International Journal of Applied and Basic Medical Research最新文献

Background: Acinetobacter baumannii is an alarming pathogen in hospital-acquired infections, particularly in the intensive care units (ICUs). Carbapenemases production and biofilm formation contribute significantly to the pathogenicity of the organism. Carbapenem resistance in A. baumannii is primarily due to the production of carbapenemases.

Aim: The study was conducted to detect the presence of carbapenemase-encoding genes in A. baumannii along with their ability to form biofilm. In addition, this study also investigated the association between biofilm formation and carbapenemase genes harboring A. baumannii isolates.

Materials and methods: One hundred and forty isolates of A. baumannii were collected from the various specimens. Of these, this study included 36 isolates that were carbapenem-resistant, metallo-β-lactamases (MBLs) producing, and extensively drug-resistant (XDR) obtained from ICUs. Identification and antibiotic susceptibility determination was done using VITEK 2. Further, the isolates were confirmed by detecting the ^bla OXA-51 carbapenemase gene intrinsic to A. baumannii. Polymerase chain reaction was performed to detect carbapenemase-encoding genes, and biofilm formation was examined using the tube method.

Results: The ^bla OXA-51 gene was present in all isolates (n = 36). A. baumannii showed highest sensitivity against colistin (100%) and minocycline (25%). Out of 36 isolates, acquired carbapenemase encoding genes were detected in 35 (97.22%) isolates, as follows: ^bla OXA-23 (35/36, 97.22%), ^bla NDM (18/36, 50%), ^bla IMP (1/36, 2.78%), and ^bla VIM (28/36, 77.78%). In 33 (91.67%) isolates, oxacillinase (OXA) and MBL genes coexisted. Among the 36 isolates, 30 (83.33%) formed biofilm.

Conclusion: The study highlights that colistin and minocycline are the viable antibiotics for treating carbapenem-resistant MBL-producing XDR A. baumannii infections. ^bla OXA-23 is the commonest carbapenemase gene, and ^bla VIM is the most frequently found MBL gene prevalent in our hospital and contributes to carbapenem resistance in A. baumannii. The study also showed a higher frequency of co-occurrence of multiple carbapenemase genes in single isolates, and most of these isolates formed biofilm. However, no statistically significant association was found between biofilm formation and carbapenemase genes in A. baumannii. This study emphasizes the molecular diagnostic value of carbapenemase gene detection to reduce the resistance rate in A. baumannii isolates.

Carcinoid tumors (CTs) are slow-growing neuroendocrine neoplasms that may arise in any part of the body. They usually affect the lungs or gut. Primary intradural extramedullary CTs of the central nervous system are rare; few cases have been reported. This case report describes a 36-year-old patient with lower back discomfort, weakness, and lower leg pain for 8 months. Contrast-enhanced magnetic resonance imaging of the lumbosacral spine, from the lower L3 vertebral level to the L4-5 disc level, revealed a 4.5 cm × 2.5 cm × 1.5 cm intradural mass lesion. The main differential diagnoses were on clinical and radiographic examination: nerve sheath tumors, meningiomas, and myxopapillary ependymomas. The tumor was excised en bloc after an L3-L5 lumbar laminectomy. Histomorphology and immunohistochemistry made a definitive diagnosis of CT of the lumbar spine. Two years after surgery, there was no clinical or radiological evidence of tumor recurrence or metastasis. The present case study is intended to effectively diagnose and treat spinal intradural extramedullary CTs.

Background: Diabetes mellitus is a prevalent metabolic disorder characterized by reduced insulin activity leading to hyperglycemia, affecting over 425 million people globally. Traditional treatments, including sulfonylureas and biguanides, often have undesirable side effects, prompting a shift toward herbal remedies for diabetes management and prevention.

Objective: This study aims to evaluate the antidiabetic effects of budding leaves from Clerodendrum infortunatum compared to metformin in preventing streptozotocin (STZ)-induced hyperglycemia in rats.

Materials and methods: An in vivo study was conducted using adult male Wistar albino rats. STZ was administered on day 15 and was followed till day 18. Methanolic extract of C. infortunatum (MECI) at different dosages (250, 500, and 1000 mg), metformin (500 mg), and normal saline were administered to different groups of rats. Blood glucose levels (at day 1, 15, and 18) and biochemical parameters (lipid profile, hepatic and renal parameters, and oxidative stress markers) were measured at days 1 and 18. At the end, a histopathological examination of the pancreas, liver, and kidney was done. Statistical analyses were performed to determine significance.

Results: The study found that while the MECI at 500 mg/kg showed a significant reduction in blood glucose levels compared to the diabetic control group (P < 0.0001), it was less effective than metformin (P > 0.05). Higher doses of MECI demonstrated potential in improving liver and renal parameters (P < 0.0001), as well as reducing oxidative stress (P < 0.0001) compared to metformin indicating its beneficial effects in diabetic conditions.

Conclusion: C. infortunatum shows promise as an adjunctive therapy for the prevention of diabetes due to its multifaceted mechanisms, including enhancing insulin secretion and reducing oxidative stress. However, further clinical trials are needed to confirm these findings and establish optimal dosages.

Context: Colorectal carcinoma is a major health concern globally, with varying prognostic outcomes influenced by molecular markers. E-cadherin and beta-catenin are proteins involved in cellular adhesion and signaling pathways, and their aberrant expression has been implicated in tumor progression and metastasis.

Aims: This study aims to evaluate the association between abnormal immunohistochemical expression of E-cadherin and beta-catenin with various clinicopathological parameters in colorectal carcinomas.

Setting and design: A retrospective cross-sectional 3-year analytical study.

Materials and methods: A total of 52 colorectal carcinoma tissue samples were analyzed using immunohistochemistry to assess the expression levels of E-cadherin and beta-catenin. Clinicopathological parameters including age, gender, tumor location, tumor differentiation, depth of invasion, perineural invasion, lymphovascular invasion, and nodal involvement were assessed and correlated with protein expression patterns.

Statistical analysis: SPSS version 24 was used for calculating P values using the Chi-squared test.

Results: Aberrant expression of E-cadherin and beta-catenin was observed in a significant proportion of the tumors. Poorly differentiated tumors showed a marked loss of E-cadherin and abnormal beta-catenin localization. In addition, increased lymphovascular and nodal involvement were significantly associated with these aberrant expression patterns.

Conclusion: The findings suggest that abnormal expression of E-cadherin and beta-catenin is linked to poor tumor differentiation and higher rates of lymphovascular and nodal involvement. These markers may serve as potential biomarkers for assessing prognosis in colorectal carcinoma patients.

Background: Neuroanatomy has always been considered a difficult topic for 1^st-year MBBS students. Project-based Learning (PjBL) is a comprehensive approach to classroom teaching and learning that is designed to engage students in solving clinical scenario-based questions. This innovative learning method employs real-world work assignments on time-limited projects to achieve mandated performance, facilitating a collaborative and collective learning experience. This engaging pedagogy is designed to enhance the understanding of neuroanatomy.

Aim and objectives: To implement and innovate PjBL sessions in neuroanatomy, and to analyze student's perceptions following each session.

Materials and methods: The phase I MBBS students and faculty involved in the teaching were sensitized regarding the projects. A baseline lecture on the topic was taken by the faculty in charge. Students were divided into four groups of 25 each and were assigned a topic and instructed to present a seminar on the given topic with the help of self-made models. Learner satisfaction survey was taken on the Likert Scale from the students regarding understanding of the given topic and faculty feedback for the same was also taken.

Results: Students testified that the project was helpful in improving their understanding of neuroanatomy and enhancing classroom engagement, collaborative learning in preparation of projects, and boosting their critical and collateral thinking.

Conclusion: Students were satisfied with the application of PjBL sessions in better understanding of neuroanatomy. It also helped them in developing concepts for various neurological disorders. The faculty involved was satisfied with the performance of students and looking forward to incorporating this teaching-learning method in the future.

Traumatic pneumocephalus is not an unusual entity. Mostly, such cases are managed according to the patient's neurological status, guided by computed tomography (CT) imaging, and the patient responds well to conservative treatment. However, it seldom progresses to tension pneumocephalus, and if it does along with deterioration of the neurological condition, then neurosurgical intervention becomes necessary. On CT, its appearance is named "Mount Fuji" sign. The most widely documented peril involves increased intracranial pressure causing mass effect and, in some cases, cerebral herniation. However, one unspoken aspect leading to sudden death is seizure. We report the case of a 52-year-old male, admitted after vehicular accident responding well to the conservative treatment along with resolution of tension pneumocephalus. However, he developed generalized tonic-clonic seizures leading to sudden death. Through this case report, we will be discussing the association of pneumocephalus with seizures and seizures leading to sudden death.

Background: Aging makes elderly people vulnerable to malnutrition; factors such as feeding difficulty, reduced mobility, psychological distress, being widowed, illiteracy, poverty, and poor access to health and social services further aggravate the condition. Decreased nutrition is one of the major factors that often go undiagnosed; hence, the diet must include a variety of foods for proper nutrition. The objectives of the study were to determine the nutritional status of elderly residents and to assess the dietary diversity among them.

Materials and methods: A community-based descriptive cross-sectional study was conducted among elderly participants residing under the selected subcenters of Budge Budge II block, West Bengal, over 3 months. A total of 210 elderly participants were selected through multistage sampling. Dietary diversity was measured using the Individual Dietary Diversity Score and nutritional status using the Mini Nutritional Assessment scale. ANOVA and independent sample t-tests were done to see any difference in the mean dietary diversity score. Binary logistic regression for nutritional status was performed, considering P < 0.05 to determine the association.

Results: Among 210 participants, 7.1% were malnourished, 48.6% were at risk of malnutrition, while 44.3% were normal. Currently, unmarried and morbid elderly are at higher risk of being malnourished. The mean dietary diversity score was 6.07 ± 0.65. Significant differences were found in age group, gender, marital status, addiction, education level, socioeconomic status, food preferences, and social assistance. With increasing dietary diversity, nutritional status score also increases.

Conclusions: Nutritional clinics should be set up at the primary health center/community health center level to provide a more detailed evaluation, regular follow-up, and dietary intervention for reversing the situation.

The authors describe a faculty development program to build the capacity of teachers of health professions. The program is offered in the form of a fellowship in hybrid mode and is centered around the concept of "assessment as learning." It harnesses the power of assessment to promote learning, uses near peer teaching, and requires the participants to apply this knowledge for an assessment project.

Context: Acute appendicitis is a common surgical emergency. While clinical diagnosis is generally effective, it is not perfect, potentially leading to negative appendectomies or delayed treatment.

Aims: This study investigated the histopathological patterns of appendectomy specimens in King Khalid Hospital, Hail Province, Saudi Arabia, correlating them with preoperative clinical diagnoses to assess diagnostic accuracy and guide optimal management.

Subjects and methods: A retrospective analysis was conducted on 198 patients who underwent appendectomies between August 2023 and July 2024. Resected appendix specimens underwent histopathological examination and were categorized as inflamed, malignant, or benign. Clinical data and histopathological findings were compared using statistical analyses, including Fisher's exact test, to assess diagnostic accuracy and explore potential associations between patient demographics, appendicitis severity, and clinical presentation.

Results: The study cohort consisted predominantly of young males (78.8%, mean age: 26 ± 9.2 years), with no pediatric cases included. The most common histopathological finding was an inflamed appendix (99.5%), with acute inflammation being most prevalent (86.9%). Perforation (10.1%) and gangrenous changes (2.5%) were also observed. A rare case of negative appendectomy (0.5%) was attributed to a perforated Meckel's diverticulum.

Conclusions: This study demonstrates a high preoperative diagnostic accuracy for acute appendicitis. However, the occurrence of negative appendectomies and complicated cases, particularly in young adult males, highlights the need for continuous vigilance and refinement of diagnostic approaches. Further research exploring age- and sex-specific risk factors for complicated appendicitis is crucial to optimizing patient management strategies and minimizing unnecessary surgical interventions.

Background: Obstructive sleep apnea (OSA) is a common sleep-breathing disorder. OSA is becoming highly prevalent, which means that to detect and prevent various hazardous complications, it is imperative that there are easy yet accurate techniques available to identify people with OSA.

Objectives: The objective was to compare two questionnaires: The STOP-BANG score and the Epworth Sleepiness Scale (ESS), used to screen the patients suspected of OSA. Polysomnography (PSG), the gold standard investigation, was used to diagnose OSA.

Materials and methods: Sixty-five suspected individuals were recruited as per inclusion/exclusion criteria. Detailed history taking, physical examination, and anthropometric examination were done in all patients. Suspects were subjected to filling up of the STOP-BANG and ESS questionnaires, following which they underwent an overnight PSG examination, which is considered the gold standard diagnostic investigation for OSA. Compiled data were used to compare the sensitivities, specificities, and positive and negative predictive values (NPVs) of the two screening scores.

Results: Of 65 screened patients, 57 (88%) had OSA. The sensitivity to predict OSA was the highest for the STOP-BANG questionnaire (91.23%), whereas ESS had a sensitivity of 70.18%. No difference in specificity (75%) of the two scores was noted. The positive predictive values of STOP-BANG and ESS questionnaires was 96.30% and 95.20%, respectively. NPV of STOP-BANG and ESS was 54.50% and 26.10%, respectively.

Conclusion: The present study was able to provide valuable insights into OSA screening. Out of the two studied OSA screening questionnaires, we found out that both had comparatively good predictive and diagnostic accuracy, with the STOP-BANG score surpassing the ESS score in the majority of measures. Considering the high global burden of undiagnosed OSA, there is a need to upregulate the screening for OSA followed by appropriate treatment measures. This would improve sleep quality and reduce the risk of complications and future adverse health outcomes.