COVID-19 Associated Fungal infections in Guntur, Andhra Pradesh: A Descriptive Study

Background: Since the onset of the COVID-19 pandemic’s second wave in India, there has been an unprecedented rise of life-threatening cases of rhinocerebral mucormycosis (RCM) by various fungi like Mucor, Aspergillus, Candida, and others in post-COVID-19 patients, especially in presence of immunosuppressive conditions due to their invasive potential. Aim: To assess the incidence of COVID-19 mucormycosis on routine culture methods and various risk factors associated with the second and third wave of COVID-19. Material and Methods: The descriptive cross-sectional study was conducted from April 1st, 2021 to February 28th 2022, in the department of Microbiology, NRI medical college, and General Hospital, Guntur, Andhra Pradesh, India. The present study included 240 specimens from suspected post-COVID mucormycosis cases. The statistical analysis of data was done using MS Excel 2010. Results: Out of 240 specimens, 192 (80%) fungal isolates were isolated. Most of the cases are seen in males and the main risk factor was diabetes mellitus (89%). Most of the species isolated were Mucor species followed by Aspergillus species, Candida species, Rhizopus species, and Absidia species. Antifungal sensitivity of Candida species showed good susceptibility to azole discs.  Conclusion: The study concluded that if infected, early diagnosis with culture, strategies to maintain a glycaemic index, and cautious use of corticosteroids, anti-fungal treatment, and surgical intervention should be sought for management, for good prognosis and less fulminant disease course can be achieved in post-COVID rhinocerebral mucormycosis cases

Microbiota and Related Disease

The microbiota is a complex community of wide range of bacteria and other microorganisms that can be found in numerous parts of human body, including the gastrointestinal tract, skin, mouth, respiratory system and vaginal canal. Over 70% of the microbiota live in a mutualistic and beneficial relationship with their host. Every individual has a distinct gut microbiota composition, which play a range of roles in the food metabolic system of the host, the structural integrity of the gut mucosal barrier, immunomodulation and pathogen protection. Taxonomically there are different microorganisms categorized in the gut microbiota. Early in life, the makeup of each human intestinal microbiota is determined by the changes in infants (gestational age, delivery, dairy feeding and weaning) as well as external variables, such as the use of antibiotics. In adult life these personal and balanced cores of native microbiota are typically constant, although enterotypes, BMI levels, working-out frequency, lifestyle, cultural and nutritional habits differ from person to person. As a result, since the gut microbiota makeup of each individual is different, there is no optimal intestinal microbiota composition. However, a balanced healthy host-microorganism must be maintained in order to perform metabolic and immunological activities in an optimal manner, and avoid disease progression. There are a number of extra-intestinal disorders that lead to microbiota dysbiosis, including metabolism, neurology, and cancer. An appropriate treatment options should assist in understanding the origin and consequences of the gut microbiota balance in health and illness and also help to preserve or restore a healthy gut microbiota composition

Detection of Insulin Resistance in Normoglycemic First-Degree Relatives of Type 2 Diabetics: A Case-Control Study

Background: Diabetes has a strong familial aggregation in Asian Indians, with a high prevalence among the first-degree relatives and vertical transmission through two or more generations. First-degree relatives of T2DM are at significant risk for developing T2DM. Aim: Evaluation of insulin resistance in normoglycemic first-degree relatives of type 2 diabetic patients. Methods: A total of 200 subjects were divided into two groups. Group A comprises non-diabetic first-degree relatives of T2DM patients between the age group of 20 to 50 years. Group B comprises healthy controls without a family history of T2DM. Subjects were analyzed for fasting plasma glucose level, fasting serum Insulin and fasting serum hs-CRP. Result: The mean value of blood sugar level did not show a significant difference between cases and controls (92.02 ± 9.23 Vs. 91.77 ± 7.99; p > 0.05). The mean values of insulin (12.52 ± 3.65 vs. 5.08 ± 1.42), HOMA-IR (2.86 ± 0.95 vs. 1.15 ± 0.34) and hs-CRP (2.4 ± 1.98 vs. 1.0 ± 0.38) (all p < 0.001) increased in cases as compared to controls. Fasting serum insulin shows a positive correlation with HOMA-IR and hs-CRP (p < 0.001). HOMA-IR strongly correlates with hs-CRP and shows a positive correlation (p < 0.05). Insulin and HOMA-IR shows strong positive correlation with each other (r = 0.94; p < 0.001). Conclusion: Normoglycemic first-degree relatives of type 2 diabetic patients were insulin resistant compared to individuals without family history of type 2 diabetes

Potential of Marine Algae (Seaweeds) in the Biosynthesis of Nanoparticles and their Biomedical Applications

Since 3000 BC, seaweeds have played an important role in human life due to their nutritional and therapeutic properties. In recent years the ability of seaweeds to biosynthesize nanoparticles has increased their potential in a variety of industrial, agricultural, and medical applications. In this review, we attempted to shed some light on the various traditional applications of seaweeds and the potential of biosynthesized nanoparticles, with a focus on the wide medical applications of biosynthesized nanoparticles in modern life

An In-Vitro Study to Compare the Dimensional Stability of Addition Silicone and Polyether Bite Registration Pastes

Introduction: The success of any prosthetic rehabilitating treatment depends on the precise mounting of casts in the articulator. However a major source of error is while taking the registration records and transferring them to the articulator. These errors can be minimized by proper selection of the materials by knowledgeable application of their properties. Aim: The present study was conducted to find and compare the dimensional stability of polyether and addition silicone bite registration pastes, 1 hour after making of interocclusal record. Materials and Method: Materials used in the study are polyether bite registration paste (Ramitec 3M) and addition silicone bite registration paste (O – Bite – DMG). A total of 40 specimens (20 specimens from each material) were made which were divided equally into 2 groups. A metal die with two sets of parallel lines in the depression of the die created a square of 1cm in its centre and two points Point A and Point B in the right corners of the square were selected for measurements. The measurements on the die were compared with those of specimens of two groups and %dimensional change of each group was calculated and analysed statistically. Result: The percentage dimensional change of polyether bite registration paste had a mean of 0.3088cm while addition silicone bite registration paste had a mean of 0.1911cm. Conclusion: The study concluded that the dimensional stability of addition silicone bite registration pastes was more than polyether bite registration pastes and the results were statistically significant

Clinical utility of serum holotranscobalamin in the assessment of Vitamin B12 deficiency in patients with Hypothyroidism

Thyroid disorder is the second most frequently encountered endocrinological condition after diabetes mellitus. When vitamin B12 deficiency coexists with hypothyroidism, neurological symptoms and signs are more pronounced. Holotranscobalamin (Active B12) may be a more sensitive marker in the early diagnosis of Vitamin B12 deficiency than total B12. The study aimed to evaluate the serum levels of active B12 in patients with clinical hypothyroidism and to correlate active B12 and thyroid profiles. The case-control study was carried out in a tertiary hospital on 80 study subjects, comprising 40 confirmed hypothyroidism patients and 40 age- and gender-matched healthy controls. Serum thyroid profile and active B12 assays were performed by Chemiluminescent Microparticle Immunoassay. Statistical methods such as independent t-test and Pearson’s correlation were used to compare and correlate quantitative data. A significant percentage (90%) of hypothyroid patients had vitamin B12 deficiency, with a mean value of 17.39 ± 5.73 pmol/L. Active B12 showed a positive correlation with T3 (r = 0.818; P < 0.001) and T4 (r = 0.851; P < 0.001) and a negative correlation with TSH (r = -0.930; P < 0.001). Vitamin B12 deficiency was found in patients with hypothyroidism. This vitamin B12 deficiency may be caused by inadequate malabsorption, as seen in hypothyroidism. HoloTC (Active B12) may be a promising marker for early detection and management of B12 deficiency, which may be beneficial in preventing irreversible neurological damage at an early stage

Thyroid Diseases with Vitamin D Deficiency in Erbil city

Vitamin D is essential for the proper growth and development of a child and is associated with numerous public health issues. Our study aimed to examine the relationship between vitamin D deficiency and thyroid diseases. Vitamin D sufficiency is defined in terms of the serum level of the prohormone 25(OH)D which is 30 ng/mL. Vitamin D level less than of it is considered as vitamin D deficiency. A total of 100 subjects were included in the present study who visited the Central Laboratory in Erbil for health examination between the beginning of September to the beginning of December 2020. The findings of the present study show a high prevalence of vitamin D deficiency (79%) among Erbil population. There was a negative correlation between Vitamin D serum levels and TSH levels (r = - 0.154) with a positive correlation between vitamin D serum levels and FT3 levels (r = 0.168) and FT4 levels (r = 0.122). The results showed that patients with vitamin D deficiency suffered from hypothyroidism. Additionally, the positive significant correlation between thyroid hormones with vitamin D and that negative significant correlation with TSH levels, suggested that low vitamin D levels are significantly associated with the severity of hypothyroidism which encourages the advisability of vitamin D supplementation

Diagnosis and Differentiation of Hypochromic Microcytic Anemia among Elementary School Children in Ranya District

Hypochromic microcytic anemia (HMA) is defined as decreased hemoglobin (Hb), mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) levels, the most common causes of microcytic anemia in children are iron deficiency anemia (IDA) and thalassemia trait (TT). The cross-sectional study was conducted to diagnose and differentiate HMA among elementary school children in the Ranya district. A total of 134 subjects were included in the study of which 28 participants were healthy, and 106 subjects were diagnosed with HMA. The study subjects were divided into three groups. Group 1 with 28 healthy subjects, Group 2 with 38 IDA patients and Group 3 with 68 TT patients. Complete blood count, iron status (ferritin, serum iron, UIBC, TSAT (%) and TIBC), T3, T4, TSH, Erythropoietin hormone, Creatinine and GFR were estimated in all three groups. The results demonstrated that there was a significant decrease (P < 0.0001) in Hb, HCT, MCV, MCH and MCHC in both IDA and TT patients. While significant increase was seen in RDW and PLT count in both IDA and TT. The result revealed a significant decrease (P < 0.0001) in serum ferritin, serum iron and TSAT (%), whereas a significant increase in TIBC and UIBC in IDA. Serum erythropoietin (EPO) was increased significantly in both IDA and TT. Thyroid hormones (T3 and T4), TSH, serum creatinine and GFR were non-significantly changed in both IDA and TT patients

Evaluation of acute toxicity of Ducetia japonica on mice model

Ducetia japonica, also known as bush cricket, is an edible insect that is valued as a food source by various tribal communities in Arunachal Pradesh. Its nutrient content makes it a novel source for both human food and animal feed. However, no research has been done on its food safety or possible toxicity. The toxicological evaluation was carried out on mice for 2-weeks at four distinct dose levels of 2000, 3000, 4000, and 5000 mg/kg bodyweight, according to the criteria of the Organisation for Economic Co-operation and Development (OECD). Bodyweight and clinical indicators showed no substantial toxicological related alterations. Furthermore, no toxicological changes in haematology were observed. When compared to a vehicle control group, serum alanine aminotransferase and creatinine levels did not differ between the experimental groups. In the liver and kidney tissues of mice, no histological and gross abnormalities were found. The relative organ weight of the treatment groups did not differ significantly from that of the vehicle control group. As a result, the LD50 value for Ducetia japonica is considered to be greater than 5000 mg/kg body weight and no evidence of toxic changes were observed in the present study

Identification and Role of Antimicrobial Susceptibility Patterns of Aerobic Bacteria in the Management of Refractory Chronic Suppurative Otitis Media – A Tertiary Hospital-based Retrospective Study

Objectives: This study identifies aerobic bacteria that cause refractory chronic suppurative otitis media (CSOM) and compares the treatment outcomes of patients treated with antibiotic sensitivity testing (AST) directed antibiotics against those treated with empirical antibiotics. Methods: This retrospective study was conducted at the departments of ENT and Microbiology, AIIMS, Patna. Data were collected from clinical and microbiological laboratory records of patients with complaints of persistent ear discharge from September 2018 to February 2020. Ear discharge samples were cultured and AST data from all patients were examined. Antibiotics were administered to those patients diagnosed with refractory CSOM based on their AST report. Patients were followed up, and their treatment responses were assessed and recorded. Data were analyzed by using IBM SPSS Statistics software Version 20.0. Descriptive analysis was performed and Pearson Chi-square tests were applied and p-values were determined to draw relevant conclusions. Results: A total of 90 patients were examined, of which 70 showed significant bacterial growth and were prescribed AST-directed antibiotics. The remaining 20 patients with insignificant growth were treated empirically. Common microorganisms isolated in our study were P. aeruginosa and S. aureus. Gram-negative and Gram-positive isolates were highly resistant to commonly used fluoroquinolones. Among intravenous (IV) formulations, piperacillin-tazobactam and cefoperazone-sulbactam had the highest sensitivity (>80%) against Gram-negative isolates. There was a statistically significant (p < 0.05) difference in cure rates between patients treated with AST-directed antibiotics (n = 54; 77.1%) and empirical therapy (n = 9; 45%). Route of antibiotic administration (oral versus IV) had no statistically significant effect on treatment outcomes (p > 0.05). Conclusion: In the management of refractory CSOM, AST-directed antibiotic therapy is more effective than empirical treatment. Oral and IV antibiotics were equally effective when combined with aural toileting and ototopical antibiotics. Therefore, when treating such cases, AST-directed antibiotics should always be used to prevent widespread antibiotic resistance caused by injudicious antibiotic use