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   Table of Contents - Current issue
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January-March 2021
Volume 5 | Issue 1
Page Nos. 1-104

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ORIGINAL ARTICLES  

Antimicrobial traits of different medicinal plants locally available in Bangladesh p. 1
Farzana Hossaini, Nayan Chandra Das, Fahamida Hossaini, Mrityunjoy Acharjee, Saurab Kishore Munshi
DOI:10.4103/bbrj.bbrj_198_20  
Background: Medicinal plants have been commonly used in traditional medicine against different ailment from ancient time. The present study was an attempt to determine the anti-bacterial traits of commonly available medicinal plants, especially having topical uses. Methods: A total of four types of locally available medicinal plant samples inclusive of Turmeric (Curcuma longa, rhizome), Marigold (Tagetes minuta, leaves), Durva Grass (Cynodon dactylon, whole plant), and Hibiscus (Hibiscus rosa-sinensis, leaves) were collected. Crude, hot water, and solvent (ethanolic and methanolic extracts of the samples) were tested for their antimicrobial traits by agar well-diffusion method on Mueller-Hinton agar. The minimal inhibitory concentration (MIC) of each sample was determined by the microdilution technique. Microbiological quality of the samples was also checked. Results: Microbial contaminations were found in all the samples. Beside viable bacteria and fungi, all samples contained Staphylococcus spp. and Pseudomonas spp. The proliferation of Klebsiella spp. was observed in the majority of the samples. Notable antimicrobial activities were exhibited by the medicinal plant parts tested in this study. Ethanolic and methanolic extracts showed remarkable efficiency in eliminating the growth of tested bacterial isolates although crude and hot water extracts projected no considerable inhibitory effects. The majority of the samples had a MIC value at 12 mg/mL. Conclusion: The findings of the present study reveal that the medicinal plant samples had remarkable antimicrobial traits which portray their potential for the commercial application against different infectious diseases.
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Variability in linear polypeptide stabilizes proteoglycan than zinc finger protein in vascular smooth muscle cells: An In Silico approach p. 7
Karthikeyan D Rajamani
DOI:10.4103/bbrj.bbrj_189_20  
Background: Structural and physicochemical topologies of proteins play a considerable role in differentiating the functional properties of the biological system. We aimed to study the physicochemical similarities, structural and functional differences of versican (VCAN) and early growth response (Egr) proteins involved in vascular injuries. Methods: For the primary structure prediction, the proteomic tools Expasy's Protparam is used, likewise, for secondary structure and content prediction SOPM and SOPMA tool is used. The transmembrane regions in VCAN and EGR proteins are predicted through SOSUI (Classification and Secondary Structure Prediction of Membrane Proteins) server. The CYSREC tool is used to identify the presence of disulphide bonds in all the VCAN and EGR proteins, additionally through homology modelling the disulphide bonds are visualized and structure of the modelled proteins are validated through Rampage (Ramachandran plot), ProQ (Protein Quality Server) and ProSA (Protein Structure Analysis) server. Results: VCAN and Egr proteins resemble hydrophilic in nature, similarly negative score of the grand average of hydropathicity index confirms hydrophilic nature. The maximum molecular weight for VCAN is observed as 39265 and 61623 Dalton for EGR protein. VCAN proteins showed a higher level of basic residues except Q86W61, while all the Egr proteins were acidic residues. The extinction coefficient (EC) has unique absorbance at 280 nm wavelength. Based on the aliphatic index (AI ≥ 45) and instability index (II ≥ 40) most of the VCAN and Egr proteins were unstable. The Classification and Secondary Structure Prediction of Membrane Proteins server classifies all Egr and few VCAN and proteins are soluble nature. Secondary structure content prediction and SOPM server show most of the VCAN proteins are beta sheets and many Egr proteins are alpha-helical, while few with mixed structures. Besides these differences, the VCAN protein stability was identified by most probable disulfide (SS) bridges using CYS_REC tool and confirmed by homology modeling in tertiary structure. Whereas the probable disulfide bonds in Egr proteins were not identified. Conclusion: The findings with these functional and structural properties will add an extra room in understanding their dual role.
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Nitrate-nitrite toxicosis associated with duckweed (Portulaca Oleracea L.) (Portulacaceae) consumption in a herd of sheep in Kenya p. 16
Joseph Mwanzia Nguta
DOI:10.4103/bbrj.bbrj_208_20  
Background: Nitrate-nitrite toxicosis associated with the consumption of duckweed (Portulaca oleracea L.) (Portulacaceae) was diagnosed in a small herd comprising of 11 sheep in Korayo Sub Location, Rangwe Sub County of Homabay County in Kenya. Methods: The clinical signs were dyspnea, froth from the mouth, labored breathing, incoordination, tachycardia, increased urination, neck, fore and hind limb distension, aggressive movements, bloat, convulsions, and coma, before death. Results: All the 11 sheep died of intoxication before institution of therapy. Brownish mucous membranes and chocolate colored and poorly clotted blood were the significant necropsy observations. Mild pulmonary edema was characterized by the presence of limited froth in the trachea and bronchioles. At postmortem, the liver of the sheep was grossly congested, and the cardiac pericardium was inflamed. There was gastritis, enlarged, and congested kidneys with pin-point hemorrhages. Diphenylamine tests carried out on the fed duckweed and on ruminal duckweed contents were positive for nitrates. Duckweed (Portulaca oleracea) fed on sheep had 7.4% nitrate on dry matter basis (DM), whereas ruminal contents had 5.38% nitrate on DM basis. Chocolate-colored blood collected during postmortem had a methemoglobin fraction of 86%. Nitrate levels in pastures of 0.5% and above have been shown to be potentially dangerous, with acute poisoning likely to occur at times when the levels are above 1%. Death in sheep can occur when blood methemoglobin levels are in the range of 67%–90%. Conclusion: The observations from the present study are indicative of death in a herd of sheep due to nitrate-nitrite poisoning associated with the consumption of duckweed (Portulaca oleracea).
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Evaluation of adnexal masses – Correlation of clinical and radiologic features with histopathologic findings: an observational study in a tertiary care center of Eastern India p. 21
Senjuti Dasgupta, Srishtidhar Mangal, Kalyani Naskar
DOI:10.4103/bbrj.bbrj_7_21  
Background: Ovarian carcinoma is the seventh most common cause of carcinoma-induced deaths among women of the world. Adnexal masses often pose a diagnostic challenge to a treating physician. The aim of the present study was to find out the incidence of various categories of ovarian tumors and their correlation with clinicopathologic parameters among patients attending a tertiary care center of Eastern India. Another aim was the evaluation of diagnostic accuracy of clinical, laboratory, and radiological findings. Methods: A prospective, observational study was carried out for a period of 1 year. Female patients with adnexal masses were included in the study. Clinical, laboratory, and sonographic findings of each patient were recorded along with their histopathological reports. Results: The median age of 59 patients included in the study was 36 years. Most patients (32, 54.2%) were between 30 and 50 years of age. Thirty-six (61%) ovarian tumors were found to be benign and the rest (23, 39%) malignant. Surface epithelial tumors were the most common type (35, 59.3%), followed by germ cell tumors (11, 18.6%) and sex cord stromal tumors (9, 15.3%). A statistically significant association was noted between parity, menstrual status, laterality, size, gross appearance of tumor, and nature (benign/malignant) of the mass. Sensitivity (57%) and specificity (86%) of the clinical diagnosis were good, but diagnostic accuracy (88%) of sonographic findings was better. While serum CA125 level measurement had a diagnostic accuracy of 78%, the risk of malignancy index (RMI) 2 score, with an accuracy of 86%, has the potential to guide further management in a patient with adnexal mass. Conclusion: Increased incidence of malignancy was noted with postmenopause, nulliparity, bilaterality of tumors, and complex tumor morphology. All these risk factors were found to be statistically significant. RMI 2 score may be used routinely for diagnosis and guidance of further management of adnexal masses.
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Computer-assisted multi-epitopes T-cell subunit Covid-19 vaccine design p. 27
Abdulwahid Abaukaka Yahaya, Salihu Sanusi, Fatima Umar Malo
DOI:10.4103/bbrj.bbrj_5_21  
Background: The world is currently facing the coronavirus disease-2019 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Researchers from different parts of the world have employed diverse approaches to create a safe and effective vaccine as it saves millions of lives. Vaccines are created from the viral particle to train the body for a natural defense against invading pathogens. It is important to understand the concept of the vaccine design, especially the multi-epitope T-cells subunit vaccine. Methods: In this regard, we employed bioinformatics and immunoinformatic tools to illustrate the concept of the computer-based vaccine design. The computational methods consist of evaluation and selection of SARS-CoV-2 structural proteins, prediction of cytotoxic T-lymphocyte (CTL) epitopes, prediction of helper T-cell (HTL) epitope, multi-epitope vaccine candidate construct, antigenicity and allergenicity prediction of the designed candidate vaccine, physiochemical properties and solubility evaluation, secondary/tertiary structure prediction, refinement and validation of model vaccine tertiary structure, molecular docking of fusion proteins and Toll-like receptor 9 protein, and in silico cloning of the vaccine. Results: A total of 454 amino acid sequences were generated from CTL and HTL epitopes. The query solubility value (QuerySol) of the vaccine construct was 0.419, including the human β-defensin-2 adjuvant and peptide linkers. A circular clone of vaccine and pEX-C-His plasmid was achieved after in silico ligation using the annealed primer. Conclusion: Here, we provide essential information on computer-assisted multi-epitopes T-cell subunit vaccine design.
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Green synthesis of silver nanoparticles using Phyllanthus amarus Seeds and their antibacterial activity assessment p. 35
Jerrine Joseph, Keren S Deborah, R Raghavi, A Mary Shamya, Wilson Aruni
DOI:10.4103/bbrj.bbrj_139_20  
Background: Green synthesis of nanoparticles has been gaining popularity due to its advantages over chemical synthesis. In the present study, silver nanoparticles (AgNPs) were synthesized by using an aqueous solution of Phyllanthus amarus leaves extract as a reducing agent. The synthesized nanoparticles were characterized using the spectroscopic techniques. The Fourier-transform infrared (FTIR) study confirmed that the seed extract also stabilized the surface of the AgNPs by acting as a capping agent. Moreover, the antibacterial activity of the plant NPs was also assessed. The synthesized nanoparticles as well as P. amarus plant extract were separately tested to examine their antibacterial activities. The activities were tested against various microorganisms, including Escherichia coli, Bacillus subtilis, Klebsiella pneumoniae, and Staphylococcus aureus. The main aim of the present study is to evaluate the green synthesis of nanoparticles using P. amarus seeds and their antibacterial activity assessment. Method: Collection and preparation of seed extract, synthesis of AgNPs, characterization of AgNPs using ultraviolet-visible (UV-Vis) absorbance spectroscopy and Fourier transforms infrared spectroscopy, determination of antibacterial activity using pathogens. All in vitro assay data signify the mean ± standard deviation of triplicates was calculated by using the MS word document. Results: The reduction of silver nitrate using the plant leaf extract was viewed by the color change in the reaction solutions. The maximum absorbance peak was seen at 400 nm for P. amarus seed extract using UV-Vis spectroscopy and FTIR measurements were carried out for the AgNPs synthesized by the plant extracts. The extracts of P. amarus seeds showed potent antimicrobial activity against Gram-positive and negative bacteria. Conclusions: The biosynthesized AgNPs using P. amarus seed extract proved to be excellent agent against pathogens. The present study showed a simple, rapid, and economical route to synthesize AgNPs. The use of P. amarus has the added advantage that this seed can be used by nanotechnology processing industries.
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Spectrum of bacterial conjunctivitis in Southern Pakistan: 10-year retrospective review of laboratory data p. 39
Tazeen Fatima, Faisal Riaz Malik, Ayesha Ahmed, Erum Khan, Sadia Shakoor
DOI:10.4103/bbrj.bbrj_165_20  
Background: Bacterial conjunctivitis contributes largely to ocular morbidity in both developed and developing countries. The spectrum of conjunctivitis is influenced by geographic and climatic factors. One previous report from Pakistan had shown adenoviruses to be predominantly responsible for keratoconjunctivitis, however little is known about the bacterial agents responsible for conjunctivitis. In this study, we report the microbial etiology of bacterial conjunctivitis by performing a 10-year retrospective review of laboratory data. Methods: All conjunctival cultures received at the Aga Khan University Clinical Microbiology Laboratory from 2004 to 2013 with bacterial growth were identified through a laboratory database. Information on patients' demographic characteristics, identification of organisms, and antibiotic susceptibility was obtained from an archived database of laboratory records. Data were entered and analyzed in MS Excel. Results: A total of 1534 conjunctival culture samples were received at the clinical microbiology laboratory during the 10-year study period (2004–2013), of which 375 showed bacterial growth. Staphylococcus aureus was found to be the most common bacterial cause of conjunctivitis. Streptococcus pneumoniae was seen predominantly in children aged 0–14 years. Higher trends of resistance were noticed for trimethoprim-sulfamethoxazole and erythromycin. Conclusions: The bacterial profile of ocular surface cultures from patients with conjunctivitis showed prevalence of S. aureus in all ages and S. pneumoniae in children, with pseudomonal infections common in older age groups, likely associated with the use of contact lenses. Antibiotic susceptibility testing showed high level of resistance to topical antibiotics. Studies designed to address the challenges of antibiotic susceptibility testing against topical antibiotics are needed to inform empiric treatment guidelines in various age groups.
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Modified VGG deep-learning architecture for COVID-19 classification using chest radiography images p. 43
R Anand, V Sowmya, Vijaykrishna Menon, A Gopalakrishnan, KP Soman
DOI:10.4103/bbrj.bbrj_143_20  
Background: The world faced a deadly disease encounter by the starting of 2020, known as coronavirus disease 2019 (COVID-19). Due to the rapid increase in the counts of COVID cases, the WHO declared the COVID-19 as a pandemic on March 11, 2020. Among the different screening techniques available for COVID-19, radiography of the chest is one of the efficient way for disease detection. While other disease detection techniques take time, radiography takes less time to identify because of the abnormalities caused by the disease in the lungs. Methods: In the rapid development era of artificial intelligence and deep-learning techniques, various models are being developed for COVID disease detection. COVID-19 can be easily detected from Chest X-ray images and the pretrained models yield high accuracy with small dataset. Results: In this paper, one of the standard deep-learning architectures, VGGNet, is modified for classifying chest X-ray images under four categories. The proposed model uses open source dataset that contains 231, 2503, 1345, and 1341 images of four classes such as COVID, bacterial, normal, and viral chest radiography images, respectively. Conclusion: The performance matrices of the proposed work were compared with the five benchmark deep-learning architectures namely VGGNet, AlexNet, GoogLeNET, Inception-v4, and DenseNet-201.
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Unmasking previously unrecognized peripheral arterial disease in patients with coronary artery disease using continuous wave doppler using continuous wave doppler imaging : does the presence of peripheral arterial disease influence the clinicopathological profile of coronary artery disease? An Indian study p. 50
Rajesh Nair, Rahul Sud, Ajay Swamy, Vikram Patra
DOI:10.4103/bbrj.bbrj_171_20  
Background: It is well established that a significant number (30%) of patients suffering from coronary artery disease (CAD) also have underlying peripheral artery disease (PAD) as the only underlying risk factor. They are at increased risk of myocardial infarction as multiple vascular beds beyond the extremities are likely to be affected by atherosclerosis. A large percentage of high-risk patients with the coexistent disease may not be diagnosed with underlying PAD, as they were largely asymptomatic. This study aims to assess the prevalence of previously unrecognized PAD among patients with CAD, the risk association for various risk factors for CAD and PAD and also to determine the relationship between the presence of PAD and severity of CAD. Methods: A 3 years randomized, prospective, cross-sectional study done at Command Hospital Airforce Bangalore, India on patients of CADs, who were planned to undergoing coronary angiogram, were evaluated for the presence of PAD in lower extremities. The interactions between risk factors, Ankle Brachial Index (ABI), and CAD were examined by multiple stepwise regression analysis. Results: A total of 300 patients were studied. PAD has a prevalence of 14% in patients with CAD and it was strongly associated with disease severity. There was statistically significant association in patients with CAD which coexistent PAD with age (P = 0.001), smoking (P = 0.014), hypertension (P = 0.015), diabetes (P = 0.043), obesity (P= 0.004), history of previous cerebrovascular accident (P = 0.0138), number of coronaries involved (P = 0.02) and low-density lipoprotein (P = 0.001) levels as compared to CAD not associated with PAD. Conclusions: The high prevalence of PAD in patients who have CAD confirms the importance of active screening for PAD using ABI and requires aggressive management. We emphasize that clinicians should keep in mind that CAD patients would have other co-morbid vascular manifestations like PAD in order to minimize morbidity and mortality in these patients.
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Detection of human papilloma virus in prostate tissue from prostatic cancer patients in AL Najaf, Iraq p. 55
Anwar Abd Hashim Al Ramahy
DOI:10.4103/bbrj.bbrj_191_20  
Background: The prostatic tumor was the third form of cancer in males being >55 years of age, after the pulmonary and colon cancer. The prostate was infected by many viruses causing repeated or chronic inflammation or enhance carcinogenesis. The aim of this study was to determine the presence and prevalence of human papillomavirus (HPV) in the prostate tissue of patients with prostate cancer. Methods: Prostate tissue samples were collected from paraffin embedding block of 70 patients diagnosed with HPV from archives of AL-Sadder Hospital in AL-Najaf City and some archives of private histopathology laboratories from January 2016 to December of the same year. We investigated the presence of HPV DNA using the polymers chain reaction technique polymerase chain reaction (PCR). Results: The sample size was 60 patients and 10 as control. The number of benign patients is 40/60 (66.7%), whereas the number of malignancies patients is 20/60 (33.3%). There are 13/60 prostatic patients who have HPV. Eight patients of them have a malignancy prostatic tumor and five with a benign prostatic tumor. There is a highly significant association between HPV and malignancy compared with the benign prostatic disease (P = 0.016). PCR results were showed a highly significant specificity (P < 0.001) to detect the presence of HPV in malignancy and benign prostatic disease. PCR results showed a highly significant specificity (P < 0.001) to detect the presence of HPV in malignancy and benign prostatic disease. Conclusions: Our study showed an association between prostatic disease and the presence of HPV DNA in samples, but there is a highly significant difference in HPV prevalence between the malignant prostate cancer and benign prostate tissue samples.
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Dimensional accuracy and surface detail reproduction of hydrophilic polyvinylsiloxane impression material tested under dry and moist salivary conditions: An In vitro study p. 59
Abhishek Singh Nayyar
DOI:10.4103/bbrj.bbrj_86_20  
Background: The dimensional accuracy and surface detail reproduction of impression materials play a major role in determining the extent to which indirectly produced prostheses and restorations have an acceptable fit. The purpose of the present study was to compare the dimensional accuracy and surface detail reproduction of hydrophilic polyvinylsiloxane (PVS) impression material tested under dry and moist salivary conditions. Methods: The study samples were assigned two groups based on the condition in which they were made. One group consisted of casts obtained from impressions made in dry condition (n = 12), while the other group consisted of casts obtained from impressions made in moist salivary conditions (n = 12). Impressions of the master model were made using hydrophilic PVS impression material by two-step putty-wash technique and working casts were obtained. Dimensional accuracy was measured by comparing the inter-abutment distance in each cast to the master model using a profile projector with an accuracy of 0.001 mm, while surface detail reproduction was evaluated using the American Dental Association specification No. 19 criteria of continuous replication of at least two of the three horizontal lines. Descriptive statistics such as mean and standard deviation were calculated for both the groups. Differences from the master model were analyzed by paired t–test, while one-way analysis of variance (ANOVA) was used for intergroup comparisons. P ≤ 0.05 was considered statistically significant. Results: One-way ANOVA revealed a highly significant difference in the dimensional accuracy of impressions made under moist conditions as against those which were made under dry condition (P < 0.001). The percentage change in dimension of 0.6% in Group A casts and 0.3% in Group B casts, also, showed a high clinical significance. Under dry condition, the impression material satisfactorily replicated the surface details in 100% of the cases, while under moist conditions, only 58% of the impressions were found to be satisfactory. Conclusion: The presence of moisture caused a significant adverse impact on the dimensional accuracy and surface detail reproduction of hydrophilic PVS impression material underlying the clinical significance of moisture control for successful impressions.
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Analysis of Transfusion Support in Dengue Epidemic in Military Setting of Sri Lanka p. 64
Samantha Kumarage, Roshan Jayamanna, Isanka Mahendra
DOI:10.4103/bbrj.bbrj_114_19  
Background: Severe dengue affects most Asian and Latin American countries and becomes a leading cause of hospitalization and death among children and adults in these regions. During the year 2017, a total of 186,101 suspected dengue cases were reported, and as of May 24, 2018, a total of 19,459 suspected dengue cases were reported to the Ministry of Health of Sri Lanka with over 320 deaths in 2017 and 202 deaths in 2018. The aim of the study was to evaluate whether the blood and component transfusion for the dengue patients and the routine inventory management at our blood bank were affected by the nonfollowed transfusion guidelines in dengue management of Sri Lanka. Methods: This retrospective descriptive study analyzed the distribution of relative frequencies of variables in the requests received and tangible transfusions done from January 1, 2017, to December 31, 2017. Results: A total of 717 transfusion requests received from the confirmed dengue patients in 2017. In this cohort, 73 requests were for dengue fever, 494 requests for dengue hemorrhagic fever (DHF), 97 requests for DHF leaking phase, 46 requests for DHF critical phase, and 7 requests for dengue shock syndrome. Conclusions: Even though 60% of the actual transfusion requests followed the guidelines of the dengue management, 40% (13 requests) violated the guidelines in the actual transfusions. However, compared to the 717, total requests for transfusions this number is very minimal (0.97%). Of 3601 inventories managed at blood bank during 2017, additional dengue-related 717 requests, less than 1% violated the guidelines of transfusion requests according to the current guidelines of dengue management. No extra burden was created to inventory management due to nonfollowed guidelines. An unusual preponderance of transfusion requirements of AB patients was highlighted. Comparing the published data, dengue management at our hospital is exemplary.
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Serum levels of interleukin-6, ferritin, C-reactive protein, lactate dehydrogenase, D-dimer, and count of lymphocytes and neutrophils in COVID-19 patients: Its correlation to the disease severity p. 69
Ali Saad Kadhim, Younus Jasim Abdullah
DOI:10.4103/bbrj.bbrj_188_20  
Background: Since its first emergence in Wuhan city, China, severe acute respiratory syndrome coronavirus 2, which is responsible for the pandemic COVID-19, has become a significant health problem all over the world affecting over 2.1 million people globally. Methods: The current study aimed to investigate serum levels of interleukin 6 (IL-6), ferritin, C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer as well as lymphocytes and neutrophils count in COVID-19 patients, and to clarify the correlation of these parameters with disease severity and progression. For these purposes, (100) patients with COVID-19 (confirmed by polymerase chain reaction) and (20) apparently healthy people (with matched age and sex) were included in the current study and considered as a control group. Results: All study population (patients and control) were subjected to the evaluation of serum levels of IL-6, ferritin, CRP, LDH, D-dimer, as well as lymphocytes and neutrophils, count. COVID-19 patients showed a significant elevation in the levels of all parameters included in this study when compared with healthy controls. We also found that all of IL-6, ferritin, CRP, LDH, D-dimer are significantly associated with the severity of the COVID-19 symptoms. Conclusion: Lymphopenia and increased neutrophils were also effectively correlated with disease progression. In line with these results, we concluded a proportional correlation between the aforementioned parameters and COVID-19 suggesting the uses of these tests to the diagnosis of critical cases.
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Evaluation of Transbronchial Needle Aspiration Samples from Sarcoidosis Patients for the Presence of Mycobacterium p. 74
Arda Kiani, Razieh Rouzpeykar, Esmaeil Idani, Mohammad Varahram, Mehdi Kazempour-Dizaji, Kimia Taghavi, Atefeh Abedini
DOI:10.4103/bbrj.bbrj_213_20  
Background: Tuberculosis (TB) and sarcoidosis are two chronic, systemic, and granulomatous diseases that have similar pulmonary and extrapulmonary manifestations. Given the similarities between the two diseases, it is suggested that the Mycobacterium genome may play a role in sarcoidosis. Identification of Mycobacterium species isolated from sarcoidosis patients optimizes the treatment process of patients. The present study investigates biopsy tissue samples from patients with sarcoidosis for the presence of Mycobacterium in the tissues. Methods: This descriptive cross-sectional study was performed on all sarcoidosis patients referred to Masih Daneshvari Hospital during 2017–2018 (401 patients). All patients who were outpatients or hospitalized in the bronchoscopy ward of Masih Daneshvari Hospital underwent transbronchial needle aspiration (TBNA). The cause of the TBNA procedure in patients was the presence of bilateral hilar lymphadenopathy in patients. Out of 401 patients with sarcoidosis, five patients showed positive smear or culture for Mycobacterium and were excluded from the study. Finally, 396 patients were included in the study. Results: The majority of participants in the present study were female (56.1%) with a mean age of 48.2 years and a mean ACE index of 73.4. Hypertension was found in16.2% of patients with sarcoidosis. 16.4% of patients had hyperlipidemia and 4.3% of patients had a history of ischemic heart disease. Redness of the eyes was seen in 13.1% of patients and 12.4% of the patients had diabetes. Also, 43.4% of the patients had skin lesions. Out of a total of 396 patients with sarcoidosis in the present study, 3.5% of the lymph and lung tissues of sarcoidosis patients (who were not infected with Mycobacterium tuberculosis by clinical signs and culture) contained amplifiable MTB DNA. Conclusion: In the present study and many previous related studies, the Mycobacterium genome has been observed in lymph node samples of mediastinal nodes and lung tissue of sarcoidosis patients. One of the strengths of the present study, which can make the results very reliable, is the high sample size in this study. It is suggested that similar studies with the use of control groups in large samples, investigate the presence of the Mycobacterium genome and its type in sarcoidosis patients.
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Prevalence and antibiotic susceptibility pattern of uropathogenic Escherichia Coli strains in sonipat region of Haryana in India p. 80
Shikha Malik, Jogender Singh Rana, Kiran Nehra
DOI:10.4103/bbrj.bbrj_212_20  
Background: To study the prevalence and antibiotic susceptibility pattern of uropathogenic Escherichia coli strains in Sonipat region of Haryana in India. Urinary tract infections (UTIs) are among the most widespread infections, caused most frequently by Escherichia coli. The past few years have witnessed a rapid rise in the spread of high antibiotic-resistant forms of these uropathogenic E. coli (UPECs). Methods: In the current study, a total of 53 UPEC isolates from patients of all age groups were collected from Sonipat and its adjoining areas from September 2017 to April 2018. All the uropathogens were subjected to antibiotic susceptibility profiling using a set of 23 antibiotics and confirmed using standard microbiological procedures. The isolates which exhibited high degree of multidrug resistance (MDR) were characterized at molecular level using 16S rRNA sequencing. Results: The evaluation of age- and gender-wise prevalence of UTI revealed that women (77.3%) were more susceptible to infection as compared to men (22.6%). It was observed that 83% of the collected UPEC isolates exhibited MDR pattern. The isolates exhibited maximum resistance to cephalosporins and fluoroquinolones; and the highest susceptibility (100%) was shown toward tigecycline, followed by 96.2% to colistin, 90.5% to amikacin, 86.7% to fosfomycin, and 84.9% to nitrofurantoin. Conclusion: The study concludes that the prevalence of MDR pathogens is high in studied region. For empirical antibiotic therapy, amikacin, fosfomycin, and nitrofurantoin should be preferred; and for MDR uropathogens, colistin, and tigecycline should be recommended.
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Antimycobacterial Properties and Metabolite Profiling of Fish Gut-Associated Streptomyces sp. MCA2 p. 88
Deepa Sudeeshna Nekkanti, Ushanandhini Sasikumar, Abirami Baskaran, Manigundan Kaari, Gopikrishnan Venugopal, Manikkam Radhakrishnan
DOI:10.4103/bbrj.bbrj_9_21  
Background: Infectious diseases such as tuberculosis and other opportunistic diseases affecting the lungs are major threats concerning public health. These pathogens have gained resistance to the currently available drugs which has prompted the discovery of novel antibiotics to fight against such pathogenic organisms. With unique pharmaceutical and biotechnological applications, Actinobacteria are considered possessing rich source of natural products. Biodiscovery of actinobacterial metabolites depends on the identification and recovery from unexplored environments and effective assessment of their metabolites. Literature states that among various ecosystems, fish are promising yet understudied source. Methods: Potential strain was screened from 13 fish gut-associated actinobacterial strains for their antimycobacterial and antitubercular properties. Ideal fermentation methodology has opted for bioactive metabolite production. Optimization procedures, minimum inhibitory concentration determination, characterization studies, and metabolite profiling through gas chromatography mass spectrometry were performed. Results: Potential strain MCA2 was selected for their antagonistic activity against Mycobacterium smegmatis. Bioactive metabolite of potential strain was produced through agar surface fermentation and extracted using ethyl acetate. Antitubercular activity was confirmed by >50% reduction in relative light unit against Mycobacterium tuberculosis H37Rv. The potential strain MCA2 was identified as Streptomyces sp. based on its phenotypic characteristics. Conclusion: The outcome of this study outlined the antimycobacterial potential of isolated fish gut-associated Streptomyces sp. strain confirming that fish guts are promising sources for isolating metabolites active against tuberculosis and other nontuberculous mycobacterial diseases.
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Therapeutic management of hypovitaminosis A and zinc deficiency in a lactating cow from a small dairy herd in muranga county, Kenya p. 94
Joseph Mwanzia Nguta
DOI:10.4103/bbrj.bbrj_221_20  
Background: Hypovitaminosis A and zinc deficiency were diagnosed in a 7-year-old Friesian cow from a small milking herd comprising of thirty Friesian cows in a zero grazing unit in Muranga County in Kenya, on Friday, November 15, 2019. The cow was weighing approximately 500 kilograms and had calved four months ago. The daily production of milk was tweny five litres. The cow had a history of sudden inappetance, reduced weight, sternal recumbency, convulsions and heavy lacrymation. Clinical examination revealed slight clouding of the cornea, and dilated pupils which did not respond to light. The menace response was almost absent but palperal and corneal reflexes were present. The cow was not apparently blind. Methods: The clinical examination of the skin revealed a fungal infection. Skin scrapings and hair from the lesions were examined for fungal species by direct microscopy in 10% KOH and lactophenol. Collected samples were inoculated on mycobiotic agar. The inoculum was incubated at 28°C for two to six weeks and examined for colony formation. Culture examination revealed Trichophyton verrucosum as the cause of dermatophytosis. Blood sample was taken from the cow into a vial containing heparin for spectrophotometric estimation of vitamin A and serum zinc concentrations. Results: Vitamin A and serum zinc concentrations were 5.12 μg/dl and 3.24 μg/L, respectively. The reference serum values for vitamin A are in the range of 15.4 to 32.3 μg/dl, while reference serum zinc levels are in the range of 6-12 μg/L for optimum physiologic functioning in dairy cattle. On the basis of history, clinical examination and significantly low serum vitamin A and zinc levels, the lactating friesian cow was diagnosed to be suffering from combined hypovitaminosis A and zinc deficiency. The dairy cow was therapeutically managed through administration of zinc sulphate orally, at a dosage rate of 1 gram per week for six weeks, administration of vitamin A at a dosage rate of 30,000 international units (IU), deep intramuscularly, once daily for seven days, and intramuscular administration of 3 mls of BelamylR, once daily for seven days. The body parts with lesions caused by T. verrucosum were treated through topical administration of zinc oxide ointment once daily for twenty one days. Following treatment of the lactating cow, significant improvement was observed in terms of disappearance of lachrymation, corneal clouding, sternal recumbency, skin lesions and convulsions. The appetite also returned to normal. All the other cows in the farm were supplemented with vitamin A and zinc. The client was also advised to include fresh napier and bermuda grass in the cattle diet, since they have been shown to contain adequate levels of beta carotene and zinc. Conclusion: In conclusion, zinc and vitamin A supplementation may be of benefit for recovery of cows from sternal recumbency and dermatophytosis.
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Hematological analysis of blood cells and isolation of pathogenic microorganisms from second-degree flame burn patient with the prevalence of multidrug resistance traits Highly accessed article p. 98
Asif Shahriar, Hossain Ahmed, Aar Rafi Mahmud
DOI:10.4103/bbrj.bbrj_173_20  
Burns are traumatic injuries that can occur in the home or workplace. It is a type of injury to flesh or skin caused by heat, electricity, chemicals, or radiation. The aims of this study to identified drug resistance traits of microorganisms, which is lead to wound infection after burn injury and causes hematological imbalanced of blood cells that are lead to the immune response against these pathogenic strains. The patient was burned by flame and seriously injured, with 24% tissue damaged. The whole blood was collected for complete blood count and peripheral blood film to analyze the components and morphological shape of blood cells. In addition, the wound samples were collected from wound infected sites to isolation and identification of microbial contamination as well as the study of antimicrobial susceptibility and resistance traits of microbes which are intensively involved in wound infection along with skin tissue damage. Among the complication period, the patient was seriously infected by pathogenic bacteria with viable bacterial count with log 107 colony-forming unit (CFU)/mL. The predominant pathogens were Escherichia coli, Klebsiella spp., Pseudomonas spp. and Staphylococcus spp. Most of the pathogens were found as drug-resistant, notably against second- and third-line antibiotics. The serious complication of microbial infection during the wound healing period was lead to increase white blood cells range along with terribly lower than the normal range of hemoglobin at 6.8 g/dl. Furthermore, the abnormal morphology of red blood cells was noted as an iron deficiency complication of the patient. Bacterial infection of the postburn patient is alarming for quick treatment. Most of the pathogens are rarely sensitive against most commercial antibiotics. Hence, bacterial colonization is the main threat for the burn-injured patient, which prohibits the immune response against in vivo infection.
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