Variable Surface Antigens of Plasmodium falciparum: Protein Families with Divergent Roles.

Malaria caused by Plasmodium falciparum (Pf) is an illness that contributes significantly to the global health burden. Pf makes significant alterations to the host cell to meet its metabolic demands and escape the immune response of the host. These include the export of a large number of parasite proteins to the infected Red Blood Cells (iRBC). Variable Surface Antigens (VSAs), which are highly polymorphic protein families with important roles in immune evasion, form an important component of the exported proteins. A total of five protein families constitute the VSAs, viz. PfEMP1 (Pf erythrocyte membrane protein 1), RIFIN (repetitive interspersed family), STEVOR (sub-telomeric open reading frame), SURFIN (surface-associated interspersed gene family), and PfMC-2TM (Pf Maurer's cleft two transmembrane). With orthologues present in various simian-infecting species, VSAs take up a variety of domain topologies and organizational structures while exhibiting differential expressions throughout the parasite life cycle. Their expression varies across clinical isolates and laboratory strains, which suggests their crucial role in host cell survival and defense. Members of VSAs are reported to contribute significantly to disease pathogenesis through immune evasion processes like cytoadherence, iRBC sequestration in the host vasculature, rosetting, reduced erythrocyte deformability, and direct immunosuppression. In this study, we have gathered information on various aspects of VSAs, like their orthologues, domain architecture, surface topology, functions and interactions, and three-dimensional structures, while emphasizing discoveries in the field. Considering the vast repertoire of Plasmodial VSAs with new emergent functions, a lot remains unknown about these families and, hence, malaria biology.

Comparing commercial versus low-cost gelatinous phantoms for ultrasound-guided needle tracking: A randomized crossover trial, among emergency medicine residents.

OBJECTIVES: The objective of this study was to devise a low-cost indigenous gelatin-based vascular phantom and to compare this newly constructed phantom with a commercially available phantom. METHODS: This was a randomized crossover study conducted at a tertiary care hospital of India. The aim of the study was to develop a prototype low-cost gelatin-based vascular phantom and compare it with a commercially available phantom. Gelatin, psyllium husk, corn starch, antiseptic liquid, food-coloring agent, latex balloons, and metallic containers were used to prepare the gelatin phantom. The newly prepared gelatin model was labeled "Model A" and the commercially available gelatin model was labeled "Model B." Emergency medicine residents (n = 34) who routinely perform ultrasound (USG)-guided invasive procedures were asked to demonstrate USG-guided in-plane and out-of-plane approach of needle-tracking in both the models and fill out a questionnaire on a Likert scale (1-5). An independent supervisor assessed the image quality. RESULTS: The cost of our phantom was USD 6-8 (vs. USD 1000-1200 for commercial phantom). The participants rated the ease of performance and tissue resemblance as 4 (interquartile range [IQR]: 4-5) for both the models "A" and "B." The supervisor rated the overall performance as 4 (IQR: 3-4) for both the models. In all the parameters assessed, model A was noninferior to model B. CONCLUSION: The indigenously developed vascular phantom was noninferior to the commercially available phantom in terms of tissue resemblance and overall performance. The cost involved was a fraction of that incurred with the currently available commercial model. The authors feel that gelatin-based models can be easily prepared in resource-constraint settings which may be used for USG-guided training and medical education in low- and middle-income countries.

Amino-functionalized novel biosorbent for effective removal of fluoride from water: process optimization using artificial neural network and mechanistic insights.

Aqueous fluoride ( F - ) pollution is a global threat to potable water security. The present research envisions the development of novel adsorbents from indigenous Limonia acidissima L. (fruit pericarp) for effective aqueous defluoridation. The adsorbents were characterized using instrumental analysis, e.g., TGA-DTA, ATR-FTIR, SEM-EDS, and XRD. The batch-mode study was performed to investigate the influence of experimental variables. The artificial neural network (ANN) model was employed to validate the adsorption. The dataset was fed to a backpropagation learning algorithm of the ANN (BPNN) architecture. The four-ten-one neural network model was considered to be functioning correctly with an absolute-relative-percentage error of 0.633 throughout the learning period. The results easily fit the linearly transformed Langmuir isotherm model with a correlation coefficient ( R 2 ) > 0.997. The maximum F - removal efficiency was found to be 80.8 mg/g at the optimum experimental condition of pH 7 and a dosage of 6 g/L at 30 min. The ANN model and experimental data provided a high degree of correlation ( R 2 = 0.9964), signifying the accuracy of the model in validating the adsorption experiments. The effects of interfering ions were studied with real F - water. The pseudo-second-order kinetic model showed a good fit to the equilibrium dataset. The performance of the adsorbent was also found satisfactory with field samples and can be considered a potential adsorbent for aqueous defluoridation.

Correlation between Transcranial Ultrasound and CT Head to Detect Clinically Significant Conditions in Post-craniectomy Patients Performed by Emergency Physician: A Pilot Study.

Background: The main objective is to detect clinically significant conditions by transcranial ultrasound (TCS) in post-decompressive craniectomy (DC) patients who come to the emergency department. Materials and methods: This was a cross-sectional observational study. We studied 40 post-DC patients. After primary stabilization, TCS was done. Computer tomography of head was done within 2 hours of performing TCS. The correlation between both modalities were assessed by the measurement of lateral ventricle (LV) (Bland-Altman plot), Midline shift and mass lesion. Additionally, normal cerebral anatomy, 3rd and 4th ventricles and external ventricular drainage (EVD) catheter visualization were also done. Results: About 14/40 patients came with non-neurosurgical complaints and 26/40 patients came with neurosurgical complaints. Patients with non-neurosurgical complaints (4/14) had mass lesions and 1/14 had MLS. Patients with neurosurgical complaints (11/26) had mass lesions and about 5 patients had MLS. A good correlation was found between TCS and CT of head in measuring LV right (CT head = 17.4 ± 13.8 mm and TCS = 17.1 ± 14.8 mm. The mean difference (95% CI) = [0.28 (-1.9 to 1.33), ICC 0.93 (0.88-0.96)], Left [CT head = 17.8 ± 14.4 mm and TCS = 17.1 ± 14.2 mm, the mean difference (95% CI) 0.63 (-1.8 to 0.61), ICC 0.96 (0.93-0.98)], MLS [CT head = 6.16 ± 3.59 (n = 7) and TCS = 7.883 ± 4.17 (n = 6)] and mass lesions (kappa 0.84 [0.72-0.89] [95% CI] p-value < 0.001). The agreement between both modalities for detecting mass lesions is 93.75%. Conclusion: Point of care ultrasound (POCUS) is a bedside, easily operable, non-radiation hazard and dynamic imaging tool that can be used for TCS as a supplement to CT head in post-DC patients in emergency as well as in ICU. However, assessment of the ventricular system (pre/post-EVD insertion), monitoring of regression/progression of mass lesion, etc. can be done with TCS. Repeated scans are possible in less time which can decrease the frequency of CT head. How to cite this article: Chouhan R, Sinha TP, Bhoi S, Kumar A, Agrawal D, Nayer J, et al. Correlation between Transcranial Ultrasound and CT Head to Detect Clinically Significant Conditions in Post-craniectomy Patients Performed by Emergency Physician: A Pilot Study. Indian J Crit Care Med 2024;28(3):299-306.

Molecular Players at the Sorting Stations of Malaria Parasite 'Plasmodium falciparum'.

The apicomplexan pathogenic parasite 'Plasmodium falciparum' (Pf) is responsible for most of the malaria related mortality. It resides in and refurbishes the infected red blood cells (iRBCs) for its own survival and to suffice its metabolic needs. Remodeling of host erythrocytes involves alteration of physical and biochemical properties of the membrane and genesis of new parasite induced structures within the iRBCs. The generated structures include knobs and solute ion channels on the erythrocyte surface and specialized organelles i.e. Maurer's clefts (MCs) in the iRBC cytosol. The above processes are mediated by exporting a large repertoire of proteins to the host cell, most of which are transported via MCs, the sorting stations in parasitized erythrocytes. Information about MC biogenesis and the molecules involved in maintaining MC architecture remains incompletely elucidated. Here, we have compiled a list of experimentally known MC resident proteins, several of which have roles in maintaining its architecture and function. Our short review covers available data on the domain organization, orthologues, topology and specific roles of these proteins. We highlight the current knowledge gaps in our understanding of MCs as crucial organelles involved in parasite biology and disease pathogenesis.

Analyzing Interaction of Rhodacyanine Inhibitor 'MKT-077' with Plasmodium falciparum HSP70s.

INTRODUCTION: MKT-077 and its derivatives are rhodacyanine inhibitors that hold potential in the treatment of cancer, neurodegenerative diseases and malaria. These allosteric drugs act by inhibiting the ATPase action of heat shock proteins of 70 kDa (HSP70). MKT-077 accumulates in the mitochondria and displays differential activity against HSP70 homologs. METHODS: The four Plasmodium falciparum HSP70s (PfHSP70) are present in various subcellular locations to perform distinct functions. In the present study, we have used bioinformatics tools to understand the interaction of MKT-077 at the ADP and HEW (2-amino 4 bromopyridine) binding sites on PfHSP70s. Our molecular docking experiments predict that the mitochondrial and endoplasmic reticulum PfHSP70 homologs are likely to bind MKT-077 with higher affinities at their ADP binding sites. RESULTS: Binding analysis indicates that the nature of the identified interactions is primarily hydrophobic. We have also identified specific residues of PfHSP70s that are involved in interacting with the ligand. CONCLUSION: Information obtained in this study may form the foundation for the design and development of MKT-077-based drugs against malaria.

Application of phytoaccumulation perspective of Monochoria hastate L. on fluoride contaminated water in hydroponic treatment: its statistical design and characterization studies.

The present research work approaches the accumulation of fluoride ions from contaminated water using an aquatic plant Monochoria hastate L. in hydroponic culture. A design of experiment (DOE) has been adopted and an analysis of variance has been conducted to establish the statistical significance of various process parameters. The different experimental factors are root and shoot (Factor A), fluoride concentration (Factor B), and experimental days (Factor C) largely influence the output response. Plants treated with 5 mg/L of fluoride solutions accumulated the highest concentration in root biomass 1.23 mg/gm, and shoot biomass 0.820 mg/gm, dry weight after 21 days' experimentation. The accumulation mechanism and potentiality of treated plants depend on root cells of the plasma membrane and energy-capturing molecules of adenosine triphosphate. Monochoria hastate L. root biomass was characterized to confirm the accumulation of fluoride ions in the experimented plants using scanning electron micrographs-energy dispersive spectrum (SEM-EDS), and Fourier transforms infrared analysis (FTIR) analysis.

The novelty of this study is the high fluoride accumulation efficiency in hydroponic treatment by Monochoria hastate L an excellent choice for phytoremediation technique. The Design of Experiment (DOE) has a good approach for the optimization of fluoride in the accumulation process. The maximum absorption of fluoride ions in root biomass is 1.23 mg/gm, and shoot biomass is 0.820 mg/gm, dry weight after 21 days of treatment. To know the fluoride ions in shoot and root biomass are characterized using scanning electron micrographs-energy dispersive spectrum (SEM-EDS), and Fourier transforms infrared analysis (FTIR).

Formulation and evaluation of herbal antioxidant face cream of Nardostachys jatamansi collected from Indian Himalayan region

Objective:To prepare and evaluate a herbal antioxidant face cream which is made by the ethanol extract of Nardostachys jatamansi (Valerianceae). Methods: Antioxidant activity of ethanol extract was assessed by previously reported 2, 2-Diphenyl-1-picrylhydrazyl method. By discovering different types of formulations, such as oil in water, we were able to create several face creams respectively classified from F1 to F6, by incorporating different concentrations of stearic acid and acetyl alcohol. The evaluation of all formulations (F1 to F6) has been done by the analysis of different parameters like pH, viscosity, spread ability and stability. Results: An ethanol fraction analyzed from a sample of Nardostachys jatamansi showed a significant antioxidant activity with an IC50 value of 58.39 μg/mL while for ascorbic acid the IC50 value was 46.68 μg/mL. Among the six formulations (F1-F6) F5 and F6 showed good spread ability, good consistency, homogeneity, appearance, pH;there is no proof of a separation phase and ease of removal. Also the formulations F5 and F6 showed no redness or edema or erythema and irritation during irritancy studies. Conclusions:These formulations can be safely used on the skin. Hence, the study suggests that the composition of extract and the base of the cream F5 and F6 are more stable and safe, but it may produce synergistic action.

A preliminary evaluation of comparative effectiveness of riluzole in therapeutic regimen for irritable bowel syndrome

Objective: To develop agents that are specifically effective in controlling the key disturbance of visceral hyperalgesia besides abating of associated multiple symptoms, and evaluate comparative effectiveness for IBS symptom relief for standard regimen (antispasmodic and probiotic) and add-on amitriptyine or riluzole regimens following two weeks administration.Methods:groups were studied. First group received standard treatment (mebeverine 200 mg twice daily and probiotic 200 mg twice daily). Second group received add-on amitriptyline 25 mg before bedtime, while the third group got add-on riluzole 50 mg twice daily. Overall gastrointestinal symptom rating scale improving symptoms and hospital anxiety depression scale improving associated psychological morbidity were employed as measures at induction and at two-week follow-up period. Individual symptom scores were also examined to define the outcome profiles.Results:108 patients with visceral hypersensitivity accompanying IBS, divided into three rating scale score, not the other two regimens. Pain relief was seen with both riluzole and amitriptyline regimens significantly superior to standard treatment regimen, but riluzole effect appeared specific and independent anxiolytic effect. Amitriptyline caused relief in diarrhea and did not benefit in constipation point to non-specific remedial role in IBS. Riluzole regimen resulted in significant reduction of overall gastrointestinal symptom Conclusions: Riluzole specifically relieves visceral hypersensitivity and is proved to be superior to current treatments in IBS patients. It appears a lead remedy based on glutamate transporter mechanisms in visceral hypersensititvity.

Myrica esculenta Buch.-Ham. ex D. Don.-a potential ethnomedicinal species in a subtropical forest of Meghalaya, northeast India

Objective: To determine the effect of anthropogenic activities on the population structure and regeneration efficacy of Myrica esculenta (M. esculenta), an ethnomedicinally important tree species in sub-tropical forests of Meghalaya. Methods: The population structure and regeneration potential of M. esculenta were studied by using quadrat method. Results: The regeneration status of M. esculenta was highly influenced by disturbance. Presence of limited number of seedlings in the forest floor denotes the lack of seeds in the forests. The low conversion of seedling into saplings was mainly due to the removal saplings by the indigenous community, who residing in the vicinity of the forest for meeting their requirement of fuel wood. Conclusions:The findings of the present study indicate that overexploitation of M. esculenta may cause threat to extinction from wild. There is an obvious need to explore non timber forest products to a desired pace that will minimize the pressure on a particular species by providing alternative to a species, leading to sustainable utilization of genetic resources.