Science–policy interface for disaster risk management in India : toward an enabling environment

The article discusses how the contribution of science in managing disaster risks in an emerging economy like India can be enhanced and enriched. It highlights some of the underlying challenges in greater science–policy interface in disaster risk management (DRM) and suggests some principles to organize and strengthen such interface at various levels of planning and implementation. The paper acknowledges that due to geography, India is one of the most disaster-prone countries in the world, and under changing climatic conditions, extreme weather phenomenon has become a norm rather than an exception

Неалкогольная энцефалопатия Вернике у пациента с трансплантированной почкой

Background. Non-alcoholic Wernicke’s encephalopathy occurs in various somatic conditions with thiamine deficiency, excessive excretion of thiamine, or impaired thiamine metabolism. Very few cases of this pathology have been described in chronic kidney disease (CKD). We present a unique case of non-alcoholic Wernicke’s encephalopathy in a patient with a kidney transplant is presented.Past medical history. The patient underwent kidney transplantation in 2008. Outpatient follow-up by a nephrologist was irregular. Renal graft function remained relatively stable: blood creatinine 200–240 μmol/L, estimated glomerular filtration rate 40–30 mL/min, tacrolimus plasma concentrations tended to increase (5.7–7.6–8.4–10.4 ng/mL); repeated graft biopsy (in 2015 and in 2017) determined the chronic toxicity of calcineurin inhibitors. The patient’s condition worsened in late January 2020: body temperature increased to 38°C, nausea, vomiting, loose, watery stools for up to 5 times per day, 8 kg weight loss, decreased diuresis. A few days later, double vision, shaky gait and then immobility appeared. Biochemical examination results: potassium 3.8 mmol/L, sodium 139 mmol/L, alpha-amylase 159 units/L (norm 0–100 units/L), creatinine 242 mmol/L, urea 13.2 mmol/L; ultrasound signs of pancreatitis. Magnetic resonance imaging (MRI) of the brain: bilateral diffuse lesions of the midbrain, thalamus, and cerebellum. Based on the clinical picture and on brain MRI results, Wernicke’s encephalopathy was diagnosed. Parenteral administration of thiamine had a good effect.Conclusion. Possible mechanisms of the development of Wernicke’s encephalopathy in a patient were discussed. Vigilance is required regarding this disease when metabolic disorders occur in patients with CKD.Актуальность. Неалкогольная энцефалопатия Вернике встречается при различной соматической патологии, сопровождающейся недостаточным поступлением, избыточной экскрецией или нарушением метаболизма тиамина. Описано крайне мало случаев этой патологии при хронической болезни почек (ХБП). Представлен уникальный случай неалкогольной энцефалопатии Вернике у пациента с трансплантированной почкой.История болезни. Пациент перенес трансплантацию почки в 2008 г. Амбулаторное наблюдение у нефролога нерегулярное. Функция почечного трансплантата сохранялась относительно стабильной: креатинин крови 200–240 мкмоль/л, расчетная скорость клубочковой фильтрации 40–30 мл/мин, плазменная концентрация такролимуса имела тенденцию к повышению (5,7–7,6–8,4– 10,4 нг/мл), при повторной биопсии трансплантата (в 2015 г. и в 2017 г.) определялась хроническая токсичность ингибиторов кальциневрина. Ухудшение состояния в конце января 2020 г.: повышение температуры тела до 38 °С, тошнота, рвота, неоформленный, водянистый стул до 5 р/сут, потеря в весе до 8 кг, снижение диуреза. Через несколько дней появились двоение в глазах, шаткость походки, затем обездвиженность. Результаты биохимического обследования: калий 3,8 ммоль/л, натрий 139 ммоль/л, альфа-амилаза 159 ед/л (норма 0–100 ед/л), креатинин 242 мкмоль/л, мочевина 13,2 ммоль/л; ультразвуковые признаки панкреатита. Магнитно-резонансная томография (МРТ) головного мозга: двустороннее диффузное поражение среднего мозга, таламусов и мозжечка. На основании клинической картины и результата МРТ головного мозга диагностирована энцефалопатия Вернике. Проводилось парентеральное введение тиамина с хорошим эффектом.Заключение. Обсуждаются возможные механизмы развития энцефалопатии Вернике у пациента. Необходима настороженность в отношении данного заболевания при возникновении метаболических нарушений у пациентов с ХБП

Topoisomerase Inhibitors Addressing Fluoroquinolone Resistance in Gram-Negative Bacteria.

Since their discovery over 5 decades ago, quinolone antibiotics have found enormous success as broad spectrum agents that exert their activity through dual inhibition of bacterial DNA gyrase and topoisomerase IV. Increasing rates of resistance, driven largely by target-based mutations in the GyrA/ParC quinolone resistance determining region, have eroded the utility and threaten the future use of this vital class of antibiotics. Herein we describe the discovery and optimization of a series of 4-(aminomethyl)quinolin-2(1H)-ones, exemplified by 34, that inhibit bacterial DNA gyrase and topoisomerase IV and display potent activity against ciprofloxacin-resistant Gram-negative pathogens. X-ray crystallography reveals that 34 occupies the classical quinolone binding site in the topoisomerase IV-DNA cleavage complex but does not form significant contacts with residues in the quinolone resistance determining region

A Meticulous Appraisal of Vyaghri Haritaki Avaleha – An Ayurvedic Medicament WSR to Stability Study

Stability study of the Ayurvedic formulations plays a significant role to provide actual shelf life of the medicament. Hence, it is necessary to perform stability studies of Ayurvedic compound formulations. The stability study was planned to observe whether any physical, chemical, and microbiological change takes place in Vyaghri Haritaki samples by keeping them at three different temperatures (47°C, 37°C, and 25–30°C) for 3 months. The samples kept for accelerated stability study were analyzed after 3 months and the details have been presented in this section

Pulmonary and intestinal tuberculosis in a kidney transplant recipient

Introduction. Tuberculosis is one of the most common infections in the general population, as well as among the recipients of solid organs. In kidney transplant recipients, the diagnosis of tuberculosis is often extremely difficult to make because of unclear clinical and radiological symptoms, and a highly frequent atypical (extrapulmonary) localization. The tuberculosis treatment in patients on drug immunosuppression is a significant problem.Clinical case. At five years after renal transplantation, the patient noted the onset of fever up to 38 degrees C. It was suspicious of respiratory infection. Chest X-ray, computed tomography, and ultrasound examination of the graft revealed no pathology. Antibacterial and antiviral therapy brought stable improvement. A repeated computer tomography demonstrated an enhanced pulmonary pattern in S6 of the left lung with visualization of small grouped lesions located peribronchially, the terminal ileitis in the abdominal cavity: (an intensive contrast accumulation in the mucosa of the affected part of the small intestine, the mesentery hypervascularity at this level). A colonoenteroscopy with a ileum intestine biopsy was performed; the findings were highly consistent with a tuberculous process. A targeted treatment of tuberculosis was carried out, which had a marked positive trend.Conclusion. Thus, the diagnosis of tuberculosis in kidney transplant recipients is complex; the clinical signs and instrumental test results are often ambiguous, which greatly complicates the timely diagnosis. An integrated approach with the use of modern diagnostic methods is required