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The focus on sustainable utilization of agricultural waste is currently a leading area of scientific research, driving significant advancements in technology and circular economy models. The fundamental capacity of bio-based products, bioprocessing techniques, and the crucial involvement of microbial treatments are opening opportunities for efficient solutions in various industries. One of the most popular green vegetables, peas are members of the Fabaceae family and have a pod-like structure. Every year, a significant amount of pea pods is discarded as waste products of peas that have negative impacts on our environment. In this comprehensive review, we explore innovative methods for utilizing pea pods to minimize their environmental footprint and optimize their viability across multiple industries. A large portion of the pea processing industry's output consists of pea pods. Variety of proteins, with major classes being globulin and albumin (13%), dietary fiber (43-58%), and minerals are abundant in these pods. Because of their diverse physiochemical properties, they find applications in many diverse fields. The porous pea pods comprised cellulose (61.35%) and lignin (22.12%), which could make them superior adsorbents. The components of these byproducts possess valuable attributes that make them applicable across treatment of wastewater, production of biofuels, synthesis of biocolors, development of nutraceuticals, functional foods, and enzymes for the textile industry, modification of oil, and inhibition of steel corrosion.
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The electrocatalytic nitrogen reduction reaction (NRR) enables the production of ammonia by the use of renewable energy, providing a direct method for nitrogen fixation. Nevertheless, the NRR process under ambient conditions is often impeded by inertness of N2 and the occurrence of hydrogen evolution as a byproduct in aqueous electrolytes, resulting in a diminished reaction rate and reduced efficiency. In this study, we synthesized Cu6(SMPP)6 nanoclusters (Cu6 NCs for short) and immobilized them on graphene oxide (GO) to investigate their electrocatalytic nitrogen reduction reaction (ENRR) using an H-cell setup. The GO-supported Cu6 NCs exhibit enhanced catalysis with a high NH3 yield rate of 4.8 µg h-1 cm-2 and a high faradaic efficiency up to 30.39% at -1.1 V. Quantum chemistry calculations reveal that the Cu6S6 cluster on GO support facilitates the N2 adsorption and NîN bond activation with a surmountable energy barrier for the potential-determining step (N2* â NNH*).
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BACKGROUND: Tuberculosis, a global health concern, was anticipated to grow to 10.6 million new cases by 2021, with an increase in multidrug-resistant tuberculosis. Despite 1.6 million deaths in 2021, present treatments save millions of lives, and tuberculosis may overtake COVID-19 as the greatest cause of mortality. This study provides a six-compartmental deterministic model that employs a fractal-fractional operator with a power law kernel to investigate the impact of vaccination on tuberculosis dynamics in a population. METHODS: Some important characteristics, such as vaccination and infection rate, are considered. We first show that the suggested model has positive bounded solutions and a positive invariant area. We evaluate the equation for the most important threshold parameter, the basic reproduction number, and investigate the model's equilibria. We perform sensitivity analysis to determine the elements that influence tuberculosis dynamics. Fixed-point concepts show the presence and uniqueness of a solution to the suggested model. We use the two-step Newton polynomial technique to investigate the effect of the fractional operator on the generalized form of the power law kernel. RESULTS: The stability analysis of the fractal-fractional model has been confirmed for both Ulam-Hyers and generalized Ulam-Hyers types. Numerical simulations show the effects of different fractional order values on tuberculosis infection dynamics in society. According to numerical simulations, limiting contact with infected patients and enhancing vaccine efficacy can help reduce the tuberculosis burden. The fractal-fractional operator produces better results than the ordinary integer order in the sense of memory effect at diffract fractal and fractional order values. CONCLUSION: According to our findings, fractional modeling offers important insights into the dynamic behavior of tuberculosis disease, facilitating a more thorough comprehension of their epidemiology and possible means of control.
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COVID-19 , Computer Simulation , Fractals , Tuberculosis , Humans , Tuberculosis/epidemiology , Tuberculosis/prevention & control , COVID-19/prevention & control , COVID-19/epidemiology , SARS-CoV-2 , Prevalence , Models, BiologicalABSTRACT
The properties of sub-nano metal clusters are governed by quantum confinement and their large surface-to-bulk ratios, atomically precise compositions and geometric/electronic structures. Advances in metal clusters lead to new opportunities in diverse aspects of sciences including chemo-sensing, bio-imaging, photochemistry, and catalysis. Naked metal clusters having synergic multiple active sites and coordinative unsaturation and tunable stability/activity enable researchers to design atomically precise metal catalysts with tailored catalysis for different reactions. Here we summarize the progress of ligand-free naked metal clusters for catalytic applications. It is anticipated that this review helps to better understand the chemistry of small metal clusters and facilitates the design and development of new catalysts for potential applications.
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Objectives This study aimed to identify the causes, clinical characteristics, and 28-day in-hospital mortality predictors in patients with acute-on-chronic liver failure (ACLF). Methods A cross-sectional study enrolled sixty-four patients aged 18-70 years with acute-on-chronic liver failure. The study was conducted at the Gastroenterology Department, Lahore General Hospital. The study classified ACLF according to the criteria of the European Association for the Study of the Liver - Chronic Liver Failure (EASL-CLIF). Patients were followed for 28 days for mortality outcomes. The outcomes between Survivor and Non-survivor groups were compared using the Chi-Square/Fisher's Exact Test for categorical variables and the Mann-Whitney U test for continuous variables. Results In this study, age and duration of chronic liver disease were not significantly different between survivors and non-survivors. The etiology of liver disease and ACLF causes had no impact on 28-day mortality. Non-survivors had lower mean arterial pressure, and higher mortality was linked with lower Glasgow Coma Scale scores, upper gastrointestinal bleeding, and Grade IV hepatic encephalopathy. Significant differences in bilirubin, serum creatinine, urea, and C-reactive protein levels were observed at 28 days. Survival rates were highest with single organ failure (35.94%) and decreased with multiple organ failures. The overall survival rate was 51.56%. Predictive validity for mortality was assessed using the Area Under the Curve (AUC), with Child-Turcotte-Pugh (CTP) at 0.679, Model for End-Stage Liver Disease (MELD) at 0.819, and Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) at 0.771. Conclusion This study concludes that in acute-on-chronic liver failure, factors like age, gender, and disease etiology do not significantly predict 28-day mortality. Key mortality indicators include clinical parameters such as lower Glasgow Coma Scale scores, hepatic encephalopathy Grade IV, and laboratory findings like elevated bilirubin and serum creatinine. The MELD score is the most compelling prognostic tool.
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AIM: The prevalence of Helicobacter pylori is escalating in developing countries, exacerbated by unjustified antibiotic usage, which leads to increased resistance. This trend has been notably amplified since the COVID-19 pandemic. Consequently, the effectiveness of existing eradication regimens has been compromised. This study aimed to compare the efficacy of two weeks of vonoprazan-based quadruple sequential therapy and lansoprazole-based quadruple sequential therapy in treating H. pylori infection. Methods: A non-randomized clinical trial was conducted over 18 months at the Department of Gastroenterology, Lahore General Hospital, Lahore, Pakistan. It included patients presenting with dyspepsia, as defined by the Rome IV criteria, and who tested positive on the urea breath test. Patients were divided into two groups, i.e., Group A and Group B. Group A patients received lansoprazole 30 mg + amoxicillin + tinidazole + tab. colloidal bismuth subcitrate for the first seven days, followed by lansoprazole + levofloxacin + azithromycin + colloidal bismuth subcitrate. Group B patients received vonoprazan + amoxicillin + tinidazole + colloidal bismuth subcitrate for the first seven days, followed by vonoprazan + levofloxacin + azithromycin + colloidal bismuth subcitrate. Both regimes continued for 14 days. Four weeks after 14 days of the treatment, an early morning urea breath test was conducted to evaluate the efficacy of the treatment. Patients were scheduled for follow-up visits at seven and 14 days post-treatment initiation to record adverse events and assess compliance with the treatment regimen. Patients who lost the follow-up and remained non-compliant to the medications were excluded from the final data analysis as per standard protocols of the per-protocol analysis. Results: A total of 252 patients were included. In Group A and Group B, 6/126 (4.76%) and 8/126 (6.35%) of the patients were lost to follow-up, respectively. The non-compliance rate in Group A was 5/126 (3.97%), compared to Group B with 3/126 (2.38%). Finally, the per-protocol analysis of the results included 115 patients in each group. Baseline characteristics, including demographics, lifestyle, and clinical factors, were comparable between groups with p-values of 0.138 for age, 0.356 for gender, 0.126 for BMI, 0.495 for residence, 0.500 for water source, 0.866 for meal habit, 0.863 for smoking, 0.188 for nonsteroidal anti-inflammatory drug (NSAID) use, 0.145 for proton pump inhibitor (PPI) use, 0.213 for antibiotics, and 0.456 for treatment history. Both treatments effectively eradicated H. pylori, as determined by a negative urea breath test at four weeks post-treatment, with Group B showing a higher eradication rate of 96.5% compared to 92.2% in Group A, although the difference was not statistically significant (p = 0.153). There was no difference in adverse effects in both treatment groups (p-value > 0.05). Conclusion: The study found that while the vonoprazan-based regime exhibited a slightly higher eradication rate of H. pylori compared to lansoprazole, the difference was not statistically significant. It was concluded that both regimens demonstrated comparable efficacy and similar profiles of adverse effects in treating H. pylori infection.
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[This corrects the article DOI: 10.3389/fmicb.2023.1216674.].
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Marine structure changes as a result of climate change, with potential biological implications for human societies and marine ecosystems. These changes include changes in temperatures, flow, discrimination, nutritional inputs, oxygen availability, and acidification of the ocean. In this study, a fractional-order model is constructed using the Caputo fractional operator, which singular and nol-local kernel. A model examines the effects of accelerating global warming on aquatic ecosystems while taking into account variables that change over time, such as the environment and organisms. The positively invariant area also demonstrates positive, bounded solutions of the model treated. The equilibrium states for the occurrence and extinction of fish populations are derived for a feasible solution of the system. We also used fixed-point theorems to analyze the existence and uniqueness of the model. The generalized Ulam-Hyers-Rassias function is used to analyze the stability of the system. To study the impact of the fractional operator through computational simulations, results are generated employing a two-step Lagrange polynomial in the generalized version for the power law kernel and also compared the results with an exponential law and Mittag Leffler kernel. We also produce graphs of the model at various fractional derivative orders to illustrate the important influence that the fractional order has on the different classes of the model with the memory effects of the fractional operator. To help with the oversight of fisheries, this research builds mathematical connections between the natural world and aquatic ecosystems.
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Ecosystem , Global Warming , Animals , Humans , Climate Change , Fisheries , OxygenABSTRACT
Starches from different botanical sources are affected in the presence of enzymes. This study investigated the impact of α-amylase on several properties of pre-gelatinized starches derived from chickpea (Cicer arietinum L.), wheat (Triticum aestivum L.), corn (Zea mays L.), white beans (Phaseolus vulgaris), and sweet potatoes (Ipomoea batatas L.). Specifically, the water holding capacity, freezable water content, sugar content, and water sorption isotherm (adsorption and desorption) properties were examined. The source of α-amylase utilized in this study was a germinated sorghum (Sorghum bicolor L. Moench) extract (GSE). The starch samples were subjected to annealing at temperatures of 40, 50, and 60 °C for durations of either 30 or 60 min prior to the process of gelatinization. A significant increase in the annealing temperature and GSE resulted in a notable enhancement in both the water-holding capacity and the sugar content of the starch. The ordering of starches in terms of their freezable water content is as follows: Chickpea starch (C.P.S) > white beans starch (W.B.S) > wheat starch (W.S) > chickpea starch (C.S) > sweet potato starch (S.P.S). The Guggenheim-Anderson-de Boer (GAB) model was only employed for fitting the data, as the Brunauer-Emmett-Teller (BET) model had a low root mean square error (RMSE). The application of annealing and GSE treatment resulted in a shift of the adsorption and desorption isotherms towards greater levels of moisture content. A strong hysteresis was found in the adsorption and desorption curves, notably within the water activity range of 0.6 to 0.8. The GSE treatment and longer annealing time had an impact on the monolayer water content (mo), as well as the C and K parameters of the GAB model, irrespective of the annealing temperature. These results can be used to evaluate the applicability of starch in the pharmaceutical and food sectors.
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Ipomoea batatas , Sorghum , Edible Grain , Amylose , Starch , alpha-Amylases , Water , Sugars , Plant ExtractsABSTRACT
Probiotics, like lactic acid bacteria, are non-pathogenic microbes that exert health benefits to the host when administered in adequate quantity. Currently, research is being conducted on the molecular events and applications of probiotics. The suggested mechanisms by which probiotics exert their action include; competitive exclusion of pathogens for adhesion sites, improvement of the intestinal mucosal barrier, gut immunomodulation, and neurotransmitter synthesis. This review emphasizes the recent advances in the health benefits of probiotics and the emerging applications of probiotics in the food industry. Due to their capability to modulate gut microbiota and attenuate the immune system, probiotics could be used as an adjuvant in hypertension, hypercholesterolemia, cancer, and gastrointestinal diseases. Considering the functional properties, probiotics are being used in the dairy, beverage, and baking industries. After developing the latest techniques by researchers, probiotics can now survive within harsh processing conditions and withstand GI stresses quite effectively. Thus, the potential of probiotics can efficiently be utilized on a commercial scale in food processing industries.
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Background: Avian influenza (AI) poses a serious threat to global public health, especially the highly pathogenic form. Awareness and protective behavior among the public, particularly the high-risk populations, are essential for prevention and control. This study aimed to ascertain the level of AI knowledge among Indonesia's poultry farmworkers. Methods: This was a cross-sectional study conducted online. A predesigned standardized questionnaire, containing six demographic questions and 14 questions on AI knowledge, was used. The questionnaire was distributed via WhatsApp and email platforms. Volunteers (respondents) included 119 men and 81 women, aged 18-50 years, who work on poultry farms in Indonesia. Data were analyzed using the chi-squared and Fisher exact tests. Results: The study's findings revealed that more than two-thirds (67.0%) of the respondents had heard about AI. Their primary sources of information were health workers (36.0%) and media, especially television (34.0%). The majority of the participants (91.3%) had good knowledge about AI as a contagious infection, transmissible from birds to other birds, animals, or humans. A total of 76.8% of the respondents believed that poultry workers and veterinarians were at high risk of contracting AI infection. Conclusions: The study concluded that poultry workers had good knowledge about AI infection, transmission, and risk variables. Health workers and television were the main sources of information on AI. The level of AI knowledge was high among the respondents.
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Influenza in Birds , Male , Animals , Humans , Female , Influenza in Birds/epidemiology , Cross-Sectional Studies , Poultry , Farmers , Indonesia/epidemiology , Health Knowledge, Attitudes, PracticeABSTRACT
Cotton has been one of the most important cash crops in Pakistan, but its production is adversely affected by biotic and abiotic stresses. Insect pests such as pink bollworm present a colossal vulnerability to such a financially important commodity. Bt toxins have been widely used to safeguard agricultural plants against notorious insect pests such as cotton bollworm and pink bollworm, and they have proven to be effective in reducing chewing insect pests. However, its efficacy has been challenged due to the development of resistance in insect pests against Bt toxins such as Cry1Ac and this poses a significant risk to the long-term adoption of these Bt crops. Resistance in insect pests against Bt toxin Cry1Ac is developed due to the mutations in the midgut receptors such as cadherin. In this study first 56 amino acids which also includes helix alpha-1 portion from N-terminus of the Cry1Ac were removed and the gene was commercially synthesized following codon optimization. Modified Cry1Ac was used to develop transgenic plants of Nicotiana tabacum and insect bioassays were conducted to check the efficacy of Cry1Ac through leaf bioassays. Cry1Ac, a modified Bt toxin, was produced pET-28a (+), and diet bioassays were performed using purified protein at various doses against Pectinophora gossypiella. Based on the insect mortality and LC50, the Cry1AcM3 form of the modified toxins was shown to be more potent than the other modified versions (Cry1AcM1, Cry1AcM2), with more than 80 % mortality against resistant pink bollworm at 1.25 g/mL and an LC50 of 0.48. The results suggest that modified toxin cry1Ac may be useful in controlling population of pink bollworm resistant against cry1Ac.
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Bacillus thuringiensis , Moths , Animals , Bacillus thuringiensis Toxins/metabolism , Bacillus thuringiensis Toxins/pharmacology , Endotoxins/genetics , Endotoxins/pharmacology , Bacillus thuringiensis/genetics , Bacillus thuringiensis/metabolism , Insecticide Resistance/genetics , Bacterial Proteins/genetics , Bacterial Proteins/pharmacology , Bacterial Proteins/metabolism , Plants, Genetically Modified/genetics , Plants, Genetically Modified/metabolism , Crops, Agricultural/genetics , Gossypium/genetics , Gossypium/metabolism , Hemolysin Proteins/genetics , Hemolysin Proteins/pharmacology , Larva/geneticsABSTRACT
Pistachio (Pistacia vera L.) is consumed in almost every part of the world enclosed in shells that are thrown out in baskets. Similarly, hulls separated from pistachio are discarded as waste in food processing industries. These waste materials contain functional constituents having immense industrial and nutraceutical applications. This review article summarizes the scientific investigations regarding the functional constituents and bioactive compounds in pistachio shells (PSs) and pistachio hulls (PHs). It also highlights the nutraceutical potential exhibited by functionally active compounds as well as their potential applications in various industries including nutraceutical, medicinal, and feed industries together with biosynthetic development of useful products and wastewater treatment. Pistachio waste (PW) comprising PS and PH is a rich source of various bioactive compounds. PS is full of lignin, cellulose, and hemicellulose. PH is an excellent source of carbohydrates (80.64⯱â¯0.98%) (including glucose, galactose, rhamnose, arabinose, xylose, mannose, galacturonic acid) as well as ash (6.32⯱â¯0.26%) and proteins (1.80⯱â¯0.28%) with small amounts of fats (0.04⯱â¯0.005%). Owing to its composition, PW can be beneficial in many nutraceuticals, including antioxidation, cytoprotection, anti-obesity, anti-diabetic, anti-melanogenesis, neuroprotection, anti-cancer, anti-mutagenesis, anti-inflammation, and anti-microbial. The waste materials have vast applications in the food industry, such as bio-preservation of oils and meat products, prevention of enzymatic browning in fruits, vegetables, and mushrooms, development of functional cereal and dairy products, production of food enzymes, emulsions, and manufacturing of biodegradable films for food packaging. The use of these waste products to develop and design novel functional foods with improved quality is important for both food industries and food sustainability.
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In the current study, we have evaluated the protective efficacy of the 'insertion domain' which is commonly found in the capsid penton base protein of many adenoviruses. Using the 'insertion domain' of the penton base protein of a representative fowl adenovirus, fowl adenovirus serotype 4 (FAdV-4), we find that the 'insertion domain' can readily be expressed in a soluble form in the bacterial system, and can be purified in sufficient quantities through simple chromatographic methods. We demonstrate that the 'insertion domain', when employed as a subunit vaccine candidate, provides complete protection against hydropericardium syndrome, caused by FAdV-4, in chickens. The data presented here indicate that the protein, adjuvanted with Montanide™ ISA71 VG, provides complete protection in chickens against a lethal FAdV-4 challenge after administration of two doses (100 µg of the protein per dose) two weeks apart (the first dose at the 7th day of life and a booster dose at the age of 21 days). Furthermore, the purified protein can be stored at low temperatures without any observable loss in the protein integrity up to one year, tested so far. Due to the conserved nature of the 'insertion domain' across the penton base protein of fowl adenoviruses, it is suggested that homologous insertion domains could be employed as highly stable and cost-effective subunit vaccine candidates against infections caused by respective fowl adenoviruses.
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Adenoviridae Infections , Aviadenovirus , Poultry Diseases , Animals , Capsid Proteins , Adenoviridae Infections/prevention & control , Adenoviridae Infections/veterinary , Chickens , Capsid , Aviadenovirus/genetics , Adenoviridae/genetics , Vaccines, Subunit , SerogroupABSTRACT
Avian influenza virus subtype H9N2 was first documented in Indonesia in 2017. It has become prevalent in chickens in many provinces of Indonesia as a result of reassortment in live bird markets. Low pathogenic avian influenza subtype H9N2 virus-infected poultry provides a new direction for influenza virus. According to the latest research, the Indonesian H9N2 viruses may have developed through antigenic drift into new genotype, posing a significant hazard to poultry and public health. The latest proof of interspecies transmission proposes that, the next human pandemic variant will be avian influenza virus subtype H9N2. Manipulation and elimination of H9N2 viruses in Indonesia, constant surveillance of viral mutation, and vaccines updates are required to achieve effectiveness. The current review examines should be investigates/assesses/report on the development and evolution of newly identified H9N2 viruses in Indonesia and their vaccination strategy.
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Influenza A Virus, H9N2 Subtype , Influenza in Birds , Animals , Chickens , Humans , Indonesia , Influenza A Virus, H9N2 Subtype/genetics , Influenza in Birds/epidemiology , Influenza in Birds/prevention & control , Poultry , Vaccination/veterinaryABSTRACT
Background and Aim: Toxoplasma gondii is an intracellular protozoan that infects humans and animals. This study aimed to estimate the seroprevalence of T. gondii and the associated alterations in hematology and serum biochemistry of one-humped camels (Camelus dromedarius) in Mianwali district, Pakistan. Materials and Methods: A total of 350 blood samples were obtained from male and female camels of different ages (≤3 years old, 4-6 years old, and ≥7 years old). To validate T. gondii antibodies, the collected samples were subjected to indirect enzyme-linked immunosorbent assay using purified recombinant micronemal protein 3 as an antibody catching antigen. Results: The prevalence of T. gondii was 50.2% higher in male camels than in female camels (16.5%) (p<0.001). Furthermore, the prevalence of T. gondii in camels was directly proportional to age (p<0.001). It was 63.33% (57/90) in camels of ≥7 years of age, 32.54% in 4-6 years old age group, and 23.08% in ≤3 years old age group. The hematological analysis of infected camels revealed a significant increase in the values of glucocorticoid-remediable aldosteronism, lymphocyte percentage, monocyte percentage (MONO%), corpuscular hemoglobin (MCH), and procalcitonin. Furthermore, substantially higher levels of liver enzymes alanine aminotransferase, aspartate aminotransferase, and the macro-mineral potassium were found in the serum of T. gondii-infected camels. Conclusion: The seropositivity of T. gondii is directly associated with the age and sex of camels, which may be considered as potential risk factors. Furthermore, T. gondii infection directly impacts the hemato-biochemistry of infected camels.
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BACKGROUND: Hepatitis C virus infection is the main cause of liver ailments across the globe. Several HCV genotypes have been identified in different parts of the world. Effective drugs for combating HCV infections are available but not affordable, particularly to infected individuals from resource-limited countries. Hence, cost-effective drugs need to be developed against important HCV drug targets. As Citrus fruits naturally contain bioactive compounds with antiviral activities, the current study was designed to identify antiviral inhibitors from Citrus fruit extracts against an important drug target, NS3 protease, of HCV genotype 3a which is found predominantly in South Asian countries. METHODS: The full-length NS3 protease alone and the NS3 protease domain in fusion with the cognate NS4A cofactor were expressed in Escherichia coli, and purified by chromatographic techniques. Using the purified protein as a drug target, Citrus extracts were evaluated in a FRET assay, and active ingredients, identified using ESI-MS/MS, were docked to observe the interaction with active site residues of NS3. The best interacting compound was further confirmed through the FRET assay as the inhibitor of NS3 protease. RESULTS: Fusion of the NS3 protease domain to the NS4A cofactor significantly improved the purification yield, and NS3-NS4A was functionally more active than the full-length NS3 alone. The purified protein (NS3-NS4A) was successfully employed in a validated FRET assay to evaluate 14 Citrus fruit extracts, revealing that the mesocarp extract of Citrus paradisi, and whole fruit extracts of C. sinesis, C. aurantinum, and C. reticulata significantly inhibited the protease activity of HCV NS3 protease (IC50 values of 5.79 ± 1.44 µg/mL, 37.19 ± 5.92 µg/mL, 42.62 ± 6.89 µg/mL, and 57.65 ± 3.81 µg/mL, respectively). Subsequent ESI-MSn analysis identified a flavonoid, hesperidin, abundantly present in all the afore-mentioned Citrus extracts. Importantly, docking studies suggested that hesperidin interacts with active site residues, and acts as a potent inhibitor of NS3 protease, exhibiting an IC50 value of 11.34 ± 3.83 µg/mL. CONCLUSIONS: A FRET assay was developed using NS3-NS4A protease, which was successfully utilized for the evaluation of Citrus fruit extracts. Hesperidin, a compound present in the Citrus extracts, was identified as the main flavonoid, which can serve as a cost-effective potent inhibitor of NS3 protease, and could be developed as a drug for antiviral therapy against HCV genotype 3a.
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Citrus , Hepatitis C , Hesperidin , Genotype , Hesperidin/pharmacology , Peptide Hydrolases/genetics , Plant Extracts/pharmacology , Serine Endopeptidases/chemistry , Serine Endopeptidases/genetics , Serine Endopeptidases/metabolism , Tandem Mass Spectrometry , Viral Nonstructural Proteins/chemistry , Viral Nonstructural Proteins/genetics , Viral Nonstructural Proteins/metabolismABSTRACT
Bronchopleural fistula is a pathological tract between the bronchial tree and the pleural space, which can be life-threatening due to tension pneumothorax. It is a rare complication in tuberculosis cases with highly variable in clinical manifestations and persistent air leaks which might lead to complications such as empyema. Herein, we present a tuberculosis and diabetic patient complicated with giant bronchopleural fistula and empyema. A 48-year-old man presented with shortness of breath for two weeks and cough with phlegm for two months. The patient was a smoker with severe Brinkman Index and diabetes. Physical examination revealed hyper resonant percussion and vesicular diminished on the left hemithorax. Laboratory results indicated the patient had anemia, leukocytosis, and hypoalbuminemia. GeneXpert sputum confirmed the presence of Mycobacterium tuberculosis and chest X-ray indicated a collapsed left lung. The patient was diagnosed with left secondary spontaneous pneumothorax, pulmonary tuberculosis, and diabetes. The patient was treated with chest tube drainage and anti- tuberculosis drugs. There was no improvement based on serial chest X-ray, and empyema appeared from the chest tube. CT-scan showed tuberculosis lesion, the collapsed of the left lung and fistula in segments 7-8 inferior lobe. Exploratory thoracostomy was performed, in which a giant bronchopleural fistula was detected and then repaired with BioGlue surgical adhesive. Unfortunately, the thoracostomy led to extensive subcutaneous emphysema and was treated by cervical mediastinotomy. The drainage was unable to be removed, and the patient was discharged with Heimlich-type drainage valves on day 28 of treatment. The empyema fluid was cultured and revealed Staphylococcus haemolyticus. This case highlights that tuberculosis could cause a bronchopleural fistula and empyema may occur secondary to late diagnosis that needs immediate surgery.
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BACKGROUND AND AIM: Rabies is an important viral zoonotic disease that is mostly transmitted through the bite of a rabid dog. Despite serious efforts regarding its control, rabies is still endemic in many provinces of Indonesia. The study aims to assess the knowledge, attitudes, and practices (KAP) related to rabies in urban and rural areas in three provinces of Indonesia. MATERIALS AND METHOD: s: A total of 432 respondents of different age groups, educational levels, geographical areas, and occupations participated in this study. Data were collected using a pre-designed questionnaire with online and offline modes to assess the KAP of rabies among the respondents. A series of Chi-square tests and frequency distribution analyses were performed to determine associations between response variables. RESULTS: Of the 432 participants, 56.9% were aware of the clinical signs of rabies. Excepting for people at high risk of contracting the disease (e.g., veterinarians), most respondents (83.1%) were not vaccinated against rabies. Surprisingly, 79.4 % of those who were bitten by an infected dog did not seek medical care from the doctor and approximately 71.8% had poor knowledge of rabies control and vaccine campaigns. Of all respondents, 64% (p<0.05, odds ratio=1.63) were vaccinated after an infected dog bite. Similarly, 32% (p<0.05, odds ratio=1.59) were aware of surveys and vaccinations in their areas. In contrast, 20.7% (p<0.05, odds ratio=0.593) reported that rabid dogs were killed in their areas. The majority (89.60%) of the respondents were aware of the fact that rabies can cause death. Most of the respondents (93%) knew that rabies is caused by an infected dog bite. The overall levels of KAP among the respondents were good. CONCLUSION: The findings of the current study generally show that participants had good knowledge about clinical signs based on their frequency percentage, but lacked knowledge regarding medical treatment and surveys for awareness and vaccination of rabies. Overall, a significant (p<0.05, odds ratio>1) relationship was found among the KAP of participants. This depicts that the majority of the population is aware of rabies and factors involved in its transmission.