Invasive Ureteral Aspergillosis Causing an Abscess: A Report of a Rare Case.

Aspergillosis is a vicious fungal infection that can develop in immunosuppressed patients. The presence of aspergillosis in the ureter or elsewhere in the genito-urinary tract is highly uncommon and rarely reported in the literature. Here, we present a 54-year-old gentleman, with uncontrolled diabetes, who presented with urosepsis. Right hydronephrosis and ureteric stricture with urinary extravasation were seen on imaging. Right percutaneous nephrostomy was done, with drainage and analysis of the pus revealing the growth of Aspergillus fumigatus species. On open exploration, a ureteric abscess cavity, which was adherent to the duodenum, was drained and uretero-ureterostomy along with feeding jejunostomy was performed. Histopathological examination and special staining confirmed the growth of aspergillosis. The patient was treated with antifungal agents and responded well with an uneventful post-operative recovery.

Chemical Profiling and In Vitro Antiurolithiatic Activity of Pleurolobus gangeticus (L.) J. St.- Hil. ex H. Ohashi & K. Ohashi Along with Its Antioxidant and Antibacterial Properties.

Pleurolobus gangeticus (L.) J. St.- Hil. ex H. Ohashi & K. Ohashi (Fabaceae) is an important medicinal plant used to treat various ailments. In this study, we report the antiurolithiatic, antioxidant, and antibacterial potential of chloroform fraction (CF) from P. gangeticus roots. For the chemical profiling, HPTLC, FT-IR, and GC-MS techniques of the CF were carried out, and phytochemical investigation was revealed that stigmasterol (45.06%) is one of the major components present in the fraction. The nucleation and aggregation assays were used to evaluate the in vitro antiurolithiatic activity at various concentration (2-10 mg/mL) of the CF. The results showed that the chloroform fraction had dose-dependent effects on Calcium Oxalate (CaOx) crystal formation. In both the assays, the maximum concentration of 10 mg/mL has shown better results. This concentration resulted significant increase in CaOx crystal nucleation along with the reduction of crystal size and the inhibition of crystal aggregation. Further, the CF showed stronger antioxidant (DPPH, NO, SOD, TRC) potential with an IC50 values of 415.9327, 391.729, 275.971, and 419.14 µg/mL, respectively. The antibacterial evaluation displayed effective results in the Agar well diffusion assay against selective urinary tract infection (UTI) pathogens (Escherichia coli, Klebsiella pneumonia, and Staphylococcus aureus). A maximum zone of inhibition (ZOI) 12.33 ± 1.05 mm for K pneumonia and minimum ZOI of 8.46 ± 0.27 mm for S. aureus were obtained. Further, the ADME-PK property of the stigmasterol was investigated, and it was found to pass the Lipinski and Ghose rules, supporting the drug-likeliness. This is the first record of the antiurolithiatic potential of P. gangeticus along with antioxidant and antibacterial activities. These findings give an insight into the effective drug development and treatment for kidney stones in future.

ANTI-INFLAMMATORY AND MOLECULAR DOCKING ANALYSIS OF LEUCAS VESTITA Wall. Ex. Benth. EXTRACT AGAINST CYCLO-OXYGENASE-2.

Leucas vestita Wall. ex. Benth., is an endemic species restricted to Western Ghats, India. In this study, the carrageenan-induced anti-inflammatory model was used to evaluate the influence of L. vestita ethanol extract on inflammation. The Ethanol extract was tested for its anti-inflammatory property at a dose of 200mg/kg po. and 400mg/kg po. The paw volume was reduced gradually, three hours after administration of the extract. The extract showed a dosage dependant activity. The compounds present in the ethanol extract were identified by using HPLC and the binding affinity of these compounds against Cyclo-oxygenase-2 (COX-2, the enzyme involved in the perception of pain) was analyzed by using FlexX molecular docking suite.

Sorghum mitigates climate variability and change on crop yield and quality.

MAIN CONCLUSION: Global food insecurity concerns due to climate change, emphasizes the need to focus on the sensitivity of sorghum to climate change and potential crop improvement strategies available, which is discussed in the current review to promote climate-smart agriculture. Climate change effects immensely disturb the global agricultural systems by reducing crop production. Changes in extreme weather and climate events such as high-temperature episodes and extreme rainfalls events, droughts, flooding adversely affect the production of staple food crops, posing threat to ecosystem resilience. The resulting crop losses lead to food insecurity and poverty and question the sustainable livelihoods of small farmer communities, particularly in developing countries. In view of this, it is essential to focus and adapt climate-resilient food crops which need lower inputs and produce sustainable yields through various biotic and abiotic stress-tolerant traits. Sorghum, "the camel of cereals", is one such climate-resilient food crop that is less sensitive to climate change vulnerabilities and also an important staple food in many parts of Asia and Africa. It is a rainfed crop and provides many essential nutrients. Understanding sorghum's sensitivity to climate change provides scope for improvement of the crop both in terms of quantity and quality and alleviates food and feed security in future climate change scenarios. Thus, the current review focused on understanding the sensitivity of sorghum crop to various stress events due to climate change and throws light on different crop improvement strategies available to pave the way for climate-smart agriculture.

Phytochemical analysis, antioxidant and antimicrobial activity of wild and in vitro derived plants of Ceropegia thwaitesii Hook - An endemic species from Western Ghats, India.

Ceropegia thwaitesii Hook (Asclepiadaceae), an endemic plant species, due to habitat destruction and over exploitation has a very restricted distribution in the Western Ghats of Tamil Nadu, India. The present wrok aimed to determine the chemical composition, the total phenolic (TPC), flavonoid (TFC) and tannin content (TEC), and to assess the antioxidant properties of various extracts of in vivo plants (IVP) and in vitro regenerated plants (IRP) of C. thwaitesii. Some phenolic compounds like gallic acid, cathechol, vanillin and salicylic acid were identified and quantified by HPLC. All the extracts possessed relevant radical scavenging activity on DPPH, Superoxide radical scavenging activity, and Nitric oxide radicals as well as total antioxidant ability. DPPH assay of in vitro methanol stems extracts and ethanol leaves extracts revealed the best antioxidant properties with important IC50 values of 0.248 ±â€¯0.45 µg/mL and 0.397 ±â€¯0.67 µg/mL, respectively, whereas in vivo chloroform stems extracts showed a lower antioxidant activity (IC50 of 10.99 ±â€¯0.24 µg/mL). The IRP methanol extracts of stem and leaves had good inhibitory activity against all tested microorganisms in a dose-dependent manner. These results suggested that in vitro raised plants of C. thwaitesii are an excellent source of antioxidant compounds to be exploited on an industrial level as food additive.

Successful Management of above Knee Amputation with Combined and Modified Nerve Blocks.

We report a successful management of a case of methicillin-resistant Staphylococcus aureus positive right lower limb cellulitis for above knee amputation under combined nerve blocks. The ongoing sepsis, thrombocytopenia, and severe respiratory infection with wheeze made us avoid both neuraxial block and general anesthesia and plan for a nerve block. We instituted a modified high inguinal femoral block along with sciatic and lateral femoral nerve blocks separately to successfully conduct the case. We decided to report as there were not as many cases as ours in the literature.

Assessment of three-dimensional setup errors in image-guided pelvic radiotherapy for uterine and cervical cancer using kilovoltage cone-beam computed tomography and its effect on planning target volume margins.

PURPOSE: To achieve the best possible therapeutic ratio using high-precision techniques (image-guided radiation therapy/volumetric modulated arc therapy [IGRT/VMAT]) of external beam radiation therapy in cases of carcinoma cervix using kilovoltage cone-beam computed tomography (kV-CBCT). MATERIALS AND METHODS: One hundred and five patients of gynecological malignancies who were treated with IGRT (IGRT/VMAT) were included in the study. CBCT was done once a week for intensity-modulated radiation therapy and daily in IGRT/VMAT. These images were registered with the planning CT scan images and translational errors were applied and recorded. In all, 2078 CBCT images were studied. The margins of planning target volume were calculated from the variations in the setup. RESULTS: The setup variation was 5.8, 10.3, and 5.6 mm in anteroposterior, superoinferior, and mediolateral direction. This allowed adequate dose delivery to the clinical target volume and the sparing of organ at risks. CONCLUSION: Daily kV-CBCT is a satisfactory method of accurate patient positioning in treating gynecological cancers with high-precision techniques. This resulted in avoiding geographic miss.

Quality of Labor Epidural Analgesia and Maternal Outcome With Levobupivacaine and Ropivacaine: A Double-Blinded Randomized Trial.

BACKGROUND: Quality of labor analgesia plays a vital role in the maternal outcome. Very few literature are available analyzing the quality of epidural labor analgesia. AIM: The aim of this study was to compare the effectiveness of 0.1% levobupivacaine and 0.1% ropivacaine with fentanyl as an adjuvant for epidural labor analgesia in terms of onset, duration, quality of analgesia, and degree of motor blockade. METHODOLOGY: Sixty nulliparous parturients, with singleton uncomplicated pregnancy, were recruited by continuous sampling. Parturients were randomized to receive either levobupivacaine 0.1% or ropivacaine 0.1% with 2 µg/ml fentanyl as an intermittent epidural bolus. The epidural analgesia was initiated with 12 ml of study drug solution in the active stage of labor (cervix 3 cm dilated). Demand bolus was given whenever the visual analog scale (VAS) score >3. Onset, duration, and quality of analgesia and degree of motor blockade were analyzed. Maternal outcome was evaluated in terms of mode of delivery, duration of labor, and assisted vaginal delivery. STATISTICAL ANALYSIS: All the data were recorded in Microsoft Office Excel. Statistical analysis was carried out using SPSS version 19.0 (IBM SPSS, USA) software with Regression Modules installed. Descriptive analyses were reported as mean and standard deviation of continuous variables. RESULTS: The mean onset of analgesia was shorter in ropivacaine (21.43 ± 2 min) than in levobupivacaine group (23.57 ± 1.71 min) (P = 0.000). Duration of analgesia was shorter in ropivacaine (60 ± 14 min) than levobupivacaine (68 ± 11 min) (P = 0.027). Levobupivacaine produced a better quality of analgesia in terms of not perceiving pain and uterine contraction during labor analgesia but was associated with 37% incidence of instrumental delivery. Duration of labor and rate of cesarean section were comparable between the groups. CONCLUSION: Quality of analgesia in labor epidural was superior to levobupivacaine but was associated with higher incidence of instrumental vaginal delivery.

Ellagic acid normalizes mitochondrial outer membrane permeabilization and attenuates inflammation-mediated cell proliferation in experimental liver cancer.

Despite great advances in our understanding of the molecular causes of liver cancer, significant gaps still remain in our knowledge of the disease pathogenesis and development of effective strategies for early diagnosis and treatment. The present study was conducted to evaluate the chemopreventive activity of ellagic acid (EA) against experimental liver cancer in rats. This is the first report that implies a possible role of EA in controlling liver cancer through activation of mitochondrial outer membrane permeability via activating proteins such as Bax, bcl-2, cyt-C, and caspase-9, which play important roles in apoptosis. Downregulation of NF-κB, cyclin D1, cyclin E1, matrix metalloproteinases (MMP)-2, MMP-9, and proliferating cell nuclear antigen (PCNA) were noted in EA-treated experimental rats and controlled inflammation mediated liver cancer when compared to the diethylnitrosamine (DEN)-induced group. Transmission electron microscopy (TEM) analysis of the livers of experimental rats demonstrated that EA treatment renovated its internal architecture. Overall, these results demonstrate the value of molecular approaches in identifying the potential role of EA as an effective chemopreventive agent.