Purification, Characterization and Functional Analysis of a Serine Protease Inhibitor from the Pulps of Cicer arietinum L. (Chick Pea)

Serine proteinase inhibitors (SPIs) are present in high amount in legume seeds where they play an important role in plant defence mechanism against pests. In the present study, a serine protease inhibitor has been identified from the seeds of Cicer arietinum (L.) and characterized for its inhibitory potency against trypsin and chymotrypsin. Ammonium sulphate fractionation was executed as an initial step to purify the inhibitor. The fraction which was obtained from 30-60% relative ammonium sulphate saturation exhibited the maximum trypsin inhibition activity against 0.2% casein using radial diffusion method. The 30–60% fraction was further subjected to ion exchange chromatography using 1 mL HiTrap Q HP column. The peak fractions were analyzed for the enzymatic activity and also characterized on 12% SDS PAGE. The results indicated that the flow through fraction has retained a significant proteolytic inhibition towards trypsin with a relative molecular mass of approximately 12-13 kDa. The kinetic results have demonstrated that the purified inhibitor from Cicer arietinum L. not only inhibited trypsin but also chymotrypsin. The Circular Dichroism spectrum analysis of the purified inhibitor has revealed that the secondary structure content is highly composed of random coils which were supported by the reports of other low molecular weight trypsin inhibitors. To conclude, a low molecular weight serine protease inhibitor possessing both trypsin and chymotrypsin inhibition from the seeds of C. arietinum has been purified, characterized and the results are reported

High initial IgG antibody levels against Orientia tsutsugamushi are associated with an increased risk of severe scrub typhus infection.

BACKGROUND: Scrub typhus is a dominant cause of febrile illness in many parts of Asia. Immunity is limited by the great strain diversity of Orientia tsutsugamushi. It is unclear whether previous infection protects from severe infection or enhances the risk. METHODS/PRINCIPAL FINDINGS: We studied IgG antibody levels against O. tsutsugamushi at presentation in 636 scrub typhus patients using enzyme-linked immunosorbent assays (ELISA). The association between ELISA optical density (OD) and risk of severe infection was modelled using Poisson regression. OD was categorised as low (<1.0), intermediate (1.0 to 2.9), and high (≥3.0). OD was also modelled as a continuous variable (cubic spline). Median age of cases was 41 years (range 0-85), with 37% having severe infection. Compared to the low category, the age-adjusted risk of severe infection was 1.5 times higher in the intermediate category (95%CI 1.2, 1.9), and 1.3 times higher in the high category (95%CI 1.0, 1.7). The effect was stronger in cases <40 years, doubling the risk in the intermediate and high categories compared to the low category. The effect was more pronounced in cases tested within 7 days of fever onset when IgG ODs are more likely to reflect pre-infection levels. CONCLUSIONS/SIGNIFICANCE: Intermediate and high IgG antibody levels at the time of diagnosis are associated with a higher risk of severe scrub typhus infection. The findings may be explained by severe infection eliciting an accelerated IgG response or by previous scrub typhus infection enhancing the severity of subsequent episodes

Midurethral bulbocavernous muscle sling for genuine stress incontinence - an alternative to synthetic slings?

Objectives: To assess the efficacy of midurethral bulbo-cavernous muscle sling (BCMS) in the treatment of genu-ine stress incontinence in women. Methods: A prospective study comprising 25 women was carried out at the Govt. Kasturba Gandhi Hospital, Chennai. The women whose age was in the range of 30-65 years had GSI as proved by urodynamic evaluation. The bulbocavernous muscle sling implies the approximation of both the bulbocavernous muscles around the midurethra with prolene sutures. The procedure is done under regional anaesthesia. Results: These patients were followed up for 2 years. Eighteen (72%) women reported complete cure, 4 (16%) were significantly improved and in 3 the surgery failed. Conclusions: The bulbocavernous muscle sling is a promising new procedure for genuine stress incontinence. There is no need for intraoperative cystoscopy and the chances of bladder injury are nonexistent. Larger sample with long term follow up and randomized controlled trials comparing it with the other surgical techniques may prove its true efficacy

Tension free vaginal tape in the management of genuine stress incontinence in women - the Indian experience

Objectives: To study retrospectively the results of the Tension Free Vaginal Tape (TVT), a new ambulatory sur-gical procedure for the treatment of stress urinary incon-tinence (SUI) among Indian women. Methods: TVT implies the implantation of a prolene tape around the mid-uretha via a minimal vaginal incision. TVT was done on 54 patients diagnosed to have Genuine Stress Incontinence (GSI). The procedure was done either under regional anaesthesia (RA) or under local anaesthesia (LA) with IV analgesics. Results: Thirty-eight patients underwent only the TVT procedure and in 16 patients concomitant procedures were done along with the TVT The TVT was done as the pri-mary procedure for GSI in 46 patients. Eight patients had prior surgery for stress incontinence. All patients were followed up from 6 months to 2 years. Forty-eight (88%) patients reported complete cure. There was significant improvement of symptoms in 4(7.4%) patients and in 2(3.7%) the surgery failed. Conclusions: These results prove that the TVT proce-dure is a minimally invasive, safe and effective method for the treatment of SUI in women

Purification, Characterization and Functional Analysis of a Serine Protease Inhibitor from the Pulps of <em>Cicer arietinum </em>L. (Chick Pea)

117-124Serine proteinase inhibitors (SPIs) are present in high amount in legume seeds where they play an important role in plant defence mechanism against pests. In the present study, a serine protease inhibitor has been identified from the seeds of&nbsp;Cicer arietinum (L.) and characterized for its inhibitory potency against trypsin and chymotrypsin. Ammonium sulphate fractionation was executed as an initial step to purify the inhibitor. The fraction which was obtained from 30-60% relative ammonium sulphate saturation exhibited the maximum trypsin inhibition activity against 0.2% casein using radial diffusion method. The 30&ndash;60% fraction was further subjected to ion exchange chromatography using 1 mL HiTrap Q HP column. The peak fractions were analyzed for the enzymatic activity and also characterized on 12% SDS PAGE. The results indicated that the flow through fraction has retained a significant proteolytic inhibition towards trypsin with a relative molecular mass of approximately 12-13 kDa. The kinetic results have demonstrated that the purified inhibitor from Cicer arietinum L. not only inhibited trypsin but also chymotrypsin. The Circular Dichroism spectrum analysis of the purified inhibitor has revealed that the secondary structure content is highly composed of random coils which were supported by the reports of other low molecular weight trypsin inhibitors. To conclude, a low molecular weight serine protease inhibitor possessing both trypsin and chymotrypsin inhibition from the seeds of C. arietinum has been purified, characterized and the results are reported

Clinical profile, outcome, and cost of care in snakebite patients requiring admissions in a single medical unit: A retrospective study from a tertiary care center in South India

Background and Aim: Snakebite is an important occupational and rural hazard. It is one of the most common causes of morbidity and mortality in tropical countries. Even though snakebite is an imminently treatable condition, it is a common life-threatening emergency. We aim to study the clinical profile, complications, as length of stay in the hospital, outcome and cost of care in snakebite patients requiring admission under a medicine unit. Materials and Methods: This retrospective study was conducted carried out from May 01, 2014, to May 01, 2019. The data were extracted from the inpatient medical records, and it was analyzed. All adult patients requiring admission in medicine unit V with a diagnosis of snake envenomation were included in the study. Descriptive statistics were obtained for all variables in the study, and appropriate statistical tests were employed to ascertain the significance. Results: The cohort consists of 80 patients with 45 (56.3%) males and aged 40.06 ± 15.24 years (mean, standard deviation [SD]). The majority of the snake species identification was not available 38 (47.5%). Viper bite was the most common bite 32 (40%). The most common clinical presentation was hemotoxic 33 (31.3%) followed by neurotoxic 16 (20%). Sixty-eight (85%) patients were treated outside before presentation. The median antisnake venom (ASV) given was 10 vials, and 12 (15%) patients had allergic reaction to ASV. Sixty-nine (86%) patients had cellulitis and 16 (20%) had acute kidney injury (AKI). Twenty-four (30%) patients required intensive care monitoring, 22 (27.5%) required mechanical ventilation, and 7 (8.8%) required hemodialysis. The mean ± SD duration of hospital stay was 5.56 ± 3.76 days. The median direct cost was Rs. 19,714.5 and cost of medicine was Rs. 10,798. The mortality in this cohort was 4 (5%). Conclusion: Snakebite causes significant morbidity. Viper bite was the most common bite in our study. ASV reaction was seen in 15%, and cellulitis and AKI were the common complications. The median direct cost was Rs. 19,714.5 and cost of medicine was Rs. 10,798. The mortality in this cohort was 4 (5%)

Investigations on the Response of Novel Layered Geopolymer Fibrous Concrete to Drop Weight Impact

In recent years, geopolymer concrete (GC) has become more popular in construction because of its multiple benefits, such as eco-friendliness, high temperature resistance and resistance to chemical attack in harsh environments. However, GC has limited deformation capability and tensile strength compared to ordinary concrete. Geopolymer fibrous concrete (GFC) exhibits high mechanical properties, such as compressive strength and impact strength. This study aimed to develop a novel composite comprising GFC at the tension zone and GC at the compression zone, and vice versa, are these composites were examined. The impact resistance of two-layered GC-GFC with various ratios (25&ndash;75, 50&ndash;50, 75&ndash;25%) was examined. In addition, a single layer specimen comprising GC and GFC was fabricated and tested as the reference specimen. Twenty-nine mixtures were developed and divided into four series. Four different types of fibre were used in this study; short polypropylene fibre, long polypropylene fibre, short steel fibre and long steel fibre. The ACI committee 544 drop weight test was used to evaluate the impact strength of specimens. Results indicated that the impact strength of GFC was significantly improved in long steel fibre-based specimens. In addition, two-layered specimens comprising different fibres&mdash;short polypropylene, long polypropylene, short steel and long steel&mdash;exhibited a positive influence on impact strength. Compared to a single-layer specimen, inferior impact strength was recorded in the two-layered specimen

Amlodipine-Induced Gingival Hyperplasia in a Young Male with Stage 5 Chronic Kidney Disease

Gingival hyperplasia is a rare finding in clinical practice. Nevertheless, when it occurs, it is a finding of great value as it can lead to definite clinical diagnosis. The present case is a 19-year-old male who was referred for further management of stage 5 chronic kidney disease. On evaluation, he was found to have gingival hyperplasia. He was evaluated for reversible causes of kidney disease, and since none were found, renal replacement therapy was advised. He had been taking amlodipine for blood pressure control. As this was presumed to be the cause of gingival hyperplasia, it was stopped and replaced by a combination of beta-blocker and prazosin. At six-month follow-up, he had complete resolution of gingival hyperplasia. Amlodipine as a cause of gingival hyperplasia is a rare occurrence. However, it is crucial to keep in mind such a possible side effect of this commonly prescribed antihypertensive drug