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Background: Invasive fungal infections have negative impact on the health of immunocompromised individuals. With the development of fungal resistance to currently available antifungal drugs, there is a need to develop novel compounds with antifungal activity. Aims and Objectives: The objectives of the study are as follows: (1) To synthesize novel 2-(2-pyridyl)-2H-pyrazole-3-carboxamide derivatives and (2) to evaluate the antifungal activity of novel 2-(2-pyridyl)-2H-pyrazole-3-carboxamide derivatives. Materials and Methods: Novel 2-(2-pyridyl)-2H-pyrazole-3-carboxamide derivatives were prepared by multi step synthesis and characterized by LC-MS, 1HNMR and 13C NMR. The antifungal activity of these derivatives was assessed using Fusarium oxysporum, Aspergillus flavus, and Candida albicans by disc diffusion method. Results: We have synthesized fourteen derivatives of 2-(2-pyridyl)-2H-pyrazole-3-carboxamide. Most of the compounds possess good antifungal activity against F. oxysporum and C. albicans strains. Conclusion: We synthesized a series of novel 2-(2-pyridyl)-2H-pyrazole-3-carboxamide derivatives having good antifungal activity against F. oxysporus and C. albicans using a simple and low cost procedure.
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Background: Studies on dengue fever demonstrated that the dengue viral infection of pancreas is often associated with disease morbidity and complication. Aims and Objectives: The pancreas-pathogen interactions in dengue-infected persons were evaluated using endocrine deregulation as an investigation marker of complication. Materials and Methods: A prospective observational study was conducted in a tertiary care medical college and hospital of West Bengal, over 1 year and 4 months. Blood samples from 286 cases and 258 controls were collected on day 2. After plasma glucose determination, 44 cases and 39 controls were excluded as frank cases of diabetes mellitus. On day 6, fasting and 2 h postprandial plasma glucose estimation were done in 73 cases and 61 controls by glucose oxidase-peroxidase method using autoanalyzer. Data were analyzed using the Statistical Package for the Social Sciences version 20.0. Results: The prevalence of impaired glucose tolerance was higher in cases on day 2 than on follow-up on day 6 (12.3% vs. 8%). There existed no statistical difference in terms of fasting plasma glucose between cases and control on day 2 and day 6 and postprandial (PP) plasma glucose on day 2. However, the PP values on day 6 in cases were significantly higher in cases in comparison to controls (P = 0.006). Among cases, day 6 values were higher than day 2 values (0.016). Conclusion: Dengue viral infection correlates with the involvement of the pancreas in terms of impaired tolerance to glucose which has implications for understanding disease pathogenesis in terms of developing chronic complications.
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Listeria monocytogenes is a facultative intracellular gram-positive bacillus which usually infects immunocompromised patients, though it can infrequently infect immunocompetent individuals, neonates and pregnant women as well. Neurological manifestations include meningitis and cerebritis. Brain Abscess is an extremely rare presentation with approximately 80 reported cases. Authors report a patient with a brain abscess identified on an MRI scan with positive blood culture for Listeria monocytogenes. Patient was managed conservatively with intravenous followed by oral antibiotics with resolution of the abscess.
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An 84-year-old gentleman underwent uneventful femtolaser-assisted cataract surgery (FLACS) with an arcuate keratotomy (AK) in the left eye. On the 18th post-operative day, a corneal infiltrate developed involving the AK. Staphylococcus epidermidis was the organism isolated on culture. The infiltrate resolved with topical fortified vancomycin and amikacin eyedrops, and the patient regained a visual acuity of 6/6 after 12 weeks. This is the first case from south-east Asia reported in the literature of an infective infiltrate along a femtosecond laser AK. We propose strict peri-operative recommendations to be followed to prevent and treat such infections.
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We here report a case of scleral buckle infection with fulminant scleral abscess secondary to Moraxella species. A 54-year-old chronic alcoholic male with a history of retinal detachment repair, with scleral buckle 8 years prior, presented with complaints of severe pain, redness, and swelling in the right eye since 2 weeks. The patient was diagnosed with scleral buckle infection, the buckle was removed, and cultures revealed Moraxella species. The postoperative course included fulminant scleral abscess treated with dual antibiotic therapy that included ceftriaxone and moxifloxacin. All systemic antibiotics were discontinued after 3 weeks, retina remained attached, and no recurrence occurred over a 1-year follow-up. Moraxella, though commonly associated with bacterial keratitis, can also lead to buckle infection, especially in chronic alcoholic and immunocompromised patients. In buckle infection, infected buckle along with sutures should be immediately removed without damaging underlying compromised sclera. Lastly, culture and drug sensitivity play a very important role in buckle infections.
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Background: Differentiation of hepatocellular carcinoma (HCC) from metastatic malignancy in liver may be difficult at times on fine-needle aspiration cytology, especially in case of moderate-to-poorly differentiated tumors. The benefit of cell-block technique is the recognition of histologic pattern of diseases along with application of a wide variety of immunohistochemical (IHC) stains to differentiate hepatic malignancies. In this study, CD10 IHC staining was done on cellblocks prepared from aspirates of clinicoradiologically/cytologically suspected malignant liver neoplasms to differentiate HCC from malignancies metastasizing to liver. Objective: The objective of the study was to assess the diagnostic utility of CD10 IHC stain on cell-block preparation for differentiating primary from Secondary malignancies of liver. Materials and Methods: Formalin-fixed, paraffin-embedded cellblocks of 61 cases (25 cases of HCC and 36 cases of metastatic carcinoma) were prepared from a fine-needle aspirate of the suspected malignant liver neoplasm and immunostained using monoclonal antibody against CD10. Results: Twenty-two (88%) of 25 cases of HCC were positive for CD10 with a canalicular staining pattern. Two (8%) were positive for CD10 with membranous and one (4%) with cytoplasmic staining pattern. Conclusion: CD10 immunostaining on cellblock is useful in discriminating HCC and metastatic carcinoma of the liver with a diagnostic accuracy of 88.52%.
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Chikungunya virus (CHIKV) infection from the acute encephalitis syndrome cases is an uncommon form and has been observed in the year 2010-11 from West Bengal, India. The case–1 and case–2 had the acute encephalitis syndrome; case–3 was of acute disseminated encephalomyelitis whereas the case–4 had the symptoms of meningo-encephalopathy with bulbar involvement. We are reporting four cases with neurological complications involving central nervous system (CNS) due to CHIKV infection from this state for the fi rst time. The virus has spread almost every districts of this state rapidly. At this stage, these cases are public health threat.
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Background: Osteosarcoma is the most common primary bone tumor occurring in second and third decades of life with a second peak later. Biopsy (needle or incision) is necessary for diagnosis along with imaging modalities (X-ray, CT scan etc) and serology. Due to diagnostic dilemma in certain cases and for prognosis of patients, immunohistochemistry is increasingly used. Aims: To assess the pathologic features and determinants of osteosarcoma in patients of the Indian subcontinent that would put an insight into its appearance and behavior. Methods and Material: Forty cases of biopsy proven osteosarcoma were selected over a period of three years. Histopathology was done for tumor typing, along with serology (pre and post-operative serum alkaline phosphatase). In all cases TNM staging and immunohistochemistry for antibodies to Osteonectin (ON) (diagnosis), S100 (differentiation), Ki 67 and Her2 (prognosis) was done. Results: Serum alkaline phosphatase was high in 37 (92%) cases initially and remained high in metastatic and recurrent lesions. Osteonectin was positive in 38 (95%) cases, S100 in 31 (77%), Ki 67 showed overlapping labeling indices between 4.8-18.8% and Her2 showed more positivity in higher stage tumors. Conclusions: Biopsy (along with imaging) is mandatory to diagnose osteosarcoma. Osteonectin is a good immunohistochemical marker to differentiate osteosarcoma from its mimics. For prognostication, serum alkaline phosphatase, post chemotherapy tumor necrosis (more than 90%), lack of Her2 expression are good parameters. S100 and Ki67 were found to have limited role in diagnosis and prognosis of osteosarcoma.
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The objectives of this hospital based cross-sectional study were to evaluate the socio-demographic profile, manner of death and histopathological changes in the lungs, liver and kidneys of individuals who died of pesticide poisoning. All fatal cases of pesticide poisoning from February 2011 to January 2012 were evaluated. Socio-demographic profile, type of exposure and manner of death were recorded for each of the cases. Autopsy was performed with detailed internal and external examinations. Random portion of Lung, Liver and Kidney were collected and fixed in 10.0% Formalin. Hematoxylin and Eosin stained sections were examined and findings recorded. The total number of deaths due to fatal pesticide poisoning was 9.6%. Highest frequency of poisoning (23.4%) was seen in the age group 20 - 29 years. The peak time of consumption of poisoning was between 6.00am and 12.00noon. The manner of poisoning was suicidal in majority of the cases. Histological findings indicated that congestion was the most common histopathological change; being observed in 60.0%, 66.0% and 74.0% of cases of liver, lung and kidney respectively. Histopathological features are supportive in establishing the diagnosis but further studies with larger sample size may be more illuminative in explaining the histopathological changes occurring due to these chemicals.
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Background: Traditionally, enteric feeds are withheld for a period of 48-72 hrs, sometimes even more following enteric anastomosis depending upon return of full peristaltic sounds. This results in a period of nonstimulation of gut –‘Gut Rest’, which was supposed to result in better anastomotic healing. But this same also deprives the intestinal mucosa of surface nutrients as well as prolongs parenteral fluid therapy, thereby depriving the patients of adequate nutrition. Along with it, prolonged parenteral therapy also keeps the patients bound to bed with its resultant complications like, prolonged hospital stay and increased cost of therapy. Objectives: To compare the benefits of early enteral feeding over conventional enteric feeding following enteric anastomosis with special regards to patients recovery and complications. Methods and materials: The selection of patients into group A (60) and group B (60) was done after having fulfilled inclusion and exclusion criteria. Informed consent was obtained. The patients of group A were fed via enteral route within 24 hrs of enteric anastomosis. The patients of group B were fed via enteral route after 48-72 hrs or appearance of full peristaltic sounds following enteric anastomosis. These patients were followed in post operative period for their drain output, any nausea, vomiting or significant abdominal distension, prolonged ileus, post operative duration of shospital stay, post operative infective complications (e.g. wound infection, UTI, RTI), and different haematological and biochemical examinations. Results: This study shows that post operative nausea-vomiting, anastomotic leakage rate, re-exploration , wound infection and RTI rates are higher in group A than those of group B. In this study, the incidence of UTI in post operative period is higher in group B. But the differences in above mentioned variables are not statistically significant. Whereas appearance of intestinal peristaltic sound is earlier in group A (42.8 ± 10.68 hours) compare to that of group B (52.6 ± 13.46 hours). Here, the difference is statistically significant (p value = 0.000022) The duration of post operative hospital stay is shorter in group A (8.45 ± 5.143 days) than that of group B (10.533 ± 4.952 days). The difference of duration post operative hospital stay is statistically significant (p value = 0.0257). Removal of nasogastric tube, resumption of oral feeding, and passage of first flatus and/or defecation were earlier in the group A than that of the group B; the differences were statistically significant. The post operative day-5 albumin level is better in group A (3.147 ± 0.4409 gm/dl) than that of group B (2.935 ± 0.3124 gm/dl). This difference is also statistically significant (p value = 0.0029). There are three mortalities in group Awhereas one mortality in group B. This difference in mortality in two groups is not statistically significant.
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A young male of 24 years was presented with a history of gradually progressive spastic quadriparesis for long four years. He was investigated and MRI revealed a neoplastic lesion in the cervical cord at the level of C4, C5 with perilesional edema and tumour syrinx formation, suggestive of astrocytoma. After total removal histopathology proved it to be an ancient schwannoma.
Subject(s)
Adult , Cervical Vertebrae , Humans , Male , Medulla Oblongata , Neurilemmoma/diagnosis , Neurilemmoma/pathology , Neurilemmoma/surgery , Spinal Cord Neoplasms/diagnosis , Spinal Cord Neoplasms/pathology , Spinal Cord Neoplasms/surgeryABSTRACT
Bloodstream infections with Salmonella typhi, is uncommon in human immunodeficiency virus [HIV]-infected persons. The symptoms in such patients are often non-specific and have a rather insidious onset and progression. We report a patient with sepsis and lower limb gangrene due to Salmonella typhi infection in an HIV-infected patient.
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This observational study was conducted on 973 healthy children between 8 and 16 years to evaluate the relation between changes in foot length and pubertal maturation. The right foot length of study children was recorded and SMR staging was done. The difference in mean foot length was statistically significant between SMR 1 and 2 (P<0.0001). No significant difference in the mean foot lengths was found thereafter. Smoothed standard deviation curves were constructed for foot length as a function of SMR stage using the LMS method. Foot length was found to rise sharply in SMR 2, which coincides with the onset of puberty.
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Purpose: The present study was carried out to characterize the ESBL types and evaluated their in vitro activity against a collection of Gram negative bacteria (GNB) from a multicentric Indian surveillance study. Material and Methods: During January 2005 to June 2006, six tertiary care centres in India forwarded 778 non-duplicate GNB to our reference laboratory. Three hundred GNB from this collection were selected based on clinical significance and were used in the present study. Tested isolates included Escherichia coli (167), Klebsiella spp. (122) and Enterobacter spp. (11). ESBL screening and confirmation was performed for all the isolates. Minimum inhibitory concentration of imipenem, meropenem, ertapenem, levofloxacin, amikacin, piperacillin/tazobactam and ceftriaxone was determined by the E-test method. Molecular typing of the ESBLs was performed by polymerase chain reaction among the 121 selected isolates. Results: The study showed excellent susceptibility among the strains to imipenem (100%), meropenem (100%) and ertapenem (98.7%); good susceptibility to amikacin (89.7%) and piperacillin/tazobactam (85.3%) was observed. TEM and CTX-M were predominantly found in E. coli (39.2%) while, among the Klebsiella spp., TEM, SHV and CTX-M occurred together in 42.6% of the isolates. Conclusion: More than one ESBL was produced by many strains, and this was correlated with increased resistance levels. Carbapenems continue to show good in vitro activity and ertapenem is a potential alternative to imipenem and meropenem. Continued antimicrobial resistance surveillance is warranted in light of these findings.