Iatrogenically Acquired Mycobacterium abscessus Infection in an Indwelling Intercostal Drainage In Situ in a Patient With Alcoholic Liver Disease and Bilateral Hepatic Hydrothorax: A Report of a Rare Case.

A 47-year-old male, a known case of alcoholic chronic liver disease with portal hypertension, presented with complaints of abdominal distension and shortness of breath. A provisional diagnosis of ethanol-related compensated chronic liver disease (CLD) with portal hypertension and splenomegaly, gross ascites with bilateral hepatic hydrothorax was made. The left-sided pleural effusion subsided after three pleural taps, but the right-sided effusion kept refilling even after four to five days of repeated therapeutic taps, so a pigtail catheter was left in situ. The pleural fluid was sent for culture which did not grow any pathogenic organisms. Cartridge-based nucleic acid amplification tests where Mycobacterium tuberculosis complex (MTBC) was not detected, Ziehl-Neelsen staining was done in which acid-fast bacilli were not seen, and cytology was done where no malignant cells were seen. The patient was discharged with the pigtail in situ on the right side and, after 20 days, the patient again presented with shortness of breath, and imaging revealed moderate right-side pleural effusion. Draining of pleural fluid was done and sent for investigation which again revealed no infective etiology. The patient was admitted to the hospital for one month as the right-sided effusion did not resolve. Suddenly, the patient developed shortness of breath, and a chest X-ray was done, which showed pigtail blockage; pigtail flushing was done, and the bag was drained. The patient was empirically started on IV meropenem 500 mg TID, IV teicoplanin 400 mg BD, and inj polymyxin B 500,000 IU IV BD. The pleural fluid was sent continuously for investigation for the first two months which again did not reveal any infective etiology. After two months of pigtail in situ, the pleural fluid was sent for CBNAAT where MTBC was not detected, and ZN stain showed smooth acid-fast bacilli. The sample was cultured, and it grew acid-fast bacilli in 72 hours on blood agar, MacConkey agar, and Lowenstein-Jensen media. A line probe assay done from the isolate revealed it to be Mycobacterium abscessus subsp. abscessus which was resistant to macrolides and sensitive to aminoglycosides. Mycobacterium abscessus subsp. abscessus was isolated from repeated cultures of pleural fluid, and the patient was advised on a combination treatment of amikacin, tigecycline, and imipenem. The patient was discharged with the indwelling pigtail with the advised treatment; unfortunately, we lost patient follow-up as the patient never returned to us.

A Case of Isolated Splenic Tuberculosis Presenting as a Splenic Abscess Complicated by Rupture Leading to Splenectomy in an Immunocompetent Male.

We report a rare case of splenic tuberculosis (TB) in a male patient with a competent immune system who had no previous record of pulmonary TB. A 56-year-old male patient came to our outpatient department complaining of upper abdominal pain with a few episodes of vomiting for three days. He had alcoholism, smoked for 15 years, and had no past history of diabetes mellitus, hypertension, TB, or HIV. An abdominal ultrasound and CT scan at admission showed pancreatitis with a splenic abscess. After five days of admission, the patient's vitals deteriorated, and he had severe abdominal pain. CT scan suggested a splenic abscess rupture with hemoperitoneum. An emergency exploratory laparotomy was performed, and a splenectomy was done due to the splenic abscess rupture. A cartridge-based nucleic acid amplification test from splenic intracapsular fluid detected a trace Mycobacterium tuberculosis complex. The patient was discharged after starting first-line antitubercular treatment for six months. After three months of follow-up, the patient was doing well with no complaints.

Christie, Atkins, Munch-Peterson (CAMP) Negative Listeria monocytogenes Meningitis in Neonates: Report of Two Cases.

Listeria monocytogenes, a gram-positive bacillus and an intracellular pathogen, is an uncommon cause of illness in the general population. During pregnancy, a perinatal infection can lead to serious complications such as abortion, stillbirth, neonatal sepsis, and meningitis. We present two cases of neonatal meningitis caused by Christie, Atkins, Munch-Peterson (CAMP)-negative Listeria monocytogenes. In the first case, a seven-day-old female term neonate delivered vaginally, presented with high-grade fever and refusal to feed. In view of the suspected late-onset sepsis, a septic workup, including cerebrospinal fluid analysis, was conducted. CSF culture reports obtained showed a growth consistent with Listeria monocytogenes, which was CAMP test negative and susceptible to the penicillin group of drugs, cotrimoxazole, erythromycin, and meropenem. The isolate was identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and confirmed by 16S rRNA sequencing. The blood culture was sterile. At 48 hours of admission, the neonate clinically deteriorated with fluctuation in oxygen saturation below 95% at room air. Thus, she was electively intubated and connected to the mechanical ventilator with appropriate settings. The antibiotics were upgraded to meropenem from the empirical antibiotic therapy. The neonate showed clinical improvement within the next 24 hours of initiating antibiotics according to culture susceptibility and was gradually weaned from the mechanical ventilator to continuous positive airway pressure (CPAP). After 24 hours, she was able to maintain normal saturation at room air. In the second case, an 11-day-old low birth weight neonate, small for gestational age, was presented to the NICU with complaints of loose stools, fever, and refusal to feed for the past two days. In view of the suspected sepsis, relevant investigations were carried out while initiating empirical antibiotics IV piperacillin-tazobactam and IV amikacin for the neonate. Meanwhile, there was a dip in oxygen saturation noted on room air for the neonate and he/she was mechanically ventilated. The CSF culture grew Listeria monocytogenes,which was identified using MALDI-TOF MS and confirmed by 16S rRNA sequencing. The isolate tested negative for the CAMP test and was susceptible to ampicillin, penicillin, cotrimoxazole, erythromycin, and meropenem. The blood culture was sterile. The antibiotics were upgraded to meropenem from the empirical antibiotic therapy, the patient's condition improved, and the baby was eventually discharged.

Rice husk valorisation by in situ grown MoS2 nanoflowers: a dual-action catalyst for pollutant dye remediation and microbial decontamination.

Rice husk (RH) is a common agricultural waste generated during the rice milling process; however, a major portion is either burned or disposed of in landfills, posing significant environmental risks. In this study, RH waste was transformed into bio-based catalysts via delignification cum in situ growth of MoS2 (DRH-MoS2) for efficient pollutant dye removal and microbial decontamination. The developed DRH-MoS2 exhibits nanoflower-like structures with a 2H-MoS2 phase and a narrow band gap of 1.37 eV, which showed strong evidence of photocatalytic activity. With the presence of abundant hydroxyl functionality, delignified rice husk (DRH) exhibits a malachite green (MG) dye adsorption capacity of 88 mg g-1. However, in situ growth of MoS2 nanosheets on DRH enhances MG degradation to 181 mg g-1 under dark conditions and 550 mg g-1 in the presence of light. Mechanistic insights reveal a synergistic adsorption-cum-degradation phenomenon, amplified by generation of reactive oxygen species during photodegradation which was confirmed from radical scavenging activity. Interestingly, DRH-MoS2 demonstrates potent antibacterial activity against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) with sustained photodegradation efficiency (>80%) over three cycles. The present work reports a cost-effective and scalable strategy for environmental remediation of real wastewater which usually contains both dye pollutants as well as microbes using abundantly available renewable resources such as sunlight and agricultural biomass wastes.

Microplastic and adhesive free, multifunctional, circular economy approach-based biomass-derived drinking straws.

Generation of voluminous single-use plastic waste and byproducts from agricultural harvests such as rice straws (RSs) are major global challenges due to their disposal issues, contributing to greenhouse gas emissions, and affecting the ecological system with threats to human health. A scalable, low-cost, and eco-friendly strategy for fabricating cellulose-silica-based drinking straws, free from microplastics and adhesive, through strategic valorization of RS is reported. Functionalization by delignification-cum-crosslinking of RS leads to development of straws with high water stability (∼5 days), solvothermal stability (0°C-95°C), tensile strength (128 MPa), low migration values (<60 mg/kg), improved biodegradability (∼126 days) with reduced wettability and hydrophobicity. RS drinking straws show antibacterial, self-cleaning, self-healing, anti-fizzing, reusable, and generate significantly lower carbon footprint (<99.8% and <53.34% global warming potential than metal and polylactic acid straws). Repurposing of agro-wastes from farms to commercially viable drinking straws which biodegrades after its consumption achieves the goal of circular economy and sustainable development.

Scalable phosphorylated cellulose production with improved environmental sustainability, crosslinkability and processability using 3D bioprinting for dye remediation.

In the present work, phosphorylated cellulose (PC) gel has been produced following an environmentally benign approach using agro-based chemicals with improved yield. The PC gels produced were transparent, negatively charged with high consistency, charge content (1133.33 mmol/kg), degree of substitution (DS) of 0.183 and increased yield (>87 %). The XPS and EDS analysis confirms the covalently bonded phosphate groups at weight percent of 9.42 % and 11.01 %, respectively. The life cycle assessment (LCA) shows that PC gel production via the phosphorylation route is an ecologically favourable strategy compared with traditional TEMPO oxidation, resulting in 1.67 times lower CO2 emission. The rheological studies of PC gels show shear-thinning behaviour with improved 3D printability followed by heat-induced crosslinking of phosphate groups. The mechanistic insights for the condensation of phosphate to form a phosphoric ester group during cross-linking were evaluated through 31P solid-state NMR and XPS studies. Interestingly, the 3D-printed structures showed high structural stability under both compression and tensile load in both dry and wet conditions, with high water absorption (5408.33 %) and swelling capacity of 700 %. The structures show improved methylene blue (MB) remediation capabilities with a maximum removal efficiency of 99 % for 10-200 mg/L and more than seven times reusability. This work provides a green, facile and energy-efficient strategy for fabricating PCs with easy processability through additive manufacturing techniques for producing value-added products, opening up new avenues for high-performance applications.

Valorization of sugarcane bagasse with in situ grown MoS2 for continuous pollutant remediation and microbial decontamination.

In this study, sugarcane bagasse (SB) was strategically subjected to a delignification process followed by the in situ growth of multi-layered molybdenum disulfide (MoS2) nanosheets with hexagonal phase (2H-phase) crystal structure via hydrothermal treatment. The MoS2 nanosheets underwent self-assembly to form nanoflower-like structures in the aligned cellulose inter-channels of delignified sugarcane bagasse (DSB), the mechanism of which was understood through FTIR and XPS spectroscopic studies. DSB, due to its porous morphology and abundant hydroxyl groups, shows remediation capabilities of methylene blue (MB) dye through physio-sorption but shows a low adsorption capacity of 80.21 mg/g. To improve the removal capacity, DSB after in situ growth of MoS2 (DSB-MoS2) shows enhanced dye degradation to 114.3 mg/g (in the dark) which further improved to 158.74 mg/g during photodegradation, due to catalytically active MoS2. Interestingly, DSB-MoS2 was capable of continuous dye degradation with recyclability for three cycles, reaching an efficiency of > 83%, along with a strong antibacterial response against Gram-positive Staphylococcus aureus (S.aureus) and Gram-negative Escherichia coli (E. coli). The present study introduces a unique strategy for the up-conversion of agricultural biomass into value-added bio-adsorbents, which can effectively and economically address the remediation of dyes with simultaneous microbial decontamination from polluted wastewater streams.

Comparative Analysis of Integrated Filtering Methods Using UWB Localization in Indoor Environment.

This research delves into advancing an ultra-wideband (UWB) localization system through the integration of filtering technologies (moving average (MVG), Kalman filter (KF), extended Kalman filter (EKF)) with a low-pass filter (LPF). We investigated new approaches to enhance the precision and reduce noise of the current filtering methods-MVG, KF, and EKF. Using a TurtleBot robotic platform with a camera, our research thoroughly examines the UWB system in various trajectory situations (square, circular, and free paths with 2 m, 2.2 m, and 5 m distances). Particularly in the square path trajectory with the lowest root mean square error (RMSE) values (40.22 mm on the X axis, and 78.71 mm on the Y axis), the extended Kalman filter with low-pass filter (EKF + LPF) shows notable accuracy. This filter stands out among the others. Furthermore, we find that integrated method using LPF outperforms MVG, KF, and EKF consistently, reducing the mean absolute error (MAE) to 3.39% for square paths, 4.21% for circular paths, and 6.16% for free paths. This study highlights the effectiveness of EKF + LPF for accurate indoor localization for UWB systems.

Isolated Unilateral Testicular Tuberculosis in a Young, Immunocompetent Patient: A Case Report.

Testicular or epididymal tuberculosis is a rare form of extrapulmonary tuberculosis. Extrapulmonary tuberculosis of any form is very difficult to diagnose by microscopy because it is usually paucibacillary. Therefore, molecular methods play a major role in the diagnosis of extrapulmonary tuberculosis. We present a rare case of unilateral testicular tuberculosis in a 23-year-old immunocompetent patient with no history of contact with a known tuberculosis case. He presented to us with swelling on his testis for one month and a discharging sinus in the left testis for 15 days, along with an intermittent fever for a week. A pus swab from the discharging sinus of the testis was sent to microbiology, where a cartridge-based nucleic acid amplification test (CBNAAT) was done, which detected Mycobacterium tuberculosis complex (MTBC), but resistance to rifampicin was not detected. A line probe assay was also done on the sample for first-line drugs, and no resistance was detected for rifampicin or isoniazid. The patient was started on first-line drugs in the intensive phase, and after the completion of two months of treatment, the patient's discharge stopped and he showed clinical improvement. Being a young patient, if he had not been diagnosed and treated as early as possible, it could have led to infertility. This again emphasizes the importance of molecular methods for the diagnosis of extrapulmonary tuberculosis.

First Case of Nocardia wallacei From India: A Case Report and Literature Review.

Nocardia is a type of bacteria that can cause infections in both immunocompromised and immunocompetent hosts. It is an obligate aerobe and is commonly found in the environment. Pulmonary nocardiosis may present as pneumonia, endobronchial inflammatory masses, lung abscess, and cavitary disease with contiguous extension, leading to effusion and empyema. We present a case of pulmonary nocardiosis in a 75-year-old male patient with type 2 diabetes mellitus. The patient presented with bilateral pneumonia and hypoxia with an oxygen saturation of 85%. Sputum samples were sent to the microbiology laboratory for testing. Acid-fast staining with 1% H2SO4 showed acid-fast branching filamentous rods, but Nocardia could not be isolated in culture. The sample was subjected to 16S rRNA gene sequencing, which identified the pathogen as Nocardia wallacei. The culture of the sputum did not grow any pathogenic organisms, and the blood culture was sterile. Unfortunately, the patient left the hospital against medical advice as he was advised for intubation. The patient could not survive and died the next day after leaving the hospital. N. wallacei can be fatal and cause disseminated infection in both immunosuppressed and immunocompetent patients. Only eight case reports of N. wallacei have been reported in the literature from various parts of the world. Our case is the first case report of N. wallacei from India.

A Fatal Case of Multidrug-Resistant Pleural Nocardiosis by Nocardia otitidiscaviarum in an Immunosuppressed Patient: A Case Report and Literature Review.

Nocardiosis is known as an opportunistic infection in immunocompromised hosts. We present to you a case of pleural nocardiosis in a 38-year-old male patient who was a chronic smoker and presented with a left-sided pleural effusion. He was a known case of thrombocytopenia due to immune thrombocytopenia (ITP) and was on steroid therapy. On admission, he was found to be positive for HIV. Pleural fluid was sent to microbiology, where acid-fast staining with 1% sulfuric acid (H2SO4)showed acid-fast branching filamentous rods and cultures grew Nocardia, which was resistant to ampicillin, ceftriaxone, imipenem, cotrimoxazole, erythromycin, tetracycline, and susceptible to amikacin, linezolid, and levofloxacin. The isolate was identified as Nocardia otitidiscaviarum using 16S rRNA gene sequencing. Culture from the chest wall drain grew Escherichia coli and Stenotrophomonas maltophilia. Subsequently, the patient developed sepsis, and paired blood cultures grew Candida guilliermondii. Unfortunately, the patient could not survive despite aggressive efforts and died after 40 days of admission.

Enhancing Industrial Communication with Ethernet/Internet Protocol: A Study and Analysis of Real-Time Cooperative Robot Communication and Automation via Transmission Control Protocol/Internet Protocol.

This study explores the important task of validating data exchange between a control box, a Programmable Logic Controller (PLC), and a robot in an industrial setting. To achieve this, we adopt a unique approach utilizing both a virtual PLC simulator and an actual PLC device. We introduce an innovative industrial communication module to facilitate the efficient collection and storage of data among these interconnected entities. The main aim of this inquiry is to examine the implementation of Ethernet/IP (EIP), a relatively new addition to the industrial network scenery. It was designed using ODVA's Common Industrial Protocol (CIP™). The Costumed real-time data communication module was programmed in C++ for the Linux Debian platform and elegantly demonstrates the impressive versatility of EIP as a means for effective data transfer in an industrial environment. The study's findings provide valuable insights into Ethernet/IP's functionalities and capabilities in industrial networks, bringing attention to its possible applications in industrial robotics. By connecting theoretical knowledge and practical implementation, this research makes a significant contribution to the continued development of industrial communication systems, ultimately improving the efficiency and effectiveness of automation processes.

The comparative study of skin staples and polypropylene sutures for securing the mesh in Lichtenstein's tension-free inguinal hernia repair in HIV and hepatitis (B and C)-positive patients: a randomized controlled trial.

Introduction: The mesh fixation in the Lichtenstein's hernioplasty was traditionally performed with polypropylene sutures. A modification of this technique uses skin staples for securing the mesh. Using polypropylene sutures may increase the needle prick injuries (NPIs) in HIV and hepatitis-positive patients. This is the first study in India to compare the efficacy of anchoring the mesh with skin staplers and polypropylene sutures in hepatitis and HIV-positive patients. Methods: Fifty-two seropositive patients undergoing sixty repairs were randomized into two groups. In the control group polypropylene mesh was secured with polypropylene sutures and the skin was closed with ethilon. In the study group polypropylene mesh was secured with skin staples and the skin was closed with staples from the same stapler. Duration of surgery, postoperative complications, NPIs, recurrences and costs were compared. Results: The operation was significantly shorter when staples were used (median 46 vs. 57 min, P<0.00001). There was no significant difference in the incidence of postoperative complications. The NPIs was statistically significant in the suture group as compared to the stapler group (P<0.05). Conclusion: Using skin staples to secure the mesh in Lichtenstein inguinal hernioplasty significantly reduced the duration of surgery. It was as effective as conventional mesh fixation with polypropylene with added advantages to reduce the operating time, duration of exposure to infected blood, and the NPIs significantly in HIV, hepatitis B virus and hepatitis C virus-positive patients.

3D printable, injectable amyloid-based composite hydrogel of bovine serum albumin and aloe vera for rapid diabetic wound healing.

Protein-based biomaterials, particularly amyloids, have sparked considerable scientific interest in recent years due to their exceptional mechanical strength, excellent biocompatibility and bioactivity. In this work, we have synthesized a novel amyloid-based composite hydrogel consisting of bovine serum albumin (BSA) and aloe vera (AV) gel to utilize the medicinal properties of the AV gel and circumvent its mechanical frangibility. The synthesized composite hydrogel demonstrated an excellent porous structure, self-fluorescence, non-toxicity, and controlled rheological properties. Moreover, this hydrogel possesses inherent antioxidant and antibacterial properties, which accelerate the rapid healing of wounds. The in vitro wound healing capabilities of the synthesized composite hydrogel were evaluated using 3T3 fibroblast cells. Moreover, the efficacy of the hydrogel in accelerating chronic wound healing via collagen crosslinking was investigated through in vivo experiments using a diabetic mouse skin model. The findings indicate that the composite hydrogel, when applied, promotes wound healing by inducing collagen deposition and upregulating the expression of vascular endothelial growth factor (VEGF) and its receptors. We also demonstrate the feasibility of the 3D printing of the BSA-AV hydrogel, which can be tailored to treat various types of wound. The 3D printed hydrogel exhibits excellent shape fidelity and mechanical properties that can be utilized for personalized treatment and rapid chronic wound healing. Taken together, the BSA-AV hydrogel has great potential as a bio-ink in tissue engineering as a dermal substitute for customizable skin regeneration.

A new species of Coenodomus Walsingham, 1888 (Epipaschiinae, Pyralidae, Lepidoptera) from India.

In the present manuscript, one new species, Coenodomus wangi Ranjan, Singh & Kirti, sp. nov., is described and diagnosed with its closely similar species, C. dudgeoni Hampson, 1896 and C. rotundinidus Hampson, 1891. An updated checklist of global Coenodomus species is provided.

On the taxonomy of genus Endotricha Zeller (Pyralinae, Pyralidae, Lepidoptera) with description of three new species from India.

Herein, we deal with the taxonomy of 12 species of Endotricha including three new species: Endotricha sikkima Ranjan, N. Singh & Kirti, sp. nov., E. fuscosimilata Ranjan, N. Singh & Kirti, sp. nov. and E. lii Ranjan, N. Singh & Kirti, sp. nov. from India. Endotricha dumalis Wang & Li, 2005 and E. valentis Kirpichnikova, 2003 are reported for the first time from India. Synonymy (if any), diagnosis, material examined, distribution, and illustrations of the male adults and genitalia are provided for all the studied species, and female adults and their genitalia for four species. For the new species, a detailed description is also given.

Evaluation of in-vitro colistin susceptibility and clinical profile of carbapenem resistant Enterobacteriaceae related invasive infections.

PURPOSE: To determine the colistin susceptibility. To compare E-test vs broth-microdilution (BMD) method for invasive carbapenem resistant Enterobacteriaceae (CRE) infections. To study treatment options for the CRE. To analyze the clinical profile and outcome of CRE infections. METHODS: Antimicrobial susceptibility testing was performed for 100 invasive CRE isolates. Gradient diffusion and BMD methods were performed to determine colistin MICs. Essential agreement (EA), categorical agreement (CA), very major error (VME), and major error (ME) were worked out between BMD method and E-test. The clinical profile of patients was analyzed. RESULTS: The majority of the patients suffered from bacteremia [47(47%)]. Klebsiella pneumoniae was the most common organism isolated overall as well as among bacteremic isolates. 9(9%) CRE isolates were colistin resistant by BMD of which six were Klebsiella pneumoniae. There was 97% CA between E-test and BMD. EA was 68%. VME was found in three out of nine colistin resistant isolates. No ME was found. Among the other antibiotics tested for CRE isolates, the highest susceptibility was seen to tigecycline [43(43%)] followed by amikacin [19 (19%)]. The most common underlying condition was post solid organ transplantation [36(36%)]. A higher survival rate was seen among non-bacteremic CRE infections (58.49%) than bacteremic CRE infections (42.6%). Four out of nine patients with colistin resistant CRE infections survived and had a satisfactory outcome. CONCLUSION: Klebsiella pneumoniae was the most common organism causing invasive infection. Survival rates were higher in non-bacteremic CRE infections than bacteremic infections. Good CA was seen between E-test and BMD for colistin susceptibility, but the EA was poor. VME was more common than ME when E-tests were used for colistin susceptibility testing resulting in false susceptibility. Tigecycline and aminoglycosides are possible adjunct drugs for the treatment of invasive CRE infections.