Association of Etiological and Pathological Features of Brain Abscess with Outcome

To study the etiological andpathological factors of brain abscess and to relatewith the final outcome.Methods: In this observational study patients withbrain abscess were observed in detail with theclinical profile, etiology, microbiology and theirfinal outcome after one year.Chi-square test wasapplied to associate etiological and pathologicalfactors with management outcome.Results: The majority of patients were in their 2ndand 3rd decade of life with two third proportioncomprising of males. The most frequent etiologicalfactor was chronic suppurative otitis media (CSOM)( 55%),followed by head injury (12% ) and congenitalheart disease (10%). Microbiological data revealed16% streptococci, 10% staph. aureus, 7% staph.epidermidis and 5% proteus as major pathogens inthe study patients. Head injury and CSOM werefound associated with death and morbidity in thisstudy.Conclusion: Brain abscess has multi dimensionalcauses. CSOM and head injury were foundassociated with death and severe morbidity ashemiparesis and fits. CT findings andmicrobiological data were not associated withoutcome

Comparative antimicrobial activity of clove and fennel essential oils against food borne pathogenic fungi and food spoilage bacteria

Antifungal and antibacterial activities of essential oils obtained from fennel seeds (Feoniculum vulgare Mill) and clove buds (Syzygium aromaticum) were studied by agar well dilution technique. Both essential oils (EOs) from fennel and clove exhibited pronounced and varying degrees of growth inhibition against fungal (86 to 39%) and bacterial pathogens (42 to 20%). Fennel oil depicted significant and greater fungitoxicity in case of three fungal strains Alternaria alternate (7.7, 3.8 cm) Fusarium oxysporum (5.9, 4.1 cm) and Aspergillus flavus (4.5, 3.7 cm) except two Aspergillus strains, Aspergillus acculeatus and Apergillus fumigatus where clove oil showed greater inhibition zone (5.5, 5.9 cm) (3.5, 3.7 cm) respectively. A. alternate was found to be most sensitive strain, which growth was suppressed up to 86% by fennel seeds oil. Bactericidal activity of culinary spices was evaluated against five food spoilage bacteria namely: Pseudomonas syringae, Bacillus subtilis, Escherichia coli, Staphylococcus sp., and Aeromicrobium erythreum. Fennel oil was found fairly active against bacterial strains as compared to clove oil with highest antibacterial activity against Gram positive bacteria Bacillus subtilis (3.8 cm) and least against Gram negative bacteria E. coli (2.2 cm). The summarizing results from the present investigation showed that fennel seeds oil is a relatively stronger antimicrobial agent against broad range of pathogens as compared to clove oil, except in case of certain Aspergillus strains and E. coli.Key words: Food spoilage, anti-bacterial, pathogenic fungi, clove, fennel, essential oil

DNA Barcoding: Amplification and sequence analysis of rbcl and matK genome regions in three divergent plant species

Background: DNA barcoding is a novel method of species identification based on nucleotide diversity of conserved sequences. The establishment and refining of plant DNA barcoding systems is more challenging due to high genetic diversity among different species. Therefore, targeting the conserved nuclear transcribed regions would be more reliable for plant scientists to reveal genetic diversity, species discrimination and phylogeny.Methods: In this study, we amplified and sequenced the chloroplast DNA regions (matk+rbcl) of Solanum nigrum, Euphorbia helioscopia and Dalbergia sissoo to study the functional annotation, homology modeling and sequence analysis to allow a more efficient utilization of these sequences among different plant species. These three species represent three families; Solanaceae, Euphorbiaceae and Fabaceae respectively. Biological sequence homology and divergence of amplified sequences was studied using Basic Local Alignment Tool (BLAST).Results: Both primers (matk+rbcl) showed good amplification in three species. The sequenced regions reveled conserved genome information for future identification of different medicinal plants belonging to these species. The amplified conserved barcodes revealed different levels of biological homology after sequence analysis. The results clearly showed that the use of these conserved DNA sequences as barcode primers would be an accurate way for species identification and discrimination.Conclusion: The amplification and sequencing of conserved genome regions identified a novel sequence of matK in native species of Solanum nigrum. The findings of the study would be applicable in medicinal industry to establish DNA based identification of different medicinal plant species to monitor adulteration

Biological Activity and Characterization of Bioactive Compounds under Lead Induced Stress in Maize

Background: Lead is most commonly released environmental contaminant making its way to air, soils and water. It causes hormonal imbalance and over production of reactive oxygen in plants when absorbed through leaves and roots. It contaminates the ground water depending on the type of soils and characteristics of lead. Plants ability to tolerate lead is linked with cell wall potential, activation of antioxidants defense mechanism and synthesis of osmolytes.Methods: The study was designed to evaluate the effects of Pb(NO3)2 induced stress on biological activity and bioactive compounds in maize. The plants were subjected under two different lead concentrations (T1- 0.35mg/ml and T2- 0.45mg/ml). Phytochemical screening revealed the presence of alkaloids, coumarins, saponins, tannins and terpenoids in maize. Total Phenolic Content (TPC) was increased (T1- 45%, T2- 58.42%) under lead stress when compared with control (36.29%). The cytotoxicity was checked using hemolytic activity against human red blood cells.Results: The scavenging rate was highest (T1- 33.5%, T2- 52%) when compared with control (18.6%). Zone of inhibition of Aspergillus niger was highest amongst other fungal strains. The HPLC results showed that maize has some phyto-ingredients which may be accountable for cell reinforcement and anti-microbial activity. The extracts were further analyzed for the biochemical profile like superoxide dismutase, peroxidase, catalase, amylase and protease. Escherichia colishowed maximum activity with control (25±3.46mm) and maximum under stress (T1- 17±1.633 mm, T2- 20±4.08 mm).Conclusion: Lead stress altered all the activities when compared to control plants. In conclusion, Maize can be used as a potential indicator for lead and other compounds to play a vital role in phytoremediation. The results would further lead to find the new compounds and plant mechanism to cope with stress.

Customized vacuum assisted closure therapy of wounds as a simple and cost-effective technique of wound closure-a prospective observational study from underdeveloped world

Background: Aim of the study was to study the efficacy and cost-effectiveness of indigenously designed customized vacuum assisted closure (VAC) of wounds in our patients. The management of difficult to heal wounds has been the main force that led to the development of advanced gadgets for their management. The technique of vacuum assisted closure has revolutionized the management of difficult to heal wounds and delivers better results as compared to conventional technique. Our aim was to assess the efficacy and cost effectiveness of customized VAC therapy.Methods: This prospective study was conducted in the department of surgery and allied specialties, GMC Srinagar, from June 2018 and September 2020. During this period, 80 patients were subjected to VAC therapy and were included in this study.Results: VAC dressing was used in 80 patients. 55 were males and 25 were females. Most of the wounds in our study were located over lower limbs (70%). RTA was the most common mode of injury followed by fall from height. After the VAC therapy, 78.8% patients were managed by STSG, 11.3% by flap cover, 6.3% by secondary suturing and 3.8% healed by secondary intention. Pain was experienced by 30% of the patients, 7.5% had hypoalbuminemia, 3.8% had surrounding skin maceration. The average total cost of the VAC therapy was 863.13 (±399.82) Indian rupees (11.76 USD). The mean duration of hospital stay for our patients was 22 days.Conclusions: Customized VAC Therapy has revolutionary potential in the management of the difficult to treat wounds as far as its safety, speed and cost effectiveness is considered especially in a setup of poor income nations like ours

Economic evaluation of bakanae disease of rice

Bakanae disease infestation levels of 5, 10, 25, 50, 75 and 100% seedlings were compared with non-infested control in a field trial. According to the results treatments with 5, 10, 25, 50, 75 and 100% infestation had significantly lower paddy yields of 4.15, 3.95, 3.75, 2.97, 2.45 and 1.87 t/ha respectively against 4.45 t/ha paddy yield in the control. Losses of 57.97% were recorded in 100% infested treatment producing 68.40% seedling infection. The study indicated the potential of the disease to cause heavy economic losses

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Genetics and mechanism of resistance to deltamethrin in a field population of Spodoptera litura (Lepidoptera: Noctuidae)

BACKGROUND: Spodoptera litura (F.) causes enormous losses in many economically important crops. The genetics of insecticide resistance has been extensively studied in several insect pests, but there is a lack of information on S. litura. Therefore, the genetics and mechanisms of the resistance of S. litura to deltamethrin were investigated. RESULTS: Bioassays at generation G1 gave resistance ratios of 9, 5, 41, 52 and 49 for deltamethrin, cypermethrin, profenofos, chlorpyrifos and triazofos respectively, when compared with the susceptible Lab-PK strain. Bioassays at G4 with a deltamethrin-selected population (Delta-SEL) showed that selection gave resistance ratios of 63 and 7 for deltamethrin when compared with the Lab-PK and UNSEL strains respectively. Cross-resistance to other insecticides tested was observed in the selected population. A notable feature of the Delta-SEL strain was that resistance to deltamethrin, cypermethrin, profenofos and chlorpyrifos did not decline over the course of five generations. Synergism tests with microsomal oxidase (MO) and esterase-specific inhibitors indicated that the deltamethrin resistance was associated with MO and, possibly, esterase activity. Reciprocal crosses between the Delta-SEL and Lab-PK strains indicated that resistance was autosomal and incompletely dominant. A direct test of monogenic inheritance suggested that resistance to deltamethrin was controlled by more than one locus. CONCLUSION: Stability and dominance of resistance and cross-resistance suggest that insecticides with different modes of action should be recommended to reduce pyrethroid selection pressure. Copyright © 2007 Society of Chemical Industr