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1.
Curr Genet ; 2021 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-34837516

RESUMO

Lipases from Pseudomonas species are particularly useful due to their broader biocatalytic applications and temperature activity. In this study, we amplified the gene encoding wild-type cold-active lipase from the genome of psychrotrophic bacterium isolated from the Himalayan glacier. The isolated CRBC14 strain was identified as Pseudomonas sp. based on the 16S rRNA gene sequence. Lipase activity was determined by observing the hydrolysis zone on nutrient agar containing tributyrin (1%, v/v). The sequence analysis of cold-active lipase revealed a protein of 611 amino acids with a calculated molecular mass of 63.71 kDa. The three-dimensional structure of this lipase was generated through template-supported modeling. Distinct techniques stamped the model quality, following which the binding free energies of tributyrin and oleic acid in the complex state with this enzymatic protein were predicted through molecular mechanics generalized born surface area (MMGBSA). A relative comparison of binding free energy values of these substrates indicated tributyrin's comparatively higher binding propensity towards the lipase. Using molecular docking, we evaluated the binding activity of cold-active lipase against tributyrin and oleic acid. Our docking analysis revealed that the lipase had a higher affinity for tributyrin than oleic acid, as evidenced by our measurement of the hydrolysis zone on two media plates. This study will help to understand the bacterial diversity of unexplored Himalayan glaciers and the possible application of their cold-adapted enzymes.

2.
Emerg Med J ; 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34759014

RESUMO

BACKGROUND: Five million people die annually due to injuries; an increasing part is due to armed conflict in low-income and middle-income countries, demanding resolute emergency trauma care. In Afghanistan, a low-income country that has experienced conflict for over 35 years, conflict related trauma is a significant public health problem. To address this, the non-governmental organisation Médecins Sans Frontières (MSF) set up a trauma centre in Kunduz (Kunduz Trauma Centre (KTC)). MSF's standardised emergency operating procedures include the South African Triage Scale (SATS). To date, there are few studies that assess how triage levels correspond with outcome in low-resource conflict settings AIM: This study aims to assess to what extent SATS triage levels correlated to outcomes in terms of hospital admission, intensive care unit (ICU) admission and mortality for patients treated at KTC. METHOD AND MATERIALS: This retrospective study used routinely collected data from KTC registries. A total of 17 970 patients were included. The outcomes were hospital admission, ICU admission and mortality. The explanatory variable was triage level. Covariates including age, gender and delay to arrival were used. Logistic regression was used to study the correlation between triage level and outcomes. RESULTS: Out of all patients seeking care, 28.7% were triaged as red or orange. The overall mortality was 0.6%. In total, 90% of those that died and 79% of ICU-admitted patients were triaged as red. CONCLUSION: The risk of positive and negative outcomes correlated with triage level. None of the patients triaged as green died or were admitted to the ICU whereas 90% of patients who died were triaged as red.

3.
Saudi J Biol Sci ; 28(11): 6050-6056, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34764738

RESUMO

Food and nutritional security continue to be the issues of concern in developing countries like ours. Exploring the reservoir of high potential unexplored genetic resources could address the world's food and nutritional insecurity. The availability of diverse data and the population structure of any crop germplasm is a valuable genetic resource for discovering genes that can help achieve food and nutritional stability. We used seven ISSR and seven SSR markers to investigate diversity among 63 buckwheat genotypes, including landraces from India's northwestern Himalayas. Various parameters such as percent polymorphism, PIC, resolving power, and marker index was used to evaluate the inequitable efficacy of these markers. We foundthat both marker systems are effective in detecting polymorphism in buckwheat germplasm. Seven ISSRs produced 55 polymorphic bands, while seven SSRs produced 32bands. When compared to ISSRs, SSRs had a greater average PIC value (0.43) than that of (0.36). ISSRs, on the other hand, had a resolving power of (4.38) compared to (1.42) for SSRs. The hierarchical cluster analysis dendrogram divided genotypes into three major clusters. We found that both marker systems were equally accurate in grouping buckwheat genotypes according to their geographical origins. Using 7 ISSR and 7 SSR markers, the model-based STRUCTURE analysis established a population with two sub-populations that correspond to species-based groupings. Within the population, there was a high level of genetic diversity. These results have consequences for both buckwheat breeding and conservation efforts.

4.
Obes Surg ; 31(12): 5303-5311, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34617207

RESUMO

BACKGROUND: Fasting during Ramadan is one of the five pillars of the Muslim faith. Despite the positive effects of fasting on health, there are no guidelines or clear recommendations regarding fasting after metabolic/bariatric surgery (MBS). The current study reports the result of a modified Delphi consensus among expert metabolic/bariatric surgeons with experience in managing patients who fast after MBS. METHODS: A committee of 61 well-known metabolic and bariatric surgeons from 24 countries was created to participate in the Delphi consensus. The committee voted on 45 statements regarding recommendations and controversies around fasting after MBS. An agreement/disagreement ≥ of 70.0% was regarded as consensus. RESULTS: The experts reached a consensus on 40 out of 45 statements after two rounds of voting. One hundred percent of the experts believed that fasting needs special nutritional support in patients who underwent MBS. The decision regarding fasting must be coordinated among the surgeon, the nutritionist and the patient. At any time after MBS, 96.7% advised stopping fasting in the presence of persistent symptoms of intolerance. Seventy percent of the experts recommended delaying fasting after MBS for 6 to 12 months after combined and malabsorptive procedures according to the patient's situation and surgeon's experience, and 90.1% felt that proton pump inhibitors should be continued in patients who start fasting less than 6 months after MBS. There was consensus that fasting may help in weight loss, improvement/remission of non-alcoholic fatty liver disease, dyslipidemia, hypertension and type 2 diabetes mellitus among 88.5%, 90.2%, 88.5%, 85.2% and 85.2% of experts, respectively. CONCLUSION: Experts voted and reached a consensus on 40 statements covering various aspects of fasting after MBS.

5.
Infect Chemother ; 53(1): 96-106, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34409783

RESUMO

BACKGROUND: Acute undifferentiated febrile illness (AUFI) is one of the most daunting challenges a physician faces in such settings. Among AUFI, rickettsial infections are most common and related infections (such as anaplasmosis, ehrlichiosis, and Q fever) which are caused by an unusual type of bacteria that can live only inside the cells of another organism. The present study was therefore planned with an objective to estimate the prevalence of rickettsial infection among patients of undifferentiated fever and to determine any association of socio-demographic characteristics with rickettsial disease. MATERIALS AND METHODS: Patients presenting with febrile illness and admitted or attending out-patient department of Sher-i-Kashmir Institute of Medical Sciences, Srinagar was approached and recruited in the study. Weil Felix Assay, enzyme-linked immunosorbent assay and indirect immunofluorescence assay were done to detect the anti-rickettsial antibodies. Serological evidence of a fourfold increase in IgG-specific antibody titer reactive with spotted fever group rickettsial antigen by indirect immunofluorescence antibody assays between paired serum specimens was considered a confirmatory diagnosis for the rickettsial disease. RESULTS: Most of the patients were males 61.6%, and most 46.2% were in the age group of 20 -39 years. Most of the patients, 80.8% belonged to rural areas, and 48% belonged to the upper middle (II) class of the socio-economic class according to modified Kuppuswamy scale. Of the studied participants, a majority, 47.0%, were determined undiagnosed, while 15.4% studied participants were diagnosed to have a rickettsial disease. In patients positive for typhus group, 67.8% were IgM positive, 28.5% were IgG positive, and only 3% were positive for IgM and IgG. In patients positive for Scrub Typhus Group, 32.7% were positive for IgM, and 62.0% were positive for IgG, and only 5.0% were positive for both IgM and IgG. In patients positive for spotted fever group, 36.1% were positive for IgM, and 58.5% were positive for IgG, and only 5.5% were positive for both IgM and IgG. The prevalence of rickettsial disease was found to be 11.3%. CONCLUSION: Rickettsial diseases, typhoid and brucellosis, were the most prevalent diseased diagnosed among patients reporting to hospitals with undifferentiated febrile illness. Clinicians must consider rickettsial diseases as one of the differential diagnosis while treating patients with fever.

6.
Gene Rep ; 24: 101270, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34250314

RESUMO

SARS-CoV-2 virus, the main culprit for COVID-19 disaster, has triggered a gust of curiosity both in the mechanism of action of this infection as well as potential risk factors for disease generation and regimentation. The prime focus of the present review, which is basically a narrative one, is in utilizing the current concepts of vitamin D3 as an agent with myriad functions, one of them being immunocompetence and a promising weapon for both innate and adaptive immunity against COVID-19 infection. Some of the manifestations of SARS-CoV-2 virus such as Acute Respiratory Distress Syndrome (ARDS) overlap with the pathophysiological effects that are overcome due to already established role of vitamin D3 e.g., amelioration of cytokine outburst. Additionally, the cardiovascular complications due to COVID-19 infection may also be connected to vitamin D3 levels and the activity of its active forms. Eventually, we summarise the clinical, observational and epidemiological data of the respiratory diseases including COVID-19 disease and try to bring its association with the potential role of vitamin D3, in particular, the activity of its active forms, circulating levels and its supplementation, against dissemination of this disease.

7.
Pituitary ; 2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34328604

RESUMO

PURPOSE: Sheehan's Syndrome (SS) is one of the most important causes of hypopituitarism in developing countries with patients having varying degrees and severity of anterior pituitary hormone deficiency including growth hormone deficiency (GHD). SS is characterized by increased clustering of metabolic and proinflammatory risk factors predisposing them to increased cardiovascular morbidity and mortality. Coronary calcium deposits (CCD), a marker for significant coronary atherosclerosis, is used for evaluation in asymptomatic individuals of global cardiac risk to develop events related to coronary heart disease (CHD). This study therefore aimed to evaluate the prevalence of coronary artery disease in patients with SS appropriately replaced for pituitary hormone deficiencies but untreated for GHD. METHODS: Thirty patients previously diagnosed with SS and stable on a conventional replacement treatment for at least 6 months before the study and thirty age and Body Mass Index (BMI) matched controls were enrolled in this observational study. The subjects underwent detailed clinical, biochemical, and hormone analysis. Coronary multidetector computed tomography was performed in 19 SS patients and 19 healthy participants by a 16-row multislice scanner. Non contrast acquisitions were performed to detect coronary calcifications. Calcium was quantified by the Agatston score (AS) in all subjects. AS > 10 indicates increased CHD risk. RESULTS: The mean (± SD) age was 38.30 ± 10.73 years and the diagnostic delay was 11.35 ± 4.74 years. Patients with SS had significantly higher mean triglyceride, total cholesterol, and low density lipoprotein (LDL) cholesterol and lower HDL cholesterol concentrations on conventional replacement therapy. The prevalence of CCD was significantly higher in patients of SS compared to controls (42.1% vs. 5.3%; P = 0.023). The presence of CCD and AS > 10 were detected in 42.1% and 31.6% of patients respectively. The presence of significant calcification (Agatston score > 10) was documented in 75% of patients (6/8) of the SS patients with CCD compared to none in the control group (P = 0.019). (Left anteriordescending, 1; left circumflex, 2; right coronary artery, 2 and posterior descending, 1) CONCLUSION: Since coronary artery calcium is an independent predictor of CHD events, the presence of significant prevalence of CCD in patients with SS compared to healthy matched controls, undermines the importance of early risk stratification of SS individuals with plethora of conventional cardiovascular risk factors that are at relatively high risk to avoid the adverse vascular consequences.

8.
J Air Waste Manag Assoc ; : 1-10, 2021 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-34292860

RESUMO

The present study aims at quantification of the quality of three varieties of composts made from municipal solid waste, green waste and combined waste by critically evaluating their physicochemical attributes, effect on soil fertility and metal pollution risk. Each waste type was treated with effective micro-organisms to compare the compost quality using Quality Control Indices. The effect of microbial consortia on the wastes was prominent resulting in decreased pH levels and increased electrical conductivity. C/N ratio ranged between 14-24 for waste composts without microbial treatment, and 8-11 for microbial treated wastes. The fertility parameter was observed to be more in microbial treated waste composts. Also, heavy metals concentration in waste compost without effective microbial treatment was higher than the types given EM. Based on the fertility and clean indices, the treated and untreated municipal solid waste and combined waste compost belonged to class RU-1 and class D, respectively. Moreover, compost prepared from treated and untreated green waste belonged to classes B and C respectively. In general, the prepared CW and GW composts have medium to high fertilizing potential and are fit for domestic as well as commercial use. However, MSW compost is not fit for agricultural purposes as it didn't improve soil fertility to a greater extent but can be used as a soil conditioner in limited quantity as it can cause metal toxicity. For this reason, proper segregation of inputs at the start of a composting process is necessary to improve its quality before being put to agricultural use as any unbalanced or unchecked content of mixed waste will affect the overall compost quality.Implications: Significance of the work: The research dealt with different combinations of segregated wastes to analyze the best fit solid waste compost. Experiments were conducted on the actual landfill site area to simulate the conditions for the process. The manuscript provides evidence and other facts advocating the use of composting for waste management and ultimately reducing pollution caused by landfilling. It ought to cause a multiplier effect if the same is to be followed in other parts of the world, and thus working our way toward getting the Smart city project to fruition. The results of the study exhibit the differences in physiochemical nature of various types of composts. A treatment of microbial consortium with restrictions enabled a conducive atmosphere in the colonies to thrive faster and initiate the process of decomposition. We observed that treated samples converted faster into compost as compared to non-treated samples. We also observed the effect of treatment on fertility parameters of prepared compost samples. In general, it was found that the organic carbon and C/N ratio declined while the total nitrogen and total potassium was observed to increase with very little to no change in phosphorous content, with the inoculation of beneficial micro-organisms throughout the composting course. A reduction in the heavy metal levels was observed in samples treated with active micro-organisms. The compost classification into A, B, C, and D classes represents the quality of compost and further use in agricultural land on commercial levels. The quality index values were determined highest for green waste compost (GWC). The municipal solid waste compost (MSWC) exhibited lowest index values. Therefore, based on the quality index values, the utilization of GWC will aid in reutilizing the green waste and in boosting soil fertility and reduce the waste quantity generation rates. It's also necessary to make compost making widespread among the farmers for a sustainable environment. The GWC has been considered as a sustainable option of waste management, being economically and ecologically viable.

9.
Semin Cancer Biol ; 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34273520

RESUMO

The lung microbiome plays an essential role in maintaining healthy lung function, including host immune homeostasis. Lung microbial dysbiosis or disruption of the gut-lung axis can contribute to lung carcinogenesis by causing DNA damage, inducing genomic instability, or altering the host's susceptibility to carcinogenic insults. Thus far, most studies have reported the association of microbial composition in lung cancer. Mechanistic studies describing host-microbe interactions in promoting lung carcinogenesis are limited. Considering cancer as a multifaceted disease where epigenetic dysregulation plays a critical role, epigenetic modifying potentials of microbial metabolites and toxins and their roles in lung tumorigenesis are not well studied. The current review explains microbial dysbiosis and epigenetic aberrations in lung cancer and potential therapeutic opportunities.

10.
Pak J Pharm Sci ; 34(1(Special)): 403-409, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34275786

RESUMO

This study was carried out to isolate the secondary metabolites and to evaluate the antibacterial, antifungal, antioxidant, phytotoxic, anti-leishmanial and α-glucosidase activities of dichloromethane and methanol extracts of whole plant of Astragalus creticus. Preliminary phytochemical screening indicated flavonoids, saponins, tannins and cardiac glycosides in this plant. Phytochemical evaluation of methanol extract resulted in isolation and characterization of Ethyl gallate, 1-triacontanoic acid, quercimeritrin, kaempferol-7-O-ß-D-glucopyranose, myricetin, kaempferol, betulinic acid, stigmasterol and Daucosterol. The structures of the compounds were determined by Mass and NMR spectroscopy. The methanol extract exhibited better activity against Staphylococcus aureus (58.75%) while dichloromethane extract was found to be very active against Bacillus subtilis (56.30%).The methanol extract demonstrated highly significant phytotoxic (92.68% at 1000µg/ml) and antioxidant (64.55±0.43%) potential while both extracts identified best inhibition of α-glucosidase enzyme. The plant extracts showed non-significant antifungal and anti-leishmanial activities. To our knowledge, it's a first research study on Astragalus creticus that indicate a great biological and phytochemical potential in it.

11.
J Trop Pediatr ; 67(3)2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34152424

RESUMO

INTRODUCTION: There is a lack of large multicentric studies in children with COVID-19 from developing countries. We aimed to describe the clinical profile and risk factors for severe disease in children hospitalized with COVID-19 from India. METHODS: In this multicentric retrospective study, we retrieved data related to demographic details, clinical features, including the severity of disease, laboratory investigations and outcome. RESULTS: We included 402 children with a median (IQR) age of 7 (2-11) years. Fever was the most common symptom, present in 38.2% of children. About 44% had underlying comorbidity. The majority were asymptomatic (144, 35.8%) or mildly symptomatic (219, 54.5%). There were 39 (9.7%) moderate-severe cases and 13 (3.2%) deaths. The laboratory abnormalities included lymphopenia 25.4%, thrombocytopenia 22.1%, transaminitis 26.4%, low total serum protein 34.7%, low serum albumin 37.9% and low alkaline phosphatase 40%. Out of those who were tested, raised inflammatory markers were ferritin 58.9% (56/95), c-reactive protein 33.3% (41/123), procalcitonin 53.5% (46/86) and interleukin-6 (IL-6) 76%. The presence of fever, rash, vomiting, underlying comorbidity, increased total leucocyte count, thrombocytopenia, high urea, low total serum protein and raised c-reactive protein was factors associated with moderate to severe disease. CONCLUSION: Fever was the commonest symptom. We identified additional laboratory abnormalities, namely lymphopenia, low total serum protein and albumin and low alkaline phosphatase. The majority of the children were asymptomatic or mildly symptomatic. We found high urea and low total serum protein as risk factors for moderate to severe disease for the first time.


Assuntos
COVID-19 , SARS-CoV-2 , Criança , Humanos , Índia/epidemiologia , Estudos Retrospectivos , Fatores de Risco
12.
Int J Prison Health ; ahead-of-print(ahead-of-print)2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34107200

RESUMO

PURPOSE: This study aims to review international literature systematically to estimate the prevalence of homelessness among incarcerated persons at the time of imprisonment and the time of discharge. DESIGN/METHODOLOGY/APPROACH: A systematic review methodology was used to identify quantitative observational studies that looked at the prevalence of homelessness at the time of imprisonment, or up to 30 days prior to that point (initial homelessness), and at the time of discharge from prisons. Studies reported in English from inception to 11 September 2019 were searched for using eight databases (PsycInfo, Medline, Embase, CINAHL, PsycArticles, Scopus, Web of Science and the Campbell Collaboration), in addition to grey literature. Studies were screened independently by three researchers. Results of studies meeting inclusion criteria were meta-analysed using a random effects model to generate pooled prevalence data. FINDINGS: A total of 18 out of 2,131 studies met the inclusion criteria. All studies originated from the USA, Canada, UK, Ireland or Australia. The estimated prevalence of initial homelessness was 23.41% and at time of discharge was 29.94%. Substantial heterogeneity was observed among studies. ORIGINALITY/VALUE: People in prisons are over twenty times more likely to be homeless than those in the general population. This is likely attributable to a range of health and social factors. Studies in this analysis suggest higher rates of homelessness in minority populations and among those with mental illnesses and neurodevelopmental disorders. While there was significant heterogeneity among studies, the results highlight the global burden of this issue and a clear necessity for targeted interventions to address homelessness in this population.

13.
Artigo em Inglês | MEDLINE | ID: mdl-34124868

RESUMO

BACKGROUND: This paper describes the access to care for mental health problems in Afghanistan, according to the nature of the mental health problems and the service provider. Following the Andersen model, it evaluates the respective roles in access to care of "predisposing," "needs," "enabling" factors, and other "environmental" factors such as exposure to traumatic events and level of danger of the place of residence. METHODS: Trans-sectional probability survey in general population by multistage sampling in 16 provinces, nationally representative: N=4445 (15 years or older), participation rate of 81%. Face to face interviews using standardized measures of mental health (CIDI, Composite International Diagnostic Interview). Different logistic regression models are presented. RESULTS: The 12-month rate of mental health help-seeking was 6.56% with substantial regional variation (2.35% to 12.65%). Providers were mainly from the health sector; the non-health sector (religious and healers) was also prevalent. Most consultations were held in private clinics (non-governmental organisation, NGO). The severity of mental health disorders as well as the perceived impairment due to mental health were independently very important: odds ratio (OR) = 6.04 for severe disorder, OR=3.79 for perceived impairment. Living in a dangerous area decreased access to care: for high level of danger and for very high level: OR=0.22. Gender, education and ethnicity were not associated with mental health help-seeking after controlling for exposure to trauma. CONCLUSION: Access to care for mental health problems depended mainly on the needs as defined as disorder severity level and impairment, and on environmental factors such as exposure to traumatic events. The system seems equitable; however, this is counterbalanced by a very challenging environment. This survey is a testimony to the hardship experienced by the Afghan population and by health professionals, and to the efforts to deliver organized mental healthcare in a challenging situation. This research may inform and support policy-makers and NGOs in other countries undergoing similar challenges.

14.
BMC Psychiatry ; 21(1): 314, 2021 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-34158003

RESUMO

BACKGROUND: This survey attempts to measure at a national level, exposures to major traumas and the prevalence of common mental health disorders in a low-income dangerous country, highly affected by conflicts: Afghanistan. METHODS: Trans-sectional probability survey in general population by multistage sampling in 8 provinces, represented nationwide: 4445 adults (4433 weighted),15 years or older, 81% participation rate. Face to face interviews used specific scales for measuring lifetime exposure (LEC 5 Life Events Checklist) and Post Traumatic Stress Disorder (PTSD Check List), a diagnostic standardized interview: Composite International Diagnostic Interview (Short Form) for. Major Depressive Episode and Generalized Anxiety Disorder, plus scales for suicidal thoughts and attempts and psychological distress (MH5 and RE from SF36). RESULTS: 52.62% of the population is illiterate, 84,61% of the women do not have any source of income; 70.92% of the population lives in rural areas, 60.62% are below 35 years, 80% lives in very dangerous areas. 64.67% of the Afghan population had personally experienced at least one traumatic event; 78.48% had witnessed one such event. 60.77% of the sample experienced collective violence in relation to war and 48.76% reported four or more events; this very much differs across regions and levels of danger; women are less at risk for trauma except sexual violence, 35 years and above are more at risk than younger. 12-month PTSD prevalence reaches a high rate: 5.34% as MDE 11,71%, whereas GAD 2.78%; suicidal thoughts 2.26%, lifetime suicidal attempts 3.50% are close to reported in other countries. Women have more risk for PTSD (0R = 1.93) and suicidal behaviours (attempts OR = 1.92) than men; the number of events increases risk for MDE, PTSD and suicidal attempts, whereas education is protective. Exposure to different war events produced different mental health effects. People suffering from PTSD have higher risk to report 12-months suicidal ideations and lifetime suicidal attempts. CONCLUSION: Our findings highlight the need to map the extent and the types of mental disorders post conflict; this would help maximise the help to be offered in guiding proper choice of interventions, including education.


Assuntos
Transtorno Depressivo Maior , Transtornos de Estresse Pós-Traumáticos , Adulto , Afeganistão/epidemiologia , Transtornos de Ansiedade/epidemiologia , Feminino , Humanos , Masculino , Saúde Mental , Transtornos de Estresse Pós-Traumáticos/epidemiologia
15.
J Trop Pediatr ; 67(2)2021 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-34100087

RESUMO

OBJECTIVE: The objective of this study is to find the organism profile and antimicrobial susceptibility patterns in children with cystic fibrosis (CF). DESIGN: Prospective cohort study. SETTING: Hospital-based study. INTERVENTION: Sputum cultures/throat swabs were collected from the study population. Relevant details like anthropometry, systemic examination findings and investigations were entered in a pre-designed format. Sputum culture was subjected to microbiological analysis at the hospital microbiology laboratory. MAIN OUTCOME MEASURE: Prevalence of positive sputum/cough swab culture in CF patients, their organism profile and antibiotic sensitivity. RESULTS: A total of 63 patients were enrolled in the study. A total of 136 organisms were grown in our study population. Thirteen different organisms were isolated, which included five gram-positive bacteria, six gram-negative bacteria, eight Candida spp. and one filamentous. Antibiotic sensitivity profile of the Pseudomonas aeruginosa showed excellent sensitivity to all the aminoglycosides, piperacillin-tazobacteum and polymixin, similarly methicillin-sensitive Staphylococcus aureus, methicillin-resistant S. aureus and Enterococcus spp. were uniformly sensitive to vancomycin, linezolid and teicoplanin. Fungal isolates showed 100% sensitivity to all the antifungals tested including azoles and amphotericin B. CONCLUSION: We observed 61% of culture positivity for different organisms in our study. Staphylococcus aureus and P. aeruginosa were the most frequently isolated organisms. Pseudomonas aeruginosa isolates were largely sensitive to aminoglycosides, carbapenems and polymixin. We found an unusually higher incidence of enterococcal infection in our study cohort with few vancomycin-resistant isolates.


Assuntos
Fibrose Cística , Staphylococcus aureus Resistente à Meticilina , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Criança , Estudos de Coortes , Fibrose Cística/tratamento farmacológico , Fibrose Cística/epidemiologia , Humanos , Índia/epidemiologia , Testes de Sensibilidade Microbiana , Estudos Prospectivos , Pseudomonas aeruginosa
16.
J Pak Med Assoc ; 71(4): 1282-12568, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34125791

RESUMO

Sheehan syndrome is an underestimated cause of hypopituitarism, which can be either partial or complete. It results from ischaemic necrosis of anterior pituitary during peripartum period leading to loss of one or more pituitary cell lines. Hyperplasia of pituitary gland during pregnancy increases demand for blood supply and at the same time compresses the pituitary gland. Severe postpartum haemorrhage leads to hypovolaemia and vasospasm of supplying vessels resulting in infarction of pituitary tissue. Congenital or acquired thrombophilia and autoimmunity exaggerate this phenomenon. Presentation is usually delayed by many years. It presents with symptoms of anterior pituitary hormone loss after a delay of many years. Rarely presentation may be acute or involve posterior pituitary as well. Low basal or stimulated pituitary hormones along with classic clinical setting clinches the diagnosis. Replacement of deficient hormones is the mainstay of treatment, however emphasis on better obstetric care to common masses would help to eradicate the disease in future.


Assuntos
Hipopituitarismo , Hemorragia Pós-Parto , Feminino , Hormônios , Humanos , Hipopituitarismo/diagnóstico , Hipopituitarismo/etiologia , Hipopituitarismo/terapia , Hipófise , Hemorragia Pós-Parto/etiologia , Hemorragia Pós-Parto/terapia , Período Pós-Parto , Gravidez
17.
Sci Rep ; 11(1): 12768, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-34140593

RESUMO

As an approach to the exploration of cold-active enzymes, in this study, we isolated a cold-active protease produced by psychrotrophic bacteria from glacial soils of Thajwas Glacier, Himalayas. The isolated strain BO1, identified as Bacillus pumilus, grew well within a temperature range of 4-30 °C. After its qualitative and quantitative screening, the cold-active protease (Apr-BO1) was purified. The Apr-BO1 had a molecular mass of 38 kDa and showed maximum (37.02 U/mg) specific activity at 20 °C, with casein as substrate. It was stable and active between the temperature range of 5-35 °C and pH 6.0-12.0, with an optimum temperature of 20 °C at pH 9.0. The Apr-BO1 had low Km value of 1.0 mg/ml and Vmax 10.0 µmol/ml/min. Moreover, it displayed better tolerance to organic solvents, surfactants, metal ions and reducing agents than most alkaline proteases. The results exhibited that it effectively removed the stains even in a cold wash and could be considered a decent detergent additive. Furthermore, through protein modelling, the structure of this protease was generated from template, subtilisin E of Bacillus subtilis (PDB ID: 3WHI), and different methods checked its quality. For the first time, this study reported the protein sequence for psychrotrophic Apr-BO1 and brought forth its novelty among other cold-active proteases.


Assuntos
Bactérias/enzimologia , Temperatura Baixa , Camada de Gelo/microbiologia , Peptídeo Hidrolases/isolamento & purificação , Microbiologia do Solo , Sequência de Aminoácidos , Bactérias/isolamento & purificação , Caseínas/metabolismo , Domínio Catalítico , Inibidores Enzimáticos/farmacologia , Estabilidade Enzimática/efeitos dos fármacos , Concentração de Íons de Hidrogênio , Hidrólise , Índia , Íons , Cinética , Metais/farmacologia , Modelos Moleculares , Peso Molecular , Oxidantes/farmacologia , Peptídeo Hidrolases/química , Peptídeo Hidrolases/genética , Filogenia , Domínios Proteicos , Solventes/farmacologia , Especificidade por Substrato/efeitos dos fármacos , Tensoativos/farmacologia
18.
Endocr Pract ; 27(9): 925-933, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33652107

RESUMO

OBJECTIVE: To define optimal intact parathyroid hormone (iPTH) cut-off threshold predictive of hypocalcemia after total thyroidectomy for safe and effective postoperative management. METHODS: This prospective single center study was done in 2 phases. In phase I, predictors of symptomatic hypocalcemia were analyzed and the receiver operating characteristic curve was used to define the optimal iPTH cut-off threshold predictive of hypocalcemia. Phase II studied giving prompt prophylactic supplemental calcium and vitamin D to all patients who had iPTH levels below the calculated threshold, while phase I patients were given prompt selective supplementation if they had postoperative hypocalcemia or symptoms. RESULTS: Univariate analysis of patients in phase I showed that postoperative iPTH was the only significant variable that can predict symptomatic hypocalcemia. Using receiver operating characteristic curve and Youden index, the confirmed optimal cut-off threshold predictive of hypocalcemia was iPTH 19.95 pg/mL, with area under the curve of 0.903, 100% sensitivity, negative predictive value, and highest Youden index, while iPTH 15 pg/mL and iPTH 10 pg/mL were less optimal. Symptomatic hypocalcemia occurred in 30% of the phase I cohort who received selective supplementation versus 3% of those in the phase II cohort who received prophylactic supplementation. Return to emergency department and need for intravenous calcium were also significantly better in phase II. CONCLUSION: iPTH cut-off for post-thyroidectomy hypocalcemia was 19.95 pg/mL. Low-risk patients were discharged with no supplementation while all high-risk patients received prompt calcium and vitamin D supplementation, which led to effective hypocalcemia management and safe 24-hour discharge.


Assuntos
Hipocalcemia , Cálcio , Humanos , Hipocalcemia/tratamento farmacológico , Hipocalcemia/epidemiologia , Hipocalcemia/etiologia , Hormônio Paratireóideo , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Tireoidectomia/efeitos adversos
19.
Ir J Med Sci ; 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33590473

RESUMO

BACKGROUND: This cross-sectional study sought to establish the prevalence of homelessness amongst inpatients in two psychiatric units in Ireland and explore the perceived relationship between psychiatric illness and homelessness. METHODS: The study employed a semi-structured interview format utilising a specifically designed questionnaire which received ethical approval from the Limerick University Hospitals Group ethics committee. RESULTS: Fifty psychiatric inpatients were interviewed. Fifteen were either "currently" homeless (n = 8) or had experienced "past" homelessness (n = 7). Those who had experienced homelessness were more likely to have a psychotic illness. A majority of those who had experienced homelessness believed that psychiatric illness contributed to their homelessness. Involuntary admission rates were more than double for patients in the homeless group. A number of participants also reported that a lack of accommodation was preventing their discharge. CONCLUSION: Homelessness affects a significant number of psychiatric patients and can be both a contributory factor to, and consequence of, mental illness. With homelessness at unprecedented levels, there is a need for the development of tailored programmes aimed at supporting these vulnerable groups.

20.
Microb Pathog ; 151: 104715, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33444698

RESUMO

Cultured fisheries of developing countries are continously challenged by a number of pathogenic microbes. Among microbial diseases, fungal and fungal like pathogen outbreaks lead to negative social and economic impacts on stakeholders. The cultured fisheries of Kashmir valley are also facing challenge from fungal pathogens, leading to tremendous socio-economic lossess to the fish farmer community hence, yearns to boost the sector with efficient management strategy. Our study was aimed at investigating the diversity of fungal communities infecting cultured rainbow trout and carp fish species. We employed classical microbiology, macro and micro morphological characteristics, and molecular analysis (multilocus typing) for fungal identification. Also histopathological approach was used to examine the pathogenicity patterns of diverse fungal groups. The study revealed that the infection in fish was predisposed to both superficial as well as visceral organs. However, skin, gills and head were predominantly infected compared to internal organs. The microbiological investigation of infected fish by culture dependent approach helped us to obtain the total of 250 fungal isolates. Out of these isolates, 21 different species were identified belonging to three diverse fungal groups which mostly included 14 species among Ascomycetes, 03 species of Oomycetes and 04 species of Zygomycetes. The majority of fungi which were infectious to cultured fish of valley are biotrophic or opportunistic soil fungi, and some of them being exclusive pathogens of fish.


Assuntos
Doenças dos Peixes , Micobioma , Oncorhynchus mykiss , Animais , Doenças dos Peixes/epidemiologia , Índia/epidemiologia , Virulência
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