Evaluation of clinical efficacy of streptokinase by comparison with the thrombolytic agent on animal model

Cardiovascular disorders, including acute myocardial infarction (AMI), often lead to blood clot formation, impacting blood circulation. Streptokinase, a cost-effective and widely available thrombolytic agent, is crucial in treating thrombosis. This study aimed to produce streptokinase from Streptococcus pyogenes EBL-48 and compare its efficacy with heparin in an animal model. We evaluated the clot-lysing effectiveness of streptokinase produced from Streptococcus pyogenes EBL-48, emphasizing its low cost and ease of production. Streptokinase was produced using pre-optimized fermentation media and purified through ion exchange and gel-filtration chromatography. In vivo analysis involved inducing clots in a trial animal model using ferric chloride, comparing streptokinase with heparin. Ultrasonography assessed the clot-lysing activity of streptokinase. Streptokinase (47 kDa) effectively lysed clots, proving its low cost, easy production, and minimal adverse effects. Ultrasonography confirmed its fibrinolytic efficacy. These findings highlight potential as an affordable and easily produced thrombolytic agent, particularly relevant in resource-limited settings. Streptokinase efficacy and minimal adverse effects make it a promising option for thrombolytic therapy, especially in economically constrained regions. Future studies could optimize production techniques, explore different strains, and conduct clinical trials for human validation. Comparative studies with other thrombolytic agents would enhance understanding of their advantages and limitations.

Reinfection or relapse of COVID-19 in health care workers; case series of 2 patients from Pakistan

During an ongoing pandemic of severe acute respiratory syndrome coronavirus 2, main question which has arisen in everyone's mind is about the immune response that may protect from reinfection. Coronaviruses are known for short-term immunity. Their ability of mutations enables them to escape host immunity, thus increasing chances of reinfection. Here we report two cases of reinfection among health care workers who presented with symptoms of COVID-19 disease, after 3 months of first infectious course. Such documentations are necessary for epidemiological purposes and also to monitor response of virus on re-exposure.

Characteristics and outcomes of hip fractures in lower limb amputees

INTRODUCTION

Lower limb amputees, regardless of age are at an increased risk of developing fragility fractures of the neck of femur. The characteristics and outcomes of the fractures of the neck of femur in lower limb amputees have not been studied in detail.

METHODS

We undertook a retrospective review of a prospectively collected single centre and single surgeon database between March 1996 and January 2017, using a standard proforma to identify patients who required surgical intervention for fracture neck of femur and had sustained a previous lower limb amputation and compared them with a cohort of standard hip fracture patients.

RESULTS

Twenty-seven patients, sustaining 28 fractures of the neck of femurs were identified of which 16 were females with mean age of 78 years (50-89). Nineteen fractures were sustained on the ipsilateral side of the amputation. Results showed that seventy percent of amputees returned to their previous level of mobility and prior residence. Mortality in this group is higher as compared to a standard hip fracture patient but pain and mobility were comparable in both groups.

DISCUSSION

The incidence of both hip fractures and amputations in increasing worldwide but no study has compared outcomes of hip fractures in amputees and compared them to a standard hip fracture patient. Amputees exhibit reduced bone density both at the hip and stump end which increases risk for osteoporosis and fragility fractures in the hip. The management of our patients followed orthopaedic principles, well established surgical interventions and rehabilitation.

CONCLUSION

This study reveals that hip fractures in amputees can have comparable results to a standard hip fracture cohort if preoperative optimisation, planning and postoperative rehabilitation is carried out.

INPP5K variant causes autosomal recessive congenital cataract in a Pakistani family

Congenital cataract (CC) is clinically and genetically highly heterogeneous. Here, we enrolled a consanguineous kindred (LUCC15) from Pakistan, with 3 affected individuals suffering with CC. Exome sequencing revealed a transition mutation [c.149 T > C; p.(Ile50Thr)] in INPP5K. Inositol polyphosphate-5-phosphatase K, encoded by INPP5K, is involved in dephosphorylation of phosphatidylinositol (PtdIns) 4,5-bisphosphate, and PtdIns 3,4,5-trisphosphate. Recently, pathogenic variants in INPP5K have been reported in families with congenital muscular dystrophies, intellectual disability, and cataract. In our family LUCC15, mild to moderate intellectual disability along with speech impairment was observed in 2 affected individuals. Magnetic resonance imaging of brain and muscles tissues did not reveal any cerebellar or muscular atrophy. However, electromyography of both upper and lower limbs revealed irritable myopathy. Comparison of clinical phenotype of all the known affected individuals, including LUCC15 family, homozygous for INPP5K alleles revealed reduced penetrance of muscular dystrophy and intellectual disability. Similarly, skeletal muscle abnormalities were highly variable among inpp5ka zebrafish mutants analyzed in this study. These phenotypic variabilities may be due to epigenetic factors and/or genetic modifiers.

Trauma-related amputations in war and at a civilian major trauma centre-comparison of care, outcome and the challenges ahead

The Afghanistan conflict has resulted in a large number of service personnel sustaining amputations. Whilst obvious differences exist between military and civilian trauma-related amputations both settings result in life changing injuries. Comparisons offer the potential of advancement and protection of the knowledge gained during the last 12 years. This paper compares the military and civilian trauma-related amputee cohorts' demographics, management and rehabilitation outcomes measures. The UK military Joint Theatre Trauma Registry and a civilian major trauma centre database of trauma-related amputees were analysed. 255 military and 24 civilian amputees were identified. A significant difference (p>0.05) was seen in median age (24, range 18-43, vs. 48, range 24-87 years), mean number of amputations per casualty (1.6±SD 0.678 vs. 1±SD 0.0), mean ISS (22±SD 12.8 vs. 14.7±SD 15.7) and gender (99% males vs. 78%). Rehabilitation outcome measures recorded included the Special Interest Group in Amputee Medicine score where the military group demonstrated significantly better scores (91% Grade E+ compared to 19%). Differences in patients underlying physiology and psychology, the military trauma system and a huge sustained investment in rehabilitation are all contributing factors for these differing outcomes. However the authors also believe that the use of a consultant-led MDT and central rehabilitation have benefited the military cohort in the acute rehabilitation stage and is reflected in the good short-term outcomes.

The role of green tea extract and powder in mitigating metabolic syndromes with special reference to hyperglycemia and hypercholesterolemia

Natural products are currently gaining popularity to combat various physiological threats. Scientific evidence has been provided that dietary phytochemicals may play important roles as chemo-preventive or chemotherapeutic agents in the prevention of many diseases. Green tea has many biologically active moieties, like flavanols and polyphenols. Catechins are flavanols that constitute the majority of soluble solids of green tea; its major components are epigallocatechin gallate (EGCG), epigallocatechin (EGC), epicatechin gallate (ECG) and epicatechin (EC). Among these, EGCG is the predominant component, contributing more than 50% of polyphenols. It has many health related characteristics, like hypoglycemic, hypocholesterolemic, anticancer, antiviral and antihypertensive activities. Ethanolic extracts of green tea was subjected to in vivo modeling. An efficacy trial was carried out on normal, hyperglycemic and hypercholesterolemic rats for 8 weeks. Control, functional and nutraceutical diets were used for each study. Drink and feed intake and body weight increased during the study period. Serum analysis showed that maximum reduction of cholesterol level was noted in hypercholesterolemic rats, up to 15.45%, due to the nutraceutical diet. It was a 21.51% reduction in the case of LDL and 12.92% for triglycerides. The serum glucose level was most reduced in hyperglycemic rats, up to 13.39% as a result of the nutraceutical diet. The functional diet resulted in a bit less reduction in the respective traits compared to the nutraceutical diet. Hematological analysis revealed that administration of green tea did not adversely affect the red blood cell, white blood cell and platelet count of the rats. The current research work enables us to conclude that green tea is effective against hypercholesterolemia and hyperglycemia.

Hydrocarbon degradation and plant colonization by selected bacterial strains isolated from Italian ryegrass and birdsfoot trefoil

AIMS

To assess the degradation potential and plant colonization capacity of four alkane-degrading strains (ITSI10, ITRI15, ITRH76 and BTRH79) in combination with birdsfoot trefoil and Italian ryegrass and to evaluate the diversity of indigenous alkane-degrading soil bacteria in the rhizo- and endosphere.

METHODS AND RESULTS

Contaminated soil was prepared by spiking agricultural soil with 10 g diesel fuel per kg soil. Italian ryegrass (Lolium multiflorum var. Taurus) and birdsfoot trefoil (Lotus corniculatus var. Leo) were inoculated with four alkane-degrading strains. Hydrocarbon degradation (up to 57%) was observed in all inoculated treatments of vegetated and unvegetated samples. Italian ryegrass in combination with compost and BTRH79 showed highest degradation, while birdsfoot trefoil performed best with compost and strain ITSI10. Cultivation-based as well as cultivation-independent analysis showed that both strains were competitive colonizers.

CONCLUSIONS

The combination between vegetation, inoculation with well-performing degrading bacteria and compost amendment was an efficient approach to reduce hydrocarbon contamination. Two Pantoea sp. strains, ITSI10 and BTRH79, established well in the plant environment despite the presence of a variety of other, indigenous alkane-degrading bacteria.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study suggests that the application of degrading bacterial strains, which are able to compete with the native microflora and to tightly associate with plants, are promising candidates to be used for phytoremediation applications.

In vitro immunomodulating properties of selected Sudanese medicinal plants

Ethanolic extracts of 23 medicinal plants, commonly used in Sudanese folk medicines against infectious diseases, were investigated for their immunomodulating activity using luminol/lucigenin-based chemiluminescence assay. Preliminary screenings on whole blood oxidative burst activity showed inhibitory activities of 14 plant extracts, while only one plant, Balanites aegyptiaca fruits exhibited a proinflammatory activity. Further investigation was conducted by monitoring their effects on oxidative burst of isolated polymorphonuclear cells (PMNs) and mononuclear cells (MNCs) by using two different phagocytosis activators (serum opsonizing zymosan-A and PMA). Results obtained showed that the fruits and barks of Acacia nilotica, and leaves and barks of Khaya senegalensis, possess average inhibitory effects in the range of 70.7, 67.1, 69.5 and 67.4% on both types of phagocytes (PMNs and MNCs), respectively, at a 6.25 microg/mL concentration. Moderate inhibitory activity (52.2%) was exerted by the aerial parts of Xanthium brasilicum, while the rest of the plants showed only a weak inhibitory activity. The inhibition of oxidative burst activity was found to be irreversible in most of the extracts, except for Peganum harmala, Tephrosia apollinea, Tinospora bakis, and Vernonia amygdalina. Interestingly, the fruits of Balanites aegyptiaca exhibited a moderate proinflammatory effect (37-40.4% increases in ROS level compared to the control) at 25-100 microg/mL concentration in the case of whole blood along with PMNs phagocyte activity. The Tinospora bakis extract showed proinflammatory response at a low concentration (6.25 microg/mL) during activation with PMA. None of these extracts affected PMNs viability (90-98%) upon 2 h incubation, except of the ethanolic extracts of Acacia nilotica fruits and Balanites aegyptiaca barks.