Waxy papules, infiltrated alopecic plaques, and shin ichthyosis.

A 38-year-old male presented with waxy papules, plaques over the neck and extremities, and ichthyotic scales over the lower limbs. Skin biopsy revealed a dense medium-sized lymphocytic infiltrate in the dermis, with perifollicular accentuation and focal exocytosis into the follicular epithelium with strong positivity for CD 3, 4, and 5. Considering the clinicopathological correlation, a diagnosis of follicular mycosis fungoides (FMF) was made. It is a variant of classic mycosis fungoides (MF) where atypical cells invade the follicular epithelium.

Rice-based integrated farming system improves the soil quality, bacterial community structure and system productivity under sub-humid tropical condition.

Rice-based integrated farming system improves the productivity and profitability by recycling resources efficiently. In the sub-humid tropics, rice production without sufficient nutrient replenishment often leads to soil health and fertility degradation. There has been very limited research on soil health and fertility after adopting a multi-enterprising rice-based integrated farming system (IFS), notably in the rice-fish-livestock and agroforestry system, when compared to a conventional farming system (CS). Therefore, the present study analyzed the dynamics of soil properties, soil bacterial community structure and their possible interaction mechanisms, as well as their effect on regulating soil quality and production in IFS, IFSw (water stagnant area of IFS) and CS. The results indicated that soil nutrient dynamics, bacterial diversity indices (Shannon index, Simpson index, Chao 1, ACE and Fisher index) and system productivity were higher in IFSw and IFS compared to CS. Moreover, relative operational taxonomic units of dominant bacterial genera (Chloroflexi, Acidobacteria, Verrucomicrobia, Planctomycetes, Cyanobacteria, Crenarchaeota and Gemmatimonadetes) were also higher in IFSw and IFS compared to CS. Mean soil quality index (SQI) was highest in IFSw (0.780 ± 0.201) followed by IFS (0.770 ± 0.080) and CS (0.595 ± 0.244). Moreover, rice equivalent yields (REY) and rice yields were well correlated with the higher levels of soil biological indices (SQIBiol) in IFS. Overall, our results revealed that rice-based IFS improved the soil health and fertility and ensuing crop productivity through positive interaction with soil bacterial communities and nutrient stoichiometry leading to agroecosystem sustainability.

'Generalised Pruritus with Prurigo-Like Lesions and Generalised Lymphadenopathy: Could be an Early Diagnostic Clue for Angioimmunoblastic T-Cell Lymphoma (AITL) and/or Histoplasmosis'.

Angioimmunoblastic T-cell lymphoma (AITL) is an uncommon systemic lymphoproliferative disorder that comprises approximately one-fifth of all mature peripheral T-cell lymphomas. A broad range of cutaneous manifestations include maculopapular, papulovesicular, erythrodermic, urticarial, plaque-like and nodular, and they are mentioned in 50% of patients and may precede systemic symptoms, which include lymphadenopathy, hepatosplenomegaly and constitutional symptoms. Histoplasmosis is a common granulomatous infection worldwide caused by Histoplasma capsulatum, a dimorphic fungus. Cutaneous manifestations are reported to occur in 10% to 25% of immunosuppressed patients with disseminated histoplasmosis. Generalised pruritus as a presenting feature is rarely described in both of these entities. We report a unique case of AITL with histoplasmosis discovered during paraclinical assessment of generalised pruritus (? neurodermatitis) with prurigo-like lesions and lymphadenopathy.

Microbiome Diversity in Vaginal Fluid and Sensitivity Patterns in Preterm Premature Rupture of Membrane Cases.

INTRODUCTION: Preterm premature rupture of membranes (PPROM) is spontaneous rupture of the fetal membranes before 37 completed weeks and before the onset of labor. PPROM occurs in 3% of all pregnancies and is responsible for approximately one-third of all preterm deliveries. It leads to increase in perinatal morbidity and mortality. AIM: The present study aimed to characterize the microbiome of vaginal fluid, which will be helpful in the selection of empiric antimicrobial therapy. MATERIALS AND METHOD: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Pradyumna Bal Memorial Hospital, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar during the period of October 2019 to June 2021 to characterize the microorganisms in the vaginal fluid and their antimicrobial sensitivity patterns found in antenatal women presenting with PPROM. A total of 160 antenatal women diagnosed with PPROM, gestational age between 28 weeks to 36 weeks and 6 days were included in the study. High vaginal swabs were collected for microbial culture and sensitivity. RESULTS: Out of 160 samples, the growth of organisms was observed in 134 (85.09%) samples. Out of them, 133 were monomicrobial, one was polymicrobial. Common isolated infections included Enterococcus faecalis (17.39%), followed by Staphylococcus aureus (14.29%), Escherichia coli (11.18%), and Staphylococcus haemolyticus (6.21%). Most of them were sensitive to ampicillin followed by linezolid and vancomycin. S. aureus was most sensitive to linezolid followed by gentamicin and vancomycin. Most isolates were multidrug-resistant. CONCLUSION: The empirical antimicrobial treatment started for PPROM management should be based on the established changing microbiological pattern and sensitivities with due consideration of geographical and demographic variations.

Evaluation of Liver Histopathological Findings of Coronavirus Disease 2019 by Minimally Invasive Autopsies.

AIM: The severe acute respiratory syndrome coronavirus 2 outbreak resulted in severe health impact with the loss of many lives across the world. Pulmonary parenchyma suffers the most from the brunt of the infection. However, evidence suggested a systemic involvement during the course of illness. Information on morphological changes of the liver is sparse in the literature. We aimed to evaluate the pathological findings in the liver by minimally invasive autopsies. METHODS: Postmortem core biopsies of the liver obtained from patients who succumbed to coronavirus disease 2019 disease were studied. Demographic findings, comorbidities, and relevant laboratory tests were collected. Detailed histopathological changes were assessed. RESULTS: Liver function tests were available in 40 cases, and it was deranged in 80% cases. A spectrum of histological changes was observed. Macrovesicular steatosis and nonspecific portal inflammation of mild degree were the common morphological changes. Features suggestive of vascular alteration were noted in more than half of the cases. These included increased portal vein branches, irregular luminal dilation, and herniation of portal veins into the periportal hepatocytes. In addition, we observed morphological changes attributed to terminal shock-related changes. CONCLUSION: The present study results highlight that liver parenchyma changes may be related to multiple pathogenic mechanisms. The presence of vascular alteration in portal tracts suggests derangement of hepatic vasculature related to systemic hypercoagulable state induced by the viral infection. It remains to be established if the histological changes are related to direct viral insult or to the systemic response caused by the viral attack.

Ultrasonography as a diagnostic aid for a neonate with gingival swelling in a COVID-19 neonatal intensive care unit.

COVID-19 pandemic has impacted all the aspects of life and has emerged as the biggest challenge to the health-care sector. Dental fraternity has also taken its significant impact since the transmission of disease is primarily through aerosol droplets. Management of infants with orofacial anomalies such as natal and neonatal teeth born to COVID-19-positive mothers is another challenge due to unavailability of dental facilities in the isolation wards. In such unforeseen circumstances, out-of-routine approaches such as extraoral mandibular ultrasonography were performed for the management of a congenital intraoral swelling in an infant and are being described in this case report.

Mutational Landscape for Indian Hereditary Breast and Ovarian Cancer Cohort Suggests Need for Identifying Population Specific Genes and Biomarkers for Screening.

BACKGROUND: Breast and ovarian cancers are the most prevalent cancers and one of the leading causes of death in Indian women. The healthcare burden of breast and ovarian cancers and the rise in mortality rate are worrying and stress the need for early detection and treatment. METHODS: We performed amplicon sequencing of 144 cases who had breast/ovarian cancer disease (total 137 cases are patients and seven are tested for BRCA1/2 carrier) Using our custom designed gene panel consisting of 14 genes, that are associated with high to moderate risk of breast and ovarian cancers. Variants were called using Torrent Variant Caller and were annotated using ThermoFisher's Ion Reporter software. Classification of variants and their clinical significance were identified by searching the variants against ClinVar database. RESULTS: From a total of 144 cases, we were able to detect 42 pathogenic mutations in [40/144] cases. Majority of pathogenic mutations (30/41) were detected in BRCA1 gene, while (7/41) pathogenic mutations were detected in BRCA2 gene, whereas, (2/41) pathogenic mutations were detected in TP53 gene and BRIP1, PALB2, and ATM genes respectively. So, BRCA genes contributed 88.09% of pathogenic mutations, whereas non-BRCA genes contributed 11.91% of pathogenic mutations. We were also able to detect 25 VUS which were predicted to be damaging by in silico prediction tools. CONCLUSION: Early detection of cancers in the Indian population can be done by genetic screening using customized multi-gene panels. Indications of our findings show that in the Indian population, apart from the common BRCA genes, there are other genes that are also responsible for the disease. High frequency mutations detected in the study and variants of uncertain significance predicted to be damaging by in silico pathogenicity prediction tools can be potential biomarkers of hereditary breast and ovarian cancer in Indian HBOC patients.

Development of gluten-free cereal bar for gluten intolerant population by using quinoa as major ingredient.

The present study was carried out to develop gluten free cereal bars for gluten intolerant population. The cereal bar was formulated using dry raw materials (quinoa, brown rice, flaxseed and dry fruits) and binding agents (honey). Honey was added as a sweetener and binding agent. The raw materials were assessed for physico-chemical parameters such as moisture, ash, crude protein and fat content and the functional parameters such as antioxidant activity, total phenolic content and ß-carotene. Dry heat treatment (80-100 °C for 8-12 min) was given to grains (quinoa, brown rice and flaxseed) prior to use in preparation of cereal bar. Significant variation was found after treatment of grains among all the physico-chemical and functional parameters of grains except ash content which showed a non-significant variation. Four formulations (F1, F2, F3 and F4) were developed using different combination of grains at different honey levels (40, 50 and 60%). On the basis of sensory evaluation, formulation- 4 at 50% honey level was found to be best. Selected cereal bar was assessed for physico-chemical and functional parameters. Selected cereal bar had 8.53% moisture content, 1.34% ash content, 10.50% protein content, 2.89% fat content, 0.51 mg GAE/g total phenolic content, 33.87% antioxidant activity and 0.384 µg/g ß-carotene.

Comprehensive cytotoxicity studies of superparamagnetic iron oxide nanoparticles.

Recently lots of efforts have been taken to develop superparamagnetic iron oxide nanoparticles (SPIONs) for biomedical applications. So it is utmost necessary to have in depth knowledge of the toxicity occurred by this material. This article is designed in such way that it covers all the associated toxicity issues of SPIONs. It mainly emphasis on toxicity occurred at different levels including cellular alterations in the form of damage to nucleic acids due to oxidative stress and altered cellular response. In addition focus is been devoted for in vitro and in vivo toxicity of SPIONs, so that a better therapeutics can be designed. At the end the time dependent nature of toxicity and its ultimate faith inside the body is being discussed.

I-gel versus laryngeal mask airway-Proseal: Comparison of two supraglottic airway devices in short surgical procedures.

BACKGROUND AND AIMS: Supraglottic airway devices have been established in clinical anesthesia practice and have been previously shown to be safe and efficient. The objective of this prospective, randomized trial was to compare I-Gel with LMA-Proseal in anesthetized spontaneously breathing patients. MATERIAL AND METHODS: Sixty patients undergoing short surgical procedures were randomly assigned to I-gel (Group I) or LMA- Proseal (Group P). Anesthesia was induced with standard doses of propofol and the supraglottic airway device was inserted. We compared the ease and time required for insertion, airway sealing pressure and adverse events. RESULTS: There were no significant differences in demographic and hemodynamic data. I-gel was significantly easier to insert than LMA-Proseal (P < 0.05) (Chi-square test). The mean time for insertion was more with Group P (41 + 09.41 secs) than with Group I (29.53 + 08.23 secs) (P < 0.05). Although the airway sealing pressure was significantly higher with Group P (25.73 + 02.21 cm of H2O), the airway sealing pressure of Group I (20.07 + 02.94 cm of H2O) was very well within normal limit (Student's t test). The success rate of first attempt insertion was more with Group I (P < 0.05). There was no evidence of airway trauma, regurgitation and aspiration. Sore throat was significantly more evident in Group P. CONCLUSION: I-Gel is a innovative supraglottic device with acceptable airway sealing pressure, easier to insert, less traumatic with lower incidence of sore throat. Hence I-Gel can be a good alternative to LMA-Proseal.

Development and Validation of RP-HPLC Method for Simultaneous Estimation of Picroside I, Plumbagin, and Z-guggulsterone in Tablet Formulation.

The aim of the present work was to develop and validate a reversed-phase high-performance liquid chromatography method for the simultaneous estimation of picroside I, plumbagin, and Z-guggulsterone in a polyherbal formulation containing Picrorhiza kurroa, Plumbago zeylanica, and Commiphora wightii extracts. The analysis was performed on a C18 column using the mobile phase consisting of solvent A (acetonitrile) and solvent B (0.1% orthophosphoric acid in water) with the following gradient: 0-12 min, 25% A; 12-17 min, 25-80% A; 17-32 min, 80% A; and 32-37 min, 80-25% A at a flow rate of 1 ml/min. Ultraviolet detection was at 255 nm. The method was validated for accuracy, precision, linearity, specificity, and sensitivity as per the norms of the International Conference on Harmonization. From the validation study, it was found that the method is specific, accurate, precise, reliable, and reproducible. Good linear correlation coefficients (r(2)>0.900) were obtained for calibration plots in the ranges tested. Limits of detection were 2.700, 0.090 and 0.099 µg/ml and limits of quantification were 9.003, 0.310, and 0.330 µg/ml for picroside I, plumbagin, and Z-guggulsterone, respectively. Intra and interday relative standard deviation (RSD) of retention times and peak areas was less than 3.0%. Recovery was found to be 100.21% for picroside I, 102.5% for plumbagin, and 103.84% for Z-guggulsterone. The established method was appropriate and the three markers were well resolved, enabling efficient quantitative analysis of picroside I, plumbagin and Z-guggulsterone. The method is a rapid and cost-effective quality control tool for routine quantitative analysis of picroside I, plumbagin, and Z-guggulsterone in tablet dosage form.

Increase in growth, productivity and nutritional status of wheat (Triticum aestivum L. cv. WH-711) and enrichment in soil fertility applied with organic matrix entrapped urea.

Field experiments were conducted during two consequent years in semi-arid, subtropical climate of Rohtak district situated in North-West Indian state Haryana to evaluate the effects of eco-friendly organic matrix entrapped urea (OMEU) on wheat (Triticum aestivum L. cv. WH-711). The OMEU prepared in granular form contained cow dung, rice bran (grain cover of Oryza sativa), neem (Azadirachta indica) leaves and clay soil (diameter of particles < 0.002 mm) in 1:1:1:1 ratios and saresh (plant gum of Acacia sp.) as binder entrapping half of the recommended dose of urea. A basal application of organic matrix entrapped urea showed increase in plant growth in terms of fresh and dry weights, root length, root number, leaf number, tillers, plant height earlet number, earlet length and productivity in terms of grain yield and straw yield over free form of urea (FU) and no fertilizer (NF) application. The OMEU increased total soluble proteins, organic N and free ammonium content in the leaves at 45 and 60 days. The nutritional status of wheat grains in OMEU applied plants was almost similar to that observed for FU applied plants. An increase in organic carbon and available phosphorus (P) was observed in OMEU applied plots on harvest whereas pH was slightly decreased over FU applied plots. The microbial population and activity in terms of fungal and bacterial colony count and activities soil dehydrogenase and alkaline phosphatase were significantly higher in OMEU applied plots as compared to the FU applied plots. Our data indicate that OMEU which are low cost, biodegradable and non-toxic can be used to replace the expensive chemical fertilizers for wheat cultivation in semi-arid, subtropical climate.

Interferon-beta counteracts inflammatory mediator-induced effects on brain endothelial cell tight junction molecules-implications for multiple sclerosis.

To elucidate mechanisms of endothelial cell (EC) dysfunction in CNS inflammatory responses and beneficial effects of interferon-beta (IFN-gamma) in multiple sclerosis (MS), we analyzed effects of individual and combinations of soluble inflammatory mediators on the intracellular localization of the EC tight junction-associated molecules zonula occludens-1 and -2 (ZO-1 and ZO-2) in human brain ECs. The cytoplasm in the majority of cells in control EC cultures was clear; ZO-1 and ZO-2 were localized peripherally near sites of cell contact and associated with submembranous cytoplasmic filaments. H2O2 induced reversible time- and concentration-dependent translocation of ZO-1 and ZO-2 to a random distribution within EC cytoplasm and retraction of EC borders. For low concentrations, these effects were accompanied by less prominent submembranous filaments but not by evidence of cytotoxicity, increased cell death or altered amounts of ZO-1. Tumor necrosis factor-beta induced similar alterations but interferon-y did not. Co-treatment with either cytokine increased H2O2 effects whereas IFN-beta reversed H2O2-induced effects. In control white matter samples, EC cytoplasm was clear and ZO-1 was located on cell borders. In inflammatory/demyelinating lesions, EC ZO-1 was diffuse, indicating that the alterations induced in vitro mimic those in active MS lesions. These findings suggest that in MS patients, IFN-beta treatment may counteract inflammatory mediator effects on CNS EC tight junction molecules, thereby preserving EC barrier function.

Mitogen activated protein kinase activation and oxidant signaling in astrocytoma cells.

Presence of increased reactive oxygen species (ROS) has been observed in most high risk factors for brain tumor development. Our past study demonstrated that ROS could induce increased brain tumor cell proliferation. Growth effects of ROS may involve modifications of cellular proteins such as mitogen-activated protein kinases (MAPKs), which regulate cell proliferation. Here, we report effects of a ROS (hydrogen peroxide, H2O2) and an antioxidant (N-acetylcysteine, NAC) on MAPK activation in astrocytoma (U373-MG) cells. MAPKs are activated by phosphorylation that can be detected by Western blot analysis. The unphosphorylated/inactivated form of MAPK exhibits slower mobility on SDS-PAGE compared to the phosphorylated/activated form. Densitometric analysis was used to measure MAPK activation. Results indicate that H2O2 caused a dose and time-dependent increase in MAPK activation in astrocytoma cells. Furthermore, ROS-induced activation was almost completely suppressed by NAC. NAC also inhibited serum-induced MAPK activation indicating there may be an oxidant-sensitive component to serum-induced growth signaling. Modifications of MAPKs by H2O2 demonstrate that ROS-induced proliferation is via biochemical pathways similar to other known growth stimuli. Understanding of processes that link a proliferation signal (ROS) to cell proliferation can aid in the selection of therapy used to suppress brain tumor growth.