Fluid Overload and AKI After the Norwood Operation: The Correlation and Characterization of Routine Clinical Markers

The purpose of this study was to determine the correlation of different methods of assessing fluid overload and determine which metrics are associated with development of acute kidney injury (AKI) in the period immediately following Norwood palliation. This was a retrospective single-center study of Norwood patients from January 2011 through January 2021. AKI was defined using the Kidney Disease Improving Global Outcomes (KDIGO). Patients were separated into two groups: those with AKI and those without. A logistic regression analysis was conducted with AKI at any point in the study period as the dependent variable and clinical and laboratory data as independent variables. Analysis was conducted as a stepwise regression. The coefficients from the logistic regression were then used to develop a cumulative AKI risk score. Spearman correlations were conducted to analyze the correlation of fluid markers. 116 patients were included, and 49 (42.4%) developed AKI. The duration of open chest, duration of mechanical ventilation, need for dialysis, need for extracorporeal membrane oxygenation, and inpatient mortality were associated with AKI (p ≤ 0.05). Stepwise logistic regression demonstrated the following significant independent associations AKI: age at Norwood in days (p < 0.01), blood urea nitrogen (p < 0.01), central venous pressure (p = 0.04), and renal oxygen extraction ratio (p < 0.01). The area under the receiver operating characteristic curve for the logistic regression was 0.74. The fluid markers had weak R-value. Urea, central venous pressure, and renal oxygen extraction ratio are associated with AKI after the Norwood operation. Common clinical metrics used to assess fluid overload are poorly correlated with each other for postoperative Norwood patients.

Oral Dextrose gel use in asymptomatic hypoglycemic newborns decreases NICU admissions and parenteral dextrose therapy: A retrospective study

BACKGROUND

Neonatal hypoglycemia is one of the most common causes of admission to neonatal intensive care unit requiring intravenous dextrose therapy. Administration of IV dextrose and transfer to the NICU may interfere with parent-infant bonding, breastfeeding, and has financial implications.

OBJECTIVE

Retrospective study to evaluate the effect of dextrose gel supplementation for asymptomatic hypoglycemia in reducing NICU admissions and intravenous dextrose therapy.

METHOD

A retrospective study conducted for eight months each before and after introduction of dextrose gel in the management of asymptomatic neonatal hypoglycemia. Asymptomatic hypoglycemic infants were given only feeds in pre dextrose gel period and dextrose gel along with feeds in the dextrose gel period. Rates of admission to NICU and the need of IV dextrose therapy were evaluated.

RESULTS

High risk characteristics (Prematurity, Large for Gestational Age, small for Gestational Age, Infants of diabetic mother etc.) were equally distributed among both the cohorts. Primary outcome results showed significant reduction in NICU admissions from 396/1801(22%) to 329/1783 (18.5%) (odds ratio, 95% CI 1.24(1.05-1.46, p 0.008). There was significant reduction in IV dextrose therapy requirement from 277/1405 (15.4%) to 182/1454 (10.2%) (odds ratio, 95% CI 1.59(1.31- 1.95, p <  0.001).Babies discharged on predominant breast feeding showed significant improvement from 237/396(59.8%) in the pre dextrose gel period to 240/329 (72.9%) (odds ratio, 95% CI 0.82(0.73-0.90, p <  0.001) in dextrose gel period.

CONCLUSIONS

Dextrose gel supplementation with feeds reduced NICU admissions, the need for parenteral dextrose therapy, avoided maternal separation and promoted breastfeeding.

Implementing FCTC Article 17 Through Participatory Research With Bidi Workers in Tamil Nadu, India

INTRODUCTION

The exploitation, poor conditions, and precarity in the bidi (hand-rolled leaf cigarette) industry in India make it ripe for the application of the FCTC's Article 17, "Provision of support for economically viable alternative activities". "Bottom-up", participatory approaches give scope to explore bidi rollers' own circumstances, experiences, and aspirations.

METHODS

A team of six community health volunteers using a participatory research orientation developed a questionnaire-based semi-structured interview tool. Forty-six bidi rolling women were interviewed by pairs of volunteers in two northern Tamil Nadu cities. Two follow-up focus groups were also held. A panel of 11 bidi rollers attended a workshop at which the findings from the interviews and focus groups were presented, further significant points were made and possible alternatives to bidi rolling were discussed.

RESULTS

Bidi workers are aware of the adverse impact of their occupation on them and their families, as well as the major risks posed by the product itself for the health of consumers. However, they need alternative livelihoods that offer equivalent remuneration, convenience, and (in some cases) dignity. Alternative livelihoods, and campaigns for better rights for bidi workers while they remain in the industry, serve to undercut industry arguments against tobacco control. Responses need to be diverse and specific to local situations, i.e. "bottom-up" as much as "top-down", which can make the issue of scaling up problematic.

CONCLUSION

Participatory approaches involving bidi workers themselves in discussions about their circumstances and aspirations have opened up new possibilities for alternative livelihoods to tobacco.

IMPLICATIONS

Progress with the FCTC's Article 17 has generally been slow and has focussed on tobacco cultivation rather than later stages in the production process. The bidi industry in India is ripe for the application of an alternative livelihoods approach. This study is one of the first to use participatory methods to investigate the circumstances, experiences, and aspirations of bidi workers themselves.

The Effect of Aminophylline on Urine Output and Fluid Balance after a Single Dose in Children Admitted to the Pediatric Cardiac Intensive Care Unit

The purpose of this retrospective study was to investigate the effects of a single dose of aminophylline on urine output and fluid balance in children admitted to the cardiac intensive care unit. A retrospective study was performed to compare variables of interest before and 24 hours after aminophylline administration in children under the age of 18 years who were admitted to the cardiac intensive care unit at our institution from January 2011 onwards. Variables of interest included age, weight, aminophylline dose, concurrently administered diuretics, specific hemodynamic parameters, and blood urea nitrogen and creatinine levels. Variables such as urine output and fluid balance were measured through a binary endpoint. Data were compared in a paired fashion and continuous variables were compared through paired t-tests. Analyses were conducted using SPSS Version 23.0. A total of 14 patients were included in the study. There was no significant change in hemodynamic parameters or creatinine levels before and after intravenous aminophylline administration of 5 mg/kg. There was a significant difference in urine output, fluid balance, and blood urea nitrogen levels from the baseline value. Concurrent usage of diuretics did not show significant association with a difference in urine output or fluid balance from baseline. No significant adverse reactions were noted 24 hours after administration of aminophylline. Use of aminophylline dosed at 5 mg/kg is safe and leads to improvement in urine output and fluid balance without negatively impacting systemic oxygen delivery or renal filtration function.

Rhizoctonia solani Kühn Pathophysiology: Status and Prospects of Sheath Blight Disease Management in Rice

Sheath blight caused by necrotrophic fungus Rhizoctonia solani Kühn is one of the most serious diseases of rice. Use of high yielding semi dwarf cultivars with dense planting and high dose of nitrogenous fertilizers accentuates the incidence of sheath blight in rice. Its diverse host range and ability to remain dormant under unfavorable conditions make the pathogen more difficult to manage. As there are no sources of complete resistance, management through chemical control has been the most adopted method for sheath blight management. In this review, we provide an up-to-date comprehensive description of host-pathogen interactions, various control measures such as cultural, chemical, and biological as well as utilizing host plant resistance. The section on utilizing host plant resistance includes identification of resistant sources, mapping QTLs and their validation, identification of candidate gene(s) and their introgression through marker-assisted selection. Advances and prospects of sheath blight management through biotechnological approaches such as overexpression of genes and gene silencing for transgenic development against R. solani are also discussed.

Inhibition of Complement Factor 3 in Geographic Atrophy with NGM621: Phase 1 Dose-Escalation Study Results

PURPOSE

To evaluate the safety and tolerability of single and multiple intravitreal injections of NGM621 in patients with geographic atrophy (GA) and to characterize the pharmacokinetics and immunogenic potential.

DESIGN

Multicenter, open-label, single- and multiple-dose phase 1 study.

METHODS

Fifteen patients enrolled at 4 sites in the United States. Participants had GA secondary to age-related macular degeneration, lesion size ≥2.5 mm², best-corrected visual acuity of 4 to 54 letters (20/80 to 20/800 Snellen equivalent) in the study eye, and no history of choroidal neovascularization in either eye. Patients who met eligibility criteria were treated in a single ascending-dose phase (2 mg, 7.5 mg, and 15 mg) or received 2 doses of NGM621 (15 mg) 4 weeks apart in the multidose phase and were monitored for 12 weeks (85 days). Assessments included adverse events, best-corrected visual acuity, low-luminance visual acuity, vital signs, clinical laboratory evaluations, GA lesion area as measured by fundus autofluorescence, spectral domain optical coherence tomography, and pharmacokinetic, immunogenicity, and pharmacodynamic assessments.

RESULTS

All 15 participants completed the 12-week study. There were no serious adverse events, no drug-related adverse events, and no choroidal neovascularization developed in either eye. Mean visual acuity and GA lesion area appeared stable through week 12 for all cohorts. Pharmacokinetic analyses indicated that NGM621 serum exposures appeared to be dose proportional, and no antidrug antibodies were identified at any of the evaluated time points.

CONCLUSIONS

In this small, open-labeled, 12-week phase 1 study, NGM621 was safe and tolerable when administered intravitreally up to 15 mg.<END ABSTRACT>.

Antibody semorinemab reduces tau pathology in a transgenic mouse model and engages tau in patients with Alzheimer's disease

Tau has become an attractive alternative target for passive immunotherapy efforts for Alzheimer's disease (AD). The anatomical distribution and extent of tau pathology correlate with disease course and severity better than other disease markers to date. We describe here the generation, preclinical characterization, and phase 1 clinical characterization of semorinemab, a humanized anti-tau monoclonal antibody with an immunoglobulin G4 (igG4) isotype backbone. Semorinemab binds all six human tau isoforms and protects neurons against tau oligomer neurotoxicity in cocultures of neurons and microglia. In addition, when administered intraperitoneally once weekly for 13 weeks, murine versions of semorinemab reduced the accumulation of tau pathology in a transgenic mouse model of tauopathy, independent of antibody effector function status. Semorinemab also showed clear evidence of target engagement in vivo, with increases in systemic tau concentrations observed in tau transgenic mice, nonhuman primates, and humans. Higher concentrations of systemic tau were observed after dosing in AD participants compared to healthy control participants. No concerning safety signals were observed in the phase 1 clinical trial at single doses up to 16,800 mg and multiple doses totaling 33,600 mg in a month.

Use of Fenoldopam in Children with Congenital Heart Disease to Decrease Fluid Balance: A Retrospective, Descriptive Study and Insights into Predictors of Decreased Fluid Balance

This retrospective study aimed to determine if fenoldopam is associated with a decrease in fluid balance and to define the factors that may promote this in children with a history of congenital heart disease at the cardiac intensive care unit (CICU). Patients cared from January 2014 to December 2018 in the CICU were reviewed, and those on fenoldopam infusion were identified. Patient cohort data included demographics, clinical information, laboratory results, hemodynamic and urine output measurements, and information regarding fenoldopam infusion were compared between those with and without decrease in fluid balance. Forty-six patients were identified. Patients received a starting dose of fenoldopam of 0.2 mcg/kg/h, a maximum dose of 0.3 mcg/kg/h, and duration of 64 hours. Over the 4-hour study period, statistically significant change was noted in systolic pressure (decrease of 5.4%; p < 0.001), diastolic pressure (decrease of 3.5%; p = 0.01), fluid balance, and urine output (decrease of 1.3%; p = 0.027). In the cohort, 34 patients (74%) had a decrease in fluid balance, 18 (39%) had an increase in urine output, and 25 (54%) had a decrease in fluid input after the initiation of fenoldopam. Patients that had a decrease in fluid balance tended to have a higher blood urea nitrogen level at the time of fenoldopam initiation. Fenoldopam was associated with decrease in fluid balance and fluid input, but not associated with an increase in urine output. The identification of factors that can decrease fluid balance may help identify those patients who can be benefited with this treatment.

FRI0061 THE ADVERSE OBSTETRIC OUTCOMES WHEN RHEUMATOID ARTHRITIS IS CONTROLLED DURING PREGNANCY: IS THE DISEASE ITSELF A PROBLEM? DATA FROM A CASE-CONTROL COHORT OF 190 PREGNANCIES AT A MULTI-NATIONALITY SPECIALIZED CENTER IN QATAR

Background:

Rheumatoid arthritis is implicated in causing adverse pregnancy outcomes including high rates of prematurity and low birth weight. But little is known about the impact of the disease when it’s controlled as most of the information is extracted from retrospective data.

Objectives:

To examine the adverse obstetric outcomes after controlling disease during pregnancy. We also took into account many confounders that might affect the outcome.

Methods:

This is an ongoing Case-Control Prospective Cohort. It is implemented in a tertiary center where cases are recruited from a single specialized pregnancy and rheumatic disease clinic to ensure standardized management. These cases were fulfilling the ACR 2010 classification criteria for rheumatoid arthritis. Disease activity was measured using CDAI once before pregnancy and once in each trimester. We excluded subjects with chronic morbidities or twin pregnancy. Data were collected in pre-specified data sheets. Routine blood tests in addition to C-reactive protein were obtained. Cases were recruited at different disease activity stages, but treatment was escalated to reach remission as possible by the third trimester. Data were analyzed using SPSS software for descriptive and comparative analyses.

Results:

Since 2017 we have recruited 215 subjects. A total of 190 completed pregnancies were analyzed in this report (114 controls and 76 cases). Five subjects were excluded as their disease was not controlled by 27 weeks of gestation. Baseline characteristics of age, baseline BMI and anemia were similar. Exposure to passive smoking was significantly higher in the control group. There was no statistical difference in the incidence of gestational diabetes, pre-eclampsia and infections. Rates of abortions and cesarean sections were significantly higher in the cases group. The incidence of PROM & low birth weight was not statistically different. Three cases of IUFD were reported among controls versus none in the cases (Table 1). Prematurity rate was numerically higher in the control group but did not reach a statistical difference. Congenital anomalies and NICU admission rates were comparable between the groups. But the incidence of neonatal morbidities was significantly higher in the control group (p. value 0.006), but the majority of morbidities were due to jaundice that resolved with phototherapy. we have evaluated the incidence of group B streptococcal Agalactae as a possible contributor to morbidities but it was similar between the groups. All cases were on DMARDs during pregnancy. Hydroxychloroquine was the most commonly used (55%) followed by sulfasalazine (40%). Steroid was used for variable duration in pregnancy in 23 cases. In most of them, it was tapered and stopped by the end of pregnancy. Biologics were used in 15 cases with few adverse outcomes including: abortion (1 case), PROM (1), maternal UTI (1), repeated URT infection (1) and neonatal bronchiolitis (1).

Table 1.

Birth Outcomes

Birth OutcomeCases (n)Controls (n)P.valueAbortion910.001IUFD030.18PROM180.09Cesarean20170.02LBW680.68Premature8250.74

Conclusion:

From this ongoing cohort we conclude that controlled RA during pregnancy carries low risk of adverse obstetric outcomes in spite the regular use of DMARDs. Although these results are reassuring, further regression models are required after recruiting more subjects.

References:

[1]Johanna M. W. Hazes. (2011). Rheumatoid arthritis and pregnancy: evolution of disease activity and pathophysiological considerations for drug use.Rheumatology, 50:1955-1968

Disclosure of Interests:

None declared

Two infants with bilateral renal agenesis who were bridged by chronic peritoneal dialysis to kidney transplantation

Bilateral renal agenesis is associated with severe oligohydramnios and was considered incompatible with postnatal life due to severe pulmonary hypoplasia. The use of renal replacement therapy was limited by significant morbidity and mortality associated with dialysis in very young infants with major pulmonary pathology. In the United States, there is a tremendous controversy about whether or not the use of prenatal amniotic fluid infusions provides a benefit to fetuses with bilateral renal agenesis. One of the critical issues identified is that there are, as yet, no children reported who had achieved long-term survival. Previous reports all indicated these children died shortly after birth or after unsuccessful peritoneal dialysis. We present two infants with a prenatal diagnosis of bilateral renal agenesis whose mothers elected to undergo prenatal amnioinfusions. One was born at 28 weeks with a birthweight of 1230 g and the other born at 34 weeks with a birthweight of 1940 g. We present the details of both cases, with initial management on chronic peritoneal dialysis, which started shortly after birth, as a bridge to living related kidney transplants.

Sodium chloride incites reactive oxygen species in green algae Chlorococcum humicola and Chlorella vulgaris: Implication on lipid synthesis, mineral nutrients and antioxidant system

In the present study, microalgae Chlorococcum humicola and Chlorella vulgaris were grown in different concentrations of NaCl (25-1000 mM) to elucidate its impact on morphology, lipid synthesis, minerals status and antioxidative responses. Scanning Electron microscopy showed distorted cell morphology and increased cell size by 33.52% (C. humicola) and 27.79% (C. vulgaris) at 100 mM NaCl. Energy Dispersive Spectroscopy data revealed reduction in mineral contents (C, S, Fe, Mg, Si, Mn and Zn) by 14-54% in both algae. Further, C. humicola was found to have high lipid content than C. vulgaris under NaCl regime. The activities of superoxide dismutase, catalase and glutathione reductase were increased by 2.5-5 folds in both algae as compared to control. The increased level of ascorbate, cysteine and proline in both algae indicated tolerance against salinity. Thus, C. humicola and C. vulgaris may exhibit dual benefits viz., high lipid production and reclamation of sodic soil.

Prospects and applications near ferroelectric quantum phase transitions: a key issues review

The emergence of complex and fascinating states of quantum matter in the neighborhood of zero temperature phase transitions suggests that such quantum phenomena should be studied in a variety of settings. Advanced technologies of the future may be fabricated from materials where the cooperative behavior of charge, spin and current can be manipulated at cryogenic temperatures. The progagating lattice dynamics of displacive ferroelectrics make them appealing for the study of quantum critical phenomena that is characterized by both space- and time-dependent quantities. In this key issues article we aim to provide a self-contained overview of ferroelectrics near quantum phase transitions. Unlike most magnetic cases, the ferroelectric quantum critical point can be tuned experimentally to reside at, above or below its upper critical dimension; this feature allows for detailed interplay between experiment and theory using both scaling and self-consistent field models. Empirically the sensitivity of the ferroelectric T _c's to external and to chemical pressure gives practical access to a broad range of temperature behavior over several hundreds of Kelvin. Additional degrees of freedom like charge and spin can be added and characterized systematically. Satellite memories, electrocaloric cooling and low-loss phased-array radar are among possible applications of low-temperature ferroelectrics. We end with open questions for future research that include textured polarization states and unusual forms of superconductivity that remain to be understood theoretically.

A radio counterpart to a neutron star merger

Gravitational waves have been detected from a binary neutron star merger event, GW170817. The detection of electromagnetic radiation from the same source has shown that the merger occurred in the outskirts of the galaxy NGC 4993, at a distance of 40 megaparsecs from Earth. We report the detection of a counterpart radio source that appears 16 days after the event, allowing us to diagnose the energetics and environment of the merger. The observed radio emission can be explained by either a collimated ultrarelativistic jet, viewed off-axis, or a cocoon of mildly relativistic ejecta. Within 100 days of the merger, the radio light curves will enable observers to distinguish between these models, and the angular velocity and geometry of the debris will be directly measurable by very long baseline interferometry.

Brain Studded with Innumerable Larger Stones: Starry Sky at Night Appearance: Multiple Calcified Giant Tuberculoma with 15 Years of Follow-up

Tuberculosis is rapidly reemerging as a major health problem due to rising incidence of HIV cases across the globe. Central nervous system involvement is rare, but rarely multiple intracerebral granulomas can occur or occasional solitary tuberculoma also develops. The authors report a unique case of 24-year-old woman suffering from pulmonary tuberculosis developed headache and vomiting. Cranial CT scan revealed multiple widespread deposit of intracranial granuloma of sizeable lesion mimicking starry sky at night appearance. Excision of one tuberculoma was done for confirmation of definitive diagnosis, and histopathology was suggestive of tuberculoma. The patient also underwent VP shunt surgery. At last follow-up at 15 years following surgery, she was doing well.

Pharmacokinetics and safety of vismodegib in patients with advanced solid malignancies and hepatic impairment

PURPOSE

Vismodegib is a Hedgehog pathway inhibitor approved for the treatment of advanced basal cell carcinoma. Currently, the pharmacokinetics (PK) and safety of vismodegib in patients with hepatic dysfunction are unknown and are the objective of this study.

METHODS

Patients with advanced solid malignancies and hepatic impairment were enrolled into one of four cohorts: normal [bilirubin (bili) < upper limit of normal (ULN)], mild (ULN < bili ≤ 1.5 × ULN), moderate (1.5 × ULN < bili ≤ 3×ULN), and severe (3 × ULN < bili < 10 × ULN) dysfunction. Patients received oral vismodegib 150 mg daily. Plasma PK samples on days 1, 3, 5, and 8 were collected. Vismodegib therapy was continued until disease progression, intolerable toxicity, or withdrawal of consent.

RESULTS

Thirty-one patients were accrued: nine normal, eight mild, eight moderate, and six severe. Four patients experienced dose-limiting toxicity of hyperbilirubinemia on study: one in the moderate cohort and three in the severe cohort. Six patients died within 30 days after the last dose of vismodegib. All deaths were attributed to disease progression. Observed maximal and average steady-state concentrations and AUC of vismodegib at steady state (day 8) were similar across cohorts. Average AAG concentrations in patients with hepatic impairment were comparable to those of patients with normal hepatic function.

CONCLUSIONS

Hepatic impairment does not appear to impact vismodegib PK, and therefore, dose adjustment is not necessary in this special population. The study was influenced by the high number of patients with hepatocellular carcinoma with advanced cirrhosis; rendering it difficult to draw any causal relationships between vismodegib exposure and the serious adverse events.

Systematic risk assessment in a mother-baby unit (MBU)–Importance for maternal and infant safety

Introduction

Systematic assessment of risks is an essential component of care in psychiatric mother baby units. Self-harm, infant neglect and harm or the vulnerable physical health of both mother and infant may all pose risks.

Aim

Development of a risk assessment tool and risk assessment among mother-infant dyads at a MBU in Bangalore, India.

Methods

Based on data from 200 admissions, doctors and nurses of the unit developed a 15-item tool for risk assessment. Risk was assessed by both nurses and doctors among 58 consecutive mothers admitted to the unit. Risk domains included risks to self, to infant, related to infant health and feeding and violence faced by mother. Frequencies of various risks were calculated. Nurses’ risk assessments were compared to the residents’ risk assessments.

Results

The mean age of the mothers was 25 (±4) years, age of infant 4 (±4) months and duration of episode was 4 (±14) months. Diagnoses included acute polymorphic psychosis (30%), BPAD (27%) and depression (21%). 47% had high suicidal risk and 28% had made an attempt in the current episode. 22% had expressed ideas of infant harm and 24% had physically harmed the infant. 48% of mothers had been physically violent. Multiple risks were seen in 47%. Doctors were able to identify risks more often than nurses.

Conclusion

Risks for self-harm, infant harm and related to infant health were high. Systematic risk assessment by both nurses and doctors is important in an MBU to ensure adequate care for the mother infant dyad.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

159 IN VITRO DEVELOPMENT OF CAPRINE EMBRYO USING CRYOPRESERVED BLACK BENGAL BUCK SEMEN

The purpose of this study was to check the competence of cryopreserved black Bengal buck semen to produce goat embryo through IVF. So far, cryopreserved black Bengal buck semen has not been used to produce goat embryos by IVF. For the study, fresh goat oviducts and ovaries were collected from slaughterhouse in a thermo flask containing 0.9% saline solution supplemented with antibiotic (400 IU mL−1 penicillin and 500 mg mL−1 streptomycin) at 30–35°C and transported to laboratory within 2–3 h of slaughter. Cumulus-oocyte complexes were collected from slaughterhouse ovaries, washed 5–6 times, and cultured in maturation media (TCM-199 + 10% FBS + 10 mg mL−1 FSH-P + 0.81 mM sodium pyruvate + 5% follicular fluid + 50 mg mL−1 gentamicin sulfate + 1 μg mL−1 oestradiol + 100 μM cysteamine) for 27 h in a 5% CO2 incubator at 38.5°C with maximum humidity. After 27 h of culture, cumulus cells were separated from matured oocytes by repeated pipetting using a fine pipette in fertilization Bracket and Oliphant’s (BO) medium. After removal of cumulus cells, the oocytes were transferred to acidified Tyrode’s medium for zona thinning for 52 s and were co-incubated with capacitated sperms for fertilization in fertilization BO medium at 38.5°C in 5% CO2 in air with maximum humidity. In the experiment I, freshly collected buck semen was used for IVF after processing for capacitation. In experiment II, cryopreserved buck semen straws were thawed and sperm were capacitated in vitro and used for fertilization. After 5 h of co-incubation, presumptive zygotes were washed thoroughly and cultured in embryo development medium for cleavage. Three different in vitro development media (RVCL, mSOF + 2.5% BSA, and KSOM + 0.5% BSA) were used. After 40 to 42 h, cleavage was observed and embryos were co-incubated with oviducal cells in replacement media for further development. In the fresh group, overall cleavage rates (%) were 37.76 ± 2.98, 39.60 ± 1.75, 29.01 ± 1.74 and morula formation rates (%) were 7.72 ± 3.38, 6.03 ± 1.29, 3.00 ± 3.00 in RVCL, mSOF, and KSOM media, respectively. However, in the cryopreserved group the overall cleavage rates (%) were 29.17 ± 2.56, 27.70 ± 2.31, and 24.17 ± 1.44 in RVCL, mSOF, and KSOM media, respectively, and morula formation (%) was achieved 2.93 ± 0.97 in RVCL media. These results indicate that cryopreserved black Bengal buck semen have competence to produce embryos and could be used for embryo development through IVF.

New Delhi metallo-β-lactamase and extended spectrum β-lactamases co-producing isolates are high in community-acquired urinary infections in Assam as detected by a novel multiplex polymerase chain reaction assay

BACKGROUND

The ability of microorganisms to evade antibiotic pressure is challenging in healthcare as patients have little or no drug treatment options. Detection of the prevalence of antibacterial resistance pattern helps towards improved antibiotic policy and empirical treatment.

OBJECTIVES

We carried out antibiogram profiling and documented the prevalence and co-prevalence of New Delhi metallo-β-lactamase (NDM) and extended spectrum β-lactamases (ESBL) encoding genes in urinary Escherichia coli and Klebsiella pneumonia isolates.

MATERIALS AND METHODS

Antibiotic susceptibilities were tested for 241 isolates of E. coli and K. pneumoniae from urine samples collected from out- and hospitalised patients. Polymerase chain reaction (PCR) was carried out on isolates tested positive for phenotypic production of metallo-β-lactamase and ESBL. A multiplex PCR assay was designed to detect the genes.

RESULTS

Multiplex PCR assay designed had a limit of detection of 10 3 CFU/mL in vitro. NDM detected was significantly higher among K. pneumoniae compared to E. coli (69.2% vs. 18.2%; P = 0.001). Of 17, 14 NDM positive isolates also harboured ESBL genes. The co-production of CTX-M + TEM + NDM (3/9; 33.3% and 5/8; 62.5%) was most common in K. pneumoniae and E. coli, respectively while CTX-M + TEM + SHV + NDM was found in one isolate. Of the 156 phenotypically ESBL producing isolates, CTX-M, TEM and SHV was detected by PCR in 85, 53 and 24 isolates, respectively.

CONCLUSION

NDM and ESBL co-producing isolates were both community (64.7%) and hospital (35.29%) acquired among E. coli. Antibiotic resistance can be effectively evaluated by a cost and time effective molecular method, such as the multiplex PCR used in this study, which complement culture and sensitivity tests.

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016

[This corrects the article DOI: 10.1186/s13054-016-1208-6.].

Pharmacodynamic and Pharmacokinetic Profiles of Sacubitril/Valsartan (LCZ696) in Patients with Heart Failure and Reduced Ejection Fraction

AIMS

Concomitant renin-angiotensin-aldosterone system blockade and natriuretic peptide system enhancement may provide unique therapeutic benefits to patients with heart failure and reduced ejection fraction (HFrEF). This study assessed the pharmacodynamics and pharmacokinetics of LCZ696 in patients with HFrEF.

METHODS

This was an open-label, noncontrolled single-sequence study. After a 24-h run-in period, patients (n = 30) with HFrEF (EF ≤ 40%; NYHA class II-IV) received LCZ696 100 mg twice daily (bid) for 7 days and 200 mg bid for 14 days, along with standard treatment for heart failure (HF) (except angiotensin-converting enzyme inhibitors [ACEIs] or angiotensin receptor blockers [ARBs]).

RESULTS

On Day 21, significant increases were observed in the plasma biomarkers indicative of neprilysin and RAAS inhibition (ratio-to-baseline: cyclic guanosine monophosphate [cGMP], 1.38; renin concentration and activity, 3.50 and 2.27, respectively; all, P < 0.05). Plasma NT-proBNP levels significantly decreased at all the time points on Days 7 and 21; plasma aldosterone and endothelin-1 levels significantly decreased on Day 21 (all, P < 0.05). Following administration of LCZ696, the Cmax of sacubitril (neprilysin inhibitor prodrug), LBQ657 (active neprilysin inhibitor), and valsartan were reached within 0.5, 2.5, and 2 h. Between 100- and 200-mg doses, the Cmax and AUC0-12 h for sacubitril and LBQ657 were approximately dose-proportional while that of valsartan was less than dose-proportional.

CONCLUSIONS

Treatment with LCZ696 for 21 days was well tolerated and resulted in plasma biomarker changes indicative of neprilysin and RAAS inhibition in patients with HF. The pharmacokinetic exposure of the LCZ696 analytes in patients with HF observed in this study is comparable to that observed in the pivotal Phase III study.

A clinical drug-drug interaction study to evaluate the effect of a proton-pump inhibitor, a combined P-glycoprotein/cytochrome 450 enzyme (CYP)3A4 inhibitor, and a CYP2C9 inhibitor on the pharmacokinetics of vismodegib

PURPOSE

The Hedgehog pathway inhibitor vismodegib exhibits pH-dependent solubility, and in vitro studies have shown that vismodegib is a substrate of P-glycoprotein (P-gp) and is metabolized by cytochrome P450 (CYP) 2C9 and 3A4. The objective of this four-arm parallel study in healthy subjects was to evaluate the effect of the proton-pump inhibitor rabeprazole, the P-gp/CYP3A4 inhibitor itraconazole, and the CYP2C9 and 3A4 inhibitor fluconazole on vismodegib steady-state pharmacokinetics.

METHODS

Cohorts included a control arm (n = 22), in which vismodegib 150 mg was administered once daily (QD) for 7 days, and 3 arms in which vismodegib was co-administered QD for 7 days with rabeprazole 20 mg (including a 4-day lead-in; n = 24); itraconazole 200 mg (n = 22); or fluconazole 400 mg (n = 22).

RESULTS

Area under the vismodegib concentration-time curve from zero to 24 h (AUC0-24h) at steady state was lower with concomitant rabeprazole administration relative to vismodegib alone [geometric mean ratio (GMR), 86.2 (associated 90 % confidence interval [CI], 76.1, 97.7)]. There was no effect of itraconazole on steady-state exposure of vismodegib [GMR, 96.4 (90 % CI 84.9, 109.6)]. Co-administration with fluconazole increased vismodegib steady-state AUC0-24h [GMR, 130.9 (90 % CI 115.2, 148.7)]. Co-administration of rabeprazole, itraconazole, and fluconazole had similar effects on the exposure of unbound vismodegib and total vismodegib.

CONCLUSION

The results of this study suggest that vismodegib can be administered with acid-reducing agents and P-gp and CYP inhibitors without the risk of a clinically meaningful pharmacokinetic drug-drug interaction. CLINICALTRIALS.

GOV IDENTIFIER

NCT01772290.

The host galaxy of a fast radio burst

In recent years, millisecond-duration radio signals originating in distant galaxies appear to have been discovered in the so-called fast radio bursts. These signals are dispersed according to a precise physical law and this dispersion is a key observable quantity, which, in tandem with a redshift measurement, can be used for fundamental physical investigations. Every fast radio burst has a dispersion measurement, but none before now have had a redshift measurement, because of the difficulty in pinpointing their celestial coordinates. Here we report the discovery of a fast radio burst and the identification of a fading radio transient lasting ~6 days after the event, which we use to identify the host galaxy; we measure the galaxy's redshift to be z = 0.492 ± 0.008. The dispersion measure and redshift, in combination, provide a direct measurement of the cosmic density of ionized baryons in the intergalactic medium of ΩIGM = 4.9 ± 1.3 per cent, in agreement with the expectation from the Wilkinson Microwave Anisotropy Probe, and including all of the so-called 'missing baryons'. The ~6-day radio transient is largely consistent with the radio afterglow of a short γ-ray burst, and its existence and timescale do not support progenitor models such as giant pulses from pulsars, and supernovae. This contrasts with the interpretation of another recently discovered fast radio burst, suggesting that there are at least two classes of bursts.

Abstract P1-14-06: A phase II randomized study with eribulin/cyclophosphamide (ErC) and docetaxel/cyclophosphamide (TC) as neoadjuvant therapy in HER2-negative breast cancer- Final analysis of primary endpoint and correlative analysis results

Background: Eribulin mesylate (Er) is a non-taxane inhibitor of microtubule growth that results in G2-M cell cycle arrest, disruption of normal mitotic spindles and apoptosis. Er demonstrated an overall survival (OS) but not progression free survival (PFS) advantage in anthracycline and taxane refractory breast cancer pts. This OS rather than PFS benefit has been attributed to Er's potential to suppress new metastases through its effects on the epithelial mesenchymal transition (EMT) pathway, even in the absence of an effect on the primary tumor or established metastases. In this study ErC was compared to TC, a standard regimen for (neo) adjuvant treatment. A companion exploratory analysis examined the EMT markers E-cadherin and vimentin, as well as the endothelial marker CD-31 assessing tumor vasculature. Final assessments of the primary endpoint of pathological complete response (pCR) and results of the correlative studies will be presented.

Methods: Women with histologically confirmed invasive HER2-negative (IHC 0-1+ or FISH/SISH negative), cT1-3, cN0-2, M0 (pN3a disease allowed) adenocarcinoma of the breast were eligible. Following a 10 pt lead-in to confirm the safety/feasibility of ErC, pts were randomized 2:1. Arm 1, Er 1.4 mg/m2 IV (Days 1 & 8) and C 600 mg/m2 IV (Day 1); Arm 2, T 75 mg/m2 IV and C 600 mg/m2 IV on Day 1, both regimens administered q 21 days x 6 cycles followed by surgery. Tumor samples were collected at baseline and from residual breast cancer at the time of surgery. Samples were assayed for E-cadherin, vimentin, and CD-31 expression by immunohistochemistry.

Results: Enrollment was completed 4/2014 (76 pts); 10 pts in lead-in phase, 66 pts were randomized (Arm 1, 44; Arm 2, 22). In the randomized population, 77% had invasive ductal adenocarcinoma; median tumor size 3.1 cm (range, 0.4-10cm; 29.5% were T3); axillary nodes clinically positive in 52%. 34% of pts were triple negative (TN). 59 pts (89%) underwent surgery after receiving neoadjuvant chemotherapy (NAC) on study. pCR rates were 9% and 18% on the TC and ErC arms respectively. 4/7 pts with pCR on the ErC arm were TN. tumor samples were analyzed from 69 pts (including lead-in pts) for expression of the EMT biomarkers. Of these, 40 pts had paired pre- and post-treatment samples, and 29 pts had either a pre- or post-treatment sample (including 8 pre-treatment samples from pts who achieved pCR). In pre-treatment tumor specimens (61 samples), E-cadherin levels were modest-high in 80%, vimentin expression was seen in 39%, and CD-31 expression observed in 21% of the samples. Analysis of pre- and post-treatment paired specimens and differential effects according to treatment regimen will be presented.

Conclusion: The observed pCR rate of 18% with ErC in this HER2- pt population was comparable with other NAC regimens. Correlative evaluation of EMT markers and tumor vascular density with response is ongoing and will be presented.

Citation Format: Yardley DA, Chandra P, Hart L, Wright GS, Ward P, Mani A, Shastry M, Finney L, Guo S, DeBusk LM, Hainsworth JD, Burris III HA. A phase II randomized study with eribulin/cyclophosphamide (ErC) and docetaxel/cyclophosphamide (TC) as neoadjuvant therapy in HER2-negative breast cancer- Final analysis of primary endpoint and correlative analysis results. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-14-06.

Removal of Cr (VI) by a halotolerant bacterium Halomonas sp. CSB 5 isolated from sāmbhar salt lake Rajastha (India)

A halotolerant chromate reducing bacterium CSB 5 isolated from the Sambhar Salt Lake (Rajasthan) was identified as Halomonas sp. CSB 5 by 16SrDNA sequence analysis. The isolate could tolerate up to 25% NaCl (w/v) and100 μg mL-1of Chromium hexavalent in the complex medium (CM). Removal of Cr (VI) at concentration of 20, 40 and 60 μg mL-1 was found to be 98%, 90.2%, and 65.7% within a period of 60 hour.Effect of factors like pH and temperature on the total removal of Cr (VI) at 60μg mL-1concentration showed maximum removal at pH 8.0 (77.9 %) and temperature 35°C (82.6%) in 60 hour. The maximum intracellular uptake and surface adsorption (3.22 ± 0.09 and 14.16 ± 0.49 μg mg-1 dry wt.) in CMB 5 bacterium was observed at 75 μg mL-1 of Cr (VI) concentration in 45 min.The results showed that contribution of surface binding was about 4-5 fold higher than the intracellular uptake. Bacterium showed concentration dependent increase in the chromate reductase activity with saturating rate at 60 μg mL-1 concentration of chromium. The values of Km and Vmax with NADH of the bacterium was found to be 0.818 μg mL-1 and 0.085 μg mL-1.min-1.mg-1 protein, respectively. Fourier Transform Infrared Spectroscopy (FTIR) analysis of Cr (VI) binding on membrane surface showed changes in wavenumber between 3300-2800 cm-1due to involvement of proteins and fatty acids in the binding of Cr (VI). The absorption peaks at wavenumbers 1654.9, 1580.3 cm-1, 1248 and 1085.6 cm-1 shifted to lower frequencies due to interaction of Cr (VI) with functional groups like amides and phosphodiester. These results suggested that the isolated CSB 5 bacterium can be used as potential bioremediating agent for removal of Cr (VI) in salt loaded waste water.

Spezifische und unspezifische Hemmung der zellfreien Proteinsynthese mit Polyanionen

The non-specific inhibition of the poly U directed polymerisation of phenylalanine through polyanions was studied. This inhibition was found to be in order as follows: dextransulfate, polyethylensulfate, heparine, ribosomal RNA and alginate. It was found that poly A, poly AP and poly AG cause a specific inhibition of the poly U directed synthesis of polyphenylalanine. Poly AG and poly AP, but not poly A were found to inhibit the poly C directed polymerisation of proline as well. The mechanism of these two types of inhibition caused by polyanions has been discussed.

Photodynamic Effects on the Template Activity of Nucleic Acids

The photodynamic inactivation of nucleic acids with pyronin, methylene blue, thiopyronin and furocoumarines has been studied. The template efficiency of DNA in RNA-Polymerase reaction was found to be decreased after the treatment of DNA with these compounds. However, the magnitude of their inhibiting capacity varied from one compound to the other. Psoralen and thiopyronin were found to be the most active inhibitors followed by xanthotoxin and methylene blue respectively. At a lower temperature the inhibiting capacity of thiopyronin was considerably decreased but that of psoralen remained nearly unaffected. We have also tried to show evidence for a complimentary code in t-RNA through a specific destruction of guanine with thiopyronin.

Zum Wirkungsmechanismus von 1-Nitroso-3-nitro-1-methyl-guanidin bei der Mutationsauslösung

The effect of NNMG on the template activities of different polynucleotides (polyuridylic acid, polycytidylic acid, polyadenylic acid and copolymer of adenylic and guanylic acid 5,5:1) and t-RNS was studied. The maximum inhibition of the messenger activity was found for poly-C, followed by poly-Α and poly-U. The acceptor activity of t-RNA was found to be inhibited by NNMG: maximum for proline, followed by serine, leucine, phenylalanine and lysine. The mechanism of these inhibitions was studied using NNMG radioactively labelled on the methyl group. Different amounts of radioactivity were found in the various polynucleotides and t-RNS.

Epidemiology of candidemia in Qatar, the Middle East: performance of MALDI-TOF MS for the identification of Candida species, species distribution, outcome, and susceptibility pattern

INTRODUCTION

Bloodstream infections (BSIs) due to Candida spp. constitute the predominant group of hospital-based fungal infections worldwide. A retrospective study evaluated the performance of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for the identification of BSI Candida isolates. The epidemiology, risk factors, demographic features, species distribution, and clinical outcome associated with candidemia in patients admitted to a single tertiary-care hospital in Qatar, were analyzed.

METHODS

A single-center, retrospective analysis covering the period from January 1, 2004 to December 31, 2010 was performed. Molecular identification used sequence analysis of the D1/D2 domains of the large subunit ribosomal DNA (LSU rDNA) and the ITS1/2 regions of the rDNA. MALDI-TOF MS-based identification of all yeast isolates was performed with the ethanol/formic acid extraction protocol according to Bruker Daltonics (Bremen, Germany). The susceptibility profiles of 201 isolates to amphotericin B, itraconazole, fluconazole, voriconazole, anidulafungin, caspofungin, posaconazole, and isavuconazole were tested using CLSI standard broth microdilution method (M27-A3 and M27 S4) guidelines. Statistical analyses were performed with the statistical package SPSS 19.0.

RESULTS

A total of 187 patients with 201 episodes of candidemia were identified. Candida albicans was the most common species isolated (33.8 %; n = 68), whereas non-albicans Candida species represented 66.2 % (n = 133) of the episodes. The species distribution and outcome of candidemia showed a difference in the crude mortality between patients infected with C. albicans (n = 30; 45.5 %) and non-albicans Candida species. For example, C. parapsilosis candidemia was associated with the lowest mortality rate (40.6 %), and patients with other non-albicans species had the highest mortality rate (68-71.4 %). High mortality rates were observed among pediatric (<1 year of age) and elderly patients (>60 years of age). All strains showed low minimum inhibitory concentrations (MICs) (MIC90 of 0.063 μg/ml) to isavuconazole. The overall resistance to voriconazole in vitro antifungal activity was 2.5 %. C. glabrata (n = 38) had an MIC90 of 8 μg/ml for fluconazole. Most yeast isolates were susceptible to anidulafungin (>99.5 %) and 81.1 % to caspofungin. Resistance to anidulafungin was detected in 1/8 (12.5 %) isolates of C. orthopsilosis. According to new Clinical and Laboratory Standards Institute (CLSI) breakpoints, C. glabrata (n = 38) showed 100 % resistance, and 37/68 (54.4 %) C. albicans isolates were susceptible dose dependent (SDD) to caspofungin. Identification by MALDI-TOF MS was in 100 % concordance with molecular identification.

CONCLUSION

The Middle East epidemiology of candidemia has a unique species distribution pattern distinct from other parts of the globe. High mortality rates were observed among pediatric (<1 year of age) and elderly patients (>60 years of age). All strains were susceptible to isavuconazole. All isolates of C.glabrata were resistant to caspofungin based on M27 S4. MALDI-TOF MS is a highly useful method for the routine identification of yeast isolates in clinical setting to achieve successful therapeutic treatment.

Abstract PD4-3: Use of community-based next-generation sequencing (NGS) in advanced breast cancer: Identification of actionable targets to guide clinical trial selection

Background: Molecularly targeted drugs specific for mutated genes are increasingly the focus of novel clinical trials. However, molecular profiling of tumors is largely unavailable in community cancer centers, where nearly 80% of cancer patients (pts) are treated. In October 2012, Sarah Cannon Research Institute (SCRI) launched a community-based molecular profiling initiative to characterize the spectrum of molecular alterations in tumors. The profiling panel focused on potentially actionable mutations for the purpose of identifying candidates for treatment with specific targeted agents (FDA approved or investigational). Herein, we report the initial data from breast cancers (BC) profiled between October 2012 and May 2013.

Methods: Metastatic breast cancer (MBC) pts &gt; 18 years of age with ECOG PS ≤ 2 who were candidates for treatment provided consent for tumor molecular profiling. Archival tumor specimens (tissue block or 10 unstained slides) obtained from either the primary or metastatic disease were collected and interrogated by NGS (1000X average coverage) in a CLIA/CAP laboratory to detect oncogenic hotspot mutations in 35 cancer-related genes. Results were reported to the treating physician within 12 calendar days of receipt of suitable tissue and were stored in a database to enable correlation with clinical outcomes. Detection of relevant molecular abnormalities was used to identify pts appropriate for clinical trials of targeted agents.

Results: As of May 31 2013, a total of 594 tumor samples were profiled, 101 (17%) of which were BC samples. 8% (8/101) of the BC samples were inadequate for assay. Of the remaining 93 samples, 60 (65%) had no mutations detected. 28% of BC had single mutations and 7% had multiple mutations. PIK3CA mutations (24%) were the most frequently identified alteration. Other genetic alterations identified included RUNX1 (4%) and FGFR3 (2%) while mutations in PIK3R1, MET, KRAS, KIT, FGFR2, HER2, BRAF, SMO, MYC, DDR2 and AKT1 were infrequent, each identified in 1 pt. Patterns and frequency of mutations in the 35 genes assayed differed in the various subtypes of BC. 6% (6/93) of BC pts with appropriate tumor mutations identified by molecular profiling have been enrolled into phase I clinical trials with PI3K or mTORC1/2 inhibitors; updated treatment results will be presented. An additional 27 patients are potentially eligible for ongoing trials at SCRI.

Conclusions: This community-based molecular profiling initiative has been well accepted by patients and physicians, and provides timely results. Potentially actionable mutations were identified in 35% of BCs tested; PIK3CA mutations accounted for 70% of all actionable mutations detected. Identification of BC patients with actionable mutations may add to treatment options and improve results, and will also accelerate development of new targeted agents.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr PD4-3.

Hepatocellular carcinoma in qatar

OBJECTIVE

The main aim of this study was to report and discuss epidemiological, etiological, type of treatment and data on survival of the patients with each mode of treatment using available data for patients with hepatocellular carcinoma (HCC) who have been diagnosed at Hamad Medical Corporation during the period March 2004-December 2010 inclusive.

MATERIALS AND METHODS

Retrospective analysis of 150 patient's data had been done, including demographic, epidemiological, etiological disease status assessment with child Pugh criteria, modes of treatment and treatment related outcome. Patient's various characteristics such as demographic, epidemiological, and other clinical characteristics were summarized using an appropriate descriptive statistics. Univariate Kaplan-Meier survival curve analysis was performed to estimate overall and group wise survival at different time points. Furthermore, the log-rank test was applied to determine any statistical difference in survival among various subgroups. In addition, the multivariate Cox regression method was used to assess the significant effects of various prognostic factors on outcome survival time.

RESULTS

The mean age of the studied HCC patients was 58.8 years (31-87years) with a male: female ratio of 3:1 (76% Male 24% Female). There were 48 (32%) Qatari and 102 (62%) non-Qatari patients. The underlying etiology HCV was the most common (45%) similar to Western European countries, HBV in (27%), alcoholic liver disease only in 6 (4%), Child-Pugh assessment was A in (33%), B in (37%) and C in (30%), nearly half of the patients (53%) were in advanced stage and had palliative treatment, the other half had chemoembolization in (17%), systemic therapy sorafenib in (13%), surgery (liver resection or transplantation) in (12%) and local ablation in (5%).

CONCLUSION

HCC is more common in males (ratio M:F 3:1). HCV is the most common underlying cause, similar to the pattern in western European countries. The survivals in our patient were comparable to other studies reported in the literature. Patients who had chemoembolization had the longest median survival [Median = 27 months, 95% CI (20.27- 33.72). Majority of cases (53%) were diagnosed at advanced stage. To improve the outcome of treatment of HCC patients, the number of early and very early stage diagnosis should be increased by improving the implementation and effectiveness of the strategic screening program.

KEYWORDS

Hepatocellular carcinoma, chemoembolization, radiofrequency, sorafenib, hepatitis C, Hepatitis B.

First Record of Rhizoctonia solani AG 1-IB on Mucuna pruriens in India

Mucuna is the source of L-Dopa (L 3,4 dihydroxyphenylalanine), a precursor of a dopamine used to treat Parkinson's disease. Leaf blight symptoms were observed on Mucuna pruriens plants in October to November 2010 in a field at the Indian Council of Agricultural Research Complex for the Northeastern Hill Region, Umiam, Meghalaya, India. Symptoms included black necrotic areas on leaves, collapsed leaf tissue and, occasionally, fungal growth visible on the leaf. In advanced infections, dead leaves were attached to the stem, followed by defoliation with only infected pods still attached. Approximately 10% of plants were infected in ~0.5 ha surveyed. Symptomatic leaf pieces were washed with sterile water, surface-sterilized using 4% NaOCl for 30 s, washed again, blotted dry, and plated on PDA amended with streptomycin (100 ppm). Characteristics of three fungal isolates were typical of Rhizoctonia solani J.G. Kühn [teleomorph = Thanatephorus cucumeris (A. B. Frank) Donk], i.e., hyphal branching at 90° angles, basal constriction at the hyphal branching point with a septum close to the lateral hyphum (3), and presence of multinucleate hyphal cells confirmed using DAPI (2-(4-amidinophenyl)-1H-indole-6-carboxamidine) staining (1). A culture was deposited at the Agharkar Research Institute, Pune, India (NFCCI No. 2602). The ITS1-5.8S-ITS2 region of nuclear rDNA of one isolate was sequenced after amplification with primers ITS1 and ITS4 (4), (GenBank Accession No. JQ675536). A BLAST search revealed 99% similarity of the sequence with that of 2 R. solani AG 1-IB isolates (AB122137 and AB000039). Sequences were aligned using MAFT Version 6. Maximum parsimony analysis using MEGA 5 placed the test isolate in AG 1-IB with 99% bootstrap support. PCR assays with primers for R. solani AG 1-IB produced a DNA band of ~300 bp (2). Koch's postulates were completed by inoculating 5-mm colonized plugs of PDA at the soil line of each of 5 potted, 40-day-old plants of M. pruriens, and covering the base of each plant with moistened cheesecloth. In addition, 3 plants were inoculated with colonized plugs at the junction of the lamina and petiole of 9 leaves/plant, spraying the plants with sterilized water, and covering the plants with polythene for 3 days. In addition, 10 detached leaves were inoculated with colonized PDA plugs and incubated in a moist chamber. Three non-inoculated plants served as a control treatment for the first 2 methods, and 10 leaves as a control treatment for the third method with sterilized PDA plugs. Symptoms of leaf blight (necrosis from base to leaf tip, with abundant fungal growth) developed in 6 to 7 days on plants inoculated at the soil line, 4 days on leaves inoculated at the junction of the lamina and petiole, and 2 to 3 days on detached leaves. Control plants and leaves remained asymptomatic for all 3 methods. R. solani was reisolated from inoculated plants as described above, and confirmed to be AG 1-IB. The fungus was not reisolated from control plants or leaves. To our knowledge, this is the first record of R. solani AG 1-IB causing leaf blight on M. pruriens in India. References: (1) M. M. Kulik and P. D. Dery. Biotech. Histochem. 70:95, 1995. (2) M. Matsumoto. Mycoscience 43:185, 2002. (3) B. Sneh et al. Identification of Rhizoctonia Species. The American Phytopathological Society Press, St Paul, MN, 1991. (4) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. M. A. Innis et al., eds. Academic Press, San Diego, CA, 1990.