Combined Medical and Surgical Management of Hepatic Mucormycosis in an Adult with Acute Myeloid Leukemia: Case Report and Review of the Literature

Hepatic mucormycosis is a disease caused by a ubiquitous fungus which is especially important in patients with hematologic malignancies. We present a case of an adult patient with acute myeloid leukemia who developed the infection after undergoing chemotherapy. His successful management was an integrated approach of a minimally invasive surgical resection with anti-fungal therapy. We describe the management of this patient and a review of the literature

Thalassemia, a human blood disorder

A group of inherited blood defects is known as Thalassemia is among the world’s most prevalent hemoglobinopathies. Thalassemias are of two types such as Alpha and Beta Thalassemia. The cause of these defects is gene mutations leading to low levels and/or malfunctioning α and β globin proteins, respectively. In some cases, one of these proteins may be completely absent. α and β globin chains form a globin fold or pocket for heme (Fe++) attachment to carry oxygen. Genes for alpha and beta-globin proteins are present in the form of a cluster on chromosome 16 and 11, respectively. Different globin genes are used at different stages in the life course. During embryonic and fetal developmental stages, γ globin proteins partner with α globin and are later replaced by β globin protein. Globin chain imbalances result in hemolysis and impede erythropoiesis. Individuals showing mild symptoms include carriers of alpha thalassemia or the people bearing alpha or beta-thalassemia trait. Alpha thalassemia causes conditions like hemolytic anemia or fatal hydrops fetalis depending upon the severity of the disease. Beta thalassemia major results in hemolytic anemia, growth retardation, and skeletal aberrations in early childhood. Children affected by this disorder need regular blood transfusions throughout their lives. Patients that depend on blood transfusion usually develop iron overload that causes other complications in the body systems like renal or hepatic impairment therefore, thalassemias are now categorized as a syndrome. The only cure for Thalassemias would be a bone marrow transplant, or gene therapy with currently no significant success rate. A thorough understanding of the molecular basis of this syndrome may provide novel insights and ideas for its treatment, as scientists have still been unable to find a permanent cure for this deadly disease after more than 87 years since it is first described in 1925

A comparative study to evaluate the effects of antibiotics, plant extracts and fluoride-based toothpaste on the oral pathogens isolated from patients with gum diseases in Pakistan

Oral diseases caused by various microorganisms are common around the world. Scientific research has now been focusing on novel medicines to overcome bacterial resistance and antibiotics side effects; therefore, the current study was designed to assess the efficacy of certain antibiotics, toothpaste, and medicinal plant extracts (Ajuga bracteosa and Curcuma longa) versus the bacterial pathogens isolated from the human oral cavity. A total of 130 samples were collected from Khyber Teaching Hospital Peshawar, Pakistan, among those 27 species isolated, and eight bacterial species were identified from the samples. Among all the bacterial species, Staphylococcus aureus (29.62%) and Proteus mirabilis (22.2%) were found to be more prevalent oral pathogens. In comparison, the least pervasive microbes were Proteus vulgaris, Shigella sonnei, Escherichia coli and Aeromonas hydrophila. The study also suggested that dental problems were more prevalent in males (41-50 years of age) than females. Among the eight antibiotics used in the study, the most promising results were shown by Foxicillin against A. hydrophila. The survey of TP1 revealed that it showed more potent antagonist activity against Proteus vulgaris as compared TP2 and TP3 that might be due to the high content of fluoride. The Curcuma longa showed more significant activity than Ajuga bracteosa (Stem, leaves and root) extracts. The data obtained through this study revealed that antibiotics were more effective for oral bacterial pathogens than toothpaste and plant extracts which showed moderate and low activity, respectively. Therefore, it is suggested that the active compounds in individual medicinal plants like Curcuma longa and Ajuga bracteosa could replace the antibiotics when used in daily routine as tooth cleansers or mouth rinses

Probiotic properties of Lactobacillus helveticus and Lactobacillus plantarum isolated from traditional Pakistani yoghurt

Probiotic bacteria are of utmost importance owing to their extensive utilisation in dairy products and in the prevention of various intestinal diseases. The objective of this study was to assess the probiotic properties of bacteriocin-producing isolates of Lactobacillus helveticus and Lactobacillus plantarum isolated from traditional Pakistani yoghurt. In this study, ten bacteriocin-producing isolates were selected to screen for the probiotic property. The isolates showed resistance to acidic pH (6-6.5), bile salt (0.01-1%), and 1-7% NaCl salt and showed good growth at acidic pH and antibacterial activity against ten different foodborne pathogens. Interestingly, these isolates were proved to be effective against Actinobacter baumannii but least effective against Klebsiella pneumoniae and Pseudomonas aeruginosa. A few isolates were found to be resistant to some antibiotics like vancomycim, gentamycin, erythromycin, streptomycin, and clindamycin. Our results provide strong evidence in favour of traditional Pakistani yoghurts as a potential source of bacteriocin-producing bacteria with an added benefit of the probiotic property. Specifically, LBh5 was considered a good probiotic isolate as compared to other isolates used in the study. Further extensive research should be done on isolation and characterisation of probiotic isolates from local fermented foods, and then, these isolates should be used in the development of probiotic enriched food supplements in Pakistan

Compared effects of sudden and progressive impositions of salt stress in three durum wheat (Triticum durum Desf.) cultivars

The effect of sudden vs. progressive exposure to salt stress at the seedling stage was investigated in three durum wheat cultivars differing in their mean level of sale and drought resistance. Both procedures of stress imposition induced a decrease in relative growth rates, K concentrations and leaf osmotic potential values, as well as an increase in Na, proline and soluble sugar contents. Growth inhibition was largest in the drought-resistant cultivar Omrabi 5, suggesting that drought and salt-resistance are not necessarily linked in Triticum durum. Suddenly-applied NaCl often appeared more detrimental than progressive exposure. Quantitative differences between the effects of the two modes of stress imposition suggested the existence of a precocious adaptative mechanism in response to progressive exposure but varied according to the physiological parameter used to evaluate plant behaviour, the final dose of NaCl and the genotype. The most salt-resistant cultivar (Belikh) was the less influenced by the kinetics of stress application. The modification of the mineral nutrition- and osmotic adjustment-related parameters is discussed in relation to the specific physiological strategy of salinity resistance postulated in Triticum durum and in light of the contrasting evidence in the literature

Effect of salt and osmotic stresses on germination in durum wheat (Triticum durum Desf.)

In order to determine the relative importance of ionic toxicity versus the osmotic component of salt stress on germination in durum wheat (Triticum durum Desf.), seeds of three cultivars differing in their salt and drought resistance (Omrabi-5, drought-resistant; Belikh, salt-resistant and Cando, salt-sensitive) were incubated in various iso-osmotic solutions of NaCl, mannitol and polyethylene-glycol (PEG) (osmotic potential of -0.15 (control solution) -0.58, -1.05 or -1.57 MPa). Moderate stress intensities only delayed germination, whereas the highest concentration of NaCl and PEG reduced final germination percentages. PEG was the most detrimental solute, while mannitol had no effect on final germination percentages. All osmotica reduced endosperm starch and soluble sugars content as well as alpha -amylase activities recorded after 48 h of treatment while beta -amylase activities were, in contrast, slightly stimulated in all cultivars. Deleterious effects of NaCl and PEG were higher on isolated embryos germinated onto an in vitro Linsmaier and Skoog (LS) medium comparatively to whole seeds. All PEG-treated embryos, however, recovered after the stress relief while NaCl-treated embryos exhibited a lower rate of recovery and some extent of abnormal germination after rinsing. It was concluded that stress inhibition of germination could not be attributed to an inhibition of mobilisation of reserves and that the main effect of PEG occurred via an inhibition of water uptake while detrimental effects of NaCl may be linked to long-term effects of accumulated toxic ions. The behaviour of the three cultivars during germination did not fully reflect their mean level of putative stress resistance in field conditions and germination is, therefore, not recommended as a reliable selection criterion for breeding purposes

Salinity and water stress have contrasting effects on the relationship between growth and cell viability during and after stress exposure in durum wheat callus

Mature embryo-derived calli obtained from three cultivars (cvs.) (Omrabi: drought-resistant; Belikh: salt-resistant; Cando: drought- and salt-sensitive) were exposed for one month to various iso-osmotic concentrations of NaCl, mannitol or polyethylene glycol (PEG) 6000. The lowest relative growth rate (RGR) for all cultivars, were observed in the presence of PEG. Correlation between RGR and cell viability estimated by reduction of 2,3,5-triphenytetrazolium chloride (TTC) was significant in the case of salt stress only. NaCl increased the relative importance of the non-phosphorylating alternative respiratory pathway while osmotic stress in contrast increased the relative importance of the CN-sensitive pathway. Neither mineral concentration, nor proline, nor soluble sugar accumulation fully accounted for lowering the internal osmotic potential in PEG-treated calli. Calli exposed to PEG were able to recover while those treated with mannitol were not. After NaCl treatment, only calli obtained from the salt-resistant cultivar Belikh recovered. It is concluded that (i) salinity and water stress have contrasting effects on the relationships between growth and cell viability, (ii) these relationships are not the same during and after the stress treatment, and (iii) maintenance of growth potential after the stress relief is linked to the maintenance of ATP-producing respiratory pathway rather than to a stress-induced stimulation of the alternative pathway. (C) 2004 Elsevier Ireland Ltd. All rights reserved