Biodegradation of polyethylene (PE), polypropylene (PP), and polystyrene (PS) microplastics by floc-forming bacteria, Bacillus cereus strain SHBF2, isolated from a commercial aquafarm

The ubiquitous proximity of the commonly used microplastic (MP) particles particularly polyethylene (PE), polypropylene (PP), and polystyrene (PS) poses a serious threat to the environment and human health globally. Biological treatment as an environment-friendly approach to counter MP pollution has recent interest when the bio-agent has beneficial functions in their ecosystem. This study aimed to utilize beneficial floc-forming bacteria Bacillus cereus SHBF2 isolated from an aquaculture farm in reducing the MP particles (PE, PP, and PS) from their environment. The bacteria were inoculated for 60 days in a medium containing MP particle as a sole carbon source. On different days of incubation (DOI), the bacterial growth analysis was monitored and the MP particles were harvested to examine their weight loss, surface changes, and alterations in chemical properties. After 60 DOI, the highest weight loss was recorded for PE, 6.87 ± 0.92%, which was further evaluated to daily reduction rate (k), 0.00118 day-1, and half-life (t1/2), 605.08 ± 138.52 days. The OD value (1.74 ± 0.008 Abs.) indicated the higher efficiency of bacteria for PP utilization, and so for the colony formation per define volume (1.04 × 1011 CFU/mL). Biofilm formation, erosions, cracks, and fragments were evident during the observation of the tested MPs using the scanning electron microscope (SEM). The formation of carbonyl and alcohol group due to the oxidation and hydrolysis by SHBF2 strain were confirmed using the Fourier transform infrared spectroscopic (FTIR) analysis. Additionally, the alterations of pH and CO2 evolution from each of the MP type ensures the bacterial activity and mineralization of the MP particles. The findings of this study have confirmed and indicated a higher degree of biodegradation for all of the selected MP particles. B. cereus SHBF2, the floc-forming bacteria used in aquaculture, has demonstrated a great potential for use as an efficient MP-degrading bacterium in the biofloc farming system in the near future to guarantee a sustainable green aquaculture production.

Development of a Python-based electron ionization mass spectrometry amino acid and peptide fragment prediction model

The increased fragmentation caused by harsher ionization methods used during mass spectrometry such as electron ionization can make interpreting the mass spectra of peptides difficult. Therefore, the development of tools to aid in this spectral analysis is important in utilizing these harsher ionization methods to study peptides, as these tools may be more accessible to some researchers. We have compiled fragmentation mechanisms described in the literature, confirmed them experimentally, and used them to create a Python-based fragment prediction model for peptides analyzed under direct exposure probe electron ionization mass spectrometry. This initial model has been tested using single amino acids as well as targeted libraries of short peptides. It was found that the model does well in predicting fragments of peptides composed of amino acids for which the model is well-defined, but several cases where additional mechanistic information needs to be incorporated have been identified.

Association of Serum Magnesium Level with Severity of Neurological Disability in Patients with Acute Ischemic Stroke

Magnesium (Mg) has important effects on vascular system and deficiency of this cation is thought to be a risk factor for cerebrovascular atherosclerosis and complications. The study was planned to find out the association of serum magnesium level with severity of neurological disability in patient with acute ischemic stroke. This cross-sectional descriptive study was conducted in the department of Neurology and Medicine at Mymensingh Medical College & Hospital, Mymensingh from June, 2018 to October, 2019. Patients with acute ischemic stroke were evaluated following informed written consent. Diagnosis was confirmed by neuroimaging of brain. Moreover, serum magnesium assay was done for each patient. Data were collected by interview, clinical examination and laboratory investigations of patients using a case record form and analysis was carried out by using the SPSS 22.0 (IBM Inc., Armonk, NY, USA). Mean age of acute ischemic stroke patients was 63.94±13.93 years with male predominance (58.30%). Majority of the respondents (70.2%) had NIH Stroke Scale (NIHSS) score 5-15 (moderate stroke), 13.1% had score 1-5 (minor stroke), 13.1% had score15-20 (Moderate to severe stroke) and 3.6% had score 21-42 (severe stroke). Mean serum magnesium level was 1.83±0.283mg/dl. Hypomagnesaemia was present in 28(33.3%) patients and it was related with higher NIHSS scoring (p<0.05). Multiple regression showed that among the risk factors, serum magnesium level was independently associated with severity of neurological disability of the acute ischemic stroke (p<0.001). In this study, the correlation coefficient between serum magnesium level and NIHSS score was found as r= - 0.667 which showed negative relationship between serum magnesium and NIHSS score. Lower serum magnesium level is associated with the severity of neurological disability of acute ischemic stroke patient. Further case-control studies are required to validate this finding.

Development and Validation of MRI Imaging Biomarkers for Prostate Cancer Using Deep Learning

PURPOSE/OBJECTIVE(S)

Given the increasing number of treatment options for patients with localized prostate cancer (PCa), there is a need for biomarkers to aid in risk stratification. Specifically, novel biomarkers can aid in the identification of high-risk phenotypes among similar patients in traditional NCCN risk groupings. One promising area for development is using pre-treatment prostate MRI to identify imaging biomarkers to identify prostate cancer patients at highest risk for recurrence. We hypothesized that deep learning could be leveraged to identify imaging biomarkers of aggressive PCa from pre-treatment prostate MRIs.

MATERIALS/METHODS

Our study included 1,020 patients treated at our institution between 2010-2022. Given pathologic extraprostatic extension (EPE) and seminal vesicle invasion (SVI) are associated with higher risk of treatment failure, we hypothesized that deep learning models which identified radiographic EPE and SVI would provide non-invasive imaging biomarkers associated with PCa prognosis. We trained two separate deep learning models using convolutional neural networks to predict SVI and EPE respectively. The model inputs were T2W prostate MRIs (n = 894) and models consisted of 8 convolutional layers. Dropout, L2 regularization, and data augmentation were used to improve model generalizability and reduce overfitting. Discriminatory ability of each model was measured using AUC on a blinded external test set of 221 patients. To assess the clinical utility of our imaging biomarkers, log-rank tests were used to evaluate biochemical free survival (BFS) for patients classified as high risk to patients classified as low risk. Biochemical failure was defined as post-treatment PSA >0.1 for patients who underwent radical prostatectomy (RP) or PSA >2ng/ml above nadir for patients receiving radiation therapy.

RESULTS

Within our cohort of 1,020 patients the median age was 66 with a median follow up of 4 years. 49.3% (n = 503) underwent RP and 50.7% (n = 517) received EBRT. 4% (n = 41) were low risk, 62.4% (n = 636) were intermediate risk, and 33% (n = 337) were high risk based on NCCN criteria. Deep learning models showed good discriminatory ability for both EPE (AUC 0.66) and SVI (AUC 0.74). Both imaging biomarkers showed prognostic ability to identify high risk prostate phenotypes. Patients deemed high risk based on EPE classifier had worse BFS (median 5 vs 9 years, p<.001). Similarly, patients classified as high risk based on SVI also showed worse BFS (median 5 vs 9 years, p = 0.024). Among intermediate risk patients, EPE biomarker showed an ability to identify high risk phenotypes (median 6 vs 9 years, p = 0.024).

CONCLUSION

Deep learning classifiers of prostate MRIs demonstrated the ability to stratify high-risk prostate cancer phenotypes beyond traditional risk paradigms. Imaging biomarkers represent a non-invasive method to help aid in the personalization of treatment for patients with localized prostate cancer and identify patients who potentially require treatment escalation.

Hospitalizations Among Adults With CKD in Public Renal Specialty Practices: A Retrospective Study From Queensland, Australia

Rationale & Objective

Little is known about hospital admissions in nondialysis patients with chronic kidney disease (CKD) before death or starting kidney replacement therapy (KRT).

Study Design

Retrospective observational cohort study.

Setting & Participants

Hospitalizations among 7,201 patients with CKD from 10 public renal clinics in Queensland (QLD), enrolled in the CKD.QLD registry starting in May 2011, were followed for 25,496.34 person-years until they started receiving KRT or died, or until June 30, 2018.

Predictors

Demographic and clinical characteristics of patients with CKD.

Outcomes

Hospital admissions.

Analytical Approach

We evaluated the association of demographic and clinical features with hospitalizations, length of hospital stay, and cost.

Results

Approximately 81.5% of the patients were admitted at least once, with 42,283 admissions, costing Australian dollars (AUD) 231 million. The average number of admissions per person-year was 1.7, and the cost was AUD 9,060, 10 times and 2 times their Australian averages, respectively. Single (1-day) admissions constituted 59.2% of all the hospital episodes, led by neoplasms (largely chemotherapy), anemia, CKD-related conditions and eye conditions (largely cataract extractions), but only 14.8% of the total costs. Approximately 41% of admissions were >1-day admissions, constituting 85.2% of the total costs, with cardiovascular conditions, respiratory conditions, CKD-related conditions, and injuries, fractures, or poisoning being the dominant causes. Readmission within 30 days of discharge constituted >42% of the admissions and 46.8% costs. Admissions not directly related to CKD constituted 90% of the admissions and costs. More than 40% of the admissions and costs were through the emergency department. Approximately 19% of the hospitalized patients and 27% of the admissions did not have kidney disease mentioned as either principal or associate causes.

Limitations

Variable follow-up times because of different dates of consent.

Conclusions

The hospital burden of patients with CKD is mainly driven by complex multiday admissions and readmissions involving comorbid conditions, which may not be directly related to their CKD. Strategies to prevent these complex admissions and readmissions should minimize hospital costs and outcomes.

Plain-Language Summary

We analyzed primary causes, types, and costs of hospitalizations among 7,201 patients with chronic kidney disease (CKD) from renal speciality clinics across Queensland, Australia, over an average follow-up of 3.54 years. The average annual cost per person was $9,060, and was the highest in those with more advanced CKD, higher age, and with diabetes. More than 85% of costs were driven by more complex hospitalizations with longer length of stay. Cardiovascular disease was the single largest contributor for hospitalizations, length of hospital stay, and total costs. Readmission within 30 days of discharge, particularly for the same disorder, and multiday admissions should be the main targets for mitigation of hospital costs in this population.

Vaccination Utilization and Subnational Inequities during the COVID-19 Pandemic: An Interrupted Time-Series Analysis of Administrative Data across 12 Low- and Middle-Income Countries

BACKGROUND

During and after the SARS-CoV-2 (COVID-19) pandemic, many countries experienced declines in immunization that have not fully recovered to pre-pandemic levels. This study uses routine health facility immunization data to estimate variability between and within countries in post-pandemic immunization service recovery for BCG, DPT1, and DPT3.

METHODS

After adjusting for data reporting completeness and outliers, interrupted time series regression was used to estimate the expected immunization service volume for each subnational unit, using an interruption point of March 2020. We assessed and compared the percent deviation of observed immunizations from the expected service volume for March 2020 between and within countries.

RESULTS

Six countries experienced significant service volume declines for at least one vaccine as of October 2022. The shortfall in BCG service volume was ~6% (95% CI -1.2%, -9.8%) in Guinea and ~19% (95% CI -16%, 22%) in Liberia. Significant cumulative shortfalls in DPT1 service volume are observed in Afghanistan (-4%, 95% CI -1%, -7%), Ghana (-3%, 95% CI -1%, -5%), Haiti (-7%, 95% CI -1%, -12%), and Kenya (-3%, 95% CI -1%, -4%). Afghanistan has the highest percentage of subnational units reporting a shortfall of 5% or higher in DPT1 service volume (85% in 2021 Q1 and 79% in 2020 Q4), followed by Bangladesh (2020 Q1, 83%), Haiti (80% in 2020 Q2), and Ghana (2022 Q2, 75%). All subnational units in Bangladesh experienced a 5% or higher shortfall in DPT3 service volume in the second quarter of 2020. In Haiti, 80% of the subnational units experienced a 5% or higher reduction in DPT3 service volume in the second quarter of 2020 and the third quarter of 2022.

CONCLUSIONS

At least one region in every country has a significantly lower-than-expected post-pandemic cumulative volume for at least one of the three vaccines. Subnational monitoring of immunization service volumes using disaggregated routine health facility information data should be conducted routinely to target the limited vaccination resources to subnational units with the highest inequities.

ʟ-glutamic acid modulates antioxidant defense systems and nutrient homeostasis in lentil (Lens culinaris Medik.) under copper toxicity

Copper (Cu), an essential micronutrient, can generate reactive oxygen species (ROS) at its supra-optimal level in living cells as a transition metal, thus producing oxidative stress in plants. Therefore, protecting plants from Cu-induced oxidative stress via the exogenous application of chemical substances, particularly L-glutamic acid (L-Glu), could be a viable strategy for mitigating the toxicity of Cu. The aim of our present study was to investigate how ʟ-Glu protects lentil seedlings from oxidative stress produced by toxic Cu and allows them to survive under Cu toxicity. The results exhibited that when lentil seedlings were exposed to excessive Cu, their growth was inhibited and their biomass decreased due to an increase in Cu accumulation and translocation to the root, shoot, and leaves. Exposure to toxic Cu also depleted photosynthetic pigments, imbalanced water content, and other essential nutrients, increased oxidative stress, and reduced enzymatic and non-enzymatic antioxidants. However, pre-treatment of ʟ-Glu improved the phenotypic appearance of lentil seedlings, which was distinctly evidenced by higher biomass production, maintenance of water balance, and an increase in photosynthetic pigments when exposed to toxic Cu. ʟ-Glu also protected the seedlings from Cu-induced oxidative stress by reducing the oxidative stress marker, specifically by the efficient action of enzymatic and non-enzymatic antioxidants, particularly ascorbate, catalase, monodehydroascorbate, and glutathione peroxidase and maintaining redox balance. Furthermore, ʟ-Glu assisted in maintaining the homeostasis of Cu and other nutrient in the roots, shoots, and leaves of lentil. Collectively, our results provide evidence of the mechanism of ʟ-Glu-mediated protective role in lentil against Cu toxicity, thus proposed as a potential chemical for managing Cu toxicity not only in lentil but also other plants.

Microplastics pollution in mud crab (Scylla sp.) aquaculture system: First investigation and evidence

Microplastics (MPs) occurrence in farmed aquatic organisms has already been the prime priority of researchers due to the food security concerns for human consumption. A number of commercially important aquaculture systems have already been investigated for MPs pollution but the mud crab (Scylla sp.) aquaculture system has not been investigated yet even though it is a highly demanded commercial species globally. This study reported the MPs pollution in the mud crab (Scylla sp.) aquaculture system for the first time. Three different stations of the selected aquafarm were sampled for water and sediment samples and MPs particles in the samples were isolated by the gravimetric analysis (0.9% w/v NaCl solution). MP abundance was visualized under a microscope along with their size, shape, and color. A subset of the isolated MPs was analyzed by scanning electron microscope (SEM), and Fourier transform infrared spectroscopy (FTIR) for the surface and chemical characterization respectively. The average MPs concentration was 47.5 ± 11.875 particles/g in sediment and 127.92 ± 14.99 particles/100 L in the water sample. Fibrous-shaped (72.17%) and transparent-colored (59.37%) MPs were dominant in all the collected samples. However, smaller MPs (>0.05-0.5 mm) were more common in the water samples (47.69%) and the larger (>1-5 mm) MPs were in the sediment samples (47.83%). SEM analysis found cracks and roughness on the surface of the MPs and nylon, polyethylene, polypropylene, and polystyrene MPs were identified by FTIR analysis. PLI value showed hazard level I in water and level II in sediment. The existence of deleterious MPs particles in the mud crab aquaculture system was well evident. The other commercial mud crab aquafarms must therefore be thoroughly investigated in order to include farmed mud crabs as an environmentally vulnerable food security concern.

Dengue presenting as a case of acute pancreatitis-A rare case report

Atypical presentations may be presented with the common symptoms in Dengue. We, hereby, present a case of Dengue who was admitted in our hospital with the complaints of fever, upper abdominal pain, and vomiting, literally diagnosed as a case of acute pancreatitis.

Chronic kidney disease in public renal practices in Queensland, Australia, 2011-2018

AIM

To describe adults with (non-dialysis) chronic kidney disease (CKD) in nine public renal practice sites in the Australian state of Queensland.

METHODS

7,060 persons were recruited to a CKD Registry in May 2011 and until start of kidney replacement therapy (KRT), death without KRT or June 2018, for a median period of 3.4 years.

RESULTS

The cohort comprised 7,060 persons, 52% males, with a median age of 68 yr; 85% had CKD stages 3A to 5, 45.4% were diabetic, 24.6% had diabetic nephropathy, and 51.7% were obese. Younger persons mostly had glomerulonephritis or genetic renal disease, while older persons mostly had diabetic nephropathy, renovascular disease and multiple diagnoses. Proportions of specific renal diagnoses varied >2-fold across sites. Over the first year, eGFR fell in 24% but was stable or improved in 76%. Over follow up, 10% started KRT, at a median age of 62 yr, most with CKD stages 4 and 5 at consent, while 18.8% died without KRT, at a median age of 80 yr. Indigenous people were younger at consent and more often had diabetes and diabetic kidney disease and had higher incidence rates of KRT.

CONCLUSION

The spectrum of characteristics in CKD patients in renal practices is much broader than represented by the minority who ultimately start KRT. Variation in CKD by causes, age, site and Indigenous status, the prevalence of obesity, relative stability of kidney function in many persons over the short term, and differences between those who KRT and die without KRT are all important to explore.

Quality of Life of Bangladeshi Doctors in the COVID-19 era: Are We Taking Good Care of Our Carers?

The Coronavirus pandemic has been affecting our healthcare professionals physically as well as psychologically since March 2020. Whilst various measures have been taken to protect their physical health, their mental wellbeing has not been brought into attention. We aimed to assess the well-being of Bangladeshi doctors and identify the high-risk group using a core-10 validated form. We performed an observational cross-sectional survey among Bangladeshi healthcare professionals. One hundred one (101) doctors filled out the core-10 form. We collected data over a 1-month-period during the first peak of COVID-19. According to our data, majority of the participants (49%) felt anxious or nervous at some point. Thirty one percent (31%) felt hopeless, unhappy even panic attacks but most significant finding was that 21% participants had at least once thought about ending their lives. This is a matter of concern and the workplaces should identify the vulnerable professionals so that they can be supported better mentally and socially. More than half of the participants (55%) were found to have moderate to severe depression in the first peak of COVID 19 pandemic. This is not over yet; more waves are coming. Therefore, it is really important that we address this issue before it is too late and ensure regular counselling, better childcare for working parents, safety measures to protect their families and financial security. Otherwise, we might exhaust our carers to a level where even they cannot help us survive this global challenge.

The impact of COVID-19 on tertiary educational institutions and students in Bangladesh

The COVID-19 forced to transform face-to-face mode of teaching to virtual in educational institutions around the globe that not only impact institutional stakeholders, but also posed as a threat to entire humanity because, all parties related to education had to change their activities. The intentions of this study therefore firstly, to determine the content analysis by interviewing tertiary students and secondly, to determine the frequency distribution by questionnaire developed from results of the content analysis. To better understand the consequences of this outbreak, we took an interview from forty respondents, including undergraduate and postgraduate students across Bangladesh. Results of Content analysis revealed that stakeholders of tertiary education are encountering severe problems in mental health, financial, technical, and study. A questionnaire was designed based on results were obtained through content analysis and distributed using email, WhatsApp, LinkedIn, Telegram, Facebook, and Instagram from May 20 to May 30, 2021. A total number of 505 valid questionnaires were received from respondents. Frequency distribution analysis disclosed that 60% respondents have no separate reading rooms. Laptops and desktops are commonly used for online classes, but unfortunately, 21% respondents have no personal electronic gadgets. Moreover, 55% reported spending less time to study during the coronavirus outbreak. Furthermore, 88% respondents reported experiencing mental health-related stress, anxiety, and depression problems. The proportion that suffered financial crisis, family disruptions, internet and technology related problems were 79%, 83% and 72% respectively. Since coronavirus pandemic is a totally new phenomenon in the world, not much empirical literature exist. So we fill the gap, investigating the issue empirically using content and frequency distribution analysis. Policy implications and recommendations are discussed accordingly.

FeedMaster: A least-cost feed formulation App for minimizing the cost and maximizing milk yield

Objective: The study aimed to develop and assess an Android app designed for farmers with a low educational status that can formulate a least-cost ration. Materials and Methods: First, a computer-android-based app named BLRI FeedMaster was developed to guide users in formulating a balanced ration at the least cost. A survey was conducted on 30 livestock officers and 18 farmers with 50 cattle to evaluate its efficacy at the field level. The study outcomes were milk yield, feeding cost, milk composition, time, and cost for management before and after using the BLRI FeedMaster app. Descriptive statistics and paired sample t-tests were used to analyze the data. Results: After adopting the BLRI FeedMaster app, a significant increase was observed in daily average milk yield (9.39 ± 0.32 l from 8.37 ± 0.36 l), while a considerable decrease was observed in daily average feed quantity (4.88 ± 0.15 kg from 5.60 ± 0.17 kg) and feed cost (BDT 28.00 ± 0.50 from BDT 29.75 ± 0.49). Besides, the number of visits, time, and cost for seeking professional services regarding feed, health care, and other information was significantly minimized. The number of visits decreased to 0.36 ± 013 from 3.07 ± 0.38, and the consumed time was reduced from 270 ± 34.30 to 235.71 ± 59.42 min (p < 0.05) after adopting the app. Conclusion: Hence, this app was very beneficial for farmers with a low economic and educational background and may ultimately help farmers with profitable animal farming and sustainable pro¬duction in the least developed countries like Bangladesh.

Concurrent IgG4-Related disease and clear cell renal cell carcinoma

We report a case of a 54-year-old man with a concurrent diagnosis of IgG4-related disease (IgG4-RD) and clear cell renal cell carcinoma (ccRCC) following asymptomatic submandibular lymphadenopathy with an incidental finding of a left renal mass. Partial nephrectomy revealed ccRCC with surrounding lymphoplasmacytic infiltrate, storiform fibrosis and a strong positivity for IgG4 on immunoperoxidase staining. The IgG4+:IgG + ratio was >40% and serum IgG4 levels were elevated at 159mg/dL. This case highlights the concurrent diagnosis of a unique dual pathology within the same organ and emphasises the importance of malignancy screening in patients with IgG4-RD and vice versa.

•

Renal cell carcinoma (RCC) can rarely be associated with IgG4-related disease (IgG4-RD).

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The importance of a thorough work up to rule out malignancies after an initial diagnosis of IgG4-RD, as concurrent pathologies can occur.

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Ensuring long term follow up and high index of suspicion for malignancies in patients with IgG4-RD. A lower threshold for further investigation of suspicious lesions not responding to conventional IgG4-RD treatment is required.

•

The underlying pathogenesis for the link between malignancies and IgG4-RD remains unclear and further studies are required in this area.

Prevalence of Hepatitis B Virus Infection among Children with Liver Disease Admitted In Mymensingh Medical College Hospital

Hepatitis B virus infection is an important cause of liver disease. Hepatitis B Virus may present with varying degree of severity. In older children, 5-10% cases leading to chronic liver disease, cirrhosis and hepatocellular carcinoma. This descriptive cross sectional study was done to assess the prevalence of Hepatitis B Virus infection among hospitalized children with liver disease in pediatric department of Mymensingh Medical College Hospital, Bangladesh from December 2015 to October 2016. All the children of both sexes having age between six months to twelve years admitted in the pediatric ward with acute or chronic liver disease were included in this study by purposive sampling. A written consent was obtained from legal guardian of children before inclusion. Ethical clearance was obtained from competent authority. A detailed history was taken from parents in each case according to pre-designed questionnaire about demography of the patients and the risk factors of the liver disease. A thorough clinical examination and available relevant investigations like serological testing for HBV infection was done in all patients. We had figure out the seropositivity of HBV among patients having liver disease by doing HBsAg and Anti-HBc IgM. Progress of the patient was monitored by daily clinical examinations and by investigating HBsAg and Anti-HBc IgM. Finally data analysis was done by SPSS version 21.0. Among total 100 patients most (44%) patients were in 7-10 years old and most (62%) of the participants were male. Acute liver disease was 58% cases and chronic liver disease was 42% cases. HBsAg was positive in 1 case among acute liver disease and 5 cases among chronic cases. Total 6 (six) patients were found positive for HBsAg. Anti HBc IgM was positive in 4 patients among acute liver disease. Among these Anti HBc IgM positive (4) patients only one had both HBsAg and Anti HBc IgM positive. So, four patients were confirming suffered from acute viral hepatitis because they had anti HBc IgM positive. On the contrary 5 patients suffered from chronic hepatitis by hepatitis B because they were only HBsAg positive. So, in this study 9 patients (9%) were confirming suffered from HBV infection. Possible transmission factors of hepatitis B were history of (H/O) blood transfusion/trauma/parenteral injection, H/O umbilical sepsis, H/O maternal illness/infection during pregnancy. HBV still is a major cause of morbidity. All the children with liver disease should be routinely tested for HBV.

Status and conservation needs of Cycas pectinata Buch.-Ham. in its natural habitat at Baroiyadhala National Park, Bangladesh

The widespread cycad Cycas pectinata was first discovered in the Bengal region by William Griffith in Baroiyadhala forest of Chattogram in 1838. In Bangladesh, this species is confined to a few hills at Baroiyadhala, Sitakunda upazila of Chattogram district. Though the Baroiyadhala forests were declared a national park in 2010, the loss of this native gymnosperm from this forest is alarming. The present study aimed to assess the status of C. pectinata populations in its native range, identify the drivers responsible for ongoing losses, and identify locations of C. pectinata occurrence in Baroiyadhala National Park suitable for in situ conservation. A random quadrat survey with 21 sample plots of 100 × 100 m was conducted during April–June 2018 in Baroiyadhala National Park. Population and growth data for C. pectinata were collected from each sample plot, along with observations of disturbances. Four focus group discussions (FGDs) were conducted with adjacent local people. The study revealed presence of 12 C. pectinata individuals per hectare and five seedlings per hectare in the study area, and significant numbers of dead and burned Cycas were also found in some sites. Based on density, five C. pectinata hotspots were identified for in situ conservation programs. Habitat destruction, indiscriminate fire, and unsustainable harvesting of leaves and male and female cones are responsible for rapid declines in C. pectinata populations in its wild habitat. Measures for protection and restoration of the species are creating awareness among the local people about ecological importance of this species; enhancing protection; banning trade of Cycas; creating opportunities of sustainable livelihood for local people to reduce dependency on forests.

Appraisals of the Bangladeshi Medicinal Plant Calotropis gigantea Used by Folk Medicine Practitioners in the Management of COVID-19: A Biochemical and Computational Approach

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first recognized in Wuhan in late 2019 and, since then, had spread globally, eventually culminating in the ongoing pandemic. As there is a lack of targeted therapeutics, there is certain opportunity for the scientific community to develop new drugs or vaccines against COVID-19 and so many synthetic bioactive compounds are undergoing clinical trials. In most of the countries, due to the broad therapeutic spectrum and minimal side effects, medicinal plants have been used widely throughout history as traditional healing remedy. Because of the unavailability of synthetic bioactive antiviral drugs, hence all possible efforts have been focused on the search for new drugs and alternative medicines from different herbal formulations. In recent times, it has been assured that the Mpro, also called 3CLpro, is the SARS-CoV-2 main protease enzyme responsible for viral reproduction and thereby impeding the host's immune response. As such, Mpro represents a highly specified target for drugs capable of inhibitory action against coronavirus disease 2019 (COVID-19). As there continue to be no clear options for the treatment of COVID-19, the identification of potential candidates has become a necessity. The present investigation focuses on the in silico pharmacological activity of Calotropis gigantea, a large shrub, as a potential option for COVID-19 Mpro inhibition and includes an ADME/T profile analysis of that ligand. For this study, with the help of gas chromatography-mass spectrometry analysis of C. gigantea methanolic leaf extract, a total of 30 bioactive compounds were selected. Our analyses unveiled the top four options that might turn out to be prospective anti-SARS-CoV-2 lead molecules; these warrant further exploration as well as possible application in processes of drug development to combat COVID-19.

272 Morbid Obesity in Lower Limb Arthroplasty: Short Length of Stay and Favourable One-Year Outcomes

Introduction

There are concerns that BMI is associated with a greater length of stay (LOS) and perioperative complications in lower limb arthroplasty.

Method

We analysed data from a six-month period to see if there was a correlation between BMI and LOS. We performed a subgroup analysis for patients with morbid obesity (BMI &gt;40).

Results

285 TKRs and 195 THRs were analysed. For TKRs, the average length of stay was 2.7 days. There was no significant correlation between BMI and LOS (r=-0.0447, p = 0.2267). The morbidly obese category (n = 33) had the shortest LOS (2.5 days) compared to other BMI categories. 30-day readmission rate was 6%. 90-day re-admission rate was 12%. Six patients had minor wound issues requiring no intervention or antibiotics only. The was one prosthetic joint infection, one stitch abscess, one DVT and one patellar tendon injury.

For THRs, the average LOS was 2.9 days. There was no significant correlation between BMI and LOS (r = 0.007, p = 0.4613). The morbid obese category (n = 9) had the shortest LOS (1.9 days) compared to other BMI categories. No patients were readmitted within 90 days or had documented complications.

Conclusions

Increased BMI is not associated with increased LOS. The morbidly obese had the shortest LOS, and commendable complication and re-admission rates.

DECIPHERING THE PHARMACOLOGICAL INSIGHTS OF FRACTIONATED ELATOSTEMA PAPILLOSUM WED. AND HOLIGARNA LONGIFOLIA ROXB. THROUGH IN VITRO AND IN VIVO STUDIES

The present research intended to explore the biological activities, namely acute toxicity test and hypoglycemic as well as in vitro anti-arthritic along with the antibacterial activity of crude methanol extracts with its different soluble fractions like petroleum ether (PESF), carbon tetrachloride (CTCSF), chloroform (CSF) and aqueous soluble fraction (AQSF) of Holigarna longifolia and Elatostema papillosum. Phytochemical screening was performed by established protocols. Acute toxicity and hypoglycemic effects were performed in experimental and alloxan-induced diabetic rats. In vitro anti-arthritic and antibacterial activity were conducted by protein denaturation inhibitory and disc diffusion methods. It was observed that no rats exhibit any lethality types, which reveal the safety of plant fractionates. It was also seen that both plants' fractionates showed significant (p < 0.01) activity on hyperglycemia compared to standard. Upon investigation, it was observed that crude methanol and its CS fraction of E. papillosum and only CS fraction of H. longifolia significantly (p < 0.05) inhibited denaturation of bovine serum albumin protein compared to standard diclofenac sodium. Moreover, it was observed that crude methanol extract and its CS fraction of E. papillosum showed significant inhibitory action on all Gram-positive bacteria's growth. In contrast, the PES fraction highlighted an inhibitory zone of 26.7 and 24.7 mm, respectively, towards B. subtilis and S. aureus. This study provides some support to explain the traditional uses of H. longifolia and E. papillosum.

Relation between Serum Magnesium Level and Migraine

Migraine is one of the most disabling types of headache. It affects 4-6% of men and 13-18% of women; more than 80% of them are under 30 years. Many theories to explain mechanism of migraine are present; role of serum magnesium is one of them. This Cross-sectional analytical study was designed to see serum magnesium level status of migraine patients in Bangladesh and to find out any relation. The study was carried out in Outpatient Department of Neurology of Mymensingh Medical College Hospital, Mymensingh, Bangladesh from July 2017 to September 2018. Seventy (70) patients between 18-60 years of both sexes with headache fulfilling the criteria for migraine were enrolled as migraine group. Patients with headache who did not fulfill the criteria of migraine enrolled as non migraine group. Patients were included in both groups after exclusion of structural lesions, magnesium containing drug intake, pregnancy, menstruation, alcoholism, renal or GIT problems. Serum magnesium levels were studied in both groups and compared with each other. All related factors such as age, sex, family history of migraine, occupation were assessed. Fifty one (51) of 70 patients (72.85%) was female and 19(27.15%) were male in migraine group. Thirty eight (54.28%) of cases were between 18 and 30 years old. Thirty nine (55.71%) of migraine patients had history of similar headache in their family. Severe headache in 51.43% of migraine patients and 30% had more than three attacks per month. Mean serum magnesium level was 1.70 mg/dl in migraine group and 1.85 mg/dl in non migraine group (p=0.001). Serum magnesium level was also lower in severe migraine headache in comparison to mild to moderate headache (p=0.01). No significant difference was found in serum magnesium level compared according to age, sex, frequency of attack and presence or absence of aura. The study concludes that serum magnesium in migraine patients was significantly lower than non migraine group. It was also lower in migraine patient having severe headache in comparison with mild to moderate headache, though in both conditions they were within normal range.

A multi-centre, cross-sectional study on coronavirus disease 2019 in Bangladesh: clinical epidemiology and short-term outcomes in recovered individuals

Coronavirus disease 2019 (COVID-19) rapidly became a global pandemic. This study aimed to investigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -associated epidemiology and clinical outcomes in Bangladesh in order to understand the future course of the COVID-19 pandemic and develop approaches to prevention. A cross-sectional study based on retrospective interviews was conducted on 1021 individuals with RT-PCR-confirmed COVID-19 admitted in six different hospitals in Bangladesh and who recovered 4 weeks before the interview date. Of the 1021 patients, 111 (10.9%) were asymptomatic and the other 910 (89.1%) were symptomatic. Higher prevalence of COVID-19 was found in the male population (75%), in cohorts with B-positive blood group (36.3%) and in the 31-40 years age group. Common symptoms observed in our study participants were fever (72.4%), cough (55.9%), loss of taste (40.7%) and body ache (40%); whereas among the biochemical parameters, neutrophil count (46.4%), D-dimer (46.1%) and ferritin (37.9%) levels were elevated. Among the recovered individuals, short-term outcomes including pains and aches (31.8%), weakened attention span (24.4%) and anxiety or depression (23.1%) were also significantly prevalent in the symptomatic cases with comorbidities. Our study showed that in Bangladesh, adult males aged between 31 and 40 years were more vulnerable to developing COVID-19. It also indicated a rising trend of asymptomatic cases as the pandemic progressed. As a consequence, deployment of interventions to curb further spread of community infection is necessary to avoid grave outcomes of COVID-19 in Bangladesh.

Ornamental fish: a potential source of pathogenic and multidrug-resistant motile Aeromonas spp

Aeromonas spp. are ubiquitous bacteria that cause diseases in fish and other aquatic animals. They are the natural inhabitants of different aquatic environments, such as freshwater, brackishwater and marinewater. Extrinsic stressors, such as crowding, unhygienic handling, poor water quality, polluted feeding and inadequate nutrition, can predispose fish to Aeromonas infection. In ornamental fish, motile Aeromonas spp. are known as aetiological agents of motile aeromonad infections, which cause significant mortality in fish and economic loss in the ornamental fish industry. The existence of different virulence factors leads to the virulence potential of motile Aeromonas spp. There are several antimicrobials used to treat bacterial infections in ornamental fish. However, the extensive use of antimicrobials in the ornamental fish industry causes multidrug resistance. This article reviewed a multitude of virulence factors that are related to the ornamental fish-borne Aeromonas pathogenicity and the antimicrobial resistance determinants related to the multidrug resistance phenotypes of motile Aeromonas spp. in ornamental fish.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

The Prospect of Stem Cells for HIV and Cancer Treatment: A Review

Background: The news regarding the successful treatment of uncured diseases is extremely exciting. Recently, the study of stem cells has been widely considered. Objectives: The stem cells have the potential to be converted to all specialized functional cells. Methods: Advances in cell engineering and genetic reprogramming of the stem cells have contributed to novel approaches that may bring hope to HIV and cancer patients. Results: In this regard, HIV patients recently received a stem-cell transplant that replaced their white blood cells with HIV-resistant versions (obtained from stem cells). However, only a few clinically successful approaches are available on new stem cells. Conclusion: This review includes two parts; in the first section, the reader can obtain a basic idea about stem cells, whereas the second part emphasizes new opportunities and directions in translating stem cells basic research to the clinical applications.

FRI0438 POST-CHIKUNGUNYA CHRONIC ARTHRITIS - SHARING OF BANGLADESH EXPERIENCE OVER ONE YEAR FOLLOW UP OF 60 PATIENTS

Background:

Chikungunya virus (CHIKV) infection is an emerging disease which is responsible for several epidemics around the world1. Systematic review and meta-analysis had shown that approximately 25% of cases of Chikungunya(CHIK) would develop CHIK-Chronic Inflammatory Rheumatism and 14% would develop persistent arthritis (or spondylitis)2.

Objectives:

To describe the frequency of the clinical patterns of chronic arthritis & to characterize the clinical symptoms in a Bangladeshi cohort of CHIK patients 12months post-infection.

Methods:

In 2017, a Chikungunya outbreak occurred in Dhaka, Bangladesh, during which a prospective cohort of CHIK patients with confirmed diagnosis was constituted. A longitudinal follow up of 60 patients from an initial cohort of 142 patients, attending the out-patient department of Rheumatology, BSMMU, was done. Patients having arthritis/ arthralgia or both lasting more than 3 months were considered as chronic cases. Their baseline and follow-up symptoms at 3m, 6m and 12months were evaluated. Functional status was assessed with the Bengali Version Health Assessment Questionnaire (HAQ).

Results:

Of the initial 142 patients enrolled in the study, 135(95.1%) had CHIKV-IgM and 29(20.4%) had IgG positive. Patients that followed up in-person were predominantly adult (age 43.73 ± 11.09 years) and female 34 (56.7%). The majority of the patients 35 (58.3%) had undifferentiated arthritis. After three months, 8 (16.3%) had oligoarthralgia, 26 (53.1%) had polyarthralgia and 8 (16.3%) had polyarthralgia with oligoarthritis. At the end of one year, 13 (21.7%) patients underwent complete remission. Among the 47 patients, 21 had joint involvement where 11(52.4%) had polyarthralgia, 5(23.8%) had polyarthralgia with oligoarthritis, 5 (23%) had oligoarthralgia and 4 (19%) had monoarthralgia. Among the 47 patients, mild, moderate and severe functional disability was present in 89.4%, 6.4% and 4.3% patients respectively.

Conclusion:

After one year of follow up, one-third of the patients remained symptomatic. Polyarthralgia was the predominant clinical feature. Mild functional disability was also observed in a significant number of patients.

References:

[1]Ali Ou Alla S, Combe B. Arthritis after infection with Chikungunya virus. Best Pract Res Clin Rheumatol. 2011;25(3):337-46.

[2]Rodríguez-Morales AJet al.Prevalence of Post-Chikungunya Infection Chronic Inflammatory Arthritis: A Systematic Review and Meta-Analysis.Arthritis. Care. Res. 68(12), 1849-1858 (2016).

Table 1.

Socio-demographic and clinical pattern of patients with Chronic CHK arthritis (n=60)

Variablesn(%)Age (in years)Mean ±SD43.73 ±11.1SexFemale34 (56.7)Male26 (43.3)First joint involvementGeneralized34 (56.7)Ankle12 (20.0)Knee6 (10.0)Wrist5 (8.3)Others (MTP, shoulder, neck and axial plane)3 (5.0)Clinical patternUndifferentiated35(58.3)Spondyloarthritis10 (16.7)Rheumatoid Arthritis7 (11.7)Pre-existing Spondyloarthritis6(10.2)Pre-existing Rheumatoid Arthritis1(1.7)Pre-existing Osteo-arthritis Arthritis1(1.7)Table 2.

Joint involvement of patients with Chronic CHIK arthritis

Joint characteristics3 m (n=49)6 m (n=36)1yr (n=21)f(%)f(%)f(%)Type of involvement in persistent painJoint only33 (55.0)28 (46.7)20 (33.3)Both joint & soft-tissue16 (26.7)8 (13.3)1 (1.7)Joint involvementMonoarthralgia1 (2.0)5 (13.9)4 (19.0)Oligoarthralgia8 (16.3)6 (16.7)5 (23.0)Polyarthralgia26 (53.1)18 (50.0)11 (52.4)Monoarthritis1 (2.0)0(0.0)0(0.0)Oligoarthritis6 (12.2)3 (8.3)0(0.0)Polyarthritis7 (14.3)9 (11.1)1 (4.8)Oligoarthralgia & monoarthritis1 (2.0)0 (0.0)0 (0.0)Polyarthralgia & monoarthritis0 (0.0)1 (2.8)0 (0.0)Polyarthralgia & oligoarthritis8 (16.3)4 (11.1)5 (23.8)Polyarthralgia & Polyarthritis1 (2.0)0 (0.0)0 (0)

Disclosure of Interests:

None declared

0353 Objectively Measured Sleep and Components of Metabolic Syndrome in Well-Functioning Older Adults

Introduction

Prior studies tying sleep to metabolic syndrome in older adults have mostly used self-report sleep measures. We investigated the association between actigraphic sleep parameters and metabolic syndrome components in well-functioning older adults.

Methods

We studied 434 participants in the Baltimore Longitudinal Study of Aging (aged 71.1±12.8 years, 41.4% women) with 6.6±1.0 nights of wrist actigraphy and data on metabolic syndrome components: blood triglyceride (TG) level &gt;150 mg/dL; high density lipoprotein (HDL) &lt;50 mg/dL; and waist circumference (WC) &gt;88.9 cm for women and &gt;101.6 cm for men. Sleep parameters were the primary predictors and metabolic syndrome components the outcomes. Logistic regression was performed, and results are expressed as odds ratio (OR) with p-values.

Results

After adjusting for age, sex, race and education, higher sleep efficiency (SEFF; per 10%) was associated with a lower odds of high WC (SEFF OR=0.60, p=0.01) and, compared to participants in the intermediate total sleep time tertile (5.5 to 6.8 h), those in the shortest tertile (&lt;5.5 h) had a slightly lower odds of high WC (TST OR=0.98, p=0.02). In adjusted models, greater wake after sleep onset (WASO; per 30 min), greater average wake bout length (WBL; per min), and lower SEFF (per 10%) were associated with a greater odds of poor HDL level (&lt;50 mg/dL) (WASO OR=1.37, p=0.05; WBL OR=1.49, p=0.007; SEFF OR=0.72, p=0.04). After further adjustment for BMI and depressive symptoms, only the association between longer WBL and poor HDL level remained significant (OR=1.48, p=0.01). There were no associations between sleep parameters and TG level.

Conclusion

Among well-functioning older adults, greater WASO but lower TST and SE are associated with poorer metabolic syndrome components. Longitudinal research is needed to evaluate the temporal associations of objectively measured poor sleep and metabolic syndrome components and evaluate the roles of BMI and depressive symptoms in these associations.

Support

The first author is supported by a Postdoctoral Fellowship by the Intramural Research Program (IRP) at the National Institute on Aging (NIA). This study was supported in part by National Institute on Aging (NIA) grant R01AG050507, the NIA Intramural Research Program (IRP), and Research and Development Contract HHSN-260-2004-00012C.

Outcome of tension free open mesh repair of inguinal hernia

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24

Species identification, virulence markers and antimicrobial resistance profiles of Aeromonas sp. isolated from marketed hard-shelled mussel (Mytilus coruscus) in Korea

Hard-shelled mussel (Mytilus coruscus) is a popular seafood in Korea. This study aimed to determine the virulence markers and antimicrobial resistance patterns of 33 Aeromonas strains isolated from mussels. The isolates were identified as A. salmonicida (n = 14), A. veronii (n = 9), A. enteropelogenes (n = 4), A. caviae (n = 3), A. allosaccharophila (n = 2) and A. bivalvium (n = 1) by gyrB gene sequencing. The sequence divergence between and within the species ranged from 3·70 to 10·40% and 0-1·50% respectively. Every species formed a distinct group in a neighbour-joining phylogenetic tree. The DNase, gelatinase, caseinase, β-haemolysis, biofilm and lipase activities were observed in 33 (100·00%), 31 (93·93%), 30 (90·90%), 27 (81·81%), 21 (63·63%) and 17 (51·51%) isolates respectively. The virulence genes were detected by PCR in the following frequencies: fla (90·09%), aer (87·88%), hlyA (87·88%), ahyB (81·19%), gcaT (75·76%), ser (69·70%), lip (66·67%), alt (57·58%), ast (51·51%) and act (21·21%). Every isolate was resistant to at least three of 18 antimicrobials in the disk diffusion test. The multiple antimicrobial resistance index values ranged from 0·11 to 0·44 among the isolates. Our study suggests that mussels can be a potential reservoir of virulent and multidrug-resistant Aeromonas sp. SIGNIFICANCE AND IMPACT OF THE STUDY: Aeromonas sp. are known as common pathogenic bacteria isolated from seafood. The virulence factors and antimicrobial resistance profiles of mussel-borne Aeromonas sp. are poorly understood. This study demonstrated for the first time the existence of virulence markers and antimicrobial resistance of Aeromonas sp. from mussels in Korea. Majority of the isolates were positive for phenotypic virulence characteristics and harboured several virulence genes which reveal the potential virulence of mussel-borne Aeromonas sp. Multiple antimicrobial resistance was also observed among the isolates. Our study highlights the importance of food safety standards in mussel consumption.

Prevalence of virulence and antimicrobial resistance genes in Aeromonas species isolated from marketed cockles (Tegillarca granosa) in Korea

This study aimed to examine incidence, virulence and antimicrobial properties in Aeromonas spp. isolated from cockles (Tegillarca granosa) in Korea. Firstly, genomic DNA was extracted from 32 Aeromonas spp. isolates, and PCR screening for virulence, antimicrobial resistance genes was carried out. The disk diffusion assay was used to examine antimicrobial susceptibility. Aeromonas spp. isolates comprised, A. hydrophila (n = 8), A. veronii (n = 15), A. media (n = 2), A. salmonicida (n = 2), A. allosaccharophila (n = 1), A. bestiarum (n = 1), A. culicicola (n = 1), A. enteropelogenes (n = 1) and A. rivipollensis (n = 1). High prevalence of virulence-related genes reported as; act (69%), alt (47%), ast (41%), aerA (56%), lip (50%), ahyB (47%), ser (28%), fla (66%), gcat (44%), ascV (50%) and hlyA (72%). All isolates were multidrug resistant, while highest resistance level observed for ampicillin (100%), followed by imipenem (81%), rifampicin (78%), cephalothin (72%), piperacillin (47%) and Colistin sulfate (31%). The presence of bla_SHV , bla_CTX , tetE, aac(6')-Ib, strA-strB, qnrS, qnrB and IntI1 genes were reported in varying combinations. Nevertheless, bla_TEM , bla_IMP , tetA, tetB, qnrA, qnrB and aphAI-IAB genes and the class1 integron were not detected. The high occurrence of virulence and antimicrobial resistance genes in cockles reveals that it can be a potential health risk source for consumers.

Phylogenetic relationships, virulence and antimicrobial resistance properties of Klebsiella sp. isolated from pet turtles in Korea

Klebsiella sp. are responsible for a multitude of infectious diseases in both humans and animals. In this study, phylogenetic relationships, virulence and antimicrobial resistance gene properties of 16 Klebsiella sp. isolated from 49 pet turtles were investigated. The isolates including Klebsiella oxytoca (n = 13) and Klebsiella pneumoniae (n = 3) were identified using 16S rRNA gene sequencing and each species formed distinct clusters in the neighbour-joining phylogenetic tree. The prevalence of virulence genes including ureC (100%) and kfu (68·75%) was observed among the isolates using Polymerase chain reaction (PCR) assay. The fimH, mrkD and rmpA genes were detected in all K. pneumoniae while these were absent in every K. oxytoca isolate. In antimicrobial susceptibility testing, high resistance rates were observed against ampicillin (100%) and cephalothin (62·50%). The resistance rates against imipenem, tetracycline, trimethoprim/sulfamethoxazole, nalidixic acid and ciprofloxacin were 12·50, 12·50, 12·50, 6·25 and 6·25% respectively. The presence of antimicrobial resistance genes such as plasmid-mediated quinolone resistance (PMQR) [qnrB (37·50%), qnrA (31·25%), qnrS (12·50%) and aac(6')-Ib-cr (12·50%)], extended-spectrum β-lactamase (ESBL) [bla_CTX-M (18·75%)], β-lactamase [bla_SHV-1 (18·75%)] and tetracycline resistance [tetE (12·50%)] was observed. The results revealed that pet turtle-borne Klebsiella sp. may carry different types of virulence and antimicrobial resistance genes which represents a potential threat to public health. SIGNIFICANCE AND IMPACT OF THE STUDY: Klebsiella sp. are nonmotile Gram-negative bacteria that are found in different environments. The virulence and antimicrobial resistance properties of pet turtle-borne Klebsiella sp. have not been studied before. Phylogenetic relationships, virulence traits and antimicrobial resistance profiles of pet turtle-borne Klebsiella sp. were characterized for the first time in Korea. Multiple virulence and antimicrobial resistance genes were observed among the isolates. The occurrence of virulence and antimicrobial resistance determinants in Klebsiella sp. may represent a potential threat to public health.

Manila clam (Ruditapes philippinarum) marketed in Korea as a source of vibrios harbouring virulence and β-lactam resistance genes

The present study assessed the occurrence, virulence determinants and antimicrobial susceptibility patterns of Vibrio spp. isolated from live Manila clam (Ruditapes philippinarum). A total of 31 Vibrio spp. including 27 V. diabolicus, two V. fluvialis, one V. alginolyticus and one V. antiquarius were isolated and identified. Phenotypic detection of DNase, lipase, phospholipase, amylase and caseinase activities was 100%; and 87% gelatinase, 45% slime production and 6% haemolysin activities were also observed. The prevalence of toxin-related virulence genes for collagenase (94%), toxR (100%), tlh (68%), and VPI (71%) was detected by PCR. Additionally, two V. fluvialis isolates carried F-toxR and hupo genes. Moreover, 61% of the isolates showed multiple antimicrobial resistance indices >0·2. The resistance rates of ampicillin, piperacillin, colistin sulfate, rifampicin, and cephalothin were 100, 81, 71, 77 and 68% respectively. The prevalence of blaCTX-M (87%), blaTEM (55%) and Int1 (90%) genes was observed, whereas blaSHV, strA-strB, tetA, tetB, and aadA2 gene cassette were reported in varying combinations. However, armA, aac(3)-IIa and quinolone resistance genes (qnrA, qnrB, qnrS) were not amplified. Thus, the virulence along with extended-spectrum β-lactamases (ESBLs) and other antimicrobial resistance genes in multidrug-resistant Manila clam-borne vibrios may pose a public health threat for consumers. SIGNIFICANCE AND IMPACT OF THE STUDY: In Korea, eating raw seafood is considered a great delicacy. This has negatively affected the public by increasing health issues over the years due to the ingestion of vibrios. For the first time, we could identify Vibrio diabolicus and Vibrio antiquarius in marketed Manila clams in Korea. The prevalent Vibrio diabolicus isolates demonstrated the Vibrio parahaemolyticus and Vibrio cholerae homologous virulence genes (toxR, tlh, and VPI). Additionally, the abundance of extended-spectrum β-lactamases (ESBLs) and integron (IntI1) harboured by Manila clam-borne vibrios elucidate the potential health risk for consumers and may complicate health treatments in the case of infection.

Prevalence of virulence and extended-spectrum β-lactamase (ESBL) genes harbouring Vibrio spp. isolated from cockles (Tegillarca granosa) marketed in Korea

The present study aimed to investigate the incidence, virulence and antibiotic properties in Vibrio spp. isolated from cockles (Tegillarca granosa) marketed in Korea. A total of 32 Vibrio spp. isolates including V. parahaemolyticus (n = 4), V. alginolyticus (n = 11), V. diabolicus (n = 14) and V. harveyi (n = 3) were detected using gyrB sequencing. The phenotypic pathogenicity revealed that the DNase, amylase and phospholipase activities were 100%, while lipase, slime production, gelatinase and caseinase were detected in 72, 88, 88 and 81% of the isolates respectively. The PCR amplification for the detection of V. parahaemolyticus species-specific tdh, tlh, trh and toxR genes were positive in 4 (13%), 16 (50%), 0 (0%) and 4 (13%) isolates respectively. The V. alginolytuicus species-specific tdh, tlh, trh, toxR and vac genes were carried by 15 (47%), 29 (91%), 0 (0%), 15 (47%) and 25 (78%) of the isolates respectively. In addition, multidrug resistance was observed by 27 (84%) isolates, whereas higher resistant rates were observed against ampicillin, piperacillin, streptomycin and cephalothin. The occurrence of bla_CTX (78%), bla_TEM (40%), bla_SHV (22%) and aac(6')-Ib (94%) were prevalent, while strAB, tetB, aphAI-IAB, intl1 and aadA1 gene cassettes were also detected. The results signify the potential health risks resulting from the consumption of raw cockles in Korea. SIGNIFICANCE AND IMPACT OF THE STUDY: Vibrios are well known to cause human infections following consumption of raw or undercooked seafood. This phenomenon has undoubtedly increased the number of health issues over the past few years in Korea. Among the identified Vibrio spp., we could detect V. diabolicus and V. harveyi for the first time in marketed cockles in Korea. The presence of species-specific genes (tdh-VA, tlh-VP, tlh-VA and toxR-VA) in V. diabolicus exhibits the close genetic affinity among V. parahaemolyticus and V. alginolyticus. Furthermore, the prevalence of extended-spectrum β-lactamases (ESBLs) and other antibiotic resistance genes along with multidrug resistance signifies the potential threat for consumers.

In vivo neuroprotective, antinociceptive, anti-inflammatory potential in Swiss albino mice and in vitro antioxidant and clot lysis activities of fractionated Holigarna longifolia Roxb. bark extract

Background The study investigated the in vivo neuroprotective, antinociceptive, anti-inflammatory potential and in vitro antioxidant and clot lysis activities of crude methanol extract with its different solvent-soluble fractions like petroleum ether (PESF), carbon tetrachloride (CTSF), chloroform (CSF) and aqueous (AQSF) of Holigarna longifolia Roxb. Methods Phenobarbitone-induced sleeping time method was used for the neuroprotective activity, writhing response experimental model introduced by acetic acid was designed for antinociceptive efficacy, carrageenan-induced paw edema model was carried out for anti-inflammatory activity, DPPH free radical scavenging activity was assessed for antioxidant activity and clot lysis model was investigated for the thrombolytic potential of the plant. Results On investigation it was found that methanol extract and CS fraction revealed statistically meaningful (p<0.05) neuroprotective activity by increasing phenobarbitone-induced sleeping time of mice, produced substantial (p<0.05) inflammation inhibitory efficacy compared to standard diclofenac sodium and also exhibited statistically significant (p<0.01) oxidative stress inhibitory efficacy by inhibiting free radical formation compared to ascorbic acid as standard. Only methanol extract produced significant (p<0.05) antinociceptive activity by inhibiting abdominal writhes produced by acetic acid compared to standard analgesic drug diclofenac sodium. And only aqueous soluble fraction exhibited moderate clot lysis activity compared to streptokinase as standard. Conclusion The findings demonstrate that H. longifolia could be potential neuroprotective due to its justified antioxidative capacity as well as clot lysis properties.

Carboxylic acid modified pH-responsive composite polymer particles

pH-responsive polymers are attracting much interest from researchers because of their wide application potentials in areas like biosensor, bioseparator, bioreactor, biocatalysis, drug delivery, and water treatments. In this investigation a two-step process is evaluated to prepare carboxyl(–COOH) functional submicrometer-sized pH-responsive composite polymer particles. First, submicrometer-sized polystyrene (PS) particles are prepared by a modified conventional dispersion polymerization. In the second step, PS/poly(methacrylic acid-acrylamide-ethylene glycol dimethacrylate) [PS/P(MAA-AAm-EGDMA)] composite polymer particles are synthesized by seeded co-polymerization of methacrylic acid, acrylamide, and ethylene glycol dimethacrylate in the presence of PS seed particles. The size distributions and morphologies analyzed by electron micrographs suggested that seeded copolymerization smoothly occurred without formation of any secondary tiny copolymer particles. The surface composition and functionality are confirmed by Fourier transform infrared spectroscopy and proton nuclear magnetic resonance. The hydrodynamic diameter increased with the increase in pH values as part of the carboxyl groups are deprotonated, which favored the swelling of copolymer layer formed around the surface of PS particles. The adsorption of cationic and anionic surfactants at two different pH values showed that adsorption of cationic surfactant is favored at higher pH value whereas that of anionic surfactant is favored at lower pH value.

Antibiotic and heavy metal resistance genes in Aeromonas spp. isolated from marketed Manila Clam (Ruditapes philippinarum) in Korea

AIMS

Manila clam (Ruditapes philippinarum) is one of the most popular seafood in Korea, owing to their unique taste and nutritional value. This study aimed to disclose the antibiotic and heavy metal resistance characteristics of Aeromonas spp. isolated from marketed Manila clam in Korea.

METHODS AND RESULTS

A total of 36 Aeromonas spp. strains were isolated and subjected to two tests: an antibiotic disk diffusion test to determine their resistance to antibiotics, and a broth dilution test to determine their resistance to heavy metals. PCR-based amplification was performed to detect the resistance genes. A high level of resistance to ampicillin (100%) and cephalothin (89%) was observed, while 42, 39, 36 and 36% of the isolates were resistant to oxytetracycline, imipenem, nalidixic acid and tetracycline respectively. In addition, among the tested heavy metals, cadmium (Cd) recorded the highest resistance rate (61%), followed by chromium (Cr) (50%), lead (Pb) (47%) and copper (Cu) (37%). However, mercury (Hg) resistance was not observed. PCRs revealed the occurrence of bla_TEM , bla_SHV , bla_CTX-M , qnrS, tetB, tetE, aac(6')-Ib, strA-strB and intI1 genes among 100, 31, 31, 78, 78, 89, 25, 50 and 72% of the isolates respectively. Moreover, heavy metal resistance genes, copA, merA and czcA were detected in 25, 47 and 61% of the isolates respectively.

CONCLUSIONS

The results suggest the importance of multi-drug and heavy metal-resistant aeromonads in Manila clam to assess the consumer safety and public health.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study is the first to elaborate on the importance of multi-drug and heavy metal-resistant aeromonads in Manila clam. Particularly, the presence of extended-spectrum-β-lactamase genes and other antibiotic resistance genes intensifies the possible health risks and may complicate therapeutic treatments upon infection, while heavy metal resistance suggests possible heavy metal exposure.

Incidence of antimicrobial resistance genes and class 1 integron gene cassettes in multidrug-resistant motile Aeromonas sp. isolated from ornamental guppy (Poecilia reticulata)

Aeromonas sp. are opportunistic pathogenic bacteria which are associated with various diseases in ornamental fish, aquaculture raised species and wild fisheries. In our study, antimicrobial resistance patterns, antimicrobial resistance genes and class 1 integron gene cassettes of 52 guppy-borne Aeromonas sp. were examined. The isolates were identified as A. veronii (n = 34), A. dhakensis (n = 10), A. hydrophila (n = 3), A. caviae (n = 3) and A. enteropelogenes (n = 2) by gyrB gene sequencing. Every isolate was resistant to at least four antimicrobials in disc diffusion test. The resistance to amoxicillin, nalidixic acid and oxytetracycline was 100% among the tested isolates. 92·30, 76·92, 71·15, 51·92, 51·92 and 50·00% of the isolates were resistant to ampicillin, rifampicin, imipenem, cephalothin, tetracycline and trimethoprim respectively. The multiple antibiotic resistance index values ranged from 0·28 to 0·67. PCR amplification of antimicrobial resistance genes implied the occurrence of tetracycline resistance (tetA (65·39%), tetE (25·00%) and tetB (15·38%)), plasmid-mediated quinolone resistance (qnrS (26·92%) and qnrB (17·31%)) and aminoglycoside resistance (aphaAI-IAB (7·69%) and aac (6')-Ib (3·84%)) genes in the isolates. The IntI gene was positive for 36·54% of the isolates and four class 1 integron gene cassette profiles (aadA2, qacE2-orfD, aadA2-catB2 and dfrA12-aadA2) were identified. These data suggest that ornamental guppy can be a reservoir of multidrug-resistant Aeromonas sp. which comprise different antimicrobial resistance genes and class 1 integrons. SIGNIFICANCE AND IMPACT OF THE STUDY: Antimicrobial resistance genes and integron gene cassettes of ornamental fish-borne aeromonads are poorly studied. The antimicrobial resistance patterns, antimicrobial resistance genes and class 1 integron gene cassettes of Aeromonas sp. isolated from ornamental guppy were characterized for the first time in Korea. The incidence of different antimicrobial resistance genes and class 1 integron gene cassettes were observed in multidrug-resistant Aeromonas isolates. This result suggests that better management practices are necessary to prevent and address the serious consequences of indiscriminate and inappropriate antimicrobial use, and the distribution of multidrug-resistant bacteria.

Appraising spatial variations of As, Fe, Mn and NO3 contaminations associated health risks of drinking water from Surma basin, Bangladesh

This study aims to appraise the spatial variations and pathways of groundwater contaminations and associated health risks in the Surma basin, Bangladesh using geostatistics, Fuzzy GIS technique and health risk modelbased on ninety groundwater samples. The results show that the mean concentrations of As, Fe, Mn and NO₃ are below the Bangladesh water quality standard, whereas As, Fe and Mn concentrations exceed World Health Organization guideline values in several sampling sites. The compositional study identifies weathering of source rocks, reductive dissolution of Fe and Mn-oxyhydroxide minerals and various anthropogenic inputs as the key sources of groundwater contamination. The kriged maps show the elevated risks of Fe, Mn and NO₃ concentrations from the south to northern parts and As concentration from the north to southwestern parts of the Surma basin. The results of fuzzy GIS maps confirm the outcomes of kriged maps. Cross validation results show better performance of indicator kriging over probability kriging. The results also show a spatial heterogeneity with As, Fe, Mn and NO₃ concentrations, indicating the low to medium risk categories. A health risk assessment is performed using hazard quotient (HQ) and hazard index (HI). The HQ values imply that the risk of contamination through oral ingestion pathway is medium to high levels for both adults and children as the trace elements show HQ values more than one. It is found that drinking water of several upazilas exhibits high contamination and that children are more susceptible to the non-carcinogenic and carcinogenic risks than adults in the study area.