AN INTERESTING CASE OF MALIGNANT TRANSFORMATION OF MATURE CYSTIC TERATOMA

Mature cystic teratomas are common benign tumors of the ovary. They are bilateral in about 10 % of cases. Carcinoma arising from mature cystic teratomas are quite rare and amounts to 0.17 – 2 %. Malignant transformation is most commonly seen in post-menopausal age group, and these carcinomas are treated with surgical excision and adjuvant chemotherapy. In this study, we present a case of a 70 year old lady with carcinoma arising from mature cystic teratoma. She was evaluated clinically, biochemically and with imaging studies, and was taken up for staging laparotomy, Total abdominal hysterectomy with bilateral salpingo opherectomy. Post operatively chemotherapy was given to her. Hence, this rare type of malignant transformation should be kept in mind when faced with a dermoid cyst, especially in older patients, or in patients with larger than usual cysts

Postpartum eclampsia: a clinical study

Background: Eclampsia, an enigmatic multisystem complication of pregnancy, is commonly defined as new onset of grand mal seizure activity and/or unexplained coma during pregnancy or postpartum. Eclampsia is associated with maternal deaths ranging from, 1.8% in developed to 14% in developing countries respectively. The worldwide incidence of delayed postpartum eclampsia is on an increasing trend, now at 16-18%, of all eclamptic seizures. Objective was to study the clinical findings and morbidity, associated with postpartum eclampsia and its correlation with neuroimaging- in our institute- SRIHER, Chennai.Methods: This is a retrospective study from a period of June 2016 to June 2021, in SRIHER, Chennai. Case records of all patients with postpartum eclampsia were analysed.Results: A total of 35 patients who satisfied the inclusion criteria were studied, out of which 55% of patients were diagnosed with hypertension or preeclampsia antenatally, and 45% presented as atypical eclampsia. In our institution, Postpartum eclampsia commonly occurred in the age group of 26-30 years of age (51.4%); was common after lower segment caesarean section (LSCS) (71.4%); most commonly occurred immediate postpartum (42.8%). Most common prodromal symptom was headache (77%), followed by blurring of vision (37%). Most common magnetic resonance imaging (MRI) finding was posterior reversible encephalopathy syndrome (PRES) (69%). 17% patients required intensive care unit (ICU) care. There was no mortality associated with postpartum eclampsia in the study period.Conclusions: This study emphasises that a high index of suspicion and a multidisciplinary approach effectively reduces mortality and morbidity associated with postpartum eclampsia. Neuroimaging is of robust help in the diagnosis and management of postpartum eclampsia.

Efficacy of supplementation of probiotics on maternal glycaemic control – A systematic review and meta-analysis of randomized controlled trials

Aim: To evaluate the evidence pertaining to the efficacy of the supplementation of probiotics on the blood glucose level of pregnant women with gestational diabetes mellitus (GDM). Background: Women with the GDM are subsequently at risk to develop type 2 diabetes mellitus, within three to six years after delivery. This makes it crucial for all pregnant women with the GDM, to monitor their blood glucose levels regularly to minimize the adverse pregnancy outcomes. The earlier studies revealed that the probiotics could improve glycaemic control and mitigate the adverse effects of type 2 diabetes mellitus. Design: A systematic review and meta-analysis. Data sources: The Google Scholar, Pubmed/Medline, Cochrane library, ProQuest, Ovid, and EMBASE were systematically searched for the available clinical trials. Review methods: Randomized clinical trials (RCTs) for evaluating the effects of the probiotics on the pregnancy outcomes such as glycaemic control as primary outcome were included to achieve the aim of this review and meta-analysis. Two reviewers from the team extracted the data and assessed the risk of bias in the eligible studies independently. The meta-analysis was performed by applying a model of fixed effects using the Revman 5.3 software. Results: Nine clinical trials involving 1053 participants were included in the meta-analysis. Though the components of probiotics varied significantly, Lactobacillus species was given to all the participants in all the trials included in this review. The results showed that the probiotics asignificantly improved the glycaemic control biomarkers (Fasting blood glucose and insulin sensitivity level) (P < 0.005). Conclusion: Probiotic-supplements seemed to improve the glycaemic control biomarkers. Thus, this review highlights the considerable evidence that the supplementation of probiotics has the beneficial effects on the glycaemic control markers and may be useful as a supplementary therapy among the women with the GDM. This finding would foster the health care professionals and the nurses to create awareness on the potential benefits of the supplementation of the probiotics among the women with the GDM and elevated glycaemic control biomarkers

Speciation of coagulase negative Staphylococcal isolates from clinically significant specimens and their antibiogram

Background: Despite their frequency as contaminants, coagulase-negative Staphylococci (CONS) have become important nosocomial pathogens, accounting for 9% of all nosocomial infections. These infections are difficult to treat because of the risk factors and the multiple drug resistance nature of these organisms. Materials and Methods: One hundred and two consecutive CONS were isolated from various clinical samples like blood, pus, urine, urine catheter tip and gastric lavage. Most of the blood samples were from patients with risk factors (immunocompromised or on medical devices). After confirming the isolates as CONS, species-level identification was performed by simple, non-expensive conventional methods and antibiotic sensitivity testing was also carried out. Results: Of 102 CONS isolates, 100 isolates could be identified to the species level. Among the 100 isolates, epidermidis was the most common species isolated, seen in 32%, followed by S. hemolyticus (18%), S. lugdunensis (12%), S. hominis (10%), S. saprophyticus (8%), S. capitis (6%), S. caprae (4%), S. xylosus (4%), S. cohni and S. warneri (3% each). In the present study, 56% of the isolates were methicillin-resistant CONS. Most of the isolates showed resistance to ampicillin and amoxyclav (89% each), followed by ceftriaxone (52%), cotrimoxazole (46%), cefotaxime (32%), gentamicin (25%), amikacin (21%). Conclusion: The increased pathogenic potential and multiple-drug resistance demonstrates the need to adopt simple, reliable and non-expensive methods for identifying and determining the antibiotic sensitivity of CONS

The anti-snake venom properties of Tamarindus indica (leguminosae) seed extract

Abstract In Indian traditional medicine, various plants have been used widely as a remedy for treating snakebites. The aim of this study was to evaluate the effect of Tamarindus indica seed extract on the pharmacological as well as the enzymatic effects induced by V. russelli venom. Tamarind seed extract inhibited the PLA2, protease, hyaluronidase, l-amino acid oxidase and 5′-nucleotidase enzyme activities of venom in a dose-dependent manner. These are the major hydrolytic enzymes responsible for the early effects of envenomation, such as local tissue damage, inflammation and hypotension. Furthermore, the extract neutralized the degradation of the Bβ chain of human fibrinogen and indirect hemolysis caused by venom. It was also observed that the extract exerted a moderate effect on the clotting time, prolonging it only to a small extent. Edema, hemorrhage and myotoxic effects including lethality, induced by venom were neutralized significantly when different doses of the extract were preincubated with venom before the assays. On the other hand, animals that received extract 10 min after the injection of venom were protected from venom induced toxicity. Since it inhibits hydrolytic enzymes and pharmacological effects, it may be used as an alternative treatment to serum therapy and, in addition, as a rich source of potential inhibitors of PLA2, metalloproteinases, serine proteases, hyaluronidases and 5¢-nucleotidases, the enzymes involved in several physiopathological human and animal diseases. Copyright © 2006 John Wiley & Sons, Ltd

Host–rabies virus protein–protein interactions as druggable antiviral targets

We present an unconventional approach to antiviral drug discovery, which is used to identify potent small molecules against rabies virus. First, we conceptualized viral capsid assembly as occurring via a host-catalyzed biochemical pathway, in contrast to the classical view of capsid formation by self-assembly. This suggested opportunities for antiviral intervention by targeting previously unappreciated catalytic host proteins, which were pursued. Second, we hypothesized these host proteins to be components of heterogeneous, labile, and dynamic multi-subunit assembly machines, not easily isolated by specific target protein-focused methods. This suggested the need to identify active compounds before knowing the precise protein target. A cell-free translation-based small molecule screen was established to recreate the hypothesized interactions involving newly synthesized capsid proteins as host assembly machine substrates. Hits from the screen were validated by efficacy against infectious rabies virus in mammalian cell culture. Used as affinity ligands, advanced analogs were shown to bind a set of proteins that effectively reconstituted drug sensitivity in the cell-free screen and included a small but discrete subfraction of cellular ATP-binding cassette family E1 (ABCE1), a host protein previously found essential for HIV capsid formation. Taken together, these studies advance an alternate view of capsid formation (as a host-catalyzed biochemical pathway), a different paradigm for drug discovery (whole pathway screening without knowledge of the target), and suggest the existence of labile assembly machines that can be rendered accessible as next-generation drug targets by the means described