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1.
Cureus ; 16(5): e61424, 2024 May.
Article in English | MEDLINE | ID: mdl-38953074

ABSTRACT

Introduction Pulmonary tuberculosis (TB) remains a global health concern, exacerbated by the emergence of extensively drug-resistant (XDR) strains of Mycobacterium tuberculosis. This study employs advanced molecular techniques, specifically polymerase chain reaction (PCR) profiling, to comprehensively characterize the genetic landscape of XDR pathogenic bacteria in patients diagnosed with pulmonary TB. The objective of the study is to elucidate the genes that are associated with drug resistance in pulmonary TB strains through the application of PCR and analyze specific genetic loci that contribute to the development of resistance against multiple drugs. Materials and methods A total of 116 clinical samples suspected of TB were collected from the tertiary healthcare setting of Saveetha Medical College and Hospitals for the identification of MTB, which includes sputum (n = 35), nasal swabs (n = 17), blood (n = 44), and bronchoalveolar lavage (BAL) (n = 20). The collected specimens were processed and subjected to DNA extraction. As per the protocol, reconstitution of the DNA pellet was carried out. The reconstituted DNA was stored at -20 °C for the PCR assay. From the obtained positive sample specimens, XDR pulmonary TB specimens were focused on the targeted genes, specifically the rpoB gene for rifampicin resistance, inhA, and katG gene for thepromoter region for isoniazid resistance. Results Out of a total of 116 samples obtained, 53 tested positive for pulmonary TB, indicative of a mycobacterial infection. Among these positive cases, 43 patients underwent treatment at a tertiary healthcare facility. Subsequently, a PCR assay was performed with the extracted DNA for the target genes rpoB, inhA, and katG. Specifically, 22 sputum samples exhibited gene expression for rpoB, inhA, and katG, while nine nasal swabs showed expression of the rpoB and inhA genes. Additionally, rpoB gene expression was detected in seven blood specimens, and both rpoB and inhA genes were expressed in five BAL samples. Conclusion The swift diagnosis and efficient treatment of XDR-TB can be facilitated by employing advanced and rapid molecular tests and oral medication regimens. Utilizing both newly developed and repurposed anti-TB drugs like pretomanid, bedaquiline, linezolid, and ethionamide. Adhering to these current recommendations holds promise for managing XDR-TB effectively. Nevertheless, it is significant to conduct well-designed clinical trials and studies to further evaluate the efficacy of new agents and shorter treatment regimens, thus ensuring continuous improvement in the management of this challenging condition.

3.
Cureus ; 16(4): e58350, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38756255

ABSTRACT

Background The evolution of new respiratory diseases, especially upper respiratory tract infections and resistance of pathogens to various antibiotic treatments, needs an alternative way of medication. Chronic respiratory infections in both adults and infants are the major cause of morbidity and mortality, particularly in developing countries. The widespread application of nanomaterials in the field of medicine and the incorporation of nanoparticles in drugs are taken into account. These nanomaterials are involved along with the biosynthesis of plant extract. In this study, selenium oxide nanoparticles (SeO-NPs), known as a significant trace element for human health, were synthesized in an eco-friendly manner. Methodology Green synthesis of Centella asiatica-mediated SeO-NPs was proceeded by titration method and nanoparticles were synthesized. The color intensity, morphological characters, functional properties, and involvement of phytochemical compounds were studied by using UV-visible spectroscopy (UV-Vis), Fourier-transform infrared spectroscopy (FT-IR), X-ray powder diffraction (XRD), scanning electron microscope (SEM), and energy-dispersive X-ray spectroscopy (EDX) analysis. Results The synthesized extract showed a color change from brown to ruby red. Results obtained by characterization and biological assays depicted that the Centella asiatica-mediated SeO-NPs showed absorbance at the peak level 320 nm by UV-Vis spectroscopy, several phytochemical compounds, and O-H functional groups by FT-IR which may be involved in the reduction of the selenium oxide nanoparticles. The XRD showed 57.1% crystalline and 42.6% amorphous nature. The SEM images showed that agglomerated spherical shapes were involved in biological activities. The EDX analysis showed the presence of Se, C, and O compounds. Further, the antibacterial activity of the synthesized nanoparticles showed significant activity in the multidrug-resistant respiratory pathogens. Conclusions Based on the characterization studies and biomedical assays, it can be concluded that the incorporation of SeO-NPs along with the plant extract serves as the best remedy and organic treatment for upper respiratory tract infections. We plan to conduct further in-vivo, toxicity-level studies, and clinical trials.

4.
Cureus ; 16(3): e56552, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38646229

ABSTRACT

Introduction This study explores the intricate relationship between bacterial flora and the occurrence of Escherichia coli (E. coli) infections in gynecological patients. It aims to provide insights into the various treatment strategies used to effectively manage bacterial pathogens, especially E. coli infections. By conducting a comprehensive analysis of the bacterial flora in gynecological patients, the study highlights the notable presence of E. coli, prompting further investigation into the factors that contribute to its colonization. The objective of the study is to comprehensively investigate and detect urinary tract infections (UTIs) specifically caused by E. coli among gynecological patients. The study aims to delve into bacterial flora prevalence, antibiotic resistance patterns, and potential virulence factors. Through this analysis, the study intends to identify effective strategies for rapid detection and diagnosis of UTIs caused by E. coli by utilizing advanced microbiological and molecular techniques. Furthermore, the study aims to formulate and propose a strategic treatment approach with a particular emphasis on selecting appropriate antibiotics to reduce the risk of severe infections and associated complications. Materials and methods The methodology employed in this study included the isolation and characterization of bacterial strains from clinical samples obtained from gynecological patients. A total of 52 urine specimens were collected from patients with complaints of infection in the urinary tract and infertility. These samples underwent both preliminary and confirmatory microbiological analysis, such as gram staining, biochemical confirmation test, and antibiotic susceptibility, and further proceeded with the multiplex polymerase chain reaction (PCR) technique. The results of PCR and antibiotic susceptibility revealed the specific gene involvement and resistant characteristics of E. coli. Results The findings revealed a total of 32 specimens positive for E. coli, of which 10 patients had infertility complaints and 22 patients had UTIs. The preliminary test, gram staining, showed the gram-negative bacilli E. coli, and the nutrient agar plate revealed smooth circular translucent colonies; MacConkey agar showed pink-colored lactose-fermented colonies; and the blood and chocolate agar plates showed grayish white moist gamma-hemolytic colonies. The biochemical confirmation of E. coli resulted in positive for indole and methyl red tests and negative for Voges-Proskauer and citrate utilization tests. The multiplex PCR analysis confirmed the E. coli strains with the presence of two target genes, stx2d and stx2e. Conclusion To summarize, this study offers valuable insights into the bacterial flora of gynecological patients impacted by E. coli infections, which provides a foundation for the development of precise and efficient treatment strategies. The results emphasize the importance of personalized treatment approaches that consider both the microbiological characteristics of the infection and the evolving landscape of antibiotic resistance. The implication of this research extends to enhancing clinical outcomes and alleviating the burden of E. coli infections in gynecological settings.

5.
Cureus ; 16(3): e55755, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38586690

ABSTRACT

Introduction Mycobacterium tuberculosis (MTB), the causative agent of tuberculosis (TB), continues to pose a significant global health threat, with increasing concerns about antimicrobial resistance (AMR). This study aims to elucidate the AMR patterns of MTB infections in tertiary care hospital settings. Materials and methods A retrospective analysis was conducted on 138 clinical samples collected from patients attending the outpatient ward with clinically suspected MTB infections from November 2022 to April 2023 in a tertiary care hospital, Saveetha Medical College and Hospital. The study focused on the sample isolates collected from various clinical specimens, such as sputum, pus, synovial fluid, wound swabs, and other forms of samples from the patients. The samples were processed and analyzed with routine microbiological confirmation tests using standard laboratory methods such as staining and culture. Further, the samples were subjected to a GeneXpert MTB/RIF assay to assess the resistance to Rifampicin (RIF). The results were interpreted, analyzed using standard statistical methods, and presented. Results The findings revealed marked resistance of the clinical isolate MTB to TIF, with positive and negative results through various peak levels shown by GeneXpert. Out of the 138 samples screened by GeneXpert for resistance, 14 samples were found to be positive (10.14%). Resistance to the first-line drug, namely RIF, was observed in the study, raising concerns about the effectiveness of standard tuberculosis treatment regimens followed in the country. Conclusion This study implies the urgency of monitoring and addressing AMR in MTB infections in tertiary care hospital settings. The emergence of resistance to even the first-line drugs necessitates continuous surveillance, the implementation of appropriate diagnostic strategies, and the development of effective treatment protocols. A comprehensive understanding of the AMR landscape in tuberculosis is crucial for optimizing therapeutic interventions, preventing the spread of drug-resistant strains, and ultimately curbing the global burden of tuberculosis.

6.
Cureus ; 16(1): e51737, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38318546

ABSTRACT

INTRODUCTION: The current development of nanoparticles (NPs) with significant antibacterial properties, low cost and low toxicity has made it possible to develop novel techniques for treatments in the medical field. The titanium metal oxide, when combined with a carbonaceous material like graphene, which has excellent absorbing capacity, is efficient in loading drugs and thus helps in drug delivery and also in biomedical applications like anticancer, anti-inflammatory, antioxidant, and antibacterial activities. MATERIALS AND METHODS: Titanium-doped graphene oxide nanoparticles (Ti/GO-NPs) were processed by the one-pot synthesis method; further characterization was performed by using UV-visible spectroscopy, Fourier transform-infrared spectroscopy (FT-IR), field emission electron microscopy (FE-SEM), and energy-dispersive X-ray spectroscopy (EDX) analysis and biomedical applications like anticancer, anti-inflammatory, antioxidant and antibacterial activities. RESULTS: The synthesized end product of Ti/GO-NPs showed a creamy white appearance. Subsequent characterization studies of UV-Vis spectroscopy revealed a peak level of 373 nm at 24 hours and 404 nm after 48 hours. FT-IR analysis exhibited a broad absorption band within the range of 1000-3500 cm-1, which was attributed to various chemical compounds of C-Br, C-I stretching, C=C bending, S=O stretching, O=H stretching, C=C stretching, H bonded and OH stretching to different absorbance wavelength ranges. SEM analysis exhibited quasi-spherical-shaped Ti/GO-NPs with an average particle size of 50- 100 nm and EDX analysis showed the elemental composition of 32.3% titanium 43.9% oxygen and 2.5% carbon. The antibacterial activity showed moderate activity against Staphylococcus aureus and no activity against Pseudomonas aeruginosa, Enterococcus faecalis and E. coli. The antioxidant activity exhibited 88% at 50 µg/mL concentration, the anti-inflammatory activity revealed 80% at 80 µg/mL concentration and the anticancer activity showed 21% at 150 µg/mL concentration. CONCLUSION: The characterization and biomedical application conclude that a combination of Ti/GO-NPs will be efficient in drug delivery. The study showed moderate antibacterial activity and significant antioxidant, anti-inflammatory and anticancer activities. Considering their physiochemical properties, absorption capacity and mechanism of drug delivery, Ti/GO-NPs can be incorporated into various applications in the medical field.

7.
Cureus ; 16(1): e52279, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38357054

ABSTRACT

INTRODUCTION:  Clerodendrum phlomidis plays a significant role in many indigenous medical systems, and it can be mostly found in Southeast Asia. The objective of the study was to synthesize and characterize the biosynthesized aluminum oxide nanoparticles (AlO-NPs) using C. phlomidis and analyze their antibacterial (bactericidal), antioxidant, and anti-inflammatory activities. METHODS: The extract was prepared by the autoclave-assisted method, and the AlO-NPs were synthesized by the green synthesis method. The biosynthesized AlO-NPs were characterized by ultraviolet-visible (UV-Vis) spectroscopy, Fourier transform infrared (FT-IR), field emission scanning electron microscopy (FE-SEM), and energy dispersive X-ray (EDX) analysis. The antibacterial property was assessed by the Kirby-Bauer well diffusion method, and the antioxidant activity was checked by DPPH (2,2-diphenyl-1-picrylhydrazyl) activity compared with the control L-ascorbic acid. Anti-inflammatory activity was evaluated by an albumin denaturation assay, and diclofenac was used as a control. IBM SPSS Statistics for Windows, Version 21.0 was used for the statistical analysis.  Results: An absorption peak at a wavelength of 380 nm was detected by UV-Vis spectroscopy analysis. It proves that AlO-NPs have been successfully produced by the green synthesis method. The results of the FT-IR study demonstrated the existence of numerous chemicals and functional groups in the 500-3500 cm-1 range. AlO-NPs from the plant extract were subjected to FE-SEM analysis, which revealed an aggregated or spherically cluster-like structure. The sample's elemental makeup, which revealed that it included 38% aluminum and 28% oxygen, was identified with the help of the EDX, and this verified the high purity of the AlO-NPs. The results of the antibacterial activity of AlO-NPs revealed that there was a zone of inhibition for Enterococcus faecalis; however, there was no zone of inhibition for Streptococcus mutans. The synthesized AlO-NPs exhibit strong antioxidative (DPPH activity) and anti-inflammatory (albumin denaturation assay) action. In this work, the in vitro antioxidant activity of C. phlomidis was assessed using the standard, L-ascorbic acid, as a measure of DPPH activity. At a maximum concentration of 500 µg/ml, the obtained results showed the incredible antioxidant properties of the investigated AlO-NPs synthesized from the plant extracts and demonstrated 90% inhibition. AlO-NPs that were biosynthesized showed effective anti-inflammatory activity at a higher concentration of 100 µg/ml and demonstrated 89% inhibition in contrast to the drug diclofenac sodium. CONCLUSION: According to the study's findings, AlO-NPs made using a greener synthesis approach have the potential to be used in a variety of industries and are also an affordable and sustainable way to effectively act as anti-inflammatory and antioxidant agents.

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