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Sinus tympani is one of the hidden space in the retrotympanic area of middle ear which is commonly invaded by cholesteatoma and known for recidivism. Conventional surgical approaches sometimes fail to access deep sinuses and eradicate the disease. The aim of our study was to measure endoscopic depth of Sinus tympani in Indian Population. Total of 30 patients underwent mastoid exploration and intraoperatively depth of Sinus Tympani was measured using a 0.5 mm calibrated probe with 30 degree rigid Hopkins endoscope. Endoscopic depth in the present study ranges between 2.5 and 5.5 mm. It was higher in right ear in case of females however no significant difference were seen in males and females on left side. It is difficult to clear disease from Sinus Tympani because of its inaccessible location. Sinus Tympani can also show variations in terms of its depth further making difficult to clear disease.
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Whether the Main Himalayan Thrust can host a single surface-rupturing event in the Himalaya with a rupture length of > 700 km remains controversial. Previous paleoseismological studies in the Darjeeling-Sikkim Himalaya (DSH) suggested medieval surface-rupturing earthquakes, correlating them with the eleventh-thirteenth century events from Nepal and Bhutan and extending the coseismic rupture length > 700 km. Conversely, there is no rupture evidence of the 1714 Bhutan and 1934 Bihar-Nepal earthquakes in the DSH, resulting in a discrepancy in the rupture extent of the great earthquakes. Consequently, we conducted a paleoseismological investigation across a ~ 10 m-high fault scarp on the Himalayan Frontal Thrust at Chenga village, DSH, revealing a surface-faulting event during 1313-395 BCE. We suggest that the DSH is a 150 km-long independent segment bounded by a transverse ridge and fault and has a recurrence interval of ~ 949-1963 years, which is significantly larger than Nepal (~ 700-900 years) and Bhutan Himalaya (~ 339-761 years).
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In our study, thirty one neck dissections in thirty patients were performed as a part of their treatment for head and neck cancers over a period of one year. In this study, we aimed to report anatomical variations of the spinal accessory nerve (SAN) encountered during neck dissection with respect to important reference points and structures in the neck and correlate them with the length of the neck and height of patient. We preserved SAN in all the neck dissections and studied its course and branching in relation to internal jugular vein (IJV), sternocleidomastoid (SCM) muscle, greater auricular point (GAP), mastoid process, clavicle, angle of mandible, length of the neck and height of the patient. In 67.7% patients, the SAN was ventral to the IJV at the level of posterior belly of digastric muscle and in 32.3%, it was dorsal to the vein. In all the cases, SAN was found cephalic to the GAP at the posterior border of the SCM muscle with a mean distance of 1.72 ± 0.54 cm (range 0.90-3.06 cm). The distance between the tip of mastoid process and the point of emergence of the SAN from the posterior border of SCM (Exit Point length) was found to be nearly constant with a mean of 6.35 ± 0.63 cm (range 5.03-8.13 cm). We also found that there is a positive correlation between various parameters and the length of the neck and height of patients. Distance of exit point of SAN from the clavicle, however, is least helpful. We infer that the GAP is one of the most reliable landmarks for the localization of the SAN, followed by distance of exit point from mastoid process and angle of mandible. Also, surgeon should be aware of the variations regarding relationship to internal jugular vein and branching pattern of the nerve. The exit point should be sought for relatively inferiorly in longer necks and taller patients. SAN has great variations and thorough knowledge of these helps to prevent debilitating sequelae and medicolegal repercussions of shoulder syndrome.
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Maize production and productivity are affected by drought stress in tropical and subtropical ecologies, as the majority of the area under maize cultivation in these ecologies is rain-fed. The present investigation was conducted to study the physiological and biochemical effects of 24-Epibrassinolide (EBR) as a plant hormone on drought tolerance in maize. Two maize hybrids, Vivek hybrid 9 and Bio 9637, were grown under three different conditions: (i) irrigated, (ii) drought, and (iii) drought+EBR. A total of 2 weeks before the anthesis, irrigation was discontinued to produce a drought-like condition. In the drought+EBR treatment group, irrigation was also stopped, and in addition, EBR was applied as a foliar spray on the same day in the drought plots. It was observed that drought had a major influence on the photosynthesis rate, membrane stability index, leaf area index, relative water content, and leaf water potential; this effect was more pronounced in Bio 9637. Conversely, the activities of antioxidant enzymes such as catalase (CAT), ascorbate peroxidase (APX), and superoxide dismutase (SOD) increased in both hybrids under drought conditions. Specifically, Vivek hybrid 9 showed 74% higher CAT activity under drought conditions as compared to the control. Additionally, EBR application further enhanced the activity of this enzyme by 23% compared to plants under drought conditions. Both hybrids experienced a significant reduction in plant girth due to drought stress. However, it was found that exogenously applying EBR reduced the detrimental effects of drought stress on the plant, and this effect was more pronounced in Bio 9637. In fact, Bio 9637 treated with EBR showed an 86% increase in proline content and a 70% increase in glycine betaine content compared to untreated plants under drought conditions. Taken together, our results suggested EBR enhanced tolerance to drought in maize hybrids. Hence, pre-anthesis foliar application of EBR might partly overcome the adverse effects of flowering stage drought in maize.
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Brassinosteroides , Esteroides Heterocíclicos , Estresse Fisiológico , Zea mays , Secas , Antioxidantes/farmacologia , Água/farmacologiaRESUMO
ABSTRACT: Pleomorphic adenoma usually presents as a painless growing mass in locations of the salivary glands and is notorious for local recurrence if previous surgical resection is incomplete. Schwannoma is a benign peripheral nerve tumor with microscopic features of sheets of spindle-shaped cells with nuclear palisading. However, when a pathologist encounters a salivary gland tumor with microscopic morphological features of biphasic components with areas of schwannoma-like morphology, it is crucial to make a prudent diagnosis by differentiating Schwannoma-like pleomorphic adenoma and its differential diagnosis as they have remarkably different outcome in patients. We herein present a case of Schwannoma-like pleomorphic adenoma and discuss its approach to diagnosis and literature search.
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Complete surgical removal of cholesteatoma has been traditionally performed by microscopic approaches. In recent years, use of endoscopes in middle ear surgery is gaining increasing importance. The wide field view offered by the endoscopes in comparison to the narrow field of view of the binocular microscope enables a surgeon to see and dissect around corners, thereby exposing 'hidden recesses' of the middle ear which can be useful during cholesteatoma surgery. To identify remnant cholesteatoma in difficult access sites of the middle ear cleft using endoscopes following a microscope assisted mastoidectomy. A cross sectional study was conducted in patients who were clinically diagnosed with cholesteatoma. Patients were subjected to High Resolution Computed Tomography of the temporal bone and pre-operative audiological tests. Mastoid exploration was performed microscopically followed by endoscopic evaluation and clearance of disease in the same setting. Patients were then followed up post-operative and endoscopically evaluated to look for any remnant disease. A total of 45 patients were included, all of which underwent microscopic assisted mastoidectomy. Remnant cholesteatoma was discovered in 15 out of 45 cases (33%) distributed in the hidden areas; in the region of sinus tympani 9(60%), anterior epitympanum 4(27%), hypotympanum 1(7%) and tip Cells 1(7%). It can be concluded that endoscopes have a definite role in evaluation and complete surgical clearance of cholesteatoma particularly from the hidden areas of middle ear cleft which would have otherwise been missed by the straight line view of a microscope thereby grossly reducing the rate of remnant disease. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04263-6.
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Background Cerebrospinal fluid (CSF) flow is altered in many conditions like normal pressure hydrocephalus (NPH), aqueduct stenosis, or Chiari malformation. It is very important to know the normal CSF flow parameters for properly diagnosing these conditions. No data on CSF flow parameters of the Indian population are available. Hence, this study was undertaken to generate normative CSF flow parameters in the Indian population. Aim Our aim was to estimate normal CSF flow parameters across the cerebral aqueduct in Indian subjects over 40 years of age. Settings and Design This observational study was done in the tertiary care institute on subjects undergoing magnetic resonance imaging (MRI) for indications like headache and having normal MRI. Methods Phase-contrast quantitative flow sequence was done in 100 subjects perpendicular to the cerebral aqueduct on 3.0T MRI (Discovery 750w with GEM suit, GE, Milwaukee, WI, United States) using a dedicated 32-channel head coil with 10 cm/s velocity encoding. The region of interest was kept at the cerebral aqueduct in cross-section. The inbuilt software calculated flow-time and velocity-time graphs and calculated peak systolic velocity (PSV), peak diastolic velocity (PDV), systolic flow (SF), and diastolic flow (DF). Stroke volume (SV) was calculated by averaging systolic and DFs. p -Value < 0.05 was considered significant. Results Mean age was 53.72 ± 10.53 (40-78) years with 41 males and 59 females. PSV, PDV, SF, DF, and SV all showed a significant linear correlation with age with p -values of 0.001, 0.004, 0.009, <0.001, and <0.001, respectively. Only PDV ( p = 0.035) and DF ( p = 0.045) varied significantly with sex, values being higher in males. Conclusion All five CSF flow parameters studied vary positively with age, and this variation is linear. Normal decadal median values calculated for these parameters can act as baseline values for the local population and help in defining conditions like NPH.
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Nematode infections are common in both humans and livestock, with major adverse planetary health and economic impacts. Wuchereria bancrofti is a parasitic nematode that causes lymphatic filariasis, a neglected tropical disease that can lead to severe disability and deformity worldwide. For the long-term survival of the bancroftian parasites in the host, a complex immune invasion strategy is involved through immunomodulation. Therefore, immunomodulation can serve as a site of research and innovation for molecular targets. Macrophage migration inhibitory factor (MIF) is a pleiotropic cytokine crucial to the host antimicrobial alarm system and stress response. Interestingly, the nematode parasite W. bancrofti also produces two homologs of MIF (Wba-MIF1 and 2). Using a mass spectrometry-based phosphoproteomics approach, we report new findings on the immunomodulatory effect and signaling mechanism of Wba-MIF2 in macrophage cells. Accordingly, we observed 1201 phosphorylated sites on 467 proteins. Out of the 1201 phosphorylated sites, 1075, 117, and 9 were found on serine (S), threonine (T), and tyrosine (Y) residues, respectively. Our bioinformatics analysis led to identification of major pathways, including spliceosomes, T cell receptor signaling pathway, Th17 differentiation pathway, interleukin-17 signaling pathway, and insulin signaling pathway upon Wba-MIF2 treatment. Wba-MIF2 treatment also enriched CDK4, CDK1, and DNAPK kinases. The comparison of the signaling pathway of Wba-MIF2 with that of human-MIF suggests both share similar signaling pathways. These findings collectively offer new insights into the role and mechanism of Wba-MIF2 as an immunomodulator and inform future diagnostics and drug discovery research for W. bancrofti.
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Anti-Infecciosos , Filariose Linfática , Fatores Inibidores da Migração de Macrófagos , Parasitos , Animais , Humanos , Wuchereria bancrofti/metabolismo , Parasitos/metabolismo , Fatores Inibidores da Migração de Macrófagos/metabolismo , Filariose Linfática/parasitologiaRESUMO
N-Heterocyclic carbenes (NHC) have been widely studied as ligands for surface chemistry, and have shown advantages compared to existing ligands (e.g. thiols). Herein, we introduce mesoionic carbenes (MICs) as a new type of surface ligand. MICs exhibit higher σ-donor ability compared to typical NHCs, yet they have received little attention in the area of surface chemistry. The synthesis of MICs derived from imidazo[1,2-a]pyridine was established and fully characterized by spectroscopic methods. The self-assembly of these MICs on gold was analyzed by X-ray photoelectron spectroscopy (XPS). Additionally, XPS was used to compare bonding ability in MICs compared to the typical NHCs. These results show that MIC overlayers on gold are robust, resistant to replacement by NHCs, and may be superior to NHCs for applications that require even greater levels of robustness.
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Helminth parasites modulate the host immune system to ensure a long-lasting asymptomatic form of infection generally, mediated by the secretion of immunomodulatory molecules and one such molecule is a homologue of human host cytokine, Macrophage migratory Inhibitory Factor (hMIF). In this study, we sought to understand the role of homologue of hMIF from the lymphatic filarial parasite, Wuchereria bancrofti (Wba-MIF2), in the immunomodulation of the Streptozotocin (STZ)-induced Type1 Diabetes Mellitus (T1DM) animal model. Full-length recombinant Wba-MIF2 was expressed and found to have both oxidoreductase and tautomerase activities. Wba-MIF2 recombinant protein was treated to STZ induced T1DM animals, and after 5 weeks pro-inflammatory (IL-1, IL-2, IL-6, TNF-α, IFN-γ) and anti-inflammatory (IL-4, IL-10) cytokines and gene expressions were determined in sera samples and spleen respectively. Pro-inflammatory and anti-inflammatory cytokine levels were significantly (p<0.05) up-regulated and down-regulated respectively, in the STZ-T1DM animals, as compared to treated groups. Histopathology showed macrophage infiltration and greater damage of islets of beta cells in the pancreatic tissue of STZ-T1DM animals, than Wba-MIF2 treated STZ-T1DM animals. The present study clearly showed the potential of Wba-MIF2 as an immunomodulatory molecule, which could modulate the host immune system in the STZ-T1DM mice model from a pro-inflammatory to anti-inflammatory milieu.
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Diabetes Mellitus Experimental , Diabetes Mellitus Tipo 1 , Filarioidea , Fatores Inibidores da Migração de Macrófagos , Parasitos , Humanos , Animais , Camundongos , Wuchereria bancrofti , Fatores Inibidores da Migração de Macrófagos/genética , Fatores Inibidores da Migração de Macrófagos/metabolismo , Parasitos/metabolismo , Estreptozocina , Fatores Imunológicos , Diabetes Mellitus Experimental/genética , Anti-Inflamatórios , Oxirredutases IntramolecularesRESUMO
Area-selective depositions (ASD) take advantage of the chemical contrast between material surfaces in device fabrication, where a film can be selectively grown by chemical vapor deposition on metal versus a dielectric, for instance, and can provide a path to nontraditional device architectures as well as the potential to improve existing device fabrication schemes. While ASD can be accessed through a variety of methods, the incorporation of reactive moieties in inhibitors presents several advantages, such as increasing thermal stability and limiting precursor diffusion into the blocking layer. Alkyne-terminated small molecule inhibitors (SMIs)âpropargyl, dipropargyl, and tripropargylamineâwere evaluated as metal-selective inhibitors. Modeling these SMIs provided insight into the binding mechanism, influence of sterics, and complex polymer network formed from the reaction between inhibitors consisting of alkene, aromatic, and network branchpoints. While a significant contrast in the binding of the SMIs on copper versus a dielectric was observed, residual amounts were detected on the dielectric surfaces, leading to variable ALD growth rates dependent on pattern-critical dimensions. This behavior can be controlled and utilized to direct film growth on patterns only above a critical threshold dimension; below this threshold, both the dielectric and metal features are protected. This method provides another design parameter for ASD processes and may extend its application to broader-ranging device fabrication schemes.
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N-heterocyclic carbene ligands (NHCs) are increasingly used to tune the properties of metal surfaces. The generally greater chemical and thermal robustness of NHCs on gold, as compared to thiolate surface ligands, underscores their potential for a range of applications. While much is now known about the adsorption geometry, overlayer structure, dynamics, and stability of NHCs on coinage elements, especially gold and copper, much less is known about their interaction with the surfaces of Pt-group metals, despite the importance of such metals in catalysis and electrochemistry. In this study, reflection absorption infrared spectroscopy (RAIRS) is used to probe the structure of benzimidazolylidene NHC ligands on Pt(111) and Ru(0001). The experiments exploit the intense absorption peaks of a CF3 substituent on the phenyl ring of the NHC backbone to provide unprecedented insight into adsorption geometry and chemical stability. The results also permit comparison with literature data for NHC ligands on Au(111) and to DFT predictions for NHCs on Pt(111) and Ru(0001), thereby greatly extending the known surface chemistry of NHCs and providing much needed molecular information for the design of metal-organic hybrid materials involving strongly reactive metals.
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This experiment was designed to investigate the postnatal development of the ovary in the Uttara fowl chicken and was conducted on 54 apparently healthy female birds divided into different age groups, namely Day 1 and Weeks 1, 4, 8, 12, 16, 20, 24, 28 with six birds each. During postnatal development, the left ovary gradually increased in size and complexity. The segmentation of the ovary started by 4 weeks, follicular eruption by 8 weeks, small liquor follicles (1-5 mm) appeared by 16 weeks, pre-hierarchical follicles by 20 weeks and hierarchical follicles by 24 weeks of age. The cortex was distinctly differentiated from the medulla in the early stage of ovarian development. However, the division between cortex and medulla was gradually obscured with age (transitional stage) and distinction was completely lost in the mature ovary. The different stages of follicular development in the chicken ovary were classified as primordial, primary, growing at Stage I, II and III stromal follicles besides pre-hierarchical and hierarchical surface follicles. The primordial and primary follicles showed cytoplasmic sudanophilic substances, especially in the Balbiani's yolk body, indicating the presence of lipids (Sudan Black B) with no activity for neutral polysaccharides (periodic acid Schiff method). It was observed that apoptotic changes may affect any stage of developing follicle resulting in arrested growth and atrophy. An early form of follicular atresia was the fate of the growth-arrested primordial and primary follicles, whereas the glandular form of atresia was commonly observed in growing follicles arrested at Stages I and II. The scanning electron micrographs unveiled the follicles as hollow oval structures with a follicular lumen lined by the perivitelline membrane (glycoprotein membrane) having lacunae giving a honeycomb-like appearance.
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Galinhas , Ovário , Feminino , Animais , Células da Granulosa , Atresia Folicular , Folículo OvarianoRESUMO
Lipomatosis of nerve, earlier known as fibrolipomatous hamartoma is a rare condition which predominantly affects peripheral nerves, cranial nerve involvement being extremely uncommon. Preoperative consideration of this entity is of paramount importance as its inadvertent complete surgical resection may inevitably result in significant neurological deficit. We report a case of trigeminal lipomatosis in a young patient with trigeminal neuralgia.
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Hamartoma , Lipoma , Lipomatose , Neuralgia , Neuralgia do Trigêmeo , Humanos , Neuralgia do Trigêmeo/diagnóstico por imagem , Neuralgia do Trigêmeo/etiologia , Neuralgia do Trigêmeo/cirurgia , Lipomatose/complicações , Lipomatose/diagnóstico por imagem , Lipomatose/cirurgia , Hamartoma/complicações , Neuralgia/complicações , Nervo TrigêmeoRESUMO
Teixobactin is a new antibiotic peptide with strong efficacy against several Gram-positive resistant bacteria, the structure of which is extremely difficult to obtain in the laboratory via multistep conventional synthesis. To face the increasing antibiotic resistant bacteria, it is fundamental to introduce new types of antibiotics with innovative mechanisms of action without resistance; thus, many scientists are studying and developing new methods to synthesize teixobactin analogues. In this work, seven Arg10-teixobactin analogues with a total lactam ring have been prepared via solid phase peptide synthesis. In order to obtain the total lactam ring, d-Thr8 was replaced by (2R,3S)-diamino-propionic acid. To verify their antimicrobial activity and efficacy, each analogue was tested with MIC against different resistant pathogens, showing an interesting activity for Nle11 containing compounds.
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BACKGROUND: As per estimates by WHO in 2021 almost half of the world's population was at risk of malaria and > 0.6 million deaths were attributed to malaria. Therefore, the present study was aimed to explore the antimalarial activity of extracts derived from the leaves of the plant Anacardium occidentale L., which has been used traditionally for the treatment of malaria. Different extracts of A. occidentale leaves were prepared and tested for their inhibitory activity against recombinant P. falciparum transketolase (rPfTK) enzyme, in vitro. Further, growth inhibitory activity against cultivated blood stage P. falciparum parasites (3D7 strain), was studied using SYBR Green fluorescence-based in vitro assays. Acute toxicity of the hydro alcoholic extracts of leaves of A. occidentale (HELA) at different concentrations was evaluated on mice and Zebra fish embryos. HELA showed 75.45 ± 0.35% inhibitory activity against the recombinant PfTk and 99.31 ± 0.08% growth inhibition against intra-erythrocytic stages of P. falciparum at the maximum concentration (50 µg/ml) with IC50 of 4.17 ± 0.22 µg/ml. The toxicity test results showed that the heartbeat, somite formation, tail detachment and hatching of embryos were not affected when Zebra fish embryos were treated with 0.1 to 10 µg/ml of the extract. However, at higher concentrations of the extract, at 48 h (1000 µg/ml) and 96 h (100 µg/ml and 1000 µg/ml, respectively) there was no heartbeat in the fish embryos. In the acute oral toxicity tests performed on mice, the extract showed no toxicity up to 300 mg/kg body weight in mice. CONCLUSION: The hydro-alcoholic extract of leaves of A. occidentale L. showed potent antimalarial activity against blood stage P. falciparum. Based on the observed inhibitory activity on the transketolase enzyme of P. falciparum it is likely that this enzyme is the target for the development of bioactive molecules present in the plant extracts. The promising anti-malarial activity of purified compounds from leaves of A. occidentale needs to be further explored for development of new anti-malarial therapy.
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Anacardium , Antimaláricos , Malária Falciparum , Malária , Animais , Camundongos , Antimaláricos/toxicidade , Plasmodium falciparum , Transcetolase/uso terapêutico , Peixe-Zebra , Malária/tratamento farmacológico , Malária/parasitologia , Malária Falciparum/tratamento farmacológico , Extratos Vegetais/farmacologiaRESUMO
Teixobactin is a cyclic undecadepsipeptide that has shown excellent potency against multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE). In this article, we present the design, synthesis, and antibacterial evaluations of 16 different teixobactin analogues. These simplified analogues contain commercially available hydrophobic, non-proteogenic amino acid residues instead of synthetically challenging expensive L-allo-enduracididine amino acid residue at position 10 together with different combinations of arginines at positions 3, 4 and 9. The new teixobactin analogues showed potent antibacterial activity against a broad panel of Gram-positive bacteria, including MRSA and VRE strains. Our work also presents the first demonstration of the potent antibiofilm activity of teixobactin analogoues against Staphylococcus species associated with serious chronic infections. Our results suggest that the use of hydrophobic, non-proteogenic amino acids at position 10 in combination with arginine at positions 3, 4 and 9 holds the key to synthesising a new generation of highly potent teixobactin analogues to tackle resistant bacterial infections and biofilms.
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Staphylococcus aureus Resistente à Meticilina , Enterococos Resistentes à Vancomicina , Relação Estrutura-Atividade , Aminoácidos/farmacologia , Antibacterianos/química , Biofilmes , Testes de Sensibilidade MicrobianaRESUMO
Purpose: To determine the role of functional magnetic resonance imaging techniques (diffusion-weighted magnetic resonance imaging [DW-MRI] and dynamic contrast-enhanced magnetic resonance imaging [DCE-MRI]) in the differentiation of various salivary gland tumours. Material and methods: In this prospective study, we evaluated 32 patients with salivary gland tumours using functional MRI. Diffusion parameters (mean apparent diffusion coefficient [ADC], normalized ADC and homogeneity index [HI]),semiquantitative DCE parameters (time signal intensity curves [TICs]) and quantitative DCE parameters (Kep, Ktrans and Ve) were analysed. Diagnostic efficiencies of all these parameters were determined to differentiate benign and malignant tumours as well as to characterize 3 major subgroups of salivary gland tumours, namely pleomorphic adenoma, Warthin tumour, and malignant tumours. Results: Mean ADC, normalized ADC and HI were insignificant in differentiating benign and malignant tumours but were significant in differentiating pleomorphic adenomas, Warthin tumours, and malignant tumours. Mean ADC was the best parameter in predicting both pleomorphic adenomas and Warthin tumours (AUC: 0.95 and 0.89, respectively). Amongst DCE parameters, only TIC pattern could differentiate between benign and malignant tumours, with an accuracy of 93.75% (AUC: 0.94). The quantitative perfusion parameters aided greatly in characterizing pleomorphic adenomas, Warthin tumours and malignant tumours. For predicting pleomorphic adenomas, the accuracy of Kep and Ktrans was 96.77% (AUC: 0.98) and 93.55% (AUC: 0.95), respectively and for predicting Warthin tumours, the accuracy of both Kep and Ktrans was 96.77% (AUC: 0.97). Conclusions: DCE parameters (particularly TIC, Kep and Ktrans) had higher accuracy in characterizing various tumour subgroups (pleomorphic adenomas, Warthin tumours, and malignant tumours) than DWI parameters. Hence, dynamic contrast-enhanced imaging adds immense value with only a minimum time penalty to the examination.
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Vitamin B12 is inextricably associated with the development and maintenance of neuronal functions. It is classically associated with subacute combined degeneration and peripheral neuropathy; however, cranial neuropathy is uncommon. We observed the rarest neurological manifestation of B12 deficiency. A 12 months infant had history of lethargy, irritability, anorexia, paleness, vomiting, and neurodevelopmental delay for 2 months. He also developed inattention and altered sleep pattern. His mother noticed bilateral inward rotation of both eyes. On examination, the infant had bilateral lateral rectus palsy. The infant was found to have anemia (7.7g/dL) and severe B12 deficiency (74pg/mL). On MRI, there was cerebral atrophy, subdural hematoma (SDH) and wide cisternal spaces and sulci. On supplementation with cobalamin, he improved clinically though mild restriction of lateral gaze on the left side persists. Follow up MRI showed significant improvement in cerebral atrophy with resolution of SDH. To date, such clinical presentation of B12 deficiency has never been reported. The authors suggest B12 supplementation for at risk population esp at antenatal stage and lactating mothers in national programs. The treatment of this condition should be initiated early to prevent long term sequelae.
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Doenças do Nervo Abducente , Deficiência de Vitamina B 12 , Masculino , Lactente , Humanos , Feminino , Gravidez , Deficiência de Vitamina B 12/complicações , Deficiência de Vitamina B 12/diagnóstico , Deficiência de Vitamina B 12/tratamento farmacológico , Lactação , Doenças do Nervo Abducente/complicações , Doenças do Nervo Abducente/tratamento farmacológico , Atrofia , Hematoma Subdural/complicações , Vitamina B 12/uso terapêuticoRESUMO
Antimicrobial peptides (AMPs) commonly target bacterial membranes and show broad-spectrum activity against microorganisms. In this research we used three AMPs (nisin, epilancin 15×, [R4L10]-teixobactin) and tested their membrane effects towards three strains (Staphylococcus simulans, Micrococcus flavus, Bacillus megaterium) in relation with their antibacterial activity. We describe fluorescence and luminescence-based assays to measure effects on membrane potential, intracellular pH, membrane permeabilization and intracellular ATP levels. The results show that our control peptide, nisin, performed mostly as expected in view of its targeted pore-forming activity, with fast killing kinetics that coincided with severe membrane permeabilization in all three strains. However, the mechanisms of action of both Epilancin 15× as well as [R4L10]-teixobactin appeared to depend strongly on the bacterium tested. In certain specific combinations of assay, peptide and bacterium, deviations from the general picture were observed. This was even the case for nisin, indicating the importance of using multiple assays and bacteria for mode of action studies to be able to draw proper conclusions on the mode of action of AMPs.