RESUMEN
This case presents a diagnostic challenge in a 28-year-old male initially evaluated for severe abdominal pain, vomiting, and constipation, leading to the presumption of post-appendectomy complications. Clinical examination revealed abdominal distension, tenderness, and signs of peritonism, along with a reducible inguinal hernia. On subsequent CT scan, a large, inflamed area of omentum localized to the right abdomen extending up to the defect in the inguinal region with mild ascites was revealed. Upon exploration, it was discovered that the patient's initial surgery had focused solely on an appendix deemed mildly inflamed by the operating surgeon, while a concurrent diagnosis of secondary omental torsion was missed. This oversight underscores the challenges in diagnosing abdominal pathologies, with the initial misdiagnosis leading to ongoing patient distress. Meticulous adhesiolysis and omentectomy were performed, resulting in the resolution of the patient's symptoms.
RESUMEN
Staphylococcus aureus (S. aureus) is an opportunistic gram-positive, non-motile, and non-sporulating bacteria that induces pneumonia, a provocative lung infection affecting mainly the terminal bronchioles and the small air sacs known as alveoli. Recently, it has developed antibiotic resistance to the available consortium as per the WHO reports; thereby, novel remedial targets and resilient medications to forestall and cure this illness are desperately needed. Here, using pan-genomics, a total of 1,387 core proteins were identified. Subtractive proteome analyses further identified 12 proteins that are vital for bacteria. One membrane protein (secY) and two cytoplasmic proteins (asd and trpG) were chosen as possible therapeutic targets concerning minimum % host identity, essentiality, and other cutoff values, such as high resistance in the MDR S. aureus. The UniProt AA sequences of the selected targets were modelled and docked against 3 drug-like chemical libraries. The top-ranked compounds i.e., ZINC82049692, ZINC85492658 and 3a of Isosteviol derivative for Aspartate-semialdehyde dehydrogenase (asd); ZINC38222743, ZINC70455378, and 5 m Isosteviol derivative for Anthranilate synthase component II (trpG); and finally, ZINC72292296, ZINC85632684, and 7 m Isosteviol derivative for Protein translocase subunit secY (secY), were further subjected to molecular dynamics studies for thermodynamic stability and energy calculation. Our study proposes new therapeutic targets in S. aureus, some of which have previously been reported in other pathogenic microorganisms. Owing to further experimental validation, we anticipate that the adapted methodology and the predicted results in this work could make major contributions towards novel drug discovery and their targets in S. aureus caused pneumonia.
Asunto(s)
Diterpenos de Tipo Kaurano , Neumonía , Staphylococcus aureus , Animales , Staphylococcus aureus/genética , Aspartato-Semialdehído Deshidrogenasa , Genómica/métodos , Antibacterianos/farmacología , Descubrimiento de DrogasRESUMEN
OBJECTIVE: To see the frequency of incidental fatty liver on ultrasound and its association with diabetes mellitus and hypertension. METHODS: A cross sectional study was conducted from January 2016 to June 2016 in the department of Surgery and Radiology at Hamdard University Hospital. Patients of both genders and all ages were selected by non purposive convenience sampling. Critically ill, trauma cases and all those patients who had a history of chronic liver disease, alcohol intake and expected pregnancy were excluded. Blood pressure and random blood sugar were recorded. RESULTS: Six hundred patients were included in the study with mean age of 44.65±18.8 years. 240 patients (40%) had incidental finding of fatty liver on ultrasound. Out of 240 with fatty liver patients 117 were males (48.8%) and 123 were females (51.3%). Total 141 patients were diagnosed with hypertension, out of which 81(57.44%, p< 0.001) had fatty liver on ultrasound. Diabetes mellitus was diagnosed in 84 patients, in which 57 patients (67.8%, p<0.001) had fatty liver. CONCLUSION: Fatty liver is a frequently found incidental finding on ultrasound. There is a significant association of fatty liver with diabetes mellitus and hypertension.