Puffy Foot Syndrome: An Important Often Overlooked Clinical Entity

The puffy foot syndrome, a novel clinical entity, describes the complication of secondary lymphedema with chronic progression in the feet, a finding that has often been overlooked in the non-tropical setting. While previously well described in the upper extremities, this complication has not been fully explored in the lower extremities. However, given increasing rates of diabetes mellitus, obesity, and a myriad of other possible etiologies in the United States, it is important to understand this entity and its non-viral, non-parasitic causes in non-tropical regions. This review delineates common illustrative properties of this syndrome observed in clinical practice as well as long-term complications, including Ruocco’s immunocompromised cutaneous district, that are often overlooked. Furthermore, a novel method of staging is suggested for this condition, reflective of increasing risk of complication, infection, and malignancy. We also highlight the increased need for improved detection and recognition of this condition to avoid possibly deleterious outcomes

Puffy Foot Syndrome: An Important Often Overlooked Clinical Entity

The puffy foot syndrome, a novel clinical entity, describes the complication of secondary lymphedema with chronic progression in the feet, a finding that has often been overlooked in the non-tropical setting. While previously well described in the upper extremities, this complication has not been fully explored in the lower extremities. However, given increasing rates of diabetes mellitus, obesity, and a myriad of other possible etiologies in the United States, it is important to understand this entity and its non-viral, non-parasitic causes in non-tropical regions. This review delineates common illustrative properties of this syndrome observed in clinical practice as well as long-term complications, including Ruocco’s immunocompromised cutaneous district, that are often overlooked. Furthermore, a novel method of staging is suggested for this condition, reflective of increasing risk of complication, infection, and malignancy. We also highlight the increased need for improved detection and recognition of this condition to avoid possibly deleterious outcomes

Bezold’s abscess: A rare complication of suppurative mastoiditis

Bezold’s abscess is a suppurative complication of mastoiditis rarely seen in the current era of antimicrobials. It can lead to seriously sequelae if not diagnosed and treated early. We describe a patient with recurrent bilateral otalgia who had received multiple courses of antimicrobials who presented with severe headache, neck pain and right sided hearing loss. Imaging studies showed chronic mastoiditis and formation of a Bezold’s abscess. Drainage was performed but symptoms persisted. Our report highlights the need for further evaluation of patients presenting with complicated mastoiditis and the need for prolonged antimicrobial therapy. Keywords: Bezold’s abscess, Suppurative mastoiditis, Skull base osteomyeliti

Identification of HPr kinase/phosphorylase inhibitors

Funding Information: This research was supported by funds from the ICAR-National Dairy Research Institute and a fellowship awarded by the Council of Scientific & Industrial Research, India (Suman Kapila and Sandeep Kumar) and by the Åbo Akademi University research mobility programme within the research profiling area “Drug Development and Diagnostics” (R.B.). The Sigrid Jusélius Foundation, Biocenter Finland Bioinformatics and Drug Discovery and Chemical Biology networks, CSC IT Center for Science, Joe, Pentti and Tor Borg Memorial Fund and Prof. Mark Johnson and Dr. Jukka Lehtonen are gratefully acknowledged for the excellent computational infrastructure at the Åbo Akademi University. This work contributes also to the activities within the strategic research profiling area Solutions for Health at Åbo Akademi University (Academy of Finland, # 336355). Publisher Copyright: © 2022, The Author(s).Enterococcus faecalis, a gram-positive bacterium, is among the most common nosocomial pathogens due to its limited susceptibility to antibiotics and its reservoir of the genes coding for virulence factors. Bacterial enzymes such as kinases and phosphorylases play important roles in diverse functions of a bacterial cell and, thus, are potential antibacterial drug targets. In Gram-positive bacteria, HPr Kinase/Phosphorylase (HPrK/P), a bifunctional enzyme is involved in the regulation of carbon catabolite repression by phosphorylating/dephosphorylating the histidine-containing phosphocarrier protein (HPr) at Ser46 residue. Deficiencies in HPrK/P function leads to severe defects in bacterial growth. This study aimed at identifying novel inhibitors of E. faecalis HPrK/P from a commercial compound library using structure-based virtual screening. The hit molecules were purchased and their effect on enzyme activity and growth of resistant E. faecalis was evaluated in vitro. Furthermore, docking and molecular dynamics simulations were performed to study the interactions of the hit compounds with HPrK/P. Among the identified hit molecules, two compounds inhibited the phosphorylation of HPr as well as significantly reduced the growth of resistant E. faecalis in vitro. These identified potential HPrK/P inhibitors open new research avenues towards the development of novel antimicrobials against resistant Gram-positive bacteria.Peer reviewe

Yields, Soil Health and Farm Profits under a Rice-Wheat System: Long-Term Effect of Fertilizers and Organic Manures Applied Alone and in Combination

The rice-wheat system (RWS), managed over 10.5 Mha in the Indo-Gangetic Plains of India suffers from production fatigue caused by declining soil organic matter, multi-nutrient deficiencies and diminishing factor productivity. We, therefore, conducted a long-term field experiment (1998&ndash;1999 to 2017&ndash;2018) in Modipuram, India to study the effect of continuous use of farmyard manure (FYM) as an organic fertilizer (OF), mineral fertilizers applied alone (RDF) and their combination (IPNS), as well as the inclusion of forage berseem (IPNS+B) or forage cowpea (IPNS+C) on crop yield, soil health and profits. The long-term yield trends were positive (p &lt; 0.05) in all treatments except the control (unfertilized) in rice, and the control and RDF in wheat. Although the yields of rice, wheat and RWS were highest under IPNS treatments (IPNS, IPNS+B, IPNS+C), the maximum annual yield increase in rice (9.2%) and wheat (13.7%) was obtained under OF. A linear regression fitted to the yield data under different IPNS options revealed a highly significant (p &lt; 0.001) annual yield increase in rice (5.1 to 6.6%) and wheat (6.8 to 7.7%) crops. Continuous rice-wheat cropping with RDF brought an increase in soil bulk density (Db) over the initial Db at different soil profile depths, more so at depths of 30&ndash;45 cm, but inclusion of forage cowpea or berseem in every third year (IPNS+B or C) helped to decrease Db, not only in surface (0&ndash;15 cm) but also in sub-surface (15&ndash;30 and 30&ndash;45 cm depth) soil. Whereas soil organic carbon (SOC) increased under OF, IPNS and IPNS + legume (B or C) treatments, it remained unaffected under RDF after 20 RW cycles. The inclusion of legumes along with IPNS not only helped to trap the NO3&ndash;N from soil layers below 45 cm but also increased its retention in the upper soil (0&ndash;15 cm depth). On the other hand, RDF had a higher NO3&ndash;N content in the lower layers (beyond 45 cm depth), indicating downward NO3&ndash;N leaching beyond the root zone. A build-up of Olsen-P was noticed under RDF at different time intervals. The soil exchangeable K and available S contents were maximal under OF and IPNS options, whereas a decline in DTPA extractable-Zn was recorded under OF. Overall, RWS economics revealed that OF treatment involved the maximum cost of cultivation (US1174 ha−1) with the least economic net return (US1211 ha&minus;1). Conversely, IPNS + legume (B or C) had lowest cost of cultivation (US707 to 765 ha−1) and a significantly higher (p < 0.05) net return (US2233 to 2260 ha&minus;1). The study, thus, underlines the superiority of IPNS over RDF or OF; the inclusion of legumes gives an added advantage in terms of production sustainability and soil health. Further studies involving IPNS ingredients other than FYM is needed to develop location-specific IPNS recommendations