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BACKGROUND: Pantoea agglomerans is an environmental pathogen known to cause infection in immunocompromised individuals, particularly after thorn injuries. However, previous data showed few cases of human disease caused by contaminated medical products such as parenteral nutrition, anesthetic agents, blood, and peritoneal dialysis solutions. Infection in hemodialysis patients is rare. In this study, we presented a detailed account of several hemodialysis patients infected with this contagious pathogen and compared them with noninfected dialysis patients. METHODS: We retrospectively reviewed the hospital records of 105 hemodialysis patients. Seventeen of 105 patients were diagnosed with P. agglomerans infection. We carefully analyzed their entire in-hospital course. RESULTS: Among infected patients, 52.9% were male with a median age of 49 (IQR: 32-66) years. Compared to the noninfected patients, age below 50 years, prior kidney transplantation, prior immunosuppression and antibiotics use, and dialysis via a tunneled vascular catheter were the significant epidemiological features. Despite negative microbiological investigations, we suspect the possible infectious spread via infected central venous catheter was the likely infectious source. Most importantly, all patients responded well to intravenous antibiotics. Only two patients required the removal of the tunneled catheter. Their mortality rate was 0%. CONCLUSION: P. agglomerans infection, although considered rare, is becoming increasingly prevalent among dialysis patients. Its occurrence must be appraised as an infectious outbreak rather than mere contamination. Prompt treatment, source identification, and early implementation of preventive strategies should always be the goal to curtail this infection at an early stage.
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Cateterismo Venoso Central , Cateteres Venosos Centrais , Pantoea , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Diálise Renal/efeitos adversos , Estudos Retrospectivos , Centros de Atenção Terciária , Antibacterianos/uso terapêutico , Surtos de DoençasRESUMO
Facultative type of Halophytes is those which can easily grow on both saline and non-saline soil conditions Launaea nudicaulis (L.) Hook f. belongs to family compositae [Asteraceae] is facultative halophyte with great medicinal values. The main objective of this study is to explore anti-oxidant and anti-bacterial potential on different morphological parts of Launaea nudicaulis (L.) Hook f. The results of the antibacterial activity of methanolic extracts of leaves stem and roots of Launaea nudicaulis (L.) Hook f. showed that the potent antibacterial activity observed in all three morphological parts against Staphylococcus aureus. DPPH scavenging activity of extracts of root, stem, leaves against standard i.e., ascorbic acid at different concentrations of 20, 40, 60, 80 and 100 showed that root extract have more significant activity when compared to the ascorbic acid. Documented potentials of halophytes are elevating its prominence which motivates scientist to further explore with extensive research.
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Anti-Infecciosos , Asteraceae , Antioxidantes/farmacologia , Plantas Tolerantes a Sal , Extratos Vegetais/farmacologia , Paquistão , Anti-Infecciosos/farmacologia , Antibacterianos/farmacologia , Ácido Ascórbico/farmacologiaRESUMO
COVID-19 has evolved into one of the most severe and acute illnesses. The number of deaths continues to climb despite the development of vaccines and new strains of the virus have appeared. The early and precise recognition of COVID-19 are key in viably treating patients and containing the pandemic on the whole. Deep learning technology has been shown to be a significant tool in diagnosing COVID-19 and in assisting radiologists to detect anomalies and numerous diseases during this epidemic. This research seeks to provide an overview of novel deep learning-based applications for medical imaging modalities, computer tomography (CT) and chest X-rays (CXR), for the detection and classification COVID-19. First, we give an overview of the taxonomy of medical imaging and present a summary of types of deep learning (DL) methods. Then, utilizing deep learning techniques, we present an overview of systems created for COVID-19 detection and classification. We also give a rundown of the most well-known databases used to train these networks. Finally, we explore the challenges of using deep learning algorithms to detect COVID-19, as well as future research prospects in this field.
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COVID-19 , Aprendizado Profundo , Algoritmos , COVID-19/diagnóstico , Humanos , Pandemias , SARS-CoV-2RESUMO
Entecavir is a well-known antiviral drug, commonly prescribed for the treatment of hepatitis B and showed promising therapeutic effects against HBV polymerase. The replication of Hepatitis B Virus requires HBV-DNA polymerase and its natural substrate is deoxyguanosine triphosphate. Entercavir inhibit its activity by phosphorylating into its active metabolite. Furthermore, the efficiency of silver nanoparticles as an antimicrobial or antiviral agent is known for centuries. This study focused on the in-silico stability studies of silver nanoparticles of entecavir. The silver nanoparticles of entecavir synthesized by previously reported method. The stability of drug metal complex was predicted by analysis of variations in internal energies including potential energy, kinetic energy and different non-bonded energies during the simulation run of 4000 picoseconds of different molecular systems. After the simulation run it was concluded that the molecular systems of drug metal complex in aqueous solution at pH 4 showed greater instability as compared to the pH 2 and 6.9. This research gives the idea about the significance of molecular dynamics simulation technique in the field of pharmaceutical sciences for the analysis and characterization of pharmaceutical products and visualizes the effects of different environmental parameters on the structure and physicochemical properties of drug molecules.
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Hepatite B Crônica , Nanopartículas Metálicas , Antivirais/uso terapêutico , DNA Viral , Farmacorresistência Viral/genética , Guanina/análogos & derivados , Vírus da Hepatite B/genética , Humanos , Concentração de Íons de Hidrogênio , Simulação de Dinâmica Molecular , Prata/farmacologiaRESUMO
The purpose of this study was to purify the phytoconstituents and to explore the antibacterial, antifungal, phytotoxic and cytotoxic potential of dichloromethane and methanol extracts of aerial and root parts of Trigonella polycerata. The phytochemical study on methanol extract of aerial parts of the plant led to the isolation and purification of seven compounds that were identified as 3,4-dimethoxycinnamaldehyde, Trigocoumarin, 6,7,8-trimethoxycoumarin, Penduletin, 5-hydroxy-3,6,7,4´-tetramethoxyflavone, 3,5,7-trihydroxy-6,4-dimethoxyflavone and 5-hydroxy-4,7-dimethoxyflavone. These structures were elucidated by interpretation of EI-MS and NMR spectral data. The plant aerial parts methanol extract (TPAM) demonstrated higher antibacterial (78.99%), phytotoxic (85% growth regulation at 1000µg/mL) and cytotoxic activities (LD50: 45.643µg/mL). While the methanol root extract (TPRM) was highly active against bacteria's; Salmonella typhi (71.56%), Staphylococcus aureus (70.15%), Escherichia coli (69%), fungi like Candida albicans (70.21%) and moderately active against Brine shrimp larvae (LD50: 125.663µg/mL). The dichloromethane aerial (TPAD) and root (TPRD) extracts exhibited significant antibacterial (78.03% and 50.21% inhibitions respectively) and phytotoxic (55% growth regulation at 1000µg/mL) potential. Only TPAD indicated the best inhibition against fungi; Aspergillus flavus (75.31%) and moderate inhibition against Microsporum canis (42.21%). This phytochemical and biological work is the first time reported in Trigonella polycerata.
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Trigonella , Antibacterianos/química , Antibacterianos/toxicidade , Antifúngicos/química , Metanol , Cloreto de Metileno/análise , Testes de Sensibilidade Microbiana , Compostos Fitoquímicos/análise , Compostos Fitoquímicos/farmacologia , Componentes Aéreos da Planta/química , Extratos Vegetais/toxicidadeRESUMO
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.
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Anti-Infecciosos/farmacologia , Antioxidantes/farmacologia , Astrágalo , Inibidores de Glicosídeo Hidrolases/farmacologia , Extratos Vegetais/farmacologia , Araceae/efeitos dos fármacos , Bacillus subtilis/efeitos dos fármacos , Extratos Vegetais/química , Staphylococcus aureus/efeitos dos fármacos , alfa-Glucosidases/efeitos dos fármacosRESUMO
This study elicits the underlying mechanism(s) of Capparis decidua when used for different gut disorders. HPLC chromatogram of C. decidua extract (CD.Cr) and its respective fractions showed a variety of phytochemicals of which, kaempferol being in a high proportion. In mice, CD.Cr at doses of 70 and 150 mg/kg enhanced the wet feces output to 33 and 44% respectively as compared to carbachol (47.6%), while doses of 500 and 700 mg/kg, presented 41 and 70% safety against castor oil-driven diarrhea, respectively. Its flavonoid constituent, kaempferol at doses of (50 and 100 mg/kg) produced 51.7 and 82% safety when compared to nifedipine which provided 95% safety at dose of 40 mg/kg against castor oil-driven diarrhea like loperamide. In isolated jejunum preparations, C. decidua extract and its respective fractions (except pet-ether) produced atropine-sensitive inhibitory effects, whereas kaempferol and nifedipine showed atropine insensitive effects. Against high K+-induced contractions, C. decidua's fractions and kaempferol both exhibited a concentration-related non-specific inhibition while displacing the Ca++ -CRCs to right-ward with suppression in maximal response like nifedipine. In isolated rat ileal preparations, CD.Cr and respective fractions elicited atropine-sensitive gut excitatory responses. In summary, this article reports C. decidua's laxative effect through cholinergic receptor activation as well as its antidiarrheal effects, where its flavonoid constituent kaempferol produces Ca++ antagonist like activity, thus justifying C. decidua folk use in constipation and diarrhea.
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Antidiarreicos/uso terapêutico , Capparis , Diarreia/tratamento farmacológico , Flavonoides/uso terapêutico , Jejuno/efeitos dos fármacos , Compostos Fitoquímicos/uso terapêutico , Animais , Antidiarreicos/isolamento & purificação , Antidiarreicos/farmacologia , Diarreia/induzido quimicamente , Feminino , Flavonoides/isolamento & purificação , Flavonoides/farmacologia , Jejuno/fisiologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Técnicas de Cultura de Órgãos , Compostos Fitoquímicos/isolamento & purificação , Compostos Fitoquímicos/farmacologia , Coelhos , Ratos , Ratos Sprague-Dawley , RoedoresRESUMO
Perovskite solar cells (PSCs) have garnered significant attention in the scientific community due to their rapid increase in performance. Inorganic perovskite devices have been noted for their high performance and long-term stability. This study introduces a device optimization process guided by modeling to produce high-efficiency PSCs using lead-free n-i-p methylammonium tin bromide (MASnBr3) materials. We have thoroughly examined the impact of both the absorber and interface layers on the optimized structure. Our approach utilized graphene as the interface layer between the hole transport and absorber layers. We employed zinc oxide (ZnO)/Al and 3C-SiC as interface layers between the absorber and electron transport layers. The optimization process involved adjusting the thicknesses of the absorber layer and interface layers and minimizing defect densities. Our proposed optimized device structure, ZnO/3C-SiC/MASnBr3/graphene/CuO/Au, demonstrates theoretical power conversion efficiencies of 31.97%, fill factors of 89.38%, a current density of 32.54 mA/cm2, a voltage of 1.112 V, and a quantum efficiency of 94%. This research underscores the ability of MASnBr3 as a nontoxic perovskite material for sustainable energy from renewable sources' applications.
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INTRODUCTION: Photodynamic therapy (PDT) has emerged as an effective therapy for various dermatology conditions, including oral lichen planus (OLP). The objective of this study was to evaluate the efficacy of PDT in managing OLP and to compare its effectiveness with corticosteroid therapy (CST). MATERIALS AND METHODS: A comprehensive electronic search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, utilizing databases such as PubMed, Embase, Google Scholar, Semantic Scholar, X-mole, and Dimensions. The inclusion criteria encompassed randomized controlled clinical trials (RCTs) that included patients with OLP undergoing treatment with PDT and CST, with no limitations on sample size or patient age. RESULTS: Out of 197 studies identified, only 8 met the inclusion criteria, involving 210 patients (104 in Group I: PDT, 106 in Group II: CST), with a female to male ratio of 3.75. Three studies reported OLP lesion numbers, six studies described lesion types, and five studies provided lesion location information. The efficacy of both PDT and CST was assessed using lesion size, pain, Thongprasom sign (ThS) scoring, efficacy index (EI), and clinical severity index (CSI). The limited and inconsistent reporting of data hindered to conduct a meta-analysis. CONCLUSIONS: PDT effectively treats OLP lesions, leading to significant symptom reduction and improved functionality. However, limited relevant RCTs and heterogeneous data reporting hinder definitive conclusions regarding the efficacy of PDT compared to CTS.
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Líquen Plano Bucal , Fotoquimioterapia , Masculino , Feminino , Humanos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Líquen Plano Bucal/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Corticosteroides/uso terapêuticoRESUMO
This study aimed to determine the percentage of anti-phospholipase A2 receptor (PLA2R) autoantibody positivity in a cross-section of 74 Pakistani patients with biopsy-proven idiopathic membranous nephropathy. It was an observational study conducted from December 2018 to June 2019. Seventy-four (n=74) consecutive biopsy-proven cases of membranous nephropathy, aged between 12-60 years, were included. Out of them, 63.5% (n=47) were males and 36.5% (n=27) were females. The mean age was 40.2±16.7 years. Anti-PLA2R antibodies were positive in 35 (47.3%) patients, negative in 38 (51.4%) patients, and borderline positive in 1(1.35%) patient. A significant difference (p ≤ 0.05) was noted among different levels of antibodies in both genders. Anti-PLA2R antibodies were detected in approximately half of the diagnosed idiopathic membranous nephropathy cases. However, this percentage was much lower than the studies conducted on other populations around the globe, indicating a possible pathogenic role of other antigens in our population. Key Words: Membranous nephropathy, Phospholipase A2 receptors, Renal biopsy.
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Glomerulonefrite Membranosa , Receptores da Fosfolipase A2 , Adolescente , Adulto , Autoanticorpos , Biópsia , Criança , Feminino , Glomerulonefrite Membranosa/diagnóstico , Glomerulonefrite Membranosa/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Adulto JovemRESUMO
Granulomatosis with polyangiitis (GPA) can present with a wide array of clinical signs and symptoms; therefore, it should be differentiated from other mimicking clinicopathological entities. We report a case of a 66-year-old gentleman who was found to have a mediastinal mass and histopathological examination showed chronic necrotizing granulomatous inflammation. The patient was managed on lines of pulmonary tuberculosis for 12 months and remained in remission for two years. Later, workup showed cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA)-associated granuloma with marked renal impairment, which responded to immunosuppression. From this, we suggest that in a patient with radiological evidence of mediastinal mass, the remote possibility of GPA must be kept in mind.
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Background: Although lupus enteritis is a rare manifestation of systemic lupus erythematosus yet results in significant distress. This disorder contributes to diagnostic and therapeutic dilemma leading to enhanced mortality. Case Description. We report a case history of a 29-year-old female who presented with severe abdominal pain, watery stools, and vomiting, and later on, she developed pancytopenia and renal impairment. On intensive workup, diagnosis of lupus-associated enteritis, nephritis, and pancytopenia was discovered. She improved drastically on initiation of plasmapheresis followed by low-dose intravenous rituximab. One year posttreatment, she remained in complete remission. Conclusion: From this case, it can be suggested that in a young female with intractable abdominal pain, the remote possibility of lupus enteritis must be kept in mind. Besides this, plasmapheresis can have a potential role in refractory lupus enteritis. Furthermore, low-dose intravenous rituximab can be a safe and cost-effective treatment option in achieving sustained remission of clinical and laboratory parameters in lupus enteritis.
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Systemic lupus erythematosus (SLE) and ulcerative colitis (UC) are multisystem autoimmune disorders that rarely coexist. We report a case history of a 21-year-old male, presenting with bloody diarrhea and, later, diagnosed to have ulcerative colitis on colonic biopsy. There was clinically silent renal impairment leading to end-stage kidney disease requiring hemodialysis possibly secondary to ongoing lupus nephritis as suggested by positive lupus-specific antibodies' detection. Besides this, the diagnosis of lupus associated with early communicating hydrocephalus was made on CT brain findings which clinically responded well to the initiation of immunosuppressive therapy. It is imperative to keep in mind the remote possibility of ulcerative colitis in an SLE patient with gastrointestinal (GI) manifestations. Communicating hydrocephalus is a rare neurological manifestation of SLE leading to seizures and can respond well to the initiation of steroids and immunosuppressants. Therefore, a trial of immunosuppressant medications must be given even in a patient with end-stage renal disease (ESRD) to halter extra renal rare lupus manifestations.
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Background Membranous nephropathy (MN) and immunoglobulin A nephropathy (IgAN) are although two different entities, yet can rarely coexist. There is not much data available on this coexistent disorder, specifically with regard to the treatment modality and outcome. Here, we analyse in detail, retrospectively, 13 cases of coexistent IgA and membranous nephropathy (IgA-MN). Methods Renal biopsy data of 1084 diagnosed cases of either membranous or IgA nephropathy was obtained from March 2015 till March 2021. Out of 1084 patients, 19 diagnosed cases of the coexistent disorder were identified. Six out of 19 patients were excluded because of their unwillingness. From remaining 13 patients, data regarding clinical presentation, investigations, management and treatment response was collected from hospital database, files and via telephonic interview. Results The overall prevalence noted was 1.75%. Among them, 53.8% were females and 46.2% were males. Their median age was 40 years (range: 14-71 years). On workup, mean serum albumin was 2.64 g/dl (range: 1.6-3.8 g/dl), mean proteinuria was 5.5 g/24 hours (range: 1.55-11.48 g/24 hours) and mean creatinine was 0.98 mg/dl (range: 0.5-2.8 mg/dl). Anti-phospholipase A2 receptor antibody positivity was only 14.2%. The renal biopsy of all patients showed thickening of the glomerular basement membrane with granular IgG deposits and mesangial expansion with granular IgA deposits. A total of 80% patients showed complete remission with steroids, calcineurin inhibitors (CNIs) and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARBs). Conclusion IgA-MN is probably a separate disorder that can only be confirmed on immunofluorescence microscopy. The response to the combination of steroids, CNIs and ACEi/ARBs is found to be the most effective; hence, this combination must often be used for the management of this coexistent disorder.
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BACKGROUND: Single-stage total knee arthroplasty (TKA) with long-stem is a viable option to treat proximal tibial stress fracture in advance knee osteoarthritis. However, in patients with old mal-united or non-united tibial fractures, treatment becomes complicated. Therefore, our aim in this study was to monitor clinical and radiological outcome in patients presenting early or late managed by single-stage long-stem TKA. METHODS: This retrospective study included 24 consecutive patients; all were female. Patients with recent and mobile stress fracture (Group A) were treated with close reduction and long-stem tibial component. However, in patients with old, sclerotic or mal-united fractures (Group B), open reduction, partial fibulectomy and plating with bone grafting was also performed. Outcome was monitored by tibiofemoral angle, functional Knee Society score and time taken for union. RESULTS: The mean age of patients was 62.34 years. There were 13 patients in Group A and 11 in Group B. The mean follow up was 42.79 months (range, 18-72 months). Knee Society score improved from 29.83 ± 6.10 to 91.57 ± 4.89 in Group A and from 27.21 ± 3.32 to 89.87 ± 3.89 in Group B. Tibiofemoral angle improved from 20.57 ± 3.00° to 0.80 ± 0.46° in 21 varus knees, whereas it improved from 22.33 ± 4.61° to 0.83 ± 0.28° in three valgus knees. Iatrogenic perforation of tibial cortex occurred in one case. Union of stress fracture was achieved in all cases with a mean duration of 4.70 months. CONCLUSION: Excellent results were obtained in both groups but were slightly lower in patients presenting late, therefore all efforts must be made to treat such cases as early as possible.
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Artroplastia do Joelho , Fraturas de Estresse/cirurgia , Osteoartrite do Joelho/cirurgia , Fraturas da Tíbia/cirurgia , Tempo para o Tratamento , Redução Fechada , Países em Desenvolvimento , Feminino , Consolidação da Fratura , Humanos , Prótese do Joelho , Pessoa de Meia-Idade , Redução Aberta , Desenho de Prótese , Estudos RetrospectivosRESUMO
In this work is presented a new category of self-growing, fibrous, natural composite materials with controlled physical properties that can be produced in large quantities and over wide areas, based on mycelium, the main body of fungi. Mycelia from two types of edible, medicinal fungi, Ganoderma lucidum and Pleurotus ostreatus, have been carefully cultivated, being fed by two bio-substrates: cellulose and cellulose/potato-dextrose, the second being easier to digest by mycelium due to presence of simple sugars in its composition. After specific growing times the mycelia have been processed in order to cease their growth. Depending on their feeding substrate, the final fibrous structures showed different relative concentrations in polysaccharides, lipids, proteins and chitin. Such differences are reflected as alterations in morphology and mechanical properties. The materials grown on cellulose contained more chitin and showed higher Young's modulus and lower elongation than those grown on dextrose-containing substrates, indicating that the mycelium materials get stiffer when their feeding substrate is harder to digest. All the developed fibrous materials were hydrophobic with water contact angles higher than 120°. The possibility of tailoring mycelium materials' properties by properly choosing their nutrient substrates paves the way for their use in various scale applications.