Interstitial Nephritis Presenting as Acute Kidney Injury Following Ingestion of Alternative Medicine Containing Lead: A Case Report

Introduction: Some studies have shown that patients consuming alternate medicine can suffer from complications like acute kidney injury (AKI) due to heavy metal poisoning. The use of traditional ayurvedic herbal remedies may be difficult to identify as a source of toxicity, especially if the treating doctor is not aware of this habit, unless a detailed history is taken. In this report, we describe a patient who had consumed ayurvedic supplements for treating fever and abdominal pain and presented to our emergency department (ED) with AKI. Case presentation: A 24-year-old male presented to the ED with complaints of abdominal pain, fever and loose stools. His blood tests revealed AKI and he was started on emergency hemodialysis. His renal function improved after only one cycle of dialysis and he was discharged in a stable condition. Conclusion: Acute lead toxicity should be suspected in patients with abdominal and neurological dysfunction who have a history of chronic ayurvedic medicine intake and thus should be promptly treated. Physicians should rule out potential toxicity from these supplements and have a heightened level of suspicion for lead toxicity in patients presenting with abdominal pain and AKI without any obvious cause

Interstitial Nephritis Presenting as Acute Kidney Injury Following Ingestion of Alternative Medicine Containing Lead: A Case Report

Introduction: Some studies have shown that patients consuming alternate medicine can suffer from complications like acute kidney injury (AKI) due to heavy metal poisoning. The use of traditional ayurvedic herbal remedies may be difficult to identify as a source of toxicity, especially if the treating doctor is not aware of this habit, unless a detailed history is taken. In this report, we describe a patient who had consumed ayurvedic supplements for treating fever and abdominal pain and presented to our emergency department (ED) with AKI. Case presentation: A 24-year-old male presented to the ED with complaints of abdominal pain, fever and loose stools. His blood tests revealed AKI and he was started on emergency hemodialysis. His renal function improved after only one cycle of dialysis and he was discharged in a stable condition. Conclusion: Acute lead toxicity should be suspected in patients with abdominal and neurological dysfunction who have a history of chronic ayurvedic medicine intake and thus should be promptly treated. Physicians should rule out potential toxicity from these supplements and have a heightened level of suspicion for lead toxicity in patients presenting with abdominal pain and AKI without any obvious cause

DETECTION AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF ESBL PRODUCING GRAM NEGATIVE BACTERIA

Objective: The ESBL producing organisms has been steadily increasing over the past years. The detection and treatment of these ESBL organisms are extremely limited. In the present study, to determine the Extended Spectrum Beta Lactamases producing organism which were isolated from various samples of Multispeciality hospital in Salem, India. Methods: A total of 278 gram negative isolates were received from various samples were used to detect the ESBL production by using double disk approximation test and Phenotypic confirmatory test with combination disc. The susceptibility of ESBL producers were analysed by antibiotic susceptibility test by using 4 commercially available beta-lactamase inhibitors combinations (Piperacillin/ tazobactam, Ampicillin/Sulbactam, Ticarcillin/Clavulanic acid and Amoxycillin/Clavulanic acid). Results: A total of 351 samples were received, from that 53 Escherichia coli, 73 Klebsiella spp, 37 Pseudomonas aeruginosa, 58 Salmonella spp, 31 Enterobacter spp and 26 Proteus spp were isolated and tested; from the 278 isolates 151 were found to be ESBL producers. From the 151 ESBL producers, P/T exhibited best activity against 134(88.74percent) followed by A/C 128(84.76percent) and A/S 126(83.44percent). T/C 108(71.52percent) shown the poor activity against all the organisms compare to other combination antibiotics. P/T exhibited significantly greater inhibitory activity against Klebsiella spp (96.15percent), E. coli (92.68percent), P. aeruginosa (90.47percent), whereas, A/C exhibited considerable antimicrobial activity against Klebsiella spp (92.30percent) and P. aeruginosa (90.47percent). The A/S exhibited greater inhibitory activity against P. aeruginosa (90.38percent) and Klebsiella spp (90.38percent). P/T, A/C and A/S exhibited better activity against rest of the organisms. All the four agents show good activity against Proteus spp. Conclusion: These data suggest that Amoxycillin/Clavulanic acid and Ampicillin/Sulbactam combination antibiotics showed maximum inhibitory activity against ESBL producers. So, it can be used for the treatment of ESBL infection.Â

PREVALENCE OF EXTENDED-SPECTRUM BETA-LACTAMASE PRODUCING ENTEROBACTERIACEAE MEMBERS ISOLATED FROM CLINICALLY SUSPECTED PATIENTS

 Objective: Emergence of extended-spectrum beta-lactamases (ESBLs) production poses another clinical problem with Gram-negative bacterial infections. The present study was aimed to evaluate the ESBL producers among various clinical samples of clinically suspected patients.Methods: A total of 1279 samples (urine [918], pus [207] and stool [154]) were collected and 465 isolates (Escherichia coli [320], Enterobacter aerogenes [119] and Klebsiella pneumoniae [26]) were isolated and screened for the presence of ESBL producers using combination disc method and double disc synergy test.Results: Of the 465 culture positive isolates, 130 (E. coli 93 [29.06%], E. aerogenes 35 [29.41%] and K. pneumoniae 2 [7.69%]) were identified as ESBL producers. Among the three Enterobacteriaceae members, E. coli 93 (29.06%) was found to be predominant ESBL producer next in order E. aerogenes 35 (29.41%) and K. pneumoniae 2 (7.69%). Maximum number of ESBL producers were recovered from urine (n=111) followed by pus (n=14) and stool (n=5). All the ESBL-producing isolates were subjected to antibiotic sensitivity test using 10 different antibiotics. ESBL producers were chiefly resistance to ceftriaxone followed by ceftazidime and cefotaxime. Of 130 ESBL producers, 15 (E. coli (8), E. aerogenes (6) and K. pneumoniae (1)] strains were selected for genotypic identification. Among, only two strains of E. aerogenes were positive isolates for CTX-M type ESBL in polymerase chain reaction.Conclusion: This study concluded that among Enterobacteriaceae members, E. coli was the predominant ESBL producers and urine was noted as the prime source for the ESBL positive isolates when compared to other source. Genotypic identification was the best method to differentiate ESBL types which were essential to provide proper treatment

Interstitial Nephritis Presenting as Acute Kidney Injury Following Ingestion of Alternate Medicine Containing Lead: A Case Report

Introduction: Some studies have shown that patients consuming alternate medicine can suffer from complications like acute kidney injury (AKI) due to heavy metal poisoning. The use of traditional ayurvedic herbal remedies may be difficult to identify as a source of toxicity, especially if the treating doctor is not aware of this habit, unless a detailed history is taken. In this report, we describe a patient who had consumed ayurvedic supplements for treating fever and abdominal pain and presented to our emergency department (ED) with AKI. Case presentation: A 24-year-old male presented to the ED with complaints of abdominal pain, fever and loose stools. His blood tests revealed AKI and he was started on emergency hemodialysis. His renal function improved after only one cycle of dialysis and he was discharged in a stable condition. Conclusion: Acute lead toxicity should be suspected in patients with abdominal and neurological dysfunction who have a history of chronic ayurvedic medicine intake and thus should be promptly treated. Physicians should rule out potential toxicity from these supplements and have a heightened level of suspicion for lead toxicity in patients presenting with abdominal pain and AKI without any obvious cause

Prioritization of Drugs for Fungal Keratitis Eye Infections: An In-Silico Analysis

The fungal keratitis (FK) infections that cause cornea inflammations are more virulent than other bacterial keratitis infections and remain one of the most ethereal and challenging infections for ophthalmologists to diagnose and treat. Thus, the urgency in understanding the current perspectives of antifungal agents and their interactions with novel therapeutic targets and the identification of novel anti-fungal agents are at the frontline of studies in the pharmaceutical industry. In this study, DNA dependent RNA polymerase was modelled and virtually screened against eight antifungal agents, and it was found that Itraconazole (−22.0427 kJ/mol), Ketoconazole (−20.2194 kJ/mol), and Voriconazole (−12.6388 kJ/mol) exhibited better binding interactions. further, the structural and electronic properties of Itraconazole calculated through density functional theory studies revealed the sites of chemical reactivity that are vital in the compounds for possible interactions with RNA polymerase (RNAP). Hence, this study explores the binding efficacies of various anti-fungal agents through docking studies and their chemical entities, which might pave a significant path for the design of novel anti-fungal agents against hyalohyphomycetes causing keratitis

Extremely Fast and Efficient Removal of Congo Red Using Cationic-Incorporated Hydroxyapatite Nanoparticles (HAp: X (X = Fe, Ni, Zn, Co, and Ag))

Congo red (CR) is a stable anionic diazo dye that causes allergic reactions with carcinogenic properties. The rapid removal of CR using cation-incorporated nanohydroxyapatite (pristine HAp: X (X = Fe, Ni, Zn, Co, and Ag)) was investigated. The pristine and cation ion-doped HAp adsorbents were coprecipitated and subjected to hydrothermal and ultrasound treatments and subsequent microwave drying. The dopant ions significantly engineered the crystallite size, crystallinity, particle size (decreased 38–77%), shape (a rod to sphere modification by the incorporation of Ag+, Ni2+, and Co2+ ions), and colloidal stability (CS) of the adsorbent. These modifications aided in the rapid removal of the CR dye (98%) within one minute, and the CR adsorption rate was found to be significantly higher (93–99%) compared to previously reported rates. Furthermore, the kinetic, Langmuir, Freundlich, and DKR isotherms and thermodynamic results confirmed that the CR adsorption on the HAp was due to the strong chemical adsorption process. The order of the maximum CR adsorption capacity was Fe-HAp > HAp > Ag-HAp > Co-HAp > Zn-HAp. Whereas the CR regeneration efficiency was Fe-HAp (92%) > Ag-HAp (42%) > Ni-HAp (30%), with the other adsorbents exhibiting a poor recycling efficiency (1–16%). These results reveal Fe-HAp as a potential adsorbent for removing CR without the formation of byproducts

Extremely Fast and Efficient Removal of Congo Red Using Cationic-Incorporated Hydroxyapatite Nanoparticles (HAp: X (X = Fe, Ni, Zn, Co, and Ag))

Congo red (CR) is a stable anionic diazo dye that causes allergic reactions with carcinogenic properties. The rapid removal of CR using cation-incorporated nanohydroxyapatite (pristine HAp: X (X = Fe, Ni, Zn, Co, and Ag)) was investigated. The pristine and cation ion-doped HAp adsorbents were coprecipitated and subjected to hydrothermal and ultrasound treatments and subsequent microwave drying. The dopant ions significantly engineered the crystallite size, crystallinity, particle size (decreased 38–77%), shape (a rod to sphere modification by the incorporation of Ag+, Ni2+, and Co2+ ions), and colloidal stability (CS) of the adsorbent. These modifications aided in the rapid removal of the CR dye (98%) within one minute, and the CR adsorption rate was found to be significantly higher (93–99%) compared to previously reported rates. Furthermore, the kinetic, Langmuir, Freundlich, and DKR isotherms and thermodynamic results confirmed that the CR adsorption on the HAp was due to the strong chemical adsorption process. The order of the maximum CR adsorption capacity was Fe-HAp > HAp > Ag-HAp > Co-HAp > Zn-HAp. Whereas the CR regeneration efficiency was Fe-HAp (92%) > Ag-HAp (42%) > Ni-HAp (30%), with the other adsorbents exhibiting a poor recycling efficiency (1–16%). These results reveal Fe-HAp as a potential adsorbent for removing CR without the formation of byproducts

IN VITRO ANTIBACTERIAL ACTIVITY OF ESSENTIAL PLANT OILS AGAINST BIOFILM FORMING METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS

An alarming increase in biofilm forming methicillin-resistant Staphylococcus aureus (MRSA) possesses a serious problem in hospital environment demands a renewed effort to seek agents from natural system that are effective against pathogenic bacteria resistant to current antimicrobials. In the study, the distribution of biofilm forming MRSA and the antibacterial activity of essential oils (Eucalyptus, Mint, Turpentine, Neem and Amla) was studied in 58 strains of S. aureus isolated from pus samples. Out of 58 clinical samples 22 S. aureus were found to be methicillin-resistant and showed a dry black crystalline morphology indicating strong biofilm production and they were screened for the antibacterial activity of five different essential oils by using agar well diffusion method. The results from the agar well diffusion method showed that 4 essential oils could inhibit the growth of biofilm forming S. aureus isolates. Among those turpentine oil had strong inhibitory effects with a zone of inhibition ranging from 16.8 ± 1.77 mm to 32.0 ±2.12 mm. Eucalyptus oil shown moderate antibacterial activity against all tested isolates and followed by mint and neem with the average zones of inhibition. The oils at all concentrations showed potent inhibitory activity against the tested S. aureus with the exception of amla oil where there were no reports of inhibition. It is known that essential oils are composed of numerous different chemical compounds and their antimicrobial activity might be attributed to several different mechanisms, which could explain the variations in their mode of action. However, more studies are required to find the compounds of essential oils responsible for their antimicrobial activity, since little is known about essential oils and their medicinal property