Determinants of mortality and impact of therapy in patients with leptospirosis admitted for intensive care in a Sri Lankan hospital--a three year retrospective study.

INTRODUCTION: Leptospirosis is a disease of epidemic proportions in Sri Lanka. There is paucity of data on the determinants of mortality and impact of therapy in patients with leptospirosis admitted to critical care settings in endemic territories. METHODOLOGY: This retrospective cross-sectional study was performed in patients with serologically confirmed leptospirosis admitted to the intensive care unit of the General Hospital, Kalutara from January 2011 to April 2014. Associations between socio-epidemiological, clinical and laboratory parameters and patient mortality were examined. RESULTS: Forty-five patients were included. The mean age was 49.11(SD = 16.95) and majority (92%) were male. Percentage mortality was 44.4%. Patient mortality was associated with age > 40 (p = 0.012), symptoms of uremia (p = 0.017), evidence of CNS involvement (p = 0.039), presence of oliguria (p = 0.002) and anuria (p = 0.014), presence of multi-organ dysfunction syndrome (MODS) (p < 0.001), CRP > 96 (p = 0.036), platelet count < 20,000 (p = 0.045), Potassium > 5.0 (p = 0.05), metabolic acidosis with pH < 7.2 (p = 0.03), INR > 2 (p = 0.037) and requirement of mechanical ventilation (p < 0.001). Cox regression analysis revealed MODS and potassium > 5 to be independently associated with mortality. CONCLUSIONS: A high mortality rate is noted. The presence of MODS and serum potassium concentration > 5.0 was independently associated with mortality in this retrospective study of patients with confirmed leptospirosis in a critical care setting.

Influence of insecticidal plant materials used during storage on sensory attributes and instrumental hardness of dry edible beans (Phaseolus vulgaris L.).

Three plant products with known insecticidal properties, a dry extract of flowers of Chrysanthemum cinerariaefolium (Trevir.) Vis. produced in Rwanda, an ethanol extract of seeds of neem, Azadirachta indica A. Juss, and crushed leaves of Tetradenia riparia Hochst Codd, a traditional Rwandan medicine, were mixed with beans, Phaseolus vulgaris L., for storage protection. These plant-protected beans were compared with "off the shelf' beans that were being sold to consumers by the Rwandan National Agricultural Products Marketing Organization (OPROVIA). A trained sensory panel determined that beans treated with neem and C. cinerariaefolium were as acceptable after 8 months storage as those being sold throughout Rwanda by the marketing organization. Beans marketed by this organization were all treated with the standard insecticide application in Rwanda, 0.01% weight/weight pirimiphos methyl in a powder formulation. Instrumental hardness (% hard-to-cook/mean gram force) after 20 months of storage was acceptable for beans stored with neem or with C. cinerariaefolium or with the conventional government application of pirimiphos methyl. Use of either neem or C. cinerariaefolium for storage protection should not affect consumer acceptance of dry beans.

Methanol suppression of trichloroethylene degradation by Methylosinus trichosporium (OB3b) and methane-oxidizing mixed cultures.

The effect of methanol on trichloroethylene (TCE) degradation by mixed and pure methylotrophic cultures was examined in batch culture experiments. Methanol was found to relieve growth inhibition of Methylosinus trichosporium (OB3b) at high (14 mg/L) TCE concentrations. Degradation of TCE was determined by both radiolabeling and gas chromatography techniques. When cultures were grown on methanol over 10 to 14 d with 0.3 mg/L TCE, OB3b degraded 16.89 +/- 0.82% (mean +/- SD) of the TCE, and a mixed culture (DT type II) degraded 4.55 +/- 0.11%. Mixed culture (JS type I) degraded 4.34 +/- 0.06% of the TCE. When grown on methane with 0.3 mg/L TCE, 32.93 +/- 2.01% of the TCE was degraded by OB3b, whereas the JS culture degraded 24.3 +/- 1.38% of the TCE, and the DT culture degraded 34.3 +/- 2.97% of the TCE. The addition of methanol to cultures grown on methane reduced TCE degradation to 16.21 +/- 1.17% for OB3b and to 5.08 +/- 0.56% for JS. Although methanol reduces the toxicity of TCE to the cultures, biodegradation of TCE cannot be sustained in methanol-grown cultures. Since high TCE concentrations appear to inhibit methane uptake and growth, we suggest the primary toxicity of TCE is directed towards the methane monooxygenase.