Early diagnosis of lupus: A possibilty. A multicentric study from SLE Special Interest Group (SIG) of Indian Rheumatology Association (IRA).

INTRODUCTION: Systemic Lupus Erythematosus (SLE) warrants an early diagnosis and prompt management. Delay in diagnosis can result in repeated flares, permanent damage, and even death. There is a large variability in the time taken to diagnose SLE across the world. We undertook this study to determine the time taken for diagnosis of SLE in India and to identify the factors associated. METHODS: Patients with SLE diagnosed within the previous 1 year as per Systemic Lupus Erythematosus International Collaborating Clinics criteria (SLICC) 2012 criteria were included in a cross-sectional multicentre questionnaire-based survey. Demographic profile, self-reported socioeconomic status as per Kuppuswamy classification of socioeconomic status (version 2022) (SES), and several healthcare related parameters including referral pattern were recorded. Median time taken for diagnosis was used to demarcate early or late diagnosis and associated factors were explored. RESULTS: We included 488 patients with SLE from 10 rheumatology centres. The median time to diagnosis was 6 months Interquartile Range (IQR 3,14.7) and within 3 months in about one third [150(30.7%)]. Very early diagnosis (<1 month) was established in 78(16.0%) patients. The mean SLE Disease Activity Index (SLEDAI) at diagnosis was 10.28+7.24. In univariate analysis, an older age, lower SES, non-southern state of residence and larger family size were significantly associated with late diagnosis. In the multivariate analysis, higher SES (AOR 0.95, 95% CI: 0.92-0.98), multiple organ system involvement at initial presentation (AOR1.75 95%CI: 1.08-2.84) and place of residence in south Indian states (AOR1.92 95%CI: 1.24-2.97) had lesser odds of being associated with late diagnosis. Distance from the closest medical centre/professional did not influence the time to diagnosis. Majority of patients had first consulted a medical graduate (42.5%) or postgraduate doctor (48.2%), and referral to rheumatologist was largely done by postgraduate (65%) doctors. More than half of our patients (61%) self-finance their treatment. CONCLUSION: Median time to diagnosis of SLE was 6 months, 1/3rd being diagnosed within 3 months and 78(16.0%) with 1 month of symptom onset. Delay in diagnosis was noted in those belonging to lower socioeconomic strata and those with single organ disease. Distance to the health care facility did not influence time to diagnosis.

A Comparative Analysis of Heart Rate Variability Indices in Patients with Liver Cirrhosis.

BACKGROUND: Cardiac autonomic dysfunction (AD) in reference to chronic liver disease (CLD) has become widely accepted as a symptomatic burden. This study will be undertaken to measure heart rate variability (HRV) indices and detect the severity of cardiac autonomic dysfunction in CLD patients. MATERIALS AND METHODS: This study was conducted on 150 patients with liver cirrhosis and compared with 110 healthy controls. Information concerning medical history, radiological and laboratory findings was extracted for interpretation and association among both groups. The HRV was assessed by recording with a polygraph (RMS Polyrite D, version 1.0), which was based on the principle of electrocardiography. RESULTS: Heart rate variability indices like standard deviation of each interval normal-to-normal (SDNN), percentage of successive RR intervals that differ by >50 ms (pNN50%), high frequency (HF), low frequency (LF), and the LF/HF ratio were found to be remarkably low in cases with CLD in comparison to the healthy control group (p < 0.05). The Child-Pugh (CP) score was class C (10-15) in 52%, class B (7-9) in 30%, and class A (5-6) in 18% of patients. The CP score in CLD patients had a statistically significant negative correlation with SDNN (r = -0.5429, p < 0.001), root mean square of successive differences (RMSSD) (r = -0.375, p < 0.001), pNN50% (r = -0.6037, p < 0.001), HF (r = -0.2033, p = 0.0125), and LF (r = -0.3674, p < 0.001). SDNN, pNN50%, and LF parameters were lowest in alcohol-related CLD, highest in hepatitis C virus (HCV)-related CLD, and intermediate in hepatitis B virus (HBV)-related CLD. CONCLUSION: Our study concluded that liver cirrhosis patients have reduced HRV compared to healthy individuals. A decrease in HRV highlights people at risk of death. This is a variable that can be used to track patients over time and aid in transplant selection.

Analysis of Hematological Indices in Patients of Systemic Lupus Erythematous and Its Correlation with SLEDAI-2K.

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease which is characterized by chronic multisystem inflammation and end-organ damage. In recent times there has been a need for new hematological markers to assess disease activity in SLE patients specifically, which can be easily available like eosinophil, basophil, neutrophil, monocytes, and platelet to lymphocyte ratios (ELR, BLR, NLR, MLR, and PLR, respectively). Materials and methods: The present investigation determines the use of a different peripheral hematological marker to assess SLE activity in 106 patients attended for medical care at Sawai Mansingh (SMS) Medical College and attached hospital, Jaipur. SLE disease activity index 2000 (SLEDAI-2K) was used to assess the disease activity in all patients. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed in each subject. The ratio of various hematological indices, like NLR, BLR, ELR, MLR, PLR, etc., analyzed and correlated with CRP, ESR, and SLEDAI-2K. Results: The present study revealed that the SLEDAI-2K score showed a significant positive correlation with ELR and MLR (p < 0.005). CRP showed a significant positive correlation with PLR (p < 0.005). ESR showed a significant positive correlation with ELR, MLR, PLR, and NLR (p < 0.005). Conclusion: The final results demonstrate that in SLE patients, the ratio of hematological indices like ELR, MLR, and PLR can be employed as disease activity markers. How to cite this article: Meena VP, Meena PD, Chejara RS, et al. Analysis of Hematological Indices in Patients of Systemic Lupus Erythematous and Its Correlation with SLEDAI-2K. J Assoc Physicians India 2023;71(11):40-42.

Emergence of Unusual Microorganisms in Microflora of Pilonidal Sinuses: A Multiple Case Series.

PURPOSE: Recent reports have noted an emergence of unusual organisms in microflora of pilonidal sinus (PNS); this study was undertaken to identify the primary microbial flora associated with infected primary PNS over a period of 1 year. DESIGN: A prospective multiple case series. SUBJECTS AND SETTING: A case series of 20 patients with primary PNS in a tertiary care center in Varanasi, India, was studied. The study was conducted at the Department of Microbiology and General Surgery, Institute of Medical Sciences, Varanasi, over a period of 1 year (September 2016 to July 2017). METHODS: Purulent exudate (pus) samples were collected from 20 patients with primary PNS from the discharging sinuses by aseptic methods. Samples were assessed for aerobic and anaerobic flora by conventional culture and molecular methods. Antimicrobial susceptibility testing was done for bacterial isolates. Bacterial diversity was compared with the demographic and clinical profile of the sinuses by multiple correspondence analysis. RESULTS: Of the total cases, 11 (55%) had purulent discharge, among which all showed polymicrobial flora. The ratio of aerobic to anaerobic organisms was 1:2 (16/32). Escherichia coli (E. coli, 4, 36.36%) and Enterococcus faecalis (E. faecalis, 4, 36.36%) were commonly isolated. Bifidobacterium was the most frequent anaerobe. Detailed molecular analysis revealed the presence of Kocuria flava as an unusual pathogen. On statistical analysis, factors like male gender, increased body mass index, absence of hair in sinus, presence of features of hirsutism, and absence of Fusobacteria were closely associated with one another in these PNS cases. CONCLUSIONS: The case series revealed the predominance of anaerobes in primarily infected PNS cases. Bifidobacterium spp and unusual pathogens like K. flava were among the emerging pathogens in infected PNS. Use of better molecular diagnostic facilities in addition to the conventional methods might enhance the verified diversity of microorganisms in such cases.

A Study of Procalcitonin as an Early Predictor of Severity in Acute Pancreatitis.

Acute Pancreatitis is an acute inflammation of the pancreas.Acute pancreatitis is an acute inflammatory process ranging clinically from mild discomfort with localized inflammation to severe disease involving remote organ systems. There is a continuum from the development of systemic inflammatory response syndrom, to the onset of multiple organ dysfunction (MODS), which is seen in about 24% of patients with acute pancreatitis and carries the highest mortality rate of 36%, and imaging tests showing characteristic findings of acute pancreatitis. Several inflammatory markers are being used routinely in various hospitals in India to assess the prognosis of patients with acute pancreatitis. Among these are the total and differential leukocyte counts, erythrocyte sedimentation rate, and C-reactive protein (CRP), interleukin-6, thioredoxin-1, and polymorphonuclear elastase. serum procalcitonin is one of the components to assess the severity of pancreatitis. Procalcitonin is an acute phase reactant that has been extensively investigated as early marker in systemic bacterial infection, sepsis, and multi organ failure. Because severe acute pancreatitis is associated with sepsis, infected pancreatic necrosis, and multi organ failure. Procalcitonin can be used as a useful marker in early prediction of severity. MATERIAL: a prospective observational hospital based study conducted on patients of Department of General Medicine with collaboration from Department of Biochemistry and Radio diagnosis of SMS Medical College Jaipur. Patient who were diagnosed as case of acute pancreatitis on basis of diagnostic criteria as per Atlanta classification 2013 guidelines7 were included. Total of 56 cases were included in this study. OBSERVATION: The finding observed are as under:- 1) The mean age of the population was 38.5 ±11.83 years. CONCLUSION: In present, study serum PCT was done in patients diagnosed as acute pancreatitis on basis of Atlanta classification within 48 hours of admission and was found to be increased (value is significant if it is more than 0.5ng/ml) in 23 patients out of 60, with mean of 1.94±2.4ng /ml. These 23 patients were later on found to have severe acute pancreatitis on the basis Atlanta classification and rest 37 patients who had mild pancreatitis had mean PCT 0.38±0.66ng/ml. A study conducted on 40 patients of acute pancreatitis which was confirmed by Computed tomography was conducted in Poland, where they collected blood samples on admission and 24 hour thereafter, in which they tried to evaluate the role of procalcitonin as an early predictor of course of acute pancreatitis and they found that procalcitonin concentration was significantly higher in patients of acute pancreatitis and cut off was estimated at 0.5ng/ml.79 Similarly, in this study PCT was found to be high in patients of severe acute pancreatitis only.

Microalbuminuria: As an Indicator of Sepsis and to Predict Mortality in Patients Admitted to Intensive Care Unit.

BACKGROUND: Sepsis is an important healthcare concern in India as well as globally. This study shows how the level of microalbuminuria predict mortality of patients diagnosed with sepsis and those without sepsis. METHODS: In this study total 150 patients of which 75 patients belonging to each sepsis and non-sepsis group, with age >15 years admitted in Medical Intensive Care Unit (ICU) were enroled Microalbuminuria levels were analyzed at admission and after 24 hours after admission. RESULTS: Microalbuminuria levels were significantly high in patients with sepsis as compared to non sepsis. Microalbuminuria has highest sensitivity of 90 % and specificity of 98 % to differentiate between sepsis and non sepsis in comparison to APACHE II and SOFA scores. CONCLUSION: Serial monitoring of bedside urine albumin-creatinine measurement might help in the early identification of patients with sepsis that requires early targeted therapy. The 24-hour ACR assessment predicts ICU survival and may have the potential to monitor the efficacy of therapeutic interventions delivered, such as fluid resuscitation, appropriate antibiotics, vasopressors, and ionotropes that affect the endothelium.

Coupling the high-resolution LC-MS characterisation of the phenolic compounds with the antimicrobial and antibiofilm properties of helencha (Enydra fluctuans Lour.).

This study reports the polyphenol profile of helencha (Enydra fluctuans Lour.), an underutilised, aquatic leafy vegetable, based on high resolution accurate mass analysis. The methanolic extract of helencha leaves was screened by ultra-high performance liquid chromatography with quadrupole time of flight mass spectrometry (LC-QToF-MS). An in-house developed database of phytochemical metabolites was referred for compound identifications. Based on the detection of the pseudomolecular ion and at least one molecule-specific fragment ion (each with < 5 ppm of mass error), 25 potentially-bioactive phenolic compounds were putatively identified. These included 6 flavonols, 4 phenolic acids, 3 lignans, 3 flavones and 1 each of flavanol, flavanone, dihydroflavonol, tetramethoxyflavone, isoflavonoid and methylated flavonol. In addition, 3 unclassified compounds are also reported. The helencha extract showed antibiofilm properties with a potent bacteriostatic activity against the clinical isolates of Pseudomonas aeruginosa, a human pathogenic bacteria. The complementary molecular docking studies indicated strong binding interactions of the identified compounds with the active site of LasR protein of P. aeruginosa. The in vitro and in silico study results would be useful to develop novel neutraceutical products based on helencha-extract and design new lead compounds to control the biofilm producing pathogenic microorganisms. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at (10.1007/s13197-021-04968-y).

Metal removal and recovery using bioelectrochemical technology: The major determinants and opportunities for synchronic wastewater treatment and energy production.

Microbial fuel cell (MFC) technology has emerged as a new and attractive bioelectrochemical approach in the last one and a half decade that offers an alternative to conventional treatment methods to remove and recover heavy metals and organics from wastewaters with simultaneous energy production. This technique has advantage over the conventional wastewater treatment techniques, which are energy intensive, sludge producing and with little effectivity at high concentrations. Significant work has been done in the recent years on MFC principle, electrode configuration, biofilm composition, application of MFC in wastewater treatment, metal removal or recovery and energy production. Basically, metal in the cathode chamber acts as acceptor of the electrons released from the oxidation of organic matter in the anode chamber by electrogenic microbes. Literature shows that efficacy of MFCs in removal and recovery of metals and power production is significantly influenced by redox potential of the metal, initial concentration, mix metal systems, carbon source in substrate, pH, biocathode, biofilm composition, gaseous environment in cathode, electrode modification and external resistance, which have been critically reviewed for the first time in the present paper to understand the role of the determinant factors that may be explored for improvement of the MFC performance. The paper provides further insights into the techno-economic aspects of MFC technology and suggests research needs for enhanced performance and reduced costs to increase its feasibility for application at commercial level.

Photoperiodic effects on somatic growth and gonadal maturation in Mickey Mouse platy, Xiphophorus maculatus (Gunther, 1866).

Photoperiod is important in initiation or suppression of reproductive timing and gonadal maturation which varies with species. The aim of the present study was to investigate the effect of two photoperiodic manipulating regimes, i.e., long (18L:6D) and short (10L:14D) photoperiods for a period of 60 days on somatic growth and gonadal maturation of a live-bearer ornamental fish, Mickey Mouse platy (Xiphophorus maculatus). The control fish were further kept under the laboratory environmental condition. The results showed a significant increase in weight gain, specific growth rate, and gonadosomatic index in fish under long photoperiod than those exposed to short photoperiod and control condition (P < 0.05). A condition factor showed significant variations between long photoperiod and control groups. Furthermore, a long photoperiod also induced a significant increase in the number of fish with mature embryo and middle-eyed embryo in the ovary. Similarly, histological analysis of testes of males showed an increase in the number of mature spermatid and spermatozoa under long photoperiod when compared to those of control and short photoperiod ones. Thus, it can be concluded that long-day photoperiodic manipulation may be applied for healthy growth and early gonadal maturation of live-bearer ornamental fishes.

Mortality in H1N1: A comparison of patient attributes in outbreaks due to A/California/7/2009 and A/Michigan/45/2015 strains.

INTRODUCTION: The resurgence of epidemic of Influenza A (H1N1) pdm 09 was phenomenal in 2015 and has become an annual phenomenon. Antigenic drift and reassortment is the rule rather than exception, conferring survival benefit to the virus. As this disease has high mortality, we compared the clinico-epidemiological profile of patients expired in the year 2015 due to "A/California/7/2009" strain with those of expired in the year 2018 due to "A/Michigan/45/2015" strain. MATERIAL AND METHOD: We collected data of all expired patients in our institute in the year 2015 from 1st January to 30th may as well as 2018 in the same time period. The data of 116 patients who expired in 2015 due to "A/California/7/2009" H1N1 strain were compared with similar data of 30 patients expired in 2018 due to "A/Michigan/45/2015" strain of H1N1. Patients of pneumonia, having age >18 years, positive for H1N1by real-time reverse-transcriptase-polymerase- chain-reaction (RT-PCR) and died in our hospital were included in this study. Clinical features and laboratory data were obtained from the hospital records of the patients. Data analysis was done using SPSS software. RESULT: In 2015 total number of hospitalized patients due to "A/California/7/2009" strain were 571 and 116(20.31%) out of them died, in 2018 those due to "A/Michigan/45/2015" total admission were 177 and 30(16.94%) out of them died (p-0.032). Though it was not statistically significant but it is lesser than in 2015 despite the fact that more patients with co morbidities were affected in 2018. Duration in ICU was significantly longer in 2018(MS) group [5(1-7)] compared to 2015 (CS) group [3(1-17)] with p value of 0.017 (i.e. < 0.05). But both groups were not different in terms of duration on mechanical ventilator. (p-0.257).The 2015 (CS) group had 74.1% with other co-morbidities versus 96.7% of those in 2018 (MS) group (p- 0.015). This implies that the mortality with "A/Michigan/45/2015" infection was mainly seen in the patients who already had one or more co-morbidities unlike "A/California/7/2009" infection.The 2018 (MS) group had significantly higher proportion (60%) of patients with acute kidney injury compared to 34.5% in 2015(CS) (p-0.019). 50% of dead patients in 2018(MS) had anemia compared to 11.2% in 2015(CS) (p<0.001). Deranged liver function test was seen in 46.7% patients in 2018(MS) compared to only 15.5% patients in 2014(CS) (p<0.001).The only reverse trend was shown in case of diabetes, A/California/7/2009 strain affected 27% diabetics compared with 6.7% affected by A/Michigan/45/2015 strain (p=0.030) (Table 5). CONCLUSION: The study showed that though "A/Michigan/45/2015" affected higher number of patients with co morbidities compared to "A/California/7/2009" but had slightly lesser mortality.

A Crossover Study Evaluating Effect of Timing of Levothyroxine on Thyroid Hormone Status in Patients of Hypothyroidism.

OBJECTIVE: Current literature shows a definite benefit of fasting state Levothyroxine administration. However, superiority of any specific timing is not yet established. Our study was designed to compare the effect of timing of levothyroxine administration, morning versus evening dose, on thyroid profile control in patients of hypothyroidism. METHODOLOGY: :A randomized double-blind crossover study was performed on 60 patients with primary hypothyroidism, euthyroid on stable levothyroxine regime of 100 µg daily, randomized into two sequence groups, morning dose first (AB sequence) versus evening dose first (BA sequence) with switch over after 6 weeks. Primary endpoints were change in thyroid function tests. RESULTS: There was an insignificant rise in TSH in morning dose first group (AB) at 6 weeks which reduced significantly in evening dose, [2.36(1.11) to 2.45(1.19) mIU/L (p=0.56)], [2.07(0.99) (p=0.006)] respectively. Levothyroxine evening dose first group (BA) showed significant reduction of TSH levels at 6 weeks followed by non significant increase [2.63(0.96) to 1.85(1.35) mIU/L, (p=0.002)], [2.14(1.16), (p=0.15)]. Group AB showed mild followed by significant rise in FT4 at 6 and 12 weeks respectively, [1.06(0.30) to 1.14(0.33) ng/dl (p=0.18)], [1.24(0.36) (p=0.008)]. FT4 of BA sequence significantly increased at 6 weeks followed by mild increase, [1.10(0.29) to 1.20(0.28) ng/dl (p=0.01)] [1.23(0.31) ng/dl (p=0.58)]. FT3 of AB revealed initial reduction (p=0.87), followed by significant rise (p=0.02). Group BA showed a significant rise (p=0.04) in FT3 followed by fall (p=0.63). CONCLUSION: Bedtime dosing of Levothyroxine showed improved thyroid hormone status control and could be a viable option in treatment of patients with hypothyroidism.

Effect of the Hemochromatosis Mutations on Iron Overload among the Indian ß Thalassemia Carriers.

BACKGROUND: Hereditary hemochromatosis is a disorder of iron metabolism characterized by increased iron absorption.HFE gene mutations C282Y and H63D are responsible for the majority of hereditary hemochromatosis cases. METHODS: We tried to look at the effect of HFE mutations on the iron status. A total of 100 ß thalassemia traits (BTT) with 100 normal individuals were screened for the C282Y and H63D mutations using PCR-RFLP. The serum ferritin levels were determined using ELISA kit. RESULTS: We did not find the C282Y mutation in our study group. The allelic frequencies for H63D mutation did not differ significantly between ß-thalassemia traits (8.5%) and normal controls (9%). ΒΤΤ with H63D genotype of H/D (143.16 ± 80.3 ng/ml) and D/D (504 ng/ml) showed higher ferritin levels as against H/H genotype (88.64 ± 92.43 ng/ml). The statistically significant difference was observed in the mean serum ferritin levels among the individuals showing H/H and D/D genotypes (P < 0.002) and H/D and D/D genotype (P < 0.01) in both the groups. CONCLUSION: This suggests that iron load in BTT tends to aggravated with the co-inheritance of the H63D mutation. The mutant H63D gene showed the presence of haplotype 6 which is reported in the European population suggesting a common origin.

Interplay of delay and multiplexing: Impact on cluster synchronization.

Communication delays and multiplexing are ubiquitous features of real-world network systems. We here introduce a simple model where these two features are simultaneously present and report the rich phenomenology which is actually due to their interplay on cluster synchronization. A delay in one layer has non trivial impacts on the collective dynamics of the other layers, enhancing or suppressing synchronization. At the same time, multiplexing may also enhance cluster synchronization of delayed layers. We elucidate several nontrivial (and anti-intuitive) scenarios, which are of interest and potential application in various real-world systems, where the introduction of a delay may render synchronization of a layer robust against changes in the properties of the other layers.

Mediastinal Lipomatosis with Dyslipidemia: Cause of Dyspnea.

We report a case who presented to us with dyspnea and was found to have ML in the absence of steroid use, diabetes, Cushing syndrome and obesity. This case provides an important differential diagnosis in a patient presenting with dyspnea widened mediastinum and cardiomegaly. This is probably among very few cases of ML with dyslipidemia.

Nitric oxide mediated amelioration of arsenic toxicity which alters the alternative oxidase (Aox1) gene expression in Hordeum vulgare L.

The role of nitric oxide (NO) as a key molecule in the signal transduction pathway of a biotic stress response has already been described. Recent studies indicate that it also participate in the signaling of abiotic stresses. In the present study, we showed the altered expression of stress responsive gene alternative oxidase (Aox1) in seedlings of barley (Hordeum vulgare L.) in response to arsenic toxicity. Arsenic toxicity decreased the germination percentage, biomass, chlorophyll and carotenoid content whereas, arsenic toxicity enhanced the MDA content and proline content in a dose dependent manner. Other enzyme activities like catalase and superoxide dismutase increased with the increase in concentrations but it fell down at higher concentration of arsenic. Pretreatment of nitric oxide results in the enhanced expression of alternative oxidase which showed the adaptation of alternative pathway during the arsenic stress and it also enhances the growth ability and adaptability towards the arsenic stress. The results support the conclusion that nitric oxide ameliorates the arsenic toxicity not only at the level of antioxidant defense but also by affecting other mechanism of detoxification.

Enhancing microbial fuel cell performance for distillery wastewater treatment and bioelectricity generation: harnessing niacin as a redox mediator.

The role of redox mediators in improving electron transport from electrochemically active bacteria to the anode is crucial for enhanced bioelectricity output from microbial fuel cells (MFCs), which makes the selection of an ideal mediator very important. This study aims at exploring a new redox mediator niacin (vit B3) for enhanced bioelectricity generation in MFC while treating distillery wastewater through facile modification of anode electrode by niacin doping (MFC-NME) and simple application of niacin to the anolyte (MFC-NAA). Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), and X-ray diffraction (XRD) of NME confirmed the effective adsorption of niacin onto the carbon felt surface. Notably, MFC-NME exhibited a significantly higher power density (PD) of 6.36 W/m3 compared to MFC-NAA (4.59 W/m3) and control MFC (3.49W/m3). The charge transfer resistance (RCT) in MFC-NME (1.73 Ω) and MFC-NAA (2.06 Ω) were lowered by more than half than that in control MFC (4.33 Ω), which underscores the efficacy of niacin as a redox mediator. SEM analysis revealed improved bacterial attachment over the bioanode in the MFC-NME as compared to that of MFC-NAA and control MFC. Removal of chemical oxygen demand (COD) was higher in MFC-NAA (85%) and MFC-NME (80%) than in control MFC (73%) suggesting that niacin in the anolyte supported greater organic matter removal due to enriched microbial activity. Niacin used in anode modification shows great potential for improved electron transfer and enhanced bioelectricity production and supports greater wastewater treatment performance. The modified bioanode NME exhibits excellent stability.

An in-depth study on survival mechanism of bacterial isolates in disinfectants within the hospital environment.

Introduction: The emergence of disinfectant resistance has become a severe threat due to reduced effectiveness. This study was undertaken to determine how bacteria adapt to survive exposure to disinfectants in the busiest section of a tertiary care hospital in Varanasi, India. Methods: Four isolates (two Klebsiella pneumoniae, Kp1 and Kp2; two Pseudomonas aeruginosa, Pa1 and Pa2) were obtained from chlorhexidine (CHX)-based handwash during microbiological surveillance of "in-use disinfectants" in hospital. Six disinfectants [4% CHX, 2% glutaraldehyde, 7.5% hydrogen peroxide, 1% sodium hypochlorite and 0.1% benzalkonium chloride (BAC), and 70% ethyl alcohol] were tested against these four isolates to determine minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Antibiotic profile, change in MIC on exposure to disinfectants and biofilm formation in the presence and absence of disinfectants was studied. Whole genome sequencing (WGS) was done to identify the resistance mechanisms. Result: The isolates showed the highest MBC/MIC ratio (4) against glutaraldehyde. Exposure to supra-inhibitory concentration of BAC for 21 days resulted in doubling of MIC/MBC. The majority (75%) of the isolates were multidrug resistant. All the isolates were strong biofilm producers. The reduction rate of biofilm formation decreased with an increase in the concentration of disinfectants (p = 0.05 for BAC). WGS revealed multiple AMR genes including bla DIM-1, disinfectant-resistant gene and efflux pump genes. Conclusion: The study emphasized the various adaptation strategies of these isolates for survival in disinfectant environment, thus posing a huge challenge for their control in the hospital environment.

Porphyrins with combinations of 4-carboxyphenyl and 4-hydroxyphenyl substituents in meso-positions as anti-HIV-1 agents.

A series of 4-carboxyphenyl/4-hydroxyphenyl meso-substituted porphyrins were synthesized, purified, and characterized. The compounds exhibited anti-HIV-1 activities, in vitro, under both non-photodynamic (non-PDT) and photodynamic (PDT) conditions. Specifically, the porphyrins inhibited HIV-1 virus entry, with c-PB2(OH)2 and PB(OH)3 showing significant anti-HIV-1 activity. All of the porphyrins inhibited HIV-1 subtype B and C virus entry under PDT conditions. Our study demonstrated that the compounds bearing combinations of 4-carboxyphenyl/4-hydroxyphenyl moieties were not toxic even at higher concentrations, as compared to the reference porphyrins 5,10,15,20-tetra-(4-carboxyphenyl)porphyrin (TCPP) and 5,10,15,20-tetra-(4-hydroxyphenyl)porphyrin (THPP), under PDT conditions. This study underscores the promising potential of these compounds as HIV entry inhibitors in both non-PDT and PDT scenarios.

Evaluation of fuel properties for possible biodiesel output based on the fatty acid composition of oleaginous plants and microalgae.

In the past decade, there has been a significant rise in sustainable biomass based biofuel production to address energy needs while mitigating environmental impacts. Traditionally, bioethanol was used for biofuel production, but concerns over food security and environmental preservation have led to growing interest in alternative sources such as neutral lipids from vegetable oil and microalgae for biodiesel production. This research paper evaluates the potential of various oleaginous plants and microalgae as feedstocks for biodiesel production, with a focus on their fatty acid composition and its impact on biodiesel properties. The study examines the fatty acid profiles of 43 different plant and microalgae species and employs various equations to estimate key physical properties of biodiesel. Additionally, the communication compares these properties to International Biodiesel Standards (EN 14214 and ASTM D6751-08) to assess the suitability of the derived biodiesel for commercial use. It is impossible to describe a single composition that is optimal in terms of all essential fuel properties due to the opposing effects of some structural features of the Fatty Acid Methyl Esters (FAME). However, biodiesel should contain relatively low concentrations of both long chain saturated and polyunsaturated FAME to ensure adequate efficiency in terms of low temperature operability and oxidative stability. The results reveal significant variations in properties amongst different feedstocks, highlighting the importance of feedstock selection in biodiesel production. The study also establishes correlations between various fuel properties, providing valuable insights in to optimizing biodiesel production processes, which will be of great use to researchers, engineers, and stakeholders involved in biodiesel production.