Sensitization of <it>Candida albicans</it> biofilms to various antifungal drugs by cyclosporine A

<p>Abstract</p> <p>Background</p> <p>Biofilms formed by <it>Candida albicans</it> are resistant towards most of the available antifungal drugs. Therefore, infections associated with <it>Candida</it> biofilms are considered as a threat to immunocompromised patients. Combinatorial drug therapy may be a good strategy to combat <it>C. albicans</it> biofilms.</p> <p>Methods</p> <p>Combinations of five antifungal drugs- fluconazole (FLC), voriconazole (VOR), caspofungin (CSP), amphotericin B (AmB) and nystatin (NYT) with cyclosporine A (CSA) were tested <it>in vitro</it> against planktonic and biofilm growth of <it>C. albicans</it>. Standard broth micro dilution method was used to study planktonic growth, while biofilms were studied in an <it>in vitro</it> biofilm model. A chequerboard format was used to determine fractional inhibitory concentration indices (FICI) of combination effects. Biofilm growth was analyzed using XTT-metabolic assay.</p> <p>Results</p> <p>MICs of various antifungal drugs for planktonic growth of <it>C. albicans</it> were lowered in combination with CSA by 2 to 16 fold. Activity against biofilm development with FIC indices of 0.26, 0.28, 0.31 and 0.25 indicated synergistic interactions between FLC-CSA, VOR-CSA, CSP-CSA and AmB-CSA, respectively. Increase in efficacy of the drugs FLC, VOR and CSP against mature biofilms after addition of 62.5 μg/ml of CSA was evident with FIC indices 0.06, 0.14 and 0.37, respectively.</p> <p>Conclusions</p> <p>The combinations with CSA re<it>s</it>ulted in increased susceptibility of biofilms to antifungal drugs. Combination of antifungal drugs with CSA would be an effective prophylactic and therapeutic strategy against biofilm associated <it>C. albicans</it> infections.</p

Perception of old age and self: A comparative study of elderly females living in community and in old age home

Aims and Objectives: To study and compare the perception of old age and self in elderly women living in community and in old age homes. Materials and Methods: By using a cross sectional study design 60 elderly females (30 each from community and old age homes) were assessed using a semi-structured proforma and an interview questionnaire. Data was qualitatively analysed and frequency computation was done. Results: The elderly women living in community had more of an attitude of ′acceptance′ towards old age and ′generativity′ was a part of ageing for them. They were found to be more satisfied with life and had better emotional support, whereas elderly in old age home perceived better instrumental support. Conclusion: Both community living and living in an old age home, have certain positive aspects. From a perspective of future policies and outreach services, it would be interesting to note the same and use best of both the worlds to provide the best for the elder in either setting

Study of loneliness, depression and coping mechanisms in elderly

Aims and Objectives: To study loneliness, depression and coping mechanism and the relationship between these factors in depressed and non-depressed elderly. Materials and Methods: Cross sectional study was done on 46 depressed and 48 non-depressed elderly were assessed clinically and using Geriatric Depression Scale-Short form [GDS-SF], loneliness scale, and brief cope scale. Statistical analysis was done using SPSS 20 software. Result: Mean GDS scores, mean loneliness (emotional and social) scores of depressed patients were higher than that of non- depressed, and this difference was found to be statistically significant [GDS: t = 14.33, p<0.001, loneliness Score: t = 7.23, p<0.001]. Self-distraction (mal-adaptive-passive) was the most commonly used coping mechanism in depressed group, while in the non-depressed group active coping (adaptive) was most common coping mechanism. Loneliness (emotional as well as social subscale) was a significant predictor of depression in both depressed and non-depressed group (Beta = .714, p<0.001) and (Beta = .629, p<0.001) and predicted 51% and 39% variance in depression respectively. Loneliness appeared as a distinct factor which seems to have a temporal and synergistic relationship with depression. Use of more adaptive coping mechanisms is associated with decrease in loneliness and depression while use of maladaptive coping mechanism is associated with decreased depression and loneliness in elderly. Conclusion: Loneliness is an important distinct factor in predicting depression in elderly. Coping mechanisms used, also affects loneliness and depression significantly

Study of suicidal ideations, hopelessness and impulsivity in elderly

Aims and Objectives: This study aimed to assess the suicidal ideations, hopelessness and impulsivity in depressed and non-depressed elderly and to study the relationship of suicidal ideations with hopelessness and impulsivity in them. Materials and Methods: This cross sectional study was done on 60 elderly patients (30 cases and 30 controls) above the age of 60 years. The scales used were Geriatric Suicide Ideation Scale, Beck Hopelessness Scale, Barrat′s Impulsiveness Scale, Geriatric Depression Scale. Results: Mean Geriatric Suicide Ideations Scale scores, mean Beck Hopelessness Scale scores and mean Barrat′s Impulsiveness Scale and scores of depressed elderly were higher than that of elderly who were not depressed and these differences were statistically significant. Hopelessness was a significant predictor of suicidal ideation in the entire sample as well as in the depressed and non-depressed elderly when the two groups were considered separately. Impulsivity when considered alone was a significant predictor of suicidal ideations in the entire sample. Conclusion: Hopelessness and impulsivity both by themselves are significant predictors for suicidal ideations in the elderly and when both are considered together hopelessness is a better predictor of suicidal ideations than impulsivity

Emergence and re-emergence of glanders in India: a description of outbreaks from 2006 to 2011

Glanders, a bacterial disease of equines caused by Burkholderia mallei, is a fatal infectious disease of equines and has zoonotic significance. The disease has been eradicated from many countries by statutory testing, elimination of infected animals and import restrictions. However, it is still endemic in parts of Africa, Asia, the Middle East and Central and South America. In India, major glanders outbreaks were reported from different parts of the country between 1976 and 1982. Later, sporadic cases of the disease were reported in 1988, 1990 and 1998. The country remained free of glanders for about eight years until the recent outbreaks occurred in eight States from 2006 to 2007. Recurrent episodes have occurred in Himachal Pradesh and Uttar Pradesh, whereas fresh outbreaks occurred in Chhattisgarh from 2009 to 2010. A total of 164 equines were declared positive; a majority of the positive cases (n = 77) were from Uttar Pradesh, followed by Maharashtra (n = 23), Uttarakhand (n = 21) and Andhra Pradesh (n = 16). Under the provision of Prevention and Control of Infectious and Contagious Disease in Animals Act, 2009, all the infected animals were euthanised and bio-security measures were implemented to curb the further spread of the disease