Study of nano-hydroxyapatite tagged alkaline protease isolated from Himalayan sub-alpine Forest soil bacteria and role in recalcitrant feather waste degradation.

Purified calcium serine metalloprotease from Stenotrophomonas maltophilia strain SMPB12 exhibits highest enzyme activity at pH 9 and temperature range between 15 °C-25 °C. Enzyme supplemented with 40 µM Ca-Hap-NP (NP-protease) showed maximum elevated activity of 17.29 µmole/min/ml (1.9-fold of original protease activity). The thermostability of the enzyme was maintained for 1 h at 60 °C over an alkaline pH range 7.5-10, as compared to the NP untreated enzyme whose activity was of 8.97 µmole/min/ml. A significant loss of activity with EDTA (1.05 µmole/min/ml, 11.75 %), PMSF (0.93 µmole/min/ml, 10.46 %) and Hg2+ (3.81 µmole/min/ml, 42.49 %) was also observed. Kinetics study of NP-protease showed maximum decreases in Km (28.11 %) from 0.28 mM (NP untreated enzyme) to 0.22 mM (NP-protease) along with maximum increase in Vmax (42.88 %) from 1.25 µmole/min/ml to 1.79 µmole/min/ml at varying temperatures. The enhanced activity of NP-protease was able to efficiently degrade recalcitrant solid wastes like feather to produce value-added products like amino acids and helps in declogging recalcitrant solid wastes. The nano-enabled protease may be utilized in a smaller amount for degrading in bulk recalcitrant solid proteinaceous waste at 15 °C temperature as declogging agents providing an eco-friendly efficient process.

Recent developments in photodynamic therapy and its application against multidrug resistant cancers.

Recently, photodynamic therapy (PDT) has received a lot of attention for its potential use in cancer treatment. It enables the therapy of a multifocal disease with the least amount of tissue damage. The most widely used prodrug is 5-aminolevulinic acid, which undergoes heme pathway conversion to protoporphyrin IX, which acts as a photosensitizer (PS). Additionally, hematoporphyrin, bacteriochlorin, and phthalocyanine are also studied for their therapeutic potential in cancer. Unfortunately, not every patient who receives PDT experiences a full recovery. Resistance to different anticancer treatments is commonly observed. A few of the resistance mechanisms by which cancer cells escape therapeutics are genetic factors, drug-drug interactions, impaired DNA repair pathways, mutations related to inhibition of apoptosis, epigenetic pathways, etc. Recently, much research has been conducted to develop a new generation of PS based on nanomaterials that could be used to overcome cancer cells' multidrug resistance (MDR). Various metal-based, polymeric, lipidic nanoparticles (NPs), dendrimers, etc, have been utilized in the PDT application against cancer. This article discusses the detailed mechanism by which cancer cells evolve towards MDR as well as recent advances in PDT-based NPs for use against multidrug-resistant cancers.

Tetralogy of Fallot Presenting with Superior Vena Cava Syndrome - A Rare Presentation.

Tetralogy of Fallot (TOF) presenting with superior vena cava (SVC) syndrome is an exceedingly rare scenario. The diagnosis of this condition is still a difficult task due to its unspecific clinical features and unclear recommendations for the best diagnostic tools. We report an interesting case of a 23-year-old male who was found to have TOF with the presentation of SVC syndrome after a sequential diagnosis. The timely diagnosis helped in the successful management of the patient. Through this case, we want to make clinicians aware of such a rare association and its diagnosis.

Telmisartan Plus Amlodipine as the Preferred Initial Combination in Newly Diagnosed Indian Patients with Hypertension: An Expert Consensus Statements.

INTRODUCTION: Hypertension (HTN) remains one of the most important risk factors for cardiovascular (CV) diseases and a leading cause of mortality worldwide. Despite improvement in detection and treatment, poor blood pressure (BP) control rates are observed globally. The situation in India is alarming with only 22.5% of patients maintaining their BP under control. Initiating early and effective treatment for HTN helps control BP within normal limits and reduces associated health risks. In India, currently, there are no guidelines on the choice of dual combination treatment that can be considered an initial treatment for newly diagnosed HTN patients to achieve effective BP control and reduce CV risks. OBJECTIVE: To provide consensus recommendations for preferred initial combinations in newly diagnosed Indian patients with HTN. METHODOLOGY: A core group of 100 experts with HTN expertise conceptualized and formulated the four key questions based on answerability, effectiveness, potential for translation to clinical practice, novelty, and potential impact on the healthcare burden. A mix of Delphi and Child Health and Nutrition Research Initiative (CHNRI) methods was adopted for acceptance or refusal of recommendations. Likert scale 1-9 was used for scoring. A score of ≥7 was considered "statement accepted," >6.50 "near to acceptance" and <6.50 "not accepted." A vote of ≥7 by at least two-thirds of the experts (66.66%) was mandatory for acceptance of the recommendation. CONCLUSION: Combination therapy could be necessary for a majority of newly diagnosed Indian patients for effective BP control. It can manage HTN with better clinical outcomes. Based on mean rating scores from experts, telmisartan plus amlodipine can be considered the preferred initial combination in the management of newly diagnosed Indian patients with HTN to achieve better BP control and improve CV outcomes.

Advances in modified antimicrobial peptides as marine antifouling material.

Biofouling is the undesirable attachment of organisms and their by-products on surfaces. It has become a severe problem in the industries that utilize devices and facilities in the marine environment. Several antifouling strategies have been developed, but many have adverse effects on numerous species, the surrounding environment, and marine devices. However, antimicrobial peptides (AMPs) have emerged as a promising non-toxic biomaterial that can modify the submerged surfaces to inhibit biofouling. AMPs are getting recognized as a highly potent material as they exhibit strong antimicrobial activity against fouling organisms and resistance towards biofilm formation. This review discusses the latest developments made in recent years regarding applying AMPs as prominent marine antifouling material. The various properties of AMPs, including structural, functional characteristics, and mechanism of action, are presented. Different types of modification of AMPs to improve their stability, efficacy, and activity against fouling organisms are discussed in detail. Furthermore, future perspectives and significant improvements required to make AMPs an integrative part of the marine antifouling process are reviewed.

Time-dependent electrochemical characteristics of a phenolic and non-phenolic compound in the presence of laccase/ABTS system.

The laccase/ABTS system has found several industrial applications ranging from biodeterioration to biodegradation and bioremediation. However, the capability of the laccase/ABTS system varies depending upon the type of substrate used. Voltammetric studies involving two widely used substrates, i.e., veratryl alcohol (VA) and alkali lignin (AL), were performed to gain new insight into the electrochemical behavior of the reactions. The individual electrochemical reactions established the differential nature of the two compounds over a concentration range, along with the mediator ABTS producing a distinguishing effect on their oxidative reactions, which was further studied over a 12hour period. It was followed by the reaction of both the compounds against the laccase/ABTS system that helped verify the role of the enzyme and the mediator in the electron transfer process and elucidate the mediated oxidations carried out by laccase against the phenolic and non-phenolic substrate through the process of cyclic voltammetry.

Ruptured sinus of Valsalva aneurysm due to Infective Endocarditis managed by device closure - a case report.

Ruptured sinus of Valsalva aneurysm (RSOV) is an uncommon cause of high output heart failure. RSOV most commonly opens into the right ventricle followed by the right atrium and non-coronary cusp involvement is relatively uncommon. Infective endocarditis (IE) is a rare cause of RSOV. We report an interesting clinical scenario of IE causing RSOV managed by device closure. A 16-year-old male patient presented to the emergency department with acute chest pain, fever, and engorged neck veins. On cardiorespiratory system examination he had features of left ventricular failure. Blood culture revealed growth of Staphylococcus aureus. Echocardiography and computed tomography aortography confirmed the diagnosis of 9 mm type IV RSOV (non-coronary cusp to right atrium) with vegetation (5 × 6 mm). The patient refused surgery. When there was no apparent visible vegetation after 6 weeks of antibiotic therapy, we proceeded with 12-mm Amplatzer duct occluder II closure of the anatomical defect. Monthly follow up has been uneventful for 6 months. As per our knowledge this is the first ever reported case of documented definitive IE by S. aureus causing Sakakibara and Konno ruptured Type IV RSOV that has been managed successfully by device closure. .

Electrochemical analysis of Catechol polymerization in presence of Trametes versicolor laccase and the mediator ABTS.

The phenolic compound catechol has found various applications in the industry but is often discharged untreated in industrial effluents. Catechol is highly toxic and adversely affects the environment. This has increased extensive investigation into elucidating the effects of various synthetic elements or different biocatalysts on catechol, thereby leading the way to its bioremediation. Hence, an electrochemical-based study on catechol in the presence of the enzyme laccase could provide a basic understanding of the unique characteristics exhibited by catechol, thus facilitating a distinct perspective to its subsequent treatment and removal. The present study focuses on the electrochemical characterization of catechol based on the oxidation of laccase and the redox mediator 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS). Catechol exhibited distinct electrochemical behavior across various concentrations. The unique electroactive nature of ABTS assisted in the polymerization of catechol which was found to be concentration-dependent. Laccase produced a higher oxidation-reduction rate, thereby producing a much more stable condition for the polymerization of catechol. However, with the laccase-mediator system (LMS), the catechol polymerization rate was distinctly higher and more gradual with the enzyme utilizing the electroactive species produced by ABTS to increase the electron transfer and producing a combinatorial impact on the phenolic compound. This study could rightly serve as the building block in developing future technologies like wastewater treatment and biosensors for catechol bioremediation.

The protective role of metformin in autophagic status in peripheral blood mononuclear cells of type 2 diabetic patients.

Autophagy plays an important role in the pathophysiology of type 2 diabetes (T2D). Metformin is the most common antidiabetic drug. The main objective of this study was to explore the molecular mechanism of metformin in starvation-induced autophagy in peripheral blood mononuclear cells (PBMCs) of type 2 diabetic patients. PBMCs were isolated from 10 diabetic patients and 7 non-diabetic healthy volunteers. The autophagic puncta and markers were measured with the help of monodansylcadaverine staining and western blot. Additionally, transmission electron microscopy was also performed. No significant changes were observed in the initial autophagy marker protein levels in PBMCs of T2D after metformin treatment though diabetic PBMCs showed a high level of phospho-mammalian target of rapamycin, p62 and reduced expression of phospho-AMP-activated protein kinase and lysosomal membrane-associated protein 2, indicating a defect in autophagy. Also, induction of autophagy by tunicamycin resulted in apoptosis in diabetic PBMCs as observed by caspase-3 cleavage and reduced expression of Bcl2. Inhibition of autophagy by bafilomycin rendered consistent expression of p62 indicating a defect in the final process of autophagy. Further, electron microscopic studies also confirmed massive vacuole overload and a sign of apoptotic cell death in PBMCs of diabetic patients, whereas metformin treatment reduced the number of autophagic vacuoles perhaps by lysosomal fusion. Thus, our results indicate that defective autophagy in T2D is associated with the fusion process of lysosomes which could be overcome by metformin.

Elucidation of the decolorization of Congo Red by Trametes versicolor laccase in presence of ABTS through cyclic voltammetry.

The azo dye Congo red is heavily used in textile industries and is actively present in the wastewater run-offs. Its structural complexity and physical characteristics make it resistant to the physicochemical treatments employed by the industry. Over time, application of the enzyme laccase has proved to be quite useful due to its ability to oxidize and eventually decolorize the dye. Moreover, the use of ABTS as the electron mediator also helps in enhancing the oxidizing capability of the enzyme with congo red. The present study involves establishing the role of the individual components i.e. laccase, ABTS and the dye, in the LMS electrochemically. Congo red doesn't have any form of electrochemical activity by itself, but the enzyme brings about a substantial change by increasing the rate of reduction. The effect of ABTS, though same, is concentration-dependent. For LMS, laccase helps in bringing about the rate of reduction much faster in the presence of the mediator, initiating the decolorization of the dye.

Severe OSA Leading to Long Pauses in 24-h Holter ECG Reversed with CPAP.

INTRODUCTION: Sleep-related problems like sleep apnea are increasing tremendously mostly owing to the disordered lifestyle the present generation is leading which is added like a topping on the base of obesity and metabolic syndrome. The burden on the society is huge taking into consideration the work-time loss and health-related financial issues arising out of these sleep disorders with obstructive sleep apnea (OSA) leading the way. Early diagnosis can prevent several complications of OSA. Cardiovascular diseases, including various arrhythmias, arising due to OSA, are described previously. CASE PRESENTATION: Herein, an interesting case of OSA, whose pacemaker installation to rectify the long pause could be avoided by simple correction of his OSA using continuous positive airway pressure, is presented. This 49-year-old male patient was diagnosed with severe OSA by using polysomnography and all his significant sinus pauses (highest one with 7.8 sec) during holter ECG monitoring were found to be occurring at night and correcting his OSA with continuous positive airway pressure (CPAP) treatment reverted all those sinus pauses and the need for any further intervention with pacemaker was discarded. DISCUSSION: OSA is caused by either partial or complete obstruction of the upper airway, and there is the simultaneously attenuated upper airway dilator muscle tone while the patient is sleeping. The gold standard test designed for the assessment of OSA is polysomnography, as approved by the American Academy of Sleep Medicine and CPAP has been found to be universally beneficial in treating OSA related complications. Physiologically, the ACC/AHA guidelines recommend pacing only in patients with prolonged asymptomatic pauses occurring during wakefulness. This case report proved the above mentioned claim of CPAP treatment.

Development of nanotechnology for advancement and application in wound healing: a review.

Wound healing is a series of different dynamic and complex phenomena. Many studies have been carried out based on the type and severity of wounds. However, to recover wounds faster there are no suitable drugs available, which are highly stable, less expensive as well as has no side effects. Nanomaterials have been proven to be the most promising agent for faster wound healing among all the other wound healing materials. This review briefly discusses the recent developments of wound healing by nanotechnology, their applicability and advantages. Nanomaterials have unique physicochemical, optical, and biological properties. Some of them can be directly applied for wound healing or some of them can be incorporated into scaffolds to create hydrogel matrix or nanocomposites, which promote wound healing through their antimicrobial, as well as selective anti- and pro-inflammatory, and proangiogenic properties. Owing to their high surface area to volume ratio, nanomaterials have not only been used for drug delivery vectors but also can affect wound healing by influencing collagen deposition and realignment and provide approaches for skin tissue regeneration.

Is autophagy associated with diabetes mellitus and its complications? A review.

Diabetes mellitus (DM) is an endocrine disorder. In coming decades it will be one of the leading causes of death globally. The key factors in the pathogenesis of diabetes are cellular injuries and disorders of energy metabolism leading to severe diabetic complications. Recent studies have confirmed that autophagy plays a pivotal role in diabetes and its complications. It has been observed that autophagy regulates the normal function of pancreatic ß cells and insulin-target tissues, such as skeletal muscle, liver, and adipose tissue. This review will summarize the regulation of autophagy in diabetes and its complications, and explore how this process would emerge as a potential therapeutic target for diabetes treatment.

Pattern of Urinary Antibiograms in a Tertiary Care Hospital of Eastern India.

BACKGROUND: Indiscriminate use of antibiotics in urinary tract infections have led to emergence of 'superbugs' worldwide. Periodical review of antibiograms is of utmost importance for optimum patient benefit. OBJECTIVE: To identify the spectrum of organisms responsible for urinary tract infection and evaluate the pattern of antibiotic sensitivity of the organisms. METHODS: Urine samples were collected from all consecutive patients getting admitted in the medicine indoor irrespective of symptomatology. The clean-catch technique of midstream urine was used for patients able to void spontaneously while specimens of catheterized patients were obtained prior to catheter change. All samples were sent for routine examination as well as culture sensitivity tests. Descriptive statistical methods were used with the help of SPSS-15th version. RESULTS: The total number of patients was 262, 160 (60.3%) were male and 102 (39.7%) female. The age of the subjects varied from 18 to 85 years. Significant bacteruria was found in 35.9% patients. The commonest organisms isolated overall were E coli (59.6%) followed by enterococcus spp (14.9%) and Klebsiella (10.6%). Among catheterized subjects apart from E coli (64%), Klebsiella was found to be commoner (12%) than Enterococcus 10%. Most Enterobactereacae showed good response to aminoglycosides, cephoperazone sulbactam and nitrofurantoin. However, organisms like Enterobacter, Citrobacter, Morganella and pseudomonas were poorly responsive to the above and required higher antibiotics like carbapenems, and polymixin B. Staph. aureus was responsive to linezolid and vancomycin only. CONCLUSIONS: The progression of resistance of common urinary pathogens to higher antibiotics is an inexorable process. Our study reveals that new generation cephalosporins, quinolones and macrolides cannot keep up with the rapidity of emergence of multiresistant strains.

Chronic Paraspinal Pain due to Multiple Aortic Aneurysms.

Aneurysms of the aorta are not uncommon, both of the thoracic aorta or the abdominal aorta and may be associated with congenital aortic valve diseases, cystic medial necrosis, Marfan's Syndrome or Ehlers-Danlos syndrome, or atherosclerosis. We report a case of a 46 year old smoker who had developed multiple aneurysms of the aorta in both the thoracic and abdominal parts and was incidentally diagnosed on work-up of a chronic back pain associated with venous prominence on left side of chest and left arm.

Purification and biochemical characterization of a newly produced yellow laccase from Lentinus squarrosulus MR13.

A novel yellow laccase was produced from Lentinus squarrosulus MR13 under solid state fermentation. The yellow laccase was purified by a factor of 12.67-fold by ammonium sulfate precipitation, anion exchange chromatography and gel filtration chromatography to a specific activity of 3,772.86 IU mg-1. Its molecular mass was determined by SDS-PAGE and found to be 66 kDa. The activity of the enzyme was measured with 2,2'-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid) as substrate and found to be stable in a broad range of pH (pH 4-9). The optimum temperature of the enzyme was 40 °C. The enzyme was stable at temperatures between 25 and 55 °C and decreased rapidly when the temperature was above 65 °C. Circular dichroism spectra also supported the temperature stability of the enzyme. The Km and Vmax values of the purified yellow laccase were 0.0714 mM and 0.0091 mM min-1, respectively.

Urinary Ascites - A Consequence of Intraoperative Injury.

Patients with complications after surgery often pose enormous challenges to physicians. We report the case of a young lady developing fever, oliguria and intractable ascites refererred to us after undergoing abdominal surgery. She was diagnosed subsequently to have a urinoma with urinary ascites masquerading as a case of sepsis. Percutaneous nephrostomy followed by definitive repair and reimplantation of ureter later led to subsidence of the symptoms.

An observational study of dengue fever in a tertiary care hospital of eastern India.

BACKGROUND: Dengue fever (DF) has become a significant resurgent tropical disease in the past 20 years all over the globe. The recent outbreak in West Bengal has once again underlined our failure in vector control and prevention. Our study outlines the clinical spectrum as well as the geographical expansion of the disease beyond urban confines. MATERIAL AND METHODS: All patients with acute febrile illness positive for IgM antibody for Dengue virus were taken as cases. The patients were subjected to clinical examination and baseline investigations so as to fill in a structured proforma. RESULT: The total number of patients were 180 of whom 92 (51.1%) were male and 88 (48.9%) were female. The maximum number of patients belonged to the age group 20-29 years (26.9%). The patients mostly hailed from Kolkata followed by Nadia, 24- Parganas(S), Murshidabad and Midnapur. The most common presentation apart from fever and bodyache were gastrointestinal symptoms. 42% patients complained of abdominal pain, 24% had vomiting, 9.6% diarrhoea. Bleeding manifestations occurred in 23% of patients. CNS features were documented 10.4%. Case fatality came out to be 3.8%. Investigations revealed thrombocytopenia in 55% and leucopenia 32.7%, transaminitis in 72% Evidence of organomegaly (22.2%) and serositis (42%) were detected. Complications included intracranial haemorrhage, DIC, pancreatitis, myocarditis and even a solitary case of splenic rupture. CONCLUSION: The current outbreak was affecting both the genders equitably and mostly the younger age group from rural as well as urban areas. A febrile illness characterised by myalgia, mild bleeding and gastrointestinal symptoms, it was more or less promptly responsive to early conservative therapy like fluids, FFP and platelet transfusion where required.

Deep vein thrombosis: a rare signature of herpes zoster.

Reactivation of varicella zoster Infection is known to cause manifold complications. However, deep vein thrombosis has been rarely described as an associate. Here we present the case of a young immunocompetent male with such a predicament.

Spontaneous splenic rupture: A rare presentation of dengue fever.

Spontaneous rupture of the spleen with hemoperitoneum is a very rare, but serious manifestation of dengue fever (DF). We report a case of a young female who was presented with atraumatic abdominal pain, hypovolemic shock, anemia, ascites and hepatosplenomegaly with a recent history of a febrile illness. Subsequent investigations proved the presence of hemoperitoneum with spontaneous splenic rupture with seropositivity for DF. Early diagnosis and conservative management in this case resulted in a favorable outcome.