Sort by
Pathogen-wise Clinical Profile, Outcome and Antibiotic Sensitivity Profile of Septic Newborns in Level III Neonatal Intensive Care Unit of a Tertiary Teaching Hospital: A Retrospective Study

Introduction: Culture positive sepsis remains to be a leading cause of death in Neonatal Intensive Care Unit (NICU) mainly among preterm and low birth weight newborns. The objective was to analyze the initial signs of sepsis, antibiotic sensitivity, and outcome of septic newborns in NICU. Methods: The demographic data, initial clinical features at suspicion of sepsis, diagnosis, laboratory abnormalities, pathogen isolated and antibiotic sensitivity patterns of the septic neonates, and their outcome were documented from their case records. Results: A total of 161 culture positive septic newborns, 76.4% were preterm and 54 died of sepsis (33.54%). Early and late onset sepsis was seen in 56 and 109 neonates, respectively. The initial clinical findings at suspicion of sepsis which had a statistical significance were tachycardia in Escherichia coli and Pseudomonas sepsis, hyperglycemia in Burkholderia, fever in Candida, sclerema in Klebsiella pneumoniae (KP), and seizures in E. coli sepsis. The cerebrospinal fluid culture positive newborns commonly presented with apnea, poor perfusion, and lethargy. Raised C reactive protein was seen in a higher proportion of newborns with Candida (60%) sepsis and E. coli (50%) sepsis. Severe thrombocytopenia was seen in 53%–62% newborns with gram-negative and fungal sepsis. Metabolic acidosis was seen in all gram-negative sepsis neonates, particularly in >80% cases of Klebsiella and Candida sepsis. Mortality was highest and statistically significant in KP (55.4%) and Citrobacter koseri (55.6%) sepsis ( p = .004). The statistically significant risk factors for mortality included neonates with raised C Reactive Protein (CRP). Most of the gram-negative pathogens were sensitive to colistin and aminoglycosides and resistant to carbapenems. Conclusion: Observing the initial clinical features at suspicion of sepsis may help predicting the likely pathogen awaiting the final blood/CSF culture report and knowing the antibiotic sensitivity profile of commonly isolated organisms in our NICU helps in the selection of a rational empirical antibiotic.

Open Access
Relevant
Tissue engineering in periodontal regeneration: A future paradigm in inflammatory disorder

Periodontitis is an inflammatory disorder that results in tissue destruction when there are too many germs present or when the host’s normal inflammatory response is disrupted. The fight against periodontal regeneration is a titanic one. Tissue engineering was suggested by Langer and colleagues as a potential method for replacing the missing periodontal tissues. The development of functional and long-lasting periodontal tissues will take the role of sick tissues thanks to the science of tissue engineering, which combines engineering and the life sciences. Tissue engineering is an emerging specialisation in the realm of medical health and sciences. It is advancing, spreading its wings over numerous facets of molecular biology, physiology, surgery, regeneration, and molecular medicine. Cell biologists, molecular biologists, biomaterial engineers, experts in microscopic imaging, robotics engineers, computer-assisted designers, and developers of equipment such as bioreactors, where tissues are grown and nurtured, are just a few of the medical and technical specialties that make up the field. Finally, legal advisors and marketing research specialists (product development, and medical implementation) are also involved in the practical process of tissue engineering. New biological organs will be created in the future using engineering and biological techniques.

Relevant
Evaluation of the clinical parameters and volumetric analysis of gingival crevicular fluid for chlohexidine vying silver nanoparticle mouthwash the avant garde for chronic periodontitis

BACKGROUND: Oral cavity ecosystem represents a dynamic pattern. Scaling and root planing (SRP) is the gold standard approach for treatment of chronic periodontitis but used alone it may not be effective in removing periodontal pathogens from sites where access is poor. Although chlorhexidine is the most effective mouthwash against oral microorganisms, the side effects of long- term use suggest the need for an alternative. Hence, this study has been undertaken to know effectiveness of silver nanoparticle mouthwash with chlorhexidine mouthwash which is effective on common microorganisms of oral cavity. OBJECTIVE: To evaluate and compare the clinical and biochemical outcome of chlorhexidine (CHX) and silver nanoparticle as an adjunct to scaling and root planing (SRP) in patients with chronic periodontitis. METHODS: Ninety- two patients with generalized moderate to severe chronic periodontitis from the Dept. of Periodontology who fulfilled the inclusion and exclusion criteria were recruited for the study. In the experimental clinical trial, the clinical parameters likewise; Plaque index (PI), Gingival index (GI), probing depth (PD), clinical attachment loss (CAL) were assessed. The volumetric analysis of gingival crevicular fluid (GCF) levels were assessed at baseline and follow up visits. The IBM SPSS Statistics for Windows software, v. 20.0 (IBM Corp., Armonk, USA), was used. The data was numerically coded and entered into the program. Both the descriptive statistics and the inferential statistics were analyzed to compare the responses between the groups. RESULTS: The statistical analysis was carried out by descriptive as well as inferential statistics and both groups demonstrated significant intragroup reduction in PI, GI, PPD, CAL, GCF from baseline to 3 months follow-up. There were statistically significant intragroup differences between both the groups for all of the parameters. CONCLUSION: Silver nanoparticle mouthwash can be an alternative adjunct for non-surgical periodontal therapy in patients with chronic periodontitis. Results of this study indicated that both the mouth rinse demonstrated an equal range of effectiveness. These conclusions were supported by the clinical parameters and biochemical outcomes.

Relevant
Photocatalytic efficacy of Magnesium oxide nanoparticles in dye Degradation: A sustainable One-Pot synthesis utilizing Syzygium samarangense L. Extract

Efficient degradation of organic pollutants is a pressing environmental concern. In our current study, we propose a novel photocatalytic solution to address this challenge, harnessing the potential of advanced nanomaterials to enhance pollutant removal rates. The present work reports the synthesis of Magnesium Oxide (MgO) nanoparticles via a green technique using an aqueous extract of Syzygium samarangense leaves. The role of reducing and capping agents in the process was owned by Syzygium samarangense leaf extract. The green synthesized MgO nanoparticles (MgO NPs) were characterized for their structural, morphology, and optical details using various analytical techniques. The formation of metal oxide in the sample was evident from a strong absorbance peak at 264 nm, and the calculated Eg value of 5.5 eV. The high crystallinity of the prepared NPs was authenticated by PXRD analysis with a cubic structure of calculated average crystalline size of 18 nm. Both leaf extract and the prepared MgO NPs were subjected to FTIR analysis, and the action of phytochemicals was affirmed by the absence of major band in MgO NPs spectrum. Precursor and agglomerated morphology were confirmed on SEM analysis. The prepared sample were utilized to perform degradation of Methylene blue (MB) and congo red (CR) dyes through photocatalysis under UV irradiation. The results affirm the decrement in absorbance with the increment of irradiation time. The affirmed decrement was put forth to study the kinetics of the degradation reaction, and the results was best aligned with 1st kinetic equation with R2 value of 0.9850 and 0.976 for MB and CR dye, respectively. The same results were utilized to study the effect of dye dosage, catalyst concentration, pH level, and presence of different scavengers. All the results found compelling and suggest the prepared MgO NPs as a potent candidate for photocatalytic dye degradation of MB and CR.

Open Access
Relevant
Prevalence and impact of cannabis use disorder on acute ischemic stroke and subsequent mortality in elderly peripheral vascular disease patients: A population-based analysis in the USA (2016 - 2019)

BackgroundGiven current evidence linking peripheral atherosclerotic disease, also known as cannabis arteritis, and acute ischemic stroke (AIS) in individuals with cannabis use disorder (CUD), we investigated the frequency and implications of CUD in relation to AIS risk and outcomes among elderly patients with peripheral vascular disease (PVD). MethodsThe National Inpatient Sample (2016–2019) was used to compare geriatric patients with PVD and cannabis use disorder CUD. CUD was correlated with AIS admissions. Adjusted multivariable regression models assessed in-hospital mortality rates. ResultsOf 5,115,824 geriatric admissions with PVD, 50.6 % were male and 77.5 % were white. 21,405 admissions had cardiovascular and CUD co-occurrence. 19.7 % of CUD patients had diabetes mellitus (DM), compared to 33.7 % of non-CUD patients. Smoking and HTN rates were comparable between groups. Patients with CUD used more recreational drugs concurrently than those without CUD. AIS prevalence was 5.2 % in CUD patients and 4.0 % in controls (p < 0.001). In the geriatric population with PVD, the presence of CUD was found to be associated with increased odds of hospitalizations due to AIS, with an adjusted odds ratio (aOR) of 1.34 (95 % confidence interval [CI] 1.18–1.52, p < 0.001). All-cause in-hospital mortality was not statistically significant, with an aOR of 0.71 (95 %CI 0.36–1.37, p = 0.302). In our study, older patients with PVD and hypertension (aOR 1.73) had a greater risk of AIS. Intriguingly, when we analyzed AIS predictors in elderly PVD patients with concurrent tobacco use disorder, we identified a counterintuitive protective effect (aOR 0.58, 95 % CI 0.42-0.79, p < 0.001). ConclusionsOur findings indicate that among geriatric patients with PVD and concurrent CUD, there is a notable 34 % risk of AIS. Importantly, this risk persists despite controlling for other CVD risk factors and substance use. Further investigations are warranted to elucidate and validate the intriguing phenomenon known as the smoker's paradox.

Relevant