Human papillomavirus related oropharyngeal cancer: identifying and quantifying topics of patient interest

OBJECTIVE

As the incidence of human papillomavirus related oropharyngeal cancer continues to rise, it is increasingly important for public understanding to keep pace. This study aimed to identify areas of patient interest and concern regarding human papillomavirus and oropharyngeal cancer.

METHOD

This study was a retrospective survey of search queries containing the keywords 'HPV cancer' between September 2015 and March 2021.

RESULTS

There was 3.5-fold more interest in human papillomavirus related oropharyngeal cancer (15 800 searches per month) compared with human papillomavirus related cervical cancer (4500 searches per month). Among searches referencing cancer appearance, 96.8 per cent pertained to the head and neck region (3050 searches per month). Among vaccination searches, 16 of 47 (34.0 per cent; 600 searches per month) referenced human papillomavirus vaccines as being a cause of cancer rather than preventing cancer.

CONCLUSION

The vast majority of online searches into human papillomavirus cancer pertain to the oropharynx. There are relatively few search queries on the topic of vaccination preventing human papillomavirus associated oropharyngeal cancer, which highlights the continued importance of patient education and awareness campaigns.

Hippocampus Segmentation-Based Alzheimer's Disease Diagnosis and Classification of MRI Images

Alzheimer's disease represents a neurological condition characterized by steady cognitive decline and eventual memory loss due to the death of brain cells. It is one of the most prominent dementia types observed in patients and which hence underlines the imminent need for potential methods to diagnose the disease early on. This work considers a novel approach by utilizing a reduced version of one of the datasets used in this work to achieve a considerably accurate prediction while also enabling quicker training. It leverages image segmentation to isolate the hippocampus region from brain MRI images and then strikes a comparison between models trained on the segmented portions and models trained on complete images. This research uses two datasets-4 classes of images from Kaggle and a popular OASIS 2 MRI and demographic dataset. A deep learning-based approach was adopted to train the Kaggle dataset to perform severity classification, and the hippocampus region segmented from a reduced version of the OASIS dataset was trained on supervised and ensemble learning algorithms to detect Alzheimer's disease. The metric used for the assessment of model performance is classification accuracy. A comparative analysis between the proposed approach and existing work was also performed, and it was observed that the proposed approach is effective in the early diagnosis of Alzheimer's disease.

Integrated network pharmacology and molecular modeling approach for the discovery of novel potential MAPK3 inhibitors from whole green jackfruit flour targeting obesity-linked diabetes mellitus

The current study investigates the effectiveness of phytocompounds from the whole green jackfruit flour methanol extract (JME) against obesity-linked diabetes mellitus using integrated network pharmacology and molecular modeling approach. Through network pharmacology, druglikeness and pharmacokinetics, molecular docking simulations, GO analysis, molecular dynamics simulations, and binding free energy analyses, it aims to look into the mechanism of the JME phytocompounds in the amelioration of obesity-linked diabetes mellitus. There are 15 predicted genes corresponding to the 11 oral bioactive compounds of JME. The most important of these 15 genes was MAPK3. According to the network analysis, the insulin signaling pathway has been predicted to have the strongest affinity to MAPK3 protein, which was chosen as the target. With regard to the molecular docking simulation, the greatest notable binding affinity for MAPK3 was discovered to be caffeic acid (-8.0 kJ/mol), deoxysappanone B 7,3'-dimethyl ether acetate (DBDEA) (-8.2 kJ/mol), and syringic acid (-8.5 kJ/mol). All the compounds were found to be stable inside the inhibitor binding pocket of the enzyme during molecular dynamics simulation. During binding free energy calculation, all the compounds chiefly used Van der Waal's free energy to bind with the target protein (caffeic acid: 102.296 kJ/mol, DBDEA: -104.268 kJ/mol, syringic acid: -100.171 kJ/mol). Based on these findings, it may be inferred that the reported JME phytocompounds could be used for in vitro and in vivo research, with the goal of targeting MAPK3 inhibition for the treatment of obesity-linked diabetes mellitus.

Phyto-Computational Intervention of Diabetes Mellitus at Multiple Stages Using Isoeugenol from Ocimum tenuiflorum: A Combination of Pharmacokinetics and Molecular Modelling Approaches

In the present study, the anti-diabetic potential of Ocimum tenuiflorum was investigated using computational techniques for α-glucosidase, α-amylase, aldose reductase, and glycation at multiple stages. It aimed to elucidate the mechanism by which phytocompounds of O. tenuiflorum treat diabetes mellitus using concepts of druglikeness and pharmacokinetics, molecular docking simulations, molecular dynamics simulations, and binding free energy studies. Isoeugenol is a phenylpropene, propenyl-substituted guaiacol found in the essential oils of plants. During molecular docking modelling, isoeugenol was found to inhibit all the target enzymes, with a higher binding efficiency than standard drugs. Furthermore, molecular dynamic experiments revealed that isoeugenol was more stable in the binding pockets than the standard drugs used. Since our aim was to discover a single lead molecule with a higher binding efficiency and stability, isoeugenol was selected. In this context, our study stands in contrast to other computational studies that report on more than one compound, making it difficult to offer further analyses. To summarize, we recommend isoeugenol as a potential widely employed lead inhibitor of α-glucosidase, α-amylase, aldose reductase, and glycation based on the results of our in silico studies, therefore revealing a novel phytocompound for the effective treatment of hyperglycemia and diabetes mellitus.

Attributable Mortality and Excess Length of Stay associated with Third-Generation Cephalosporin Resistant Enterobacterales Bloodstream Infections - a prospective cohort study in Suva, Fiji

OBJECTIVES

There are scant primary clinical data on antimicrobial resistance (AMR) burden from low- and middle-income countries (LMICs). We adapted recent World Health Organization methodology to measure the impact of third-generation cephalosporin resistance (3GC-R) on mortality and excess length of hospital stay in Fiji.

METHODS

We conducted a prospective cohort study of inpatients with Enterobacterales bloodstream infections (BSIs) at Colonial War Memorial Hospital, Suva. We used cause-specific Cox proportional hazards models to estimate the effect of 3GC-R on the daily risk (hazard) of in-hospital mortality and being discharged alive (competing risks), and multistate modelling to estimate the excess length of hospital stay.

RESULTS

From July 2020 to February 2021 we identified 162 consecutive Enterobacterales BSIs, 3GC-R was present in 66 (40.7%). Crude mortality for patients with 3GC-susceptible and 3GC-R BSIs was 16.7% (16/96) and 30.3% (20/66), respectively. 3GC-R was not associated with the in-hospital mortality hazard rate (adjusted hazard ratio (aHR) 1.13, 95% CI 0.51-2.53) or being discharged alive (aHR 0.99, 95% CI 0.65-1.50), whereas Charlson comorbidity index score (aHR 1.62, 95% CI 1.36-1.93) and Pitt bacteraemia score (aHR 3.57, 95% CI 1.31-9.71) were both associated with an increased hazard rate of in-hospital mortality. 3GC-R was associated with an increased length of stay of 2.6 days (95% CI 2.5-2.8). 3GC-R was more common among hospital-associated infections, but genomics did not identify clonal transmission.

CONCLUSION

Patients with Enterobacterales BSIs in Fiji had high mortality. There were high rates of 3GC-R, which was associated with increased hospital length of stay but not with in-hospital mortality.

Corrigendum: Everything Old Is New Again: Drug Repurposing Approach for Non-Small Cell Lung Cancer Targeting MAPK Signaling Pathway

[This corrects the article DOI: 10.3389/fonc.2021.741326.].

Amelioration of fly annoyance in dairy cattle by using illuminated fly traps

Blood-sucking and biting flies are a significant source of annoyance to warm-blooded animals. Behavioural changes in animals may include attempts to pursue, remove or avoid the disturbance caused by the fly by means of body movement. In the presesnt study the behaviour during a 10 min period in each four-hour interval i.e. 1 AM, 5 AM, 9 AM, 1 PM, 5 PM and 9 PM was analysed and noted for inclusion in the ethogram. The cows with light trap (treatment) were compared with those without light traps (control) to study the effectivenss of the fly trap in reducing annoyance in cattle. All the seven avaoidance behaviours were counted such as head movement, ear shaking, tail movement, skin twitching, licking, kicking on belly and restlessness and were recorded by scan method. The results of this study indicated that the incidence of all the seven fly avoidance behaviours were significantly higher (p<0.01) in the control group. It could also be concluded that the occurance of all the behaviours in the control group at 1 PM were significantly high followed by 5 PM. The findings of the study suggest that fly activity in dairy farms was high during the afternoon hours followed by evening time and illuminated fly traps could be used effectively in controlling flies, so that the fly avoidance behavior by cattle was reduced on dairy farms.

Seroprevalence to common infectious abortifacient and infertility causing agents in the dairy herds of India

BACKGROUND

Information on the prevalence of infectious agents in dairy farms forms the basis for formulating a suitable control strategy; especially in endemic situations.

AIMS

A cross-sectional study was undertaken to determine the prevalence of six economically important bovine diseases, causing reproductive disorders including bovine abortion in organized dairy herds in India.

METHODS

A total of 1,075 animals (cattle and buffaloes) from 09 dairy farms were screened by ELISA tests.

RESULTS

Bovine viral diarrhoea (BVD) was the most prevalent (56.5%) disease followed by infectious bovine rhinotracheitis (IBR) (45.4%). Prevalence of Q-fever (5.4%) and neosporosis (6.1%) were less on the farms. Although 16.3% of the samples turned positive for brucellosis, the contribution of calf-hood vaccination (B. abortus S19 vaccine) to the prevalence of antibodies cannot be ruled out. The overall prevalence of bovine anaplasmosis, known to cause sporadic abortions in dairy herds, was 34.1% in the 9 farms with a prevalence of less than 20% in 5 farms. Infection of multiple abortifacient (seroprevalence to more than two pathogens) was recorded in 56.8% of animals. A very strong association was observed between BVD and brucellosis (Odds ratio 14.2; P<0.001). Further, a positive association was also seen between seroprevalence of IBR and anaplasmosis, and neosporosis and Q fever (P<0.05).

CONCLUSION

Viral diseases were found to be more common in the dairy herds than bacterial and protozoan diseases. Increased susceptibility of IBR seropositive cows to other bacterial and viral infections was observed.

Effectiveness of livestock delivery services of dairy cooperatives of Kerala state

The present study aimed to know the effectiveness of livestock services delivered by the veterinarians working under state regional cooperative milk producers’ union (SRCMPU) and farmers views on these services. An ex-post-facto research design was adopted for the study. A total of fifteen veterinarians working under SRCMPU, Kerala, and thirty livestock farmers dependent on SRCMPU for the livestock services were selected. Data collection was done through using structured interview schedule method. The result from the study revealed that majority of the veterinarians and livestock farmers perceived curative services (60.00% and 46.66%), production services (53.33% and 63.33%), preventive services (53.34% and 56.66%), extension services (60.00% and 50.00%) and miscellaneous services (60.00% and 60.00%) as average. About satisfaction level, majority of the livestock farmers had medium level of satisfaction towards curative services (66.66%), production services (43.33%), preventive services (60.00%), extension services (50.00%) and miscellaneous services (60.00%). It is concluded from the result that there is need to improve the quality of livestock services from both veterinarians and farmers point of view. It is the need of hour to analyze and interpret the current scenario of service delivery systems of state regional cooperative milk producers’ union through assessing the constraints perceived by them in livestock service delivery.

Comprehensive Analysis and Assessment on Codon Usage Pattern of Hemolytic Genes from Different Strains of Leptospira interrogans

Background: Leptospirosis is a disease that is zoonotic in nature. It is easily able to survive in the environment and gets transmitted from the reservoir hosts such as rat to humans. Though the cause of Leptospira interrogans virulency is not determined, these studies expresses that the product of a Leptospira interrogans gene sphH is hemolytic in nature and is capable of lysing the erythrocyte cells and also few epithelial cell membranes. Aim: In this study, we have analyzed the codon usage bias of the gene sphH, taken from 49 strains of Leptospira interrogans. Materials and Methods: Data Collection: The full CDSs nucleotide of the gene sphH from 49 Leptospira interrogans was downloaded separately in FASTA format from the NCBI nucleotide database. Molecular Evolutionary Genetics Analysis (MEGA) program was used to edit and align the coding sequences. With the help of statistical techniques such as RSCU and ENC we have determined the codons mostly used to express the gene sphH and source of the bias with methods such as parity rule 2, neutrality plots. Result: The nucleotide content of the , gene across 49 variants of leptospira divulged that the usage of A (36.03% ± 0.74) and T (31.81% ± 0.65) occurred more frequently than the usage of G (17.88% ± 0.57) and C (14.28% ± 0.66) making the gene composition AT more than GC. The composition of bases in the 3rd position saw base T most frequent than base A. Conclusion: The codon and amino acid use patterns reflect this bias in genetic composition. Leptospiral strains have a similar general codon usage pattern and are slightly biassed. The majority of the frequently occurring codons are A- and U-ending, showing that mutational bias is the primary driver determining codon usage in this bacterium. There were significant changes in synonymous codon usage frequencies between Leptospira interrogans and with other virulent strains. Codon use preferences to account for these differences.

Everything Old Is New Again: Drug Repurposing Approach for Non-Small Cell Lung Cancer Targeting MAPK Signaling Pathway

Non-small cell lung cancer (NSCLC) is a prominent subtype of lung carcinoma that accounts for the majority of cancer-related deaths globally, and it is responsible for about 80% to 85% of lung cancers. Mitogen-Activated Protein Kinase (MAPK) signaling pathways are a vital aspect of NSCLC, and have aided in the advancement of therapies for this carcinoma. Targeting the Ras/Raf/MEK/ERK pathway is a promising and alternative method in NSCLC treatment, which is highlighted in this review. The introduction of targeted medicines has revolutionized the treatment of patients with this carcinoma. When combined with current systems biology-driven stratagems, repurposing non-cancer drugs into new therapeutic niches presents a cost-effective and efficient technique with enhancing outcomes for discovering novel pharmacological activity. This article highlights the successful cutting-edge techniques while focusing on NSCLC targeted therapies. The ultimate challenge will be integrating these repurposed drugs into the therapeutic regimen of patients affected with NSCLC to potentially increase lung cancer cure rates.

Synonymous codon usage pattern among the S, M, and L segments in Crimean-congo hemorrhagic fever virus

Crimean-Congo hemorrhagic fever (CCHF) virus is one among the major zoonosis viral diseases that use the Hyalomma ticks as their transmission vector to cause viral infection to the human and mammalian community. The fatality of infectious is high across the world especially in Africa, Asia, Middle East, and Europe. This study regarding codon usage bias of S, M, and L segments of the CCHF virus pertaining to the host Homo sapiens, reveals in-depth information about the evolutionary characteristics of CCHFV. Relative Synonymous Codon Usage (RSCU), Effective number of codons (ENC) were calculated, to determine the codon usage pattern in each segment. Correlation analysis between Codon adaptation index (CAI), GRAVY (Hydrophobicity), AROMO (Aromaticity), and nucleotide composition revealed bias in the codon usage pattern. There was no strong codon bias found among any segments of the CCHF virus, indicating both the factors i.e., natural selection and mutational pressure shapes the codon usage bias.

458 Patient Willingness to Undergo Elective Orthopaedic Surgery in Relation to the COVID-19 Outbreak

Objective

To determine patients’ willingness to undergo elective orthopaedic surgery during the COVID-19 pandemic.

Method

4 groups of patients were chosen based on type of surgery. A telephone survey was conducted, including questions on diagnosis, symptom duration, pain severity, co-morbidities, anxiety levels for COVID-19 and surgery. Patients were given the conditions for surgery and asked whether they would undergo surgery, have the operation carried out by another consultant and any factors that would increase their confidence.

Results

Of 200 patients, 156 participated (78%). 78.2% were willing to undergo surgery. There was a statistically significant difference in willingness between age groups 40-49 (100%) and 80 + (58.3%). Differences in willingness between surgery types, BOA risk class, sex, symptom duration and pain scores, were not statistically significant.

Patients unwilling to undergo surgery reported statistically higher anxiety scores for health (4.39) and surgery (4.62) compared to the willing group (2.89 and 2.71 respectively). Patients’ main concern was contracting COVID (35.2%).

Conclusions

Our study demonstrated that the majority of patients were willing to undergo surgery. This can be used to inform strategies for resuming elective surgeries. It has also highlighted several areas in patient perception that warrant further investigation and the importance of enhanced consent on the specific risks.

Biosorption of oxybenzene using biosorbent prepared by raw wastes of Zea mays and comparative study by using commercially available activated carbon

Organic pollutants present in waste water have undesirable effect on the environment. Industry activities are the key sources of organic pollutants. Prime pollutants released from various sources react instantly with the environment and become derived (secondary) pollutants, which stay for an elongated time. The present research work has been carried out using biosorbent prepared from various Zea mays wastes for elimination of oxybenzene. Different parameters viz contact time, initial concentration; adsorbent dose, temperature and pH were optimized for the biosorption of oxybenzene on to the biosorbent samples. BCS (Baby corn silk) showed higher percentage of biosorption at optimum contact time of 3 h, pH between 5 and 6 and temperature at 25 °C. Analysis of equilibrium biosorption data in terms of several isotherm models revealed that Langmuir isotherm and Freundlich isotherm indicates better agreement with the experimental data. The kinetics of oxybenzene biosorption on to the biosorbents was described with the pseudo-first-order model. Thermodynamic parameters indicated that biosorption onto biosorbent was feasible in nature, spontaneous, and endothermic for some biosorbents, but on contrary not feasible, exothermic and non spontaneous for other biosorbents. The result of this study showed that the biosorbent derived from Zea mays can be used as a prospective biosorbent for oxybenzene in wastewater and also can be an alternative for the commercially activated carbon.

In silico evaluation of flavonoids as effective antiviral agents on the spike glycoprotein of SARS-CoV-2

The novel coronavirus pandemic has spread over in 213 countries as of July 2020. Approximately 12 million people have been infected so far according to the reports from World Health Organization (WHO). Preventive measures are being taken globally to avoid the rapid spread of virus. In the current study, an in silico approach is carried out as a means of inhibiting the spike protein of the novel coronavirus by flavonoids from natural sources that possess both antiviral and anti-inflammatory properties. The methodology is focused on molecular docking of 10 flavonoid compounds that are docked with the spike protein of SARS-CoV-2, to determine the highest binding affinity at the binding site. Molecular dynamics simulation was carried out with the flavonoid-protein complex showing the highest binding affinity and highest interactions. The flavonoid naringin showed the least binding energy of -9.8 Kcal/mol with the spike protein which was compared with the standard drug, dexamethasone which is being repurposed to treat critically ill patients. MD simulation was carried out on naringin-spike protein complex for their conformational stability in the active site of the novel coronavirus spike protein. The RMSD of the complex appeared to be more stable when compared to that of the protein from 0.2 nm to 0.4 nm. With the aid of this in silico approach further in vitro studies can be carried out on these flavonoids against the novel coronavirus as a means of viral protein inhibitors.

Phyto-Mediated Synthesis of Silver Nanoparticles Using Terminalia chebula Fruit Extract and Evaluation of Its Cytotoxic and Antimicrobial Potential

The increasing interest in developing potent non-toxic drugs in medicine is widening the opportunities for studying the usage of nanostructures in the treatment of various diseases. The present work reports a method for a facile and an eco-friendly synthesis of silver nanoparticles (AgNPs) using Terminalia chebula fruit extract (TCE). The obtained AgNPs was characterized by using different spectroscopic and microscopic techniques. The analysis of the results revealed that the as-obtained AgNPs have spherical morphology with an average diameter of 22 nm. Furthermore, the preliminary bioactivity evaluations revealed that the bio-conjugation of AgNPs, using TCE, significantly enhanced the antibacterial and anti-breast cancer potentials of the latter. The antibacterial activity of the as-prepared AgNPs showed that B. subtilis was more sensitive towards the AgNPs, followed by P. aeruginosa; while, E. coli and S. mutans showed comparatively minimal sensitivity toward the AgNPs. The IC₅₀ values of TCE, AgNPs and TCE + AgNPs treatment of MCF-7 were found to be 17.53, 14.25 and 6.484 µg/mL, respectively. Therefore, it can be ascertained that the bio-conjugation may provide a headway with regard to the therapeutic employment of T. chebula, upon mechanistically understanding the basis of observed antibacterial and anticancer activities.

Multiple anthelmintic resistance in gastrointestinal nematodes of Caprines on Mountain Research Centre for Sheep and Goat at Kashmir Valley, India

The study was conducted to evaluate the status of anthelmintic resistance in Gastro-Intestinal Nematodes (GINs) of goats at an organized farm located in Kashmir, as there is no report of resistance against these parasites of goats from this temperate region, although it has been reported worldwide including India. Caprines reared at this farm exhibited reduced efficacy to multiple anthelmintics following treatments with Fenbendazole (FBZ), Closantel and Ivermectin (IVM) in Faecal Egg Count Reduction Test (FECRT). The results suggested that the overall efficacy was highest for IVM at 83.5% and 90.0% on 7^th and 14^th day post-treatment, respectively and least for FBZ at 44.3% and 62.5%, respectively, whereas the corresponding figures for closantel were 68.3% and 86.2%, respectively. The pre-treatment faecal culture revealed Haemonchus contortus, Teladorsagia circumcincta and Trichostrongylus colubriformis as predominant strongyles, however, in post-treatment samples, only H. contortus was observed. Further, the infective larvae were subjected to Allele specific PCR (AS-PCR) for accurate diagnosis of BZ resistance. The AS-PCR revealed 52% of H. contortus were homozygous resistant (rr) and 17% were heterozygous (rS) on day “0” before treatment and 100% homozygous resistant (rr) on 7th day post treatment. In both T. colubriformis and T. circumcincta, 100% population was homozygous susceptible (SS) at day “0” before treatment. The overall frequency of resistant (r) allele for H. contortus was 60.5% and for susceptible allele (s) was 39.5%. For T. colubriformis and T. circumcincta the frequency of susceptible allele (s) was 100%. The survey indicated that the GINs of goats on the farm have developed multiple anthelmintic resistance to FBZ, closantel and IVM and the condition is alarming in the farm. Moreover surveillance studies about status of anthelmintic resistance in other farms (Govternment as well as Private) of Kashmir valley should be carried out at large scale to develop effective and sustainable control strategies against GI Nematodes.

Significance of third trimester ultrasound in detecting congenital abnormalities of kidney and urinary tract-a prospective study

INTRODUCTION

Antenatal hydronephrosis is defined as dilatation of the renal pelvis with or without dilatation of calyces in the developing fetus. Although second trimester scan is more sensitive in detecting congenital abnormalities of kidney and urinary tract (CAKUT), it has been suggested that the third trimester scan is more predictive of postnatal outcome.

OBJECTIVES

This study aims to determine the incidence of antenatal hydronephrosis at our institution and the significance of third trimester scan in detecting CAKUT postnatally.

STUDY DESIGN

It is a prospective observational study. During the 3-year study period from June 2013 to May 2016, all cases of antenatal hydronephrosis, defined as renal pelvic diameter (RPD) ≥4 mm in the second trimester and ≥7 mm in the third trimester scan, diagnosed in the fetal medicine unit of our hospital, were included and were followed up postnatally for 6 months.

RESULTS

In the fetal medicine unit, 32,443 women were screened for anomalies, and hydronephrosis was detected in 269 cases. Incidence of antenatal hydronephrosis was observed to be 0.83% in our institution. In second trimester scan, of 80 cases with the left hydronephrosis, only 22 (27.5%) had postnatal CAKUT and of 70 cases with the right hydronephrosis, 18 (25.7%) had CAKUT. In the third trimester scan, it was observed that with RPD >10 mm, on the left side hydronephrosis, 87% had CAKUT on postnatal scan, and 85% with the right hydronephrosis had CAKUT.

CONCLUSION

Sixty percent cases of hydronephrosis detected in the second trimester scan resolve in utero. In the third trimester scan with RPD <10 mm, the possibility of postnatal CAKUT is 23%, whereas if RPD is > 10 mm, then the possibility of postnatal CAKUT is 86%.

Isolation and analysis of the molecular epidemiology and zoonotic significance of Mycobacterium tuberculosis in domestic and wildlife ruminants from three states in India

The majority of tuberculosis cases in ruminants are caused by Mycobacterium bovis (MB). However, in this study, the authors reported the isolation of Mycobacterium tuberculosis (MT) from bovine milk, nasal swabs and post-mortem tissue samples (n = 841) collected from cattle and buffaloes in the states of Telangana, Maharashtra and Gujarat in India in the period from 2010 to 2015. The isolates (n = 7) were confirmed as Mycobacterium due to their growth characteristics and colony morphology in a commercial liquid medium Mycobacterial Growth Indicator Tube (MGIT)™ employing the BD BACTEC™ MGIT™ 960 system and the Löwenstein-Jensen (LJ) medium supplemented with glycerol but not with sodium pyruvate, and BD-DIFCO™ Middlebrook 7H10 agar containing oleic albumin dextrose catalase (OADC). These isolates were initially identified as members of the M. tuberculosis complex (MTC) using a commercial nested polymerase chain reaction (PCR) kit based on the IS6110 MTC specific nucleotide sequence. The isolates were confirmed as MT using three commercial line probe assay kits, were further genotyped, and the spoligotypes identified were of East African Indian (EAI) 3_IND, EAI5, Central-Asian (CAS) 1_DELHI, U and T1 lineages. Two MT isolates from one antelope (Antilope cervipara) andone gazelle (Gazella bennettii) from Gujarat, which were identified previously, were spoligotyped during this study and identified as belonging to EAI3_IND and EAI5 lineages, respectively. The epidemiological significance and zoonotic implications of regional presence and documentation of the same or two differents poligotypes in different species within the family Bovidae as well as humans is discussed.

Systematic review of the outcome of cemented versus uncemented total hip arthroplasty following pelvic irradiation

PURPOSE

The objective of this study is to evaluate the outcomes of total hip arthroplasty (THA) in patients with radiation-related changes to the bone, and specifically whether there is a difference in outcomes between cemented and uncemented acetabular components.

METHODS

A database search was performed to identify available studies reporting adults undergoing THA who have previously had pelvic irradiation. Data were extracted and analysed with respect to the use of cemented versus uncemented acetabular components. Statistical analysis was performed using the Chi-square test for independence.

RESULTS

The all-cause revision rate was 24% in the cemented THA group (27/111), compared with 15% of uncemented THAs (22/143) (p = 0.073). Revision for acetabular aseptic loosening occurred in 16% of cases (18/111) in the cemented group and 10% (15/143) in the uncemented group (p = 0.178). Acetabular aseptic loosening was reported in 24% of cemented THAs (27/111) and 14% of uncemented THAs (20/143), which was statistically significant (p = 0.035). Not all of these went on to have revision THA. The Incidence of prosthetic joint infection was similar in both groups.

CONCLUSION

Overall outcomes appear to be better for uncemented THAs in post-radiotherapy patients, with a significantly lower rate of aseptic loosening and an appreciable (but not statistically significant) reduction in revision rate. The best outcomes seem to be associated with the use of acetabular reinforcement across both cemented and uncemented groups, but further work is needed to evaluate this.

Phyto anti-biofilm elicitors as potential inhibitors of Helicobacter pylori

Helicobacter pylori (H. pylori) infection is a global public health concern. Due to its high adaptability in various adverse environments (temperature, pH, adhesion, phenotypic forms), targeting the bacterium is quite challenging. Moreover, due to its high persistence, decreased patience compliance and emerging antibiotic resistance, researchers have been forced to search for novel candidates with lesser or no side effects. Hence, in the current study, phytobioactives have been screened for its anti-biofilm attributes against H.pylori. Gastric biopsy samples have been screened using confirmatory techniques (microbiological, biochemical and molecular) for their virulent and non-virulent biomarkers. Physico-nutritive parameters were standardized. H. pylori biofilms were assessed using microtitre plate assay. Biofilms' biomass and exopolysaccharide have been evaluated using crystal violet and ruthenium red staining, respectively. Anti-biofilm screening was performed using potent aqueous phytochemicals namely Acorus calamus, Colocasia esculenta and Vitex trifolia. The results indicated the confluent growth of the H. pylori biofilms confirmed through genotyping and grew best at 37 °C for 72 h at a pH of 7.5 on polystyrene plates. Further, among the phytochemicals tested, Acorus calamus exhibited the highest H. pylori anti-biofilm activity via a dose-dependent pattern. The overall observations of the study will pave way for newer approaches to understand and combat bacterial pathogenesis and will contribute towards better health and hygiene.

Immune response against subclinical haemonchosis in Himalayan hill goats

Haemonchosis commonly occurs as chronic and subclinical infection in small ruminants, and understanding of immunological response against subclinical haemonchosis is of paramount importance for designing and implementing effective control strategies. The present study was designed to evaluate immunological response during subclinical haemonchosis, experimentally established in goats. Sixteen 5-6 month-old helminth naive kids were randomly allocated into one of two groups, infected and uninfected; the infected group being infected per os with 250 Haemonchus contortus larvae per kg body weight. Faecal, blood and serum samples were collected every third day up to 30 days post-infection (DPI), thereafter weekly up to 58 DPI to record changes in faecal egg count (FEC), haemoglobin (Hb), packed cell volume (PCV), peripheral eosinophil percentage and immunological parameters, such as macrophage cytokine interleukin-12 (IL-12), Th1 cytokine (IFN-γ), Th2 cytokines (IL-4, 13, 25, 33) and immunoglobulins (IgG and IgE). Pre-patent period of H. contortus in the present study was 18 days and eggs per gram (EPG) peaked on 30 DPI. The total reduction in body weight gain in the infected group was 26 g per day when compared with uninfected animals. Hb (7.35 ± 0.34 g/dL in infected animals compared with 9.76 ± 0.67 in control animals) and PCV levels (22 ± 1.54 g/dL in infected animals compared with 29.2 ± 1.27 in control animals) decreased significantly up to 44 DPI in infected group (P = 0.000). IL-4, IL-13, IL-33, IgG and IgE showed significant increase in infected animals at different periods. IFN-γ, IL-12 and IL-25 did not show any significant changes barring a steep rise of IFN-γ on 27 DPI. A positive correlation was observed between IgE and IL-4 in subclinical haemonchosis. Of particular note was that all the major cytokines, such as IFN-γ (P = 0.000), IL-4 (P = 0.000), IL-13 (P = 0.009), and both IgG (P = 0.000) and IgE (P = 0.003), were observed at the lowest concentration on 24 DPI. The effect of infection was found to be significant on cytokines with a strong interaction with time. Taken together, the data suggest that Th2 immune response is predominating in subclinical haemonchosis. The economic loss in term of body weight gain due to subclinical haemonchosis was considerable.

Recurrence after hospitalization for acute coronary syndrome among HIV-infected and HIV-uninfected individuals

OBJECTIVES

We evaluated the association of HIV infection and immunodeficiency with acute coronary syndrome (ACS) recurrence, and with all-cause mortality as a secondary outcome, after hospitalization for ACS among HIV-infected and HIV-uninfected individuals.

METHODS

We conducted a retrospective cohort study within Kaiser Permanente Northern California of HIV-infected and HIV-uninfected adults discharged after ACS hospitalization [types: ST-elevation myocardial infarction (STEMI), non-STEMI, or unstable angina] during 1996-2010. We compared the outcomes of ACS recurrence and all-cause mortality within 3 years, both overall by HIV status and stratified by recent CD4 count, with HIV-uninfected individuals as the reference group. Hazard ratios (HRs) were obtained from Cox regression models with adjustment for age, sex, race/ethnicity, year, ACS type, smoking, and cardiovascular risk factors.

RESULTS

Among 226 HIV-infected and 86 321 HIV-uninfected individuals with ACS, HIV-infected individuals had a similar risk of ACS recurrence compared with HIV-uninfected individuals [HR 1.08; 95% confidence interval (CI) 0.76-1.54]. HIV infection was independently associated with all-cause mortality after ACS hospitalization overall (HR 2.52; 95% CI 1.81-3.52). In CD4-stratified models, post-ACS mortality was higher for HIV-infected individuals with CD4 counts of 201-499 cells/μL (HR 2.64; 95% CI 1.66-4.20) and < 200 cells/μL (HR 5.41; 95% CI 3.14-9.34), but not those with CD4 counts ≥ 500 cells/μL (HR 0.67; 95% CI 0.22-2.08), compared with HIV-uninfected individuals (P trend < 0.001).

CONCLUSIONS

HIV infection and immunodeficiency were not associated with recurrence of ACS after hospitalization. All-cause mortality was higher among HIV-infected compared with HIV-uninfected individuals, but there was no excess mortality risk among HIV-infected individuals with high CD4 counts.

Irradiation-Induced Compositional Effects on Human Bone After Extracorporeal Therapy for Bone Sarcoma

The present study investigates Raman scattering of human bone irradiated with 50 Gy single dose during therapeutic treatment of Ewing and Osteosarcoma. Bone quality was evaluated via mineral-to-matrix ratio, degree of crystallinity, change in amount of calcium, and carbonate substitution. Alteration in collagen and its cross-links was quantified through second-derivative deconvolution of Amide I peak. A dose of 50 Gy radiation leads to almost 50% loss of mineral content, while maintaining mineral crystallinity, and small changes in carbonate substitution. Deconvolution of Amide I suggested modifications in collagen structure via increase in amount of enzymatic trivalent cross-linking (p < 0.05). Overall irradiation led to detrimental effect on bone quality via changes in its composition, consequently reducing its elastic modulus with increased plasticity. The study thus quantifies effect of single-dose 50 Gy radiation on human bone, which in turn is necessary for designing improved radiation dosage during ECRT and for better understanding post-operative care.

Outcome Analysis of Neonates following Laparotomy for Acute Abdomen: A Prospective Study

Background Low and middle-income countries (LMIC) bear the majority of the global pediatric surgical burden. Despite increasing volume of pediatric surgeries being performed in LMIC, outcomes of these surgeries in low and middle-income countries remain unknown due to lack of robust data. Objective The objective of our study was to collect data on and evaluate neonatal surgical outcomes at a tertiary level center in India. Method The surgical outcomes data of all neonates undergoing laparotomy between February 15, 2015 and October 14, 2015, at Sir Ganga Ram Hospital, New Delhi, India was collected prospectively. Descriptive statistics were used to determine the rates of various postoperative outcomes. Result A total of 37 neonatal surgeries were performed during the study period. The mean age of the neonates on the day of surgery was 7 days (range: 1-30 days). Most of the neonates (72.9%, n=27) were males. About 40% (n=15) of the neonates were preterm and 15 (40.5%) of them were small for gestational age. In our study, 10 neonates (28.6%) needed ventilation for 48 hours or less after surgery and 5 neonates (13.5%) were kept Nil per Oral (NPO) postoperatively for more than 10 days. Out of 37 neonates, 4 (10.80%) developed a surgical site infection and 8 neonates (21.6%) had postoperative sepsis. The in-hospital mortality rate among neonates undergoing laparotomy during the study period was 8.1 deaths per 100 neonates. Conclusion Co-ordination of care among pediatric surgeons, neonatologists, nursing and anesthesia team is required for optimal surgical outcome.

Recent advancements and new perspectives in animal models for Neurocysticercosis immunopathogenesis

Neurocysticercosis (NCC), one of the most common parasitic diseases of the central nervous system, is caused by Taenia solium. This parasite involves two hosts, intermediate hosts (pig and human) and a definitive host (human) and has various stages in its complex life cycle (eggs, oncosphere, cysticerci and adult tapeworm). Hence, developing an animal model for T. solium that mimics its natural course of infection is quite challenging. We have reviewed here the animal models frequently used to study immunopathogenesis of cysticercosis and also discussed their usefulness for NCC studies. We found that researchers have used mice, rats, guinea pigs, dogs, cats and pigs as models for this disease with varying degrees of success. Mice and rats models have been utilized extensively for immunopathogenesis studies due to their relative ease of handling and abundance of commercially available reagents to study these small animal models. These models have provided some very exciting results for in-depth understanding of the disease. Of late, the experimentally/naturally infected swine model is turning out to be the best animal model as the disease progression closely resembles human infection in pigs. However, handling large experimental animals has its own challenges and limitations.

Polymerase chain reaction (PCR) based amplification of hmcp3 and hmcp6 cysteine protease genes of Haemonchus contortus from small ruminants

Haemonchus contortus is a haematophagous nematode in small ruminants population and causes anaemia, weakness and mortality especially in young animals. In the present study, hmcp3 partial gene of 836 bp and hmcp6 full length gene of 1041 bp were amplified from the cDNA of Bareilly isolate of adult male H. contortus by polymerase chain reaction. Further gene characterization and expression studies are warranted to know the immunoprophylactic potential of hmcp3 and hmcp6 proteins of H. contortus.

Competition in Indian Banking

It is widely perceived that competition in the Indian banking sector has increased since the inception of the financial sector reforms in 1992. Using annual data on scheduled commercial banks for the period 1996–2004, the article evaluates the validity of this proposition in the Indian context. The empirical evidence reveals that Indian banks earn revenues as if under monopolistic competition.

Primary lymphoma of CNS, mycophenolate mofetil and lupus

Lymphoproliferative disorders are known to complicate immunosuppressive therapy and two cases of primary lymphoma of CNS (PCNSL) have previously been described in association with mycophenolate mofetil (MMF) treatment. We report the third case of PCNSL in a patient with lupus nephropathy while on MMF treatment. PCNSL may be seen more frequently considering the increased use of MMF in immunosuppressant responsive conditions.

Leg Ulcers and Oedema: A Study Exploring the Prevalence, Aetiology, and Possible Significance of Oedema in Venous Ulcers

Oedema is commonly associated with venous leg ulcers, and is thought to discourage wound healing. However, little attention has been paid to the mechanism or significance of oedema in this condition. This study assessed the prevalence of oedema and lymphatic insufficiency and their influence on wound healing amongst 56 patients. Two populations were studied – community and hospital-managed, with an almost equal number of cases in each. The presence of oedema and lymphatic insufficiency was assessed clinically and, the duration of the current ulcer was used as an indicator of healing rate.

Oedema was present in 55% of patients, but its prevalence in the community-treated group was much greater than in the hospital-treated group. Lymphatic insufficiency was present in 22% of patients with an equal prevalence in the two groups. The presence of oedema was associated with a longer duration of ulcer whereas the use of diuretics was associated with a shorter duration. This suggests that oedema may be an important factor in discouraging the healing of ulcers.

Greater attention should be paid clinically to the prevention of oedema, as its presence suggests inadequate treatment and a failure to heal.

Biomimetic Synthesis of Silver Nanoparticles Using Endosymbiotic Bacterium Inhabiting Euphorbia hirta L. and Their Bactericidal Potential

The present investigation aims to evaluate biomimetic synthesis of silver nanoparticles using endophytic bacterium EH 419 inhabiting Euphorbia hirta L. The synthesized nanoparticles were initially confirmed with change in color from the reaction mixture to brown indicating the synthesis of nanoparticles. Further confirmation was achieved with the characteristic absorption peak at 440 nm using UV-Visible spectroscopy. The synthesized silver nanoparticles were subjected to biophysical characterization using hyphenated techniques. The possible role of biomolecules in mediating the synthesis was depicted with FTIR analysis. Further crystalline nature of synthesized nanoparticles was confirmed using X-ray diffraction (XRD) with prominent diffraction peaks at 2θ which can be indexed to the (111), (200), (220), and (311) reflections of face centered cubic structure (fcc) of metallic silver. Transmission electron microscopy (TEM) revealed morphological characteristics of synthesized silver nanoparticles to be polydisperse in nature with size ranging from 10 to 60 nm and different morphological characteristics such as spherical, oval, hexagonal, and cubic shapes. Further silver nanoparticles exhibited bactericidal activity against panel of significant pathogenic bacteria among which Pseudomonas aeruginosa was most sensitive compared to other pathogens. To the best of our knowledge, present study forms first report of bacterial endophyte inhabiting Euphorbia hirta L. in mediating synthesizing silver nanoparticles.

Immediate tangential excision accelerates wound closure but does not reduce scarring of mid-dermal porcine burns

Current evidence supports the use of excision to remove eschar from deep dermal and full-thickness burns. However, the role of excision of mid-dermal burns remains unclear. This study aimed to develop a porcine model that could produce reproducible middermal thermal burns that undergo tangential excision; and investigate the effects of immediate tangential excision (30 minutes postburn) on healing and scarring. An aluminum bar preheated in hot water (70°C) was applied for 20 or 30 s to produce a total of sixteen mid-dermal burns per pig on each of six pigs. Thirty minutes after burn creation, half of the burns were tangentially excised. Four partial- thickness wounds per pig were created as controls. Depth of burn injury (1 and 24 h), reepithelialization (7 and 10 d) and scar depth (28 d) were assessed microscopically. Total scar surface area was grossly evaluated on day 28. Exposure of porcine skin to a preheated aluminum bar at 70 °C for 20 or 30 sec resulted in reproducible mid-dermal burns, where immediate excision enhanced complete wound closure as judged by complete re-epithelialization, but did not reduce initial depth of injury, scar contraction and scar depth. Immediate surgical intervention is sufficient to enhance wound closure, but not to mitigate mid-dermal burn scar formation. This work provides a suitable animal model to evaluate novel therapies that may be used to inhibit burn progression, accelerate wound closure and decrease scarring, especially those therapies unable to penetrate burn eschar.