Interventions using the Qur'an to promote mental health: a systematic scoping review

BACKGROUND

Accommodating and addressing the beliefs and attitudes of Muslim patients, means designing culturally competent mental health services. Practicing Muslims around the world often use the Qur'an when seeking guidance for health.

AIMS

The aim of this study was to identify interventions using the Qur'an as a promoting factor for mental health.

METHODS

The paucity of academic literature in the area meant a systematic scoping review of the evidence was appropriate. Conducting the search for peer-reviewed evidence used six databases, searching for grey literature used Google Scholar, for evidence published up to 29^th December 2022. Analysis used the Patterns, Advances, Gaps, Evidence for practice and Research recommendations (PAGER) framework for scoping reviews to report the findings clearly and accessibly.

RESULTS

Out of 1590 articles from databases and 35 from other sources (n = 1625), 79 full-text articles meeting the inclusion criteria were retrieved. Further assessment for eligibility, excluded 35 articles; leaving 44 studies in the final analysis. Interventions identified Salah and supplicant praying, recitation, reading, memorizing and listening to the Qur'an to reduce anxiety, depression and stress and increase quality of life and coping. There was a paucity of evidence from Western countries utilising the Qur'an to support mental health and wellbeing, suggesting a lack of cultural accommodation. Interventions tended to be mostly biomedical and excluded exploration of psychosocial factors such as the effect of social support.

CONCLUSIONS

Future research could utilise the Qur'an for Muslim patients, integrating it into routine health care interventions and delivery platforms and more closely relating to Islamic lifestyles. This aims to promote mental health and wellbeing, working towards the WHO 2013-2030 MHAP building mental health and psychosocial support capacity and the United Nations Sustainable Development Goal 3, good health and wellbeing, by 2030.

Correlation between Depth of Medial and Lateral Curvatures of Clavicle

Having the first bone to ossify clavicle is a bone of pectoral girdle. It is the only bony attachment between the trunk and upper limb. To obtain the precise data that is required to investigate the range in size and morphological features of the human clavicle, a study was undertaken on dry human clavicles which had been sourced from the Department of Anatomy. The purpose for undertaking this study was to obtain baseline data on the clavicular bow in the transverse plane. This cross-sectional descriptive study having some analytical components was done among 150 (65 right and 85 left) fully ossified dry clavicles in Mymensingh Medical College, Bangladesh from January 2020 to December 2020. Sample which met the inclusion criteria was collected through non random sampling technique, from Anatomy department of Mymensingh Medical College and Community Based Medical College Bangladesh. The parameters (the depth of medial and lateral curvatures) were measured with the help of rigid osteometry board and were expressed in millimeter. In the current study, the mean±SD depth of medial curvature of 65 clavicles of right side was 15.54±3.54mm and 15.45±3.24mm of 85 left clavicles. The mean±SD depth of lateral curvature of right side was 11.71±2.54mm and of left side was 9.21±2.31mm. Correlation was done in between depth of medial and lateral curvatures on both sides and the regression line showed positive correlation but these differences were statistically non-significant on both sides.

SOCIAL ISOLATION AND RESILIENCE COPING AS CORRELATES OF MENTAL ILLNESS IN ADULTS DURING COVID-19

Objective: The current study has been designed to investigate the relationship between social isolation and mental illness and to identify the mediating role of resilience coping in adults. Methods: The online data of 600 adults were recruited through a snowball sampling strategy. The age range of the participants was 18 years and above (M=25.64, SD=7.635). UCLA Loneliness Scale (Russel, 1996), Brief Resilience Coping Scale (Sinclair & Wallston, 2004), and Depression, Anxiety and Stress Scale (Lovibond & Lovibond, 1995) were used. Results: Findings showed a significant positive association between social isolation and mental illness, while a negative association between social isolation and resilience coping. Additionally, resilience coping mediated the association between social isolation and mental illness [95% CI (LLCI: .0132, ULCI: .0802)]. Conclusion: Social isolation poses significant mental health risks and resilience coping can be used to improve mental illnesses. KEYWORDS: COVID-19, Social Isolation, Resilience Coping, Depression, Anxiety, Stress, Mental illness.

82 Acute Acalculous Cholecystitis Caused by Epstein–Barr Virus Infection: Cohort Study of Literature

Aim

To perform a cohort study of literature to provide the best available evidence on clinical features and management of acute acalculous cholecystitis (AAC) caused by acute Epstein-Barr virus (EBV) infection

Method

A comprehensive search of electronic information sources was performed to identify all reported cases in the literature comprising patients of any age or gender who were found to have AAC due to acute EBV infection. Simple descriptive statistics were applied to present outcome data.

Results

Overall, 42 eligible patients were identified. The mean age of the included population was 17; 83% were female and 17% were male. Overall, 62% were from Europe; 21% from North America, 17% from Asia. Abdominal pain was present in all patients; sore throat in 62%; pharyngitis or tonsillitis in 50%; cervical lymphadenopathy in 62%; jaundice in 36%, hepatosplenomegaly in 60%; positive Murphy's sign in 69%. All patients had gallbladder wall thickening on imaging. Overall, 98% of patients were treated conservatively. Among those who were treated conservatively, all recovered with conservative management. The patient's preference was the reason for surgery in the patient who was not treated conservatively. As part of conservative management, antibiotics were used in 48% of patients. The mean length of hospital stay was 10 days

Conclusions

AAC caused by EBV infection is a rare condition that occurs in young patients and is more common in females and in European countries. EBV-associated AAC has a very good clinical prognosis and can be treated conservatively without a need for antibiotics or surgical intervention.

P-314 Quantitative analysis of uterine peristalsis using optical flow for motion quantification

Study question

Do women with adenomyosis have altered uterine peristalsis?

Summary answer

Women with adenomyosis have altered uterine peristalsis on transvaginal sonography (TVS), as measured using optical flow for motion quantification.

What is known already

Adenomyosis can reduce the chance of clinical pregnancy in women undergoing assisted conception, with altered uterine peristalsis proposed as a mechanism. Uterine peristalsis can be visualised by TVS and is thought to play an important role in sperm transport and embryo implantation. Ultrastructural myometrial abnormalities in adenomyosis cause a disturbance in normal myocyte contractility with subsequent loss of normal rhythmic contraction. We aimed to develop an objective tool to quantify uterine peristalsis on TVS using an algorithm based on optical flow for wave motion quantification in women with adenomyosis.

Study design, size, duration

Prospective observational cohort study, July - December 2021, of women with moderate/severe adenomyosis (n = 16) and a normal pelvis (n = 21), having TVS during assisted conception. TVS was performed in the mid-sagittal plane for 4 minutes at baseline (BL), day 6-12 of ovarian stimulation (OS) and day of embryo transfer (ET). Recordings were stored offline for analysis using 3D Slicer (Ver. 4.11) and sampled at constant intervals to achieve a set of frames for optical flow analysis.

Participants/materials, setting, methods

We recruited women with moderate/severe adenomyosis or normal uterus on TVS. Optical flow was used to track pixels over successive TVS frames. Pixel-level displacements for points at endometrial-myometrial junction were used to compute time-period(inverse of frequency, 1/f) and amplitude(u) by fitting to the 2D-wave equation. Fit error was taken as a measure of coordination of wave at endometrial-myometrial junction(uterine peristalsis - up). Myometrial zone standard deviation quantifies spread, a measure of coordination of myometrial contractility(mc).

Main results and the role of chance

The observed wave of uterine peristalsis (up) at the endometrial-myometrial junction in women with adenomyosis showed a significantly poorer fit with the ideal wave equation compared to women with a normal uterus at all time points (BL (+ 0.725), OS (+ 0.612) and ET (+ 0.627) (n = 37, p < 0.001)), indicating lower coordination of uterine peristalsis in women with adenomyosis compared to women with a normal uterus. Coordination of myometrial contractility was also significantly lower in women with adenomyosis compared to women with a normal uterus at all time points (BL (+ 0.656) , OS (+ 0.510) and ET (+ 0.639) (n = 37, p < 0.001). Statistically significant difference was not found in wave amplitude or frequency between groups (p > 0.06 for both).

Limitations, reasons for caution

Optical flow for motion quantification has been used here to quantify uterine peristalsis in women with adenomyosis and women with a normal uterus and would require validation prior to use in other uterine pathology.

Wider implications of the findings

Women with adenomyosis have altered uterine peristalsis and myometrial contractility, which may account for their reduction in chances of conception. The proposed approach for wave motion quantification is an objective tool to quantify uterine peristalsis, with potential for wide clinical application in the gynaecology and assisted conception setting.

Trial registration number

Not applicable

Inducible expression of human papillomavirus-16 L1 capsomeres in the plastomes of Nicotiana tabacum: Transplastomic plants develop normal flowers and pollen

Human papillomavirus type-16 (HPV-16) is the major HPV type involved in causing cervical cancer among women. The disease burden is high in developing and underdeveloped countries. Previously, the constitutive expression of HPV-16 L1 protein led to male sterility in transplastomic tobacco plants. Here, the HPV-16 L1 gene was expressed in chloroplasts of Nicotiana tabacum under the control of an ethanol-inducible promoter, trans-activated by nucleus-derived signal peptide. Plants containing nuclear component were transformed with transformation vector pEXP-T7-L1 by biolistic gun. The transformation and homoplasmic status of transformed plants was verified by polymerase chain reaction and Southern blotting, respectively. Protein was induced by spraying 5% ethanol for 7 consecutive days. The correct folding of L1 protein was confirmed by antigen-capture ELISA using a conformation-specific antibody. The L1 protein accumulated up to 3 μg/g of fresh plant material. The L1 protein was further purified using affinity chromatography. All transplastomic plants developed normal flowers and produced viable seeds upon self-pollination. Pollens also showed completely normal structure under light microscope and scanning electron microscopy. These data confirm the use of the inducible expression as plant-safe approach for expressing transgenes in plants, especially those genes that cause detrimental effects on plant growth and morphology.

Dark triad, risk propensity and interpersonal relationship satisfaction in clients with substance use disorder

Abstract Objective: To examine the relationship of drug addicts with personality triad, risk propensity and interpersonal relationship satisfaction. Methods: The correlational study was conducted from September 2019 to February 2020 in different hospitals of Lahore, Pakistan, and comprised male drug addicts aged 18-30 years. Data was collected using the Dark Triad of Personalityscale, the Risk Propensity Scale and the Interpersonal Relationship Satisfaction Scale. Data was analysed using SPSS 21. Results: There were 100 men with a mean age of 25.03+/-3.82 years. Conclusion: Dark triad and risk propensity significantly predicted interpersonal relationship satisfaction, while narcissism did not predict interpersonal relationship satisfaction. Key Words: Dark triad, Risk propensity, Interpersonal relationship satisfaction, Drug addicts. Continuous...

Social appearance anxiety, emotional regulation and quality of life in individuals with premature canities: A correlational study

OBJECTIVE

To examine and predict the relationship among social appearance anxiety, emotional regulation and quality of life in individuals with premature canities.

METHODS

The correlational study was conducted from September 2019 to February 2020 in Lahore, Pakistan, after approval from the Riphah International University, Lahore, and comprised individuals of either gender aged 15-25 years with premature canities. Social Appearance Anxiety Scale, Emotional Regulation Questionnaire and the Quality of Life Scale were used to measure the study variables. Data was analysed using SPSS 21.

RESULTS

Of the 100 subjects, 50(50%) each were males and females. The overall mean age was 19.80±3.33 years. Individuals with premature canities had significant social appearance anxiety which was positively correlated with emotional suppression. As social appearance anxiety increased, the quality of life decreased (p<0.05). Lower level of cognitive reappraisal and higher expressive suppression were linked with improved quality of life in individuals with premature canities (p<0.05).

CONCLUSIONS

Social appearance anxiety, emotional regulation along with age were together found to be the predictors of quality of life.

Improving tenderness and quality of M. biceps femoris from older cows through concentrate feeding, zingibain protease and sous vide cooking

The study investigated the effect of zingibain protease and sous vide cooking on tenderness and water-holding capacity of M. biceps femoris (BF) from 30 older Angus cows (6-7 years) fed concentrates for 0, 28, 42 or 56 days. BF were cooked for 1, 8, and 18 h at 65 °C and 75 °C, without any pre-treatment, after they have been injected with water only or after they have been injected with either 1 g/L or 2 g/L ginger powder solution (containing zingibain). Samples were tested for cooking loss, total water content, Warner-Bratzler shear force (WBSF), collagen content, and myofibrillar fragmentation index (MFI). Results revealed the significant interactions between concentrate feeding, ginger powder injection, cooking temperature, and time on quality traits. WBSF was reduced (P < 0.001) by increasing zingibain concentration at 65 °C but a gradual decrease was noted at 75 °C. Collagen solubility and MFI increased (P < 0.05) with increasing zingibain concentration. Injecting zingibain along with sous vide cooking demonstrated the weakening of myofibrillar and connective tissue proteins contributing to enhanced collagen solubility and tenderness in BF.

P–628 Predicting oocyte yield in patients with diminished ovarian reserve using basal antral follicle count

Study question

Is basal antral follicle count (bAFC) taken on day 1 to 3 of stimulation a useful predictor of oocyte yield in that cycle, in women with diminished ovarian reserve (DOR)?

Summary answer

Basal AFC has moderate correlation with final oocyte yield. A median 75% of the antral follicle count is collected as oocytes.

What is known already

The current theory of folliculogenesis suggests that all follicles available for recruitment are visible on ultrasound in the ovary at the point when ovarian stimulation is applied. This implies a tight correlation between the AFC on day 1–3 of a stimulation cycle (bAFC) and the eventual number of follicles collected. We hypothesise that in women with diminished ovarian reserve who receive maximum stimulation basal AFC would be a useful predictor of final oocyte yield in that cycle.

Study design, size, duration

This was a prospective single centre, observational study in a tertiary referral hospital in London. 125 women with DOR underwent controlled ovarian stimulation between December 2018 and January 2021.

Participants/materials, setting, methods

All study participants were given an antagonist cycle with a starting stimulation dose of 450iu and remained on the same dose throughout their treatment. We assessed the correlation between bAFC taken on day 1–3 of the stimulation cycle and the total number of oocytes collected.

Main results and the role of chance

A total of 150 treatment cycles were included in the analysis. The median age was 37 (IQR 35 – 39). The median AMH was 6.0 (IQR 4.4 – 8.9) and the median FSH was 7.6 (IQR 5.7 – 9.4). The median bAFC at the start was 9 (IQR 6 – 11). The median total stimulation dose was 4050iu (IQR 4050 – 4500). The median oestradiol on day of trigger was 5906 (IQR 4166 – 7397) and median number of oocytes collected was 7 (IQR 5 – 9).

There was a moderate correlation between bAFC and the number of oocytes collected (r = 0.549, p = 0.005). The median ratio of oocytes collected over the number of antral follicles observed at the start was 72.7% (IQR 58.3 – 100).

Limitations, reasons for caution

We have standardised approach to AFC determination and have previously shown that AFC inter and intra-observer variability in our unit is low. Nevertheless, our study involved multiple operators for AFC determination which may introduce variability. Further variability may have been introduced at egg collection by varying technique.

Wider implications of the findings: Studies of antagonist protocol in good prognosis patients suggest poor correlation between basal AFC and oocyte yield. In contrast, our study shows that in a population of women with DOR basal AFC provides useful information which can be used to counsel women around the expected oocyte yield of their cycle.

Trial registration number

Not applicable

P–466 Fertility preservation for medical reasons: International and intra-national variation in provision and the gap between guideline and practice

Study question

What is the gap between guidance and practice of fertility preservation between countries and within countries with common clinical guidelines?

Summary answer

Substantial variation in provision of FP exists between countries and within individual countries with gaps between national and international guidelines and policies governing provision.

What is known already

A robust guideline on female FP was published by ESHRE in 2020, advising the application of FP in cancer and other conditions where treatment with cytotoxic agents or surgery will compromise reproductive function. Across Europe, in 13 countries (43.3%) FP is funded for all available FP procedures, in 13 countries (43.3%) no FP funding is available, and in 4 countries (13.3%) at least one FP option is funded. Variation in state provision of fertility care in different countries in Europe was highlighted in the ESHRE guidance. It did not specifically examine individual national policies or whether a national policy exists.

Study design, size, duration

Five clinicians performing FP in Europe were contacted to collect current FP provision data. Policies retrieved from the internet were not included as they could not be verified. Finally, FP funding policies for 135 Clinical Commissioning Groups (CCGs) in England, 14 Health Boards in Scotland, 7 Health Boards in Wales and 5 Trusts in Northern Ireland and 17 policies for regional heath services in Spain were included were included.

Participants/materials, setting, methods

Policies on FP for the UK and Spain were reviewed (n = 178), including policies from the 161 regions from the four nations of the UK and policies of 17 autonomous bodies in Spain. Information on funded procedures, type of conditions included for funding and duration of storage were extracted. The provision of FP was compared to the current European Society of Human Reproduction and Embryology (ESHRE) and National Institute for Health and Care Excellence (NICE) guidelines.

Main results and the role of chance

In England, 127/128 (99%) CCGs fund cryopreservation of oocytes, sperm and embryos. Cancer is the exclusive indication in 11%. Provision of FP for transgender individuals is specified in 28%, ovarian tissue cryopreservation is funded in 8% and storage funding varies from five to ten years.

In Scotland, a national policy is applied. All 14 health boards equitably fund cryopreservation of oocytes, sperm, embryos and ovarian and testicular tissue. Funding is provided for cancer, medical conditions which may impair fertility and transgender individuals. Storage funding is based on a five yearly review until age 43 in women and 60 in men. In Wales and Northern Ireland, cryopreservation of oocytes, sperm and embryos is funded for people undergoing medical or surgical treatment that is likely to make them infertile, provision for transgender individuals is not specified and ovarian tissue cryopreservation is not funded.

In Spain, all 17 Health Services fund cryopreservation of oocytes, sperm and embryos for patients whose fertility is at risk due to gonadotoxic treatments or other pathological processes. Ovarian tissue cryopreservation is funded in 94%, provision for transgender individuals is specified in 12%, and storage funding is available until the age of 50 in women and 55 in men.

Limitations, reasons for caution

Inability to retrieve fertility preservation policies for every country in Europe is a limitation, for which ongoing collaboration is sought. The variable nature of FP provision is likely to be multi-factorial; a lag in publication of guidelines and updated policies, ethical considerations and resource distribution may govern health policies.

Wider implications of the findings: The study highlights that provision of FP not only varies between countries but is also inconsistent within the same country. It is clear that there is a gap between ideal, evidence-based practice and actual provision. Variation in policies limits uniform access to care for patients.

Trial registration number

Not applicable.

Luminescent, sorptive and antibacterial potential of bismuth-organic framework

Metal organic frameworks are formed by the three-dimensional linkage of metal cores and organic linkers. In this work, bismuth-based metal organic framework (Bi-MOF) has been synthesized by using 5-hydroxyisophthalic acid (H2HIA) as linker via hydrothermal method. The said MOF was structurally characterized by UV/Vis, Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), 1H NMR, energy dispersive spectroscopy (EDS), thermogravimetric analysis (TGA) and X-ray diffraction technique. This MOF showed highly porous structure with surface area 1096 m2/g as determined by BET analysis. A model batch adsorption experiment was performed to evaluate the efficiency of methylene blue (MB) dye removal from aqueous media. It was found that monolayer adsorption capacity calculated from the Langmuir isotherm was 0.6240 mg/g. Bi-MOF was also screened for its antibacterial and luminescent behavior.                     KEY WORDS: Bismuth, Metal-organic Frameworks, Luminescence, Sorption   Bull. Chem. Soc. Ethiop. 2021, 35(1), 119-128. DOI: https://dx.doi.org/10.4314/bcse.v35i1.10

Resource use efficiency of cotton in improved vs conventional planting geometry with exogenous application of bio-stimulant and synthetic growth retardant

Plant growth regulators and improved planting density are the innovative techniques in the establishment of more productive cotton crop. A field study was planned to assess the role of growth regulators in the resource utilization efficiency of cotton cultivars under different row spacing at Agronomic Research Area, Bahauddin Zakariya University Multan and Usmania Agricultural Farm, Shujaabad during Kharif 2012. The study was comprised of cotton cultivars viz. CIM-573 and CIM-598, cultivated under conventional (75 cm), medium (50 cm) and improved ultra-narrow row spacing (25 cm) and foliar spray of growth regulators viz. moringa leaf extract (MLE) and mepiquat chloride (MC), either alone or in combination, distilled water as a control. The application of MLE alone and in combination (MLE + MC) showed the promoting effect on crop growth rate, net assimilation rate, leaf area index, leaf area duration, sympodial branches and number of bolls leading to higher seed cotton yield of both cotton cultivars grown under conventional row spacing. While application of MC averts the plant growth without considerably improving the productivity. MLE being rich source of growth promoting hormone and nutrients showed its potential to a far greater extent under conventional row spacing in efficient utilization of available resources compared to MC and distilled water.

Potential Nutraceutical Benefits of In Vivo Grown Saffron (Crocus sativus L.) As Analgesic, Anti-inflammatory, Anticoagulant, and Antidepressant in Mice

Crocus sativus, a medicinally important herbaceous plant, has been traditionally used to cure coughs, colds, insomnia, cramps, asthma, and pain. Moreover, the therapeutic applications of saffron include its immunomodulatory and anticancer properties. The current experimental analysis was performed to explore the potential nutraceutical efficacy of corm, leaf, petal, and stigma of saffron ethanolic extracts as analgesic, anti-inflammatory, anticoagulant, and antidepressant using hot plate, carrageenan-induced paw edema, capillary tube and forced swim test, respectively in mice. The results indicated that among all the extracts, stigma ethanolic extract (SEE) represented maximum latency activity (72.85%) and edema inhibition (77.33%) followed by petal ethanolic extract (PEE) with latency activity and edema inhibition of 64.06 and 70.50%, respectively. Corm ethanolic extract (CEE) and leaf ethanolic extract (LEE) displayed mild analgesic activity of 22.40% and 29.07%, respectively. Additionally, LEE (53.29%) and CEE (47.47%) exhibited mild to moderate response against inflammation. The coagulation time of SEE (101.66 s) was almost equivalent to the standard drug, aspirin (101.66 s), suggesting a strong anticoagulant effect followed by PEE (86.5 s). LEE (66.83 s) represented moderate inhibitory effect on coagulation activity while CEE (42.83 s) showed neutral effect. Additionally, PEE and SEE also expressed itself as potential antidepressants with immobility time ≤76.66 s, while CEE (96.50 s) and LEE (106.83 s) indicated moderate to mild antidepressant efficacy. Based on the in vivo activities, saffron extract, particularly SEE and PEE, can be used as a potential nutraceutical and therapeutic agent due to its significant pharmacological activities.

Lessons in Public Health Leadership

Background

The UK Faculty of Public Health (FPH) is a world leader in developing a dynamic competency-based curriculum and delivering high quality training and professional development of a multidisciplinary public health specialist workforce in the UK. This includes capacity building and shaping tomorrow's public health leaders.

Objectives

Strong Leadership is increasingly the need of the day to deal with the complex public health challenges in a rapidly evolving and shifting global landscape. Can a public health curriculum and training (like that of the FPH) provide the framework for the knowledge, skills, attitudes and behaviours required for producing world class public health systems leaders?

Body of the session

Key principles of developing systems leadership include providing an enabling environment, developing the right skill mix, acquiring relevant knowledge, framing placements with experienced supervision and appropriate coaching and mentoring are some of the elements built into the training opportunities for public health registrars, their supervisors and new consultants. This presentation will give an overview of some lessons in public health leadership, the skills and knowledge base required to perform effectively as a public health systems leader and explore some of the challenges faced by the world of public health. The panel will encourage interactive discussion to share the learning from other countries and systems required to develop the next generation of public health leaders.

Conclusions

Public health, of all specialties, lends itself best to lead across and beyond organisational boundaries, lead without authority and create change whilst not being in charge. It is imperative that systems are put in place to train, develop and build public health leaders for tomorrow.

Pharmacological evaluation of Acacia modesta bark for antipyretic, anti-inflammatory, analgesic, antidepressant and anticoagulant activities in Sprague Dawley rats

In this study the bark of Acacia modesta was evaluated for anti-inflammatory, antipyretic, analgesic, antidepressant and anticoagulant activity by carrageenan, hot plat, forced swim and capillary tube method respectively in rats. Highest anti-inflammatory activity was exhibited by chloroform (AMC) extract (74.96% inhibition) while other two active fractions being n-hexane (AMH) and ethyl acetate (AME) exhibited 71.26% and 52.87% inhibition of edema respectively. On the other hand, the aqueous (AMA) fraction showed most effective response with 67.06% analgesic activity. Additionally, the significant (p<0.05) post-treatment antipyretic effect was found by all fractions in time dependent manner. The current findings showed that AMC, AME and AMA had significant reduction in immobility time in the antidepressant test, while AMH showed mild antidepressant activity. In anticoagulant assay, the coagulation time of crude extract A. modesta and its all fractions were comparable to that of positive control aspirin (208s). Moreover, neither mortality nor lethality was observed in the tested animals. Overall, the plant extracts showed potent anti-inflammatory, antipyretic, analgesic, antidepressant and anticoagulant activities which concludes that the bark of A. modesta have significant therapeutic potential.

Antidiabetic and antioxidant potential of Alnus nitida leaves in alloxan induced diabetic rats

ETHNOPHARMACOLOGICAL RELEVANCE

Leaves of Alnus nitida are used by local communities for the management of diabetes and in inflammatory disorders.

METHODS

Powder of shade dried leaves of A. nitida was extracted with methanol (ANME) and fractionated in escalating polarity i.e n-hexane (ANHE), chloroform (ANCE), ethyl acetate (ANEE) and soluble residual aqueous fraction (ANAE). The extract/fractions were evaluated for antidiabetic in vitro assays; α-amylase, α-glucosidase and dipeptidyl peptidase-4 (DPP-4). The in vivo investigations were carried out on ANEE and ANAE (100 mg/kg; 200 mg/kg, p.o.) in alloxan (125 mg/kg i.p.) induced hyperglycemic rats. Serum analysis was performed on liver, pancreas and kidney function markers. Analysis of antioxidant enzymes and genotoxic studies were carried out on pancreas, liver and kidneys tissues. GC-MS analysis was performed on ANME whereas HPLC analysis was carried out on ANME, ANEE and ANAE.

RESULTS

Preliminary in vitro assays indicated appreciable antidiabetic activity of ANEE and ANAE against α-amylase, α-glucosidase and DPP-4 assay. Furthermore, in vivo antidiabetic effect of ANEE and ANAE was inveterate by anti-hyperglycemic action in normal glucose loaded and diabetic glucose loaded animals. Single dose of alloxan (125 mg/kg) decreased the level of insulin and high density lipoprotein while raised the level of amylase and lipase, ALT, AST, total lipids, triglycerides, cholesterol, creatinine, BUN, CPK, CK-Mb in serum. Concentration of H₂O₂, lipid peroxidation (TBARS) and nitrite was increased (P < 0.05) whereas level of tissue protein, glutathione content (GSH) and antioxidant enzymes decreased in pancreas, liver and kidneys as compared to control group. Administration of ANEE and ANAE for 14 days after induction of diabetes decreased the hyperglycemia and restored the level of these parameters. Histopathological and genotoxic studies also endorsed the defensive strategies of ANEE and ANAE. GC-MS analysis of ANME demonstrated the presence of antidiabetic constituents i.e. linalool, Vitamin E and phytol.

CONCLUSION

Results obtained in this study suggests antidiabetic and antioxidant abilities and provides the scientific proof of the folklore medicine.

Expression of ESAT-6 antigen from Mycobacterium tuberculosis in broccoli: An edible plant

Tuberculosis (TB) is one of the major infectious diseases caused by Mycobacterium tuberculosis. The development of an effective and economical vaccine for controlling TB is essential especially for developing countries. Edible plants can serve as biofactories to produce vaccine antigens. In this study, 6 kDa early secretory antigenic target (ESAT-6) of M. tuberculosis was expressed in Brassica oleracea var. italica via Agrobacterium-mediated transformation to facilitate oral delivery of antigen. ESAT-6 gene was cloned using Gateway® cloning strategy. Transformation and presence of transgene was confirmed through PCR. Expression level of transgene was calculated via quantitative real-time PCR (qRT-PCR) and the maximum integrated transgene number was two. Maximum amount of total soluble fraction of ESAT-6 was evaluated by immunoblotting, estimated to accumulate up to 0.5% of total soluble protein. The recombinant ESAT-6 protein was further purified and detected using silver staining and Western blotting. ESAT-6 protein induced humoral immune response in mice immunized orally and subcutaneously. The expression of M. tuberculosis antigen in edible plants could aid in the development of cost-effective and oral delivery of an antigen-based subunit vaccine against TB. To the best our knowledge, it is the first report of expression of a vaccine antigen in broccoli.

Improving health outcomes in Northamptonshire’s Homeless population

Issue

Homeless people experience inequalities and barriers to accessing healthcare. Northamptonshire had significantly higher number of homeless compared to the England average.

This pilot aimed to provide health screening and interventions for Northampton’s homeless population using an integrated system wide approach. This would inform commissioning and contribute to the database.

Description

The project used a collaborative resource pooling approach by 24 NHS and non-NHS partners. Planning was reliant on information from voluntary sector so budgets were estimated.

Health outreach clinics were planned over 3 months and delivered over 3 weeks at 10 voluntary centres offering blood borne viruses (BBV) and latent tuberculosis screening; basic health checks; and Hepatitis B and seasonal flu vaccinations. Unregistered people were supported to register with a GP. Evaluation will determine how to better collect data and promote and offer such a service.

Results

127 people received basic health checks; 27 were overweight and 20 had high blood pressure. Of the 102 tested for BBVs, 5 were Hep C +ive and 2 were Hep B +ive. A fifth of those tested for LTBI were positive. In total, 67 Hepatitis B and 12 seasonal-flu vaccinations were given. 12 people required GP registrations. Primary and secondary care referrals were made.

Following the pilot, services will provide wrap around care for Northamptonshire’s homeless. Clinics at various times and locations will enable homeless people to engage with health and social services.

Lessons

Difficult to stratify the homeless and identify needs This innovative project was used as a case study by other areas Published data underestimates numbers of homeless Allow Adequate preparation for such events Consider health and safety risk assessment of venues during planning Staff continuity ensures consistent team working Dedicated communications lead support required

Key messages

Wraparound health promoting services are required to enable this cohort of population to engage with and seek health and social care. A multisectoral approach is required to improve and address inequalities of vulnerable groups.

Impacts of improved extension services on awareness, knowledge, adoption rates and perceived benefits of smallholder dairy farmers in Pakistan

The provision of effective extension services to smallholder farmers across both developing and developed countries remains a challenge worldwide. The objective of the study is to demonstrate the impacts of improved extension services on awareness, knowledge, adoption rates and perceived benefits of smallholder dairy farmers in Pakistan. An extension program was developed and implemented in five districts of Punjab (Okara, Pakpattan, Jhelum, Kasur and Bhakkar) and two districts of Sindh (Thatta and Badin) provinces. The extension program involved the provision of research-based information on a monthly basis to smallholder farming families (FF = 523) over a 4-year period. The extension program was primarily a knowledge transfer-based system, but also relied on farmer engagement and feedback to help drive research and topics for discussion. No financial incentives were provided to the farmers for their participation. A ‘whole-family approach’ was used in the extension program, where comprehensive interdisciplinary training on the whole dairy-farming system was provided to the males, females and children of the farming household. To encourage greater participation and support different learning strategies, several information transfer media were used (including group discussions, one-on-one visits, practical demonstrations, problem-based learning techniques and videos). To assess the impact of this extension program on farms involved, data on farmer awareness, knowledge, adoption and their perceived benefits were collected using a mixed-method approach from three different groups of farmers; registered (IMPreg = 179) farmers directly involved in the extension program, non-registered (IMPnon-reg = 116) farmers indirectly benefiting from the program and traditional (IMPtrad = 104) farmers not associated with any project activities. Overall awareness, knowledge and adoption rates relating to seven different recommendations in the extension program were significantly (P &lt; 0.05) higher in the registered farmers than in the non-registered and traditional farmers. The perceived benefits of the adopted recommendations varied between the different extension messages, but farmers described that they observed increases in milk production, improvements in animal health (body condition and morbidity) and labour efficiency (time savings). These results suggest that adopting improved extension services using a whole-family approach we can significantly achieve higher adoption rates, leading to on-farm benefits to smallholder dairy farmers and their families.

Perspectives on the production of milk on small-holder dairy farms and its utilisation in developing countries

The profitability of milk production in the developing world varies widely among farming systems. This results from poor animal productivity and an inefficient marketing-chain structure in which farmers seldom profit from their dairying activities. The lack of chilling facilities for milk storage and the need to adulterate the raw product along the market chain to enhance profit margins means that consumers are not well catered for. Co-operative selling of milk, along with the acquisition of higher-quality feeds and veterinary medicines, has boosted the financial resilience of small-holder farming communities worldwide, although, in many regions, the co-operative model has not succeeded largely through a lack of trust between families even within the communities. Commercial reality dictates that farming communities work together to achieve financial sustainability, although the model adopted for each community may differ. Although milk has traditionally provided many consumers with their only source of animal protein, vitamin and minerals, we are now discovering its many other virtues, particularly in relation to cognitive development and memory retention and the provision of antioxidants. The impact of milk-processing technology on some of these remarkable properties requires further investigation to ensure that milk consumers worldwide benefit from these positive attributes.

Methodology of ECG Interpretation in the Glasgow Program

This paper describes the methods currently used in Glasgow Royal Infirmary for computer analysis of electrocardiograms. The software is designed to analyse from 3 to 15 simultaneously recorded leads, with facilities for analysis of rhythm and serial changes. Options for Minnesota Code (with serial comparison) and XYZ lead interpretation are available.

Patient satisfaction following endoscopic endonasal dacryocystorhinostomy: a quality of life study

PURPOSE

To assess the subjective success and quality of life of adult patients post endoscopic endonasal dacryocystorhinostomy (EE-DCR) for acquired nasolacrimal duct obstruction.

DESIGN

Retrospective, questionnaire study performed at least 6 months post EE-DCR.

PARTICIPANTS

Hundred and ten of the 282 consecutive patients who underwent EE-DCR.

METHODS

A standardised questionnaire (Glasgow Benefit Inventory, GBI) was used to analyse the quality of life. The questionnaire examines four parameters, providing total, subscale, social, and physical scores.

MAIN OUTCOME MEASURES

We aimed to assess patient experience following EE-DCR surgery. Total GBI scores range from -100 to +100, the former reflecting maximal negative benefit and corresponding to subjective worsening of tearing and impact on quality of life. Any positive score reflects a satisfactory surgical outcome and +100 represents maximal positive benefit. A score of zero is no perceived benefit.

RESULTS

The average age was 62 years, 63% were female. In three of the parameters measured, there was a subjective improvement post surgery: subscale score 22.16 (95% CI: 15.23-29.09), total score 15.04 (95% CI: 9.74-20.35), and social support score 4.67 (95% CI: 0.93-8.42). Physical health scored -4.47 (95% CI: -10.25 to 1.32). Secondary analyses demonstrate no statistical significance with respect to outcome whether a trainee or consultant performed the procedure. Younger patients (under split median of 63.5) had a better total score 19.04 (95% CI: 11.35-27.74) than those older than 63.5 years (11.04, 95% CI: 3.61-18.47).

DISCUSSION

This study shows that EE-DCR gave patients improvement in quality of life, proven by a validated questionnaire. The mean total score of 15.04 found in our study compares with the 18.7 recorded by Feretis et al in 2009. Results were irrespective of the grade of surgeon, similar to the findings of Fayers et al for functional successes.

CONCLUSION

This study supports the use of EE-DCR for the improvement of quality of life in adult patients.

Curvularia Geniculata Fungal Peritonitis: A Case Report with Review of Literature

Peritonitis is the "Achilles heel" of patients on peritoneal dialysis. Fungal peritonitis though not that common is associated with increased morbidity and mortality. We report the first case in the literature of a patient who developed peritonitis caused by Curvularia geniculata. We discuss the reported cases of Curvularia lunata peritonitis in literature and emphasize the early removal of catheter and treatment with intravenous amphotericin B.

Chronic orchidectomy does not influence the sensitivity of the pituitary somatotropes to varying doses of GHRH administered intravenously to the adult male rhesus monkey

In the present study, the pituitary growth hormone (GH) response to graded doses of GH-releasing hormone (GHRH) was determined in intact (n = 3) and chronically orchidectomized (n = 3) adult rhesus monkeys (Mucaca mulatta). GHRH in doses of 0, 6.25, 12.5 and 25 microg/kg BW was infused through a teflon cannula implanted in the saphenous vein. Blood samples were collected 60 min before and 90 min after the injection of the neurohormone at 15 min intervals. All bleedings were carried out under ketamine hydrochloride anesthesia. The plasma levels of GH were determined by using AutoDELFIA time-resolved flouroimmunoassay, whereas plasma levels of testosterone and estradiol were determined using specific radioimmunoassay systems. The GH responses to GHRH were not significantly different between intact and chronically orchidectomized monkeys at any of the dose levels tested (p > 0.05). The administration of GHRH resulted in a significant (p < 0.05) stimulation of GH secretion at all the doses tested and in both the groups studied. In both intact and orchidectomized animals, the greatest response was observed at 6.25 microg/kg and no further increase was noted with the higher doses of GHRH. In conclusion, the present study suggests that chronic orchidectomy does not influence the sensitivity of the pituitary somatotropes to GHRH stimulation implying that the responsiveness of the pituitary somatotropes to GHRH is independent of testicular steroid modulation.

Association of Various Point Mutations as Risk Factors for Synthetic Graft Thrombosis in African American Hemodialysis Patients

Single-nucleotide polymorphisms in the genes that code for coagulation factor V (factor V (Leiden)) and II (prothrombin G20210A), as well as the methyltetrahydrofolate reductase (MTHFR) have been implicated in the majority of cases of hereditary thrombophilia. In our hemodialysis patient population, comprised mainly of African Americans, we have seen a high incidence of early vascular access thrombosis without any identifiable predisposing factors. In some instances, there is recurrent access thrombosis that may be related to an inherited condition. In this study we evaluated the presence of these gene mutations and their association with increased risk of recurrent vascular access thrombosis in our hemodialysis patient population. Our results show that factor V Leiden and factor II prothrombin point mutations did not appear to increase the risk of vascular access thrombosis in African Americans with end-stage renal disease on hemodialysis. Patients heterozygous for the MTHFR gene, also did not show a significant increased risk for synthetic graft thrombosis.

Minimal change glomerulonephritis following a wasp sting

We report the case of a young white male who developed the nephrotic syndrome after being stung by a wasp. A percutaneous renal biopsy was done revealing minimal change glomerulonephritis. The patient was treated with oral prednisone with resolution of proteinuria. Corticosteroids were gradually tapered, the patient did not experience a relapse, and remains in good health with normal renal function. Herein, we also include a review of the literature on wasp bite associated nephrotic syndrome in patients who underwent a renal biopsy.

Fluorescence polarization in homogeneous nucleic acid analysis II: 5'-nuclease assay

When the temperature and viscosity of the solvent is held constant, the degree of fluorescence polarization (FP) detected when a fluorescent dye is excited by plane polarized light depends mostly on the molecular weight of the dye molecule. By monitoring the FP of a fluorescent dye molecule, one can detect significant changes in the molecular weight of a fluorescent molecule without separation or purification. The 5'-nuclease (TaqMan) assay is a robust single nucleotide polymorphism genotyping method where an allele-specific probe that binds to a perfectly complementary target is cleaved by the 5'-nuclease activity of Taq DNA polymerase. Because the TaqMan probe is labeled with a fluorescent dye, it has high FP value when intact but a low FP value after cleavage. In this study, we compared the results of the 5'-nuclease assay based on standard fluorescence intensity readings and FP readings when genotyping 90 individuals with 20 single nucleotide polymorphisms. Our results show that FP is just as robust and reliable as the standard fluorescence detection method. Use of FP detection makes it possible to reduce the cost of TaqMan probes by abrogating the need for a fluorescence quencher.

Discovery of novel ansamycins possessing potent inhibitory activity in a cell-based oncostatin M signalling assay

We describe the isolation and characterisation of novel non-benzoquinone ansamycin metabolites related to geldanamycin from a culture of Streptomyces sp. S6699. The compounds possess potent inhibitory activity in a cell-based assay measuring inhibition of oncostatin M signalling in a reporter cell line utilising a secreted placental alkaline phosphatase (sPAP) readout. In this paper we report the isolation and structure elucidation of the compounds and describe some of their biological properties.

11Beta-hydroxysteroid dehydrogenase in the Dahl rat

Dahl salt sensitive (Dahl-S) rats develop hypertension soon after birth. The cause of the increased salt-sensitivity in the Dahl-S rat is unknown. The mineralocorticoid specificity of the kidney receptor is conferred by the activity of 11beta-hydroxysteroid dehydrogenase (11beta-HSD). There are two isoforms of 11beta-HSD (11beta-HSD1 and 11beta-HSD2). Deficiency or inhibition of 11beta-HSD2 causes sodium retention and hypertension. In the present study we measured the activity of hepatic and kidney 11beta-HSD1 in Dahl-S and R rats before and after the development of hypertension. The activity of 11beta-HSD1 in the liver was lower in the Dahl-S rats at 6 weeks of age (S = 8.01 +/- 0.89 v R = 11.91 +/- 0.84 nmol/mg protein/10 min (P < .02) but there was no difference at 10 weeks. In contrast, 11beta-HSD1 in the kidney was not different at 6 weeks but it was significantly lower in the Dahl-S rats at 10 weeks (S = 0.91 +/- 0.04 v R = 1.12 +/- 0.01 nmol/mg protein/10 min (P < .001). Plasma renin concentration was lower at 6 (6w) and 10 weeks (10w) in the Dahl-S rats: S-6w = 4.2 +/- 0.4 versus R-6W = 6.3 +/- 0.8 ng angiotensin I (AI)/mL/h (P < .04) and S-10w = 6.4 +/- 0.7 versus R-10w = 10 +/- 0.9 ng AI/mL/h (P < .009). Plasma aldosterone and corticosterone were not different between the two strains. Systolic blood pressure (SBP) in the Dahl-S rats was 124 +/- 3 mm Hg at 6 weeks and 241 +/- 6 mm Hg at 10 weeks (P < .001). SBP in the Dahl-R rats was 113 +/- 5 mm Hg at 6 weeks and 143 +/- 4 mm Hg at 10 weeks. In conclusion, Dahl-S rats have lower hepatic 11beta-HSD1 activity at 6 weeks of age and lower kidney 11beta-HSD1 at 10 weeks of age compared with Dahl-R rats of the same age. These findings suggest that diminished activity of both liver and kidney 11beta-HSD1 may play a role in the salt sensitivity and development of hypertension in the Dahl-S rat.

Stress and psychiatric disorder in rural Punjab. A community survey

BACKGROUND

The prevalence of psychiatric disorders in rural Punjab is unknown. Previous studies in rural areas elsewhere in the Indian subcontinent have yielded widely differing estimates.

METHOD

First-stage screening of a village near Gujar Khan used the Bradford Somatic Inventory and Self Reporting Questionnaire. Psychiatric interviews were conducted with stratified samples using the ICD-10 Diagnostic Criteria for Research.

RESULTS

It is estimated that 66% of women and 25% of men suffered from anxiety and depressive disorders. Levels of emotional distress increased with age in both genders. Women living in unitary households reported more distress than those living in extended or joint families. With younger men and women, lower levels of education were associated with greater risk of psychiatric disorders. Social disadvantage was associated with more emotional distress.

CONCLUSIONS

This study in rural Punjab confirms that findings of a previous study in Chitral, northern Pakistan, of high levels of emotional distress and psychiatric morbidity among women in rural areas of Pakistan.

Pulmonary mucormycosis in diabetic renal allograft recipients

Renal allograft recipients are prone to opportunistic infections due to their need of immunosuppression to prevent rejection. Mucormycosis is a rare opportunistic infection caused by a fungi of the order Mucorales. Risk factors predisposing to this disease include prolonged neutropenia, chelation therapy for iron or aluminum overdose, diabetes, and patients who are immunosuppressed. Life-threatening infections can occur, as this fungi has the propensity to invade blood vessel endothelium, resulting in hematologic dissemination. Early diagnosis and prompt aggressive therapy is imperative to achieve an improved outcome. We present two cases of pulmonary mucormycosis in diabetic renal allograft recipients who were treated successfully with amphotericin B and surgical resection of the lesions with preservation of their allograft function. In this era of intensified immunosuppression, we may see an increased incidence of mucormycosis in our transplant population.

Automated serial ECG comparison based on the Minnesota code

The Minnesota code was introduced in 1960, and since then, a number of computer programs have been written for classifying electrocardiograms according to the rules of the code. However, in 1982, extended rules for serial comparison based on the Minnesota code were published. This article presents the details of implementation of automated serial electrocardiographic comparison using the code. Its application in the West of Scotland Coronary Prevention Study, which was a double-blind trial of lipid lowering in 6.595 men, is also discussed.

Direct erosion of lumbar spine by an abdominal aortic aneurysm, resulting in paraparesis: unusual presentation. Case report

Abdominal aortic aneurysm is a condition affecting nearly 4% of the elderly population. It has a potential for producing a wide range of symptoms, including abdominal pain and back pain. The latter is particularly difficult to interpret in patients with chronic rheumatological conditions, and delayed diagnosis may be associated with a poor outcome. We present a patient with rheumatoid arthritis and chronic low back pain, who developed bilateral leg weakness and hesitancy of micturition, due to an abdominal aortic aneurysm invading the spine.

Heart rate variability in left ventricular hypertrophy

BACKGROUND

Electrocardiographic left ventricular hypertrophy and strain are associated with increased cardiac morbidity and mortality. Impaired cardiac autonomic function, assessed non-invasively by spontaneous heart rate variability on Holter monitoring, is associated with an increased risk of sudden death after myocardial infarction.

AIM

To study the effect of left ventricular hypertrophy on heart rate variability.

PATIENTS

36 controls and 154 patients with left ventricular hypertrophy (94 with hypertension and 60 with aortic valve disease).

SETTING

Tertiary referral centre.

METHODS

Heart rate variability was measured on 24 h Holter recordings by non-spectral methods. Left ventricular mass index and fractional shortening were measured by echocardiography.

RESULTS

Patients with left ventricular hypertrophy had a higher left ventricular mass index (P < 0.001) and reduced heart rate variability (P < 0.001) compared with those of the controls. A continuous inverse relation was apparent between heart rate variability and left ventricular mass index (r = -0.478, P < 0.001). Heart rate variability was not affected by age, the presence of coronary artery disease in patients with left ventricular hypertrophy, or beta blocker treatment for hypertension. Multivariate analysis showed that left ventricular mass index is the most important determinant of heart rate variability.

CONCLUSION

Heart rate variability is significantly reduced in patients with left ventricular hypertrophy secondary to hypertension or aortic valve disease. A continuous inverse relation exists between heart rate variability and left ventricular mass index. Impaired cardiac autonomic function in left ventricular hypertrophy may contribute to the mechanism of sudden death.

Activity of 11 beta-hydroxysteroid dehydrogenase in toad bladder: effects of 11-dehydrocorticosterone

11 beta-Hydroxysteroid dehydrogenase (11 beta-OHSD) transforms circulating glucocorticoids to their "biologically inert" 11-dehydro derivatives. Isoforms of 11 beta-OHSD with different cofactor requirements and biochemical properties [Michaelis constant (Km) and maximal velocity (Vmax)] exist in the kidney. Since epithelial cells derived from the toad bladder also contain this enzyme, we wished to further characterize its properties in prepared cell homogenates. 11 beta-OHSD from toad bladder demonstrated a clear preference for NAD+ over NADP+ as a cofactor similar to that observed in renal cortical collecting duct (CCD) cells. Furthermore, 11 beta-OHSD had a rapid onset of action. The apparent Km for corticosterone was 16.3 x 10(-8) M, a value comparable to that observed for enzyme from CCD, and a Vmax of 4.8 x 10(-12) mol.mg protein-1.min-1. The end product, 11-dehydrocorticosterone (compound A), influenced enzyme activity; it increased 11 beta-OHSD activity at corticosterone concentrations below the apparent Km for the enzyme and inhibited 11 beta-OHSD activity at corticosterone concentrations above the Km for the enzyme. The inhibitory effects of compound A appeared noncompetitive with an apparent equilibrium constant (Ki) of 2.8 x 10(-7) M. Consistent with its inhibitory action on 11 beta-OHSD, compound A (10(-6) M) enhanced the short-circuit current response to corticosterone (10(-7) M) in the intact toad bladder (experimental 2.03 +/- 0.33 vs. control 1.40 +/- 0.17 times above baseline; n = 7, P < 0.01). Thus 11 beta-OHSD in toad bladder resembles the isoform found in CCD, and compound A may be biologically important as a regulator of 11 beta-OHSD.

Methodology of ECG interpretation in the Glasgow program

This paper describes the methods currently used in Glasgow Royal Infirmary for computer analysis of electrocardiograms. The software is designed to analyse from 3 to 15 simultaneously recorded leads, with facilities for analysis of rhythm and serial changes. Options for Minnesota Code (with serial comparison) and XYZ lead interpretation are available.

Microbial transformations of steroids--VI. Transformation of testosterone and androstenedione by Botryosphaerica obtusa

The 7 beta progesterone-hydroxylating microorganism Botryosphaerica obtusa was tested for its ability to hydroxylate at this site the C-19 androstene-based compounds, androstenedione (androst-4-ene-3,17-dione) and testosterone (17 beta-hydroxyandrost-4-en-3-one). Only very limited 7 beta hydroxylation of both substrates was observed. The products included traces of 7 beta-monohydroxytestosterone and 6 beta,7 beta-dihydroxyandrostenedione from testosterone, and of 6 beta,7 beta-dihydroxyandrostenedione from androstenedione. 6 beta,7 beta-Dihydroxyandrostenedione does not appear to have been reported previously as a microbial transformation product. Both substrates were monohydroxylated in significant amounts at the isomeric 7 alpha site and at the 6 beta site. Testosterone was also significantly monohydroxylated at the 15 alpha site and in minor amounts at the 11 alpha and 12 beta sites. Some monohydroxytestosterones had also been oxidised at their 17-OH group, converting them into the corresponding monohydroxy androstenediones. The 7 alpha-hydroxy metabolites and 15 alpha-hydroxytestosterone being chemically demanding to synthesis are valuable microbial transformation products.

Microbial transformations of steroids--V. Transformation of progesterone by whole cells and extracts of Botryosphaerica obtusa

Members of the genus Botryosphaerica are reported 7 alpha steroid hydroxylators [1]. We found that the species B. obtusa efficiently hydroxylated progesterone in a 1-day transformation but it gave 7 beta-hydroxyprogesterone as the main product rather than the expected 7 alpha-hydroxy isomer, which was produced in only trace amounts. Also formed in minor amounts were 6 beta-, possibly 9 alpha- (see main text), 14 alpha- and 15 beta-monohydroxyprogesterones. The transformation mixtures included appreciable amounts of dihydroxylated progesterones which were mainly based on 7 beta-hydroxyprogesterone. The second hydroxyl group was at one of the minor monohydroxylation sites. The relative concentrations of the progesterone diols increased and those of the mono-alcohols concomitantly decreased when transformation was extended beyond 1 day. Monohydroxylated 6-dehydroprogesterones began to accumulate after about 3 days and these compounds seemed to have been formed by 6,7-dehydration of the dihydroxyprogesterones. We prepared mycelial cell-free extracts which were capable of transforming progesterone and retained the site-specificity of whole cells. These extracts converted 7 beta-hydroxyprogesterone to its 6-dehydro derivative, confirming that ring B desaturation occurs in this organism by dehydration. The dehydratase activity necessary for the conversion was separable from the hydroxylase activity by ultra-centrifugation. All hydroxylase activity co-sedimented with the membrane fraction, implying that steroid hydroxylation is effected by a membrane-bound enzyme(s). Dehydratase activity was present in both the pellet and the supernatant fractions, which suggests that it may involve a loosely bound, and easily removed, membrane-associated enzyme.

Microbial transformations of steroids--IV. 6,7-Dehydrogenation; a new class of fungal steroid transformation product

Microbial steroid dehydrogenation is quite common. The reaction seems to occur mainly in bacteria and usually results in hydrogen abstraction from positions C(1)-C(2) and/or C(4)-C(5) with occasional aromatisation of ring A. We have screened large numbers of fungal cultures for their ability to monohydroxylate steroids at unusual sites and in the course of our investigations we have identified seven fungal strains capable of dehydrogenating ring B of progesterone and androstenedione at positions C(6)-C(7). Microbiological dehydrogenation at this site seems not to have been reported previously. The structures of the metabolites isolated from progesterone, and the producing fungi, are: 6-dehydroprogesterone (Botryodiplodia theobromae), 11 alpha-hydroxy-6-dehydroprogesterone (Botryosphaerica obtusa, Mucor racemosus and Nigrospora sphaerica), 12 alpha-, 15 beta- and 16 alpha-hydroxy-6-dehydroprogesterones (B. obtusa) and 14 alpha-hydroxy-6-dehydroprogesterone (Apiocrea chrysosperma) [1]. From androstenedione we isolated 6-dehydroandrostenedione (Absidia coerulea and Curvularia lunata) and 6-dehydrotestosterone (C. lunata).