magnetic order is promising for searching new magnetoelectric materials.

Lipomatous neurofibromas with giant pigmented lesion

Neurofibroma is the most common benign neural tumour. Among the large number of histopathological variants reported, lipomatous neurofibroma is exceedingly infrequent, and shows the presence of intratumoral adipocytes admixed with spindle cells in the dermis. We present a case of a 37-year-old man with lipomatous neurofibromas associated with a giant garment-like pigmented lesion involving his lower trunk and right thigh.

Bandgap engineering through nanocrystalline magnetic alloy grafting on reduced graphene oxide

Grafting of nanocrystalline Co₈₀Ni₂₀on reduced graphene oxide causes a significantly large moment (1.2μ_B), ∼10 times localization of conductivity and significant magnetoconductance of hybrid-materials, which is promising toward spintronic applications.

Corrective role of Eugenia jambolana on testicular impairment in streptozotocin-induced diabetic male albino rat: an approach through genomic and proteomic study

The present study was conducted to explore the effect of ethyl acetate fraction of hydro-methanolic (40 : 60) extract of seed of Eugenia jambolana on testicular impairment in diabetic rats. In this respect, biomarkers of oxidative stress, genomics and proteomics in testicular tissue were assessed. Side by side, glycated haemoglobin, serum testosterone, activities of glutamate oxaloacetate transaminase and glutamate pyruvate transaminase in serum, epididymal sperm count including reproductive organosomatic indices were evaluated. Results indicate that a significant recovery (P < 0.05) in the levels of these parameters in fraction-treated diabetic group in comparison with diabetic control. A significant recovery was noted (P < 0.05) in the expression of Bax and Bcl-2 gene towards the control after the treatment of said fraction. Histological study also focused a significant recovery (P < 0.05) in the number of different generation of germ cells at stage VII of spermatogenesis in fraction-treated diabetic group. The said fraction treatment to diabetic rat can recover the activities of serum glutamate oxaloacetate transaminase and glutamate pyruvate transaminase significantly towards the control (P < 0.05). Finally, it may be concluded that ethyl acetate fraction of seed of E. jambolana has a promiseable remedial effect on diabetes-induced testicular dysfunctions in male rat without inducing any metabolic toxicity.

Evaluation of Nutritional Status by Mid-Upper Arm Circumference Amongst Affluent Children

Introduction: Anthropometry is widely accepted as low-cost technique for defining the nutritional status of children. The mid upper arm circumference (MUAC) is a fast screening method in detecting acute malnutrition and it is also a predictor of childhood mortality. Materials and Methods: This is the retrospective study to evaluate the nutritional status based on mid upper arm circumference (MUAC) among urban, pre-school age children. A total of 1060 children, aged 1 to 3 years, attending the vaccination clinic of the Indian Red Cross Society Paschim Medinipur Hospital over a two years period, were enrolled in the study. The measurement of MUAC (in centimetres) was taken by the standard technique. Undernutrition was defined based on age and sex-specific MUAC cut-off values as recommended by the World Health Organization (WHO). Results: Boys were higher level of mean MUAC than girls at all ages and there was no significant sex differences. The age-combined rate of overall undernutrition was 18.96% and it was slightly higher among the boys (19.38%) than girls (18.46%). The age-combined moderate undernutrition was higher among the boys (16.08% vs 14.11%) but girls’ value was higher in case of severe undernutrition (3.28% vs 4.35%). Conclusion: The present study showed that a remarkable number of pre-schooler was undernourished based on MUAC. J. Nepal Paediatr. Soc. 32(2) 2012 113-116 doi: http://dx.doi.org/10.3126/jnps.v32i2.5689

Methotrexate for treatment of lichen planus: old drug, new indication

Treatment of generalized lichen planus is often disappointing and is associated with relapses. Though reports have suggested a beneficial role of various immunosuppressive and immunomodulatory agents, most of these reports are retrospective series or anecdotes. Oral methotrexate has been found to be useful in recent studies. In this study, we prospectively evaluated the role of low-dose oral methotrexate (15 mg/week in adults or 0.25 mg/kg/week for children) in generalized lichen planus. Mean improvement in 24 evaluated patients (two of them were of paediatric age group) at the end of 14 weeks of treatment was 79%. By the end of 24 weeks treatment, 14 of 24 (58%) patients had complete remission of their disease. Side effects were observed in 12 of 24 (50%) patients. Most of these adverse effects were mild; only one requiring treatment discontinuation due to significantly deranged liver function test. During post-treatment follow-up of 3 months, none had relapse of lichen planus. Overall, low- dose methotrexate is effective and reasonably safe option in treatment of eruptive lichen planus, provided haematological and biochemical parameters are regularly monitored.

Peripheral type of primitive neuroectodermal tumour arising from the left orbital floor

Primitive neuroectodermal tumours (PNETs) are rare tumours that originate from primitive neural crest cells. They are usually found in children below ten years of age. Peripheral PNETs (pPNETs) occur in soft tissues of the body, but have the same genetic changes as Ewing's sarcoma of the bone (now called soft tissue Ewing's sarcoma). They commonly present in the thoracopulmonary region, abdomen, pelvis and the extremities. The head and neck regions may also be involved. Our case demonstrates a PNET in the peripheral tissue arising from the left orbital floor and spreading locally to involve the left maxillofacial region, cheek and gum. The incidence of pPNETs is likely to be under-reported in the literature. Recent diagnostic advances, including cytogenetic and immunohistochemical analysis, have allowed these tumours to be distinguished from other small, poorly differentiated round cell tumours such as rhabdomyosarcoma, lymphoma and poorly differentiated synovial sarcoma.

Analysis of the optimal cut-point for HIV-p24 antigen testing to diagnose HIV infection in HIV-exposed children from resource-constrained settings

BACKGROUND

Nucleic-acid-testing (NAT) to diagnose HIV infection in children under age 18 months provides a barrier to HIV-testing in exposed children from resource-constrained settings. The ultrasensitive HIV-p24-antigen (Up24) assay is cheaper and easier to perform and is sensitive (84-98%) and specific (98-100%). The cut-point optical density (OD) selected for discriminating between positive and negative samples may need assessment due to regional differences in mother-to-child HIV-transmission rates.

OBJECTIVES

We used receiver operator characteristics (ROC) curves and logistic regression analyses to assess the effect of various cut-points on the diagnostic performance of Up24 for HIV-infection status among HIV-exposed children. Positive and negative predictive values at different rates of disease prevalence were also estimated.

STUDY DESIGN

A study of Up24 testing on dried blood spot (DBS) samples collected from 278 HIV-exposed Haitian children, 3-24-months of age, in whom HIV-infection status was determined by NAT on the same DBS card.

RESULTS

The sensitivity and specificity of Up24 varied by the cut-point-OD value selected. At a cut-point-OD of 8-fold the standard deviation of the negative control (NCSD), sensitivity and specificity of Up24 were maximized [87.8% (95% CI, 83.9-91.6) and 92% (95% CI, 88.8-95.2), respectively]. In lower prevalence settings (5%), positive and negative predictive values of Up24 were maximal (75.9% and 98.8%, respectively) at a cut-point-OD that was 15-fold the NCSD.

CONCLUSIONS

In low prevalence settings, a high degree of specificity can be achieved with Up24 testing of HIV-exposed children when a higher cut-point OD is used; a feature that may facilitate more frequent use of Up24 antigen testing for HIV-exposed children.