India Ink Research Articles

A Comparative Study of Different Diagnostic Modalities, India Ink, Gram Stain & ICT (Rapid Card) for the Detection of Cryptococcal Meningitis among HIV-Infected Patients in a Tertiary Care Hospital at Kanpur

A Comparative Study of Different Diagnostic Modalities, India Ink, Gram Stain & ICT (Rapid Card) for the Detection of Cryptococcal Meningitis among HIV-Infected Patients in a Tertiary Care Hospital at Kanpur

Pinter and Stoppard: A Director’s View

Pinter and Stoppard: A Director’s View

The Life-Giving Efficacy of Beauty and Desire in Stoppard's Drama

Abstract: In Rosencrantz and Guildenstern Are Dead (1967), Arcadia (1993), and Indian Ink (1995), the playwright Tom Stoppard poses existential questions about the inevitability of both cosmic and individual disintegration and death. However, as characters from Arcadia and Indian Ink engage in romantic encounters and acts of aesthetic creation driven by desire, they interrupt the cyclical inevitability of death embodied in Rosencrantz and Guildenstern Are Dead , and they oppose entropic disintegration by instigating encounters with beauty and desire that lead to reconciliation over time. This generative impulse of love and desire parallels Elaine Scarry's assertion in On Beauty and Being Just that encounters with beauty and desire are fundamentally life-giving.

The Life-Giving Efficacy of Beauty and Desire in Stoppard's Drama

Abstract: In Rosencrantz and Guildenstern Are Dead (1967), Arcadia (1993), and Indian Ink (1995), the playwright Tom Stoppard poses existential questions about the inevitability of both cosmic and individual disintegration and death. However, as characters from Arcadia and Indian Ink engage in romantic encounters and acts of aesthetic creation driven by desire, they interrupt the cyclical inevitability of death embodied in Rosencrantz and Guildenstern Are Dead , and they oppose entropic disintegration by instigating encounters with beauty and desire that lead to reconciliation over time. This generative impulse of love and desire parallels Elaine Scarry's assertion in On Beauty and Being Just that encounters with beauty and desire are fundamentally life-giving.

Microanatomical organization of hepatic venous lymphatic system in humans.

Lymphatic fluid drains from the liver via the periportal lymphatic, hepatic venous lymphatic, and superficial lymphatic systems. We performed a postmortem study to clarify the three-dimensional structure and flow dynamics of the human hepatic venous lymphatic system, as it still remains unclear. Livers were excised whole from three human cadavers, injected with India ink, and sliced into 1-cm sections from which veins were harvested. The distribution of lymphatic vessels was observed in 5 μm sections immunostained for lymphatic and vascular markers (podoplanin and CD31, respectively) using light microscopy. Continuity and density of lymphatic vessel distribution were assessed in en-face whole-mount preparations of veins using stereomicroscopy. The structure of the external hepatic vein wall was assessed with scanning electron microscopy (SEM). The lymphatic dynamics study suggested that lymphatic fluid flows through an extravascular pathway around the central and sublobular veins. A lymphatic vessel network originates in the wall of sublobular veins, with a diameter greater than 110 μm, and the peripheral portions of hepatic veins and continues to the inferior vena cava. The density distribution of lymphatic vessels is smallest in the peripheral portion of the hepatic vein (0.03%) and increases to the proximal portion (0.22%, p = 0.012) and the main trunk (1.01%, p < 0.001), correlating positively with increasing hepatic vein diameter (Rs = 0.67, p < 0.001). We revealed the three-dimensional structure of the human hepatic venous lymphatic system. The results could improve the understanding of lymphatic physiology and liver pathology.

Clinical and Epidemiological Characteristics of Neurocryptococcosis Associated with HIV in Northeastern Brazil.

Cryptococcal meningitis is a serious infection of the central nervous system that is predominant in developing countries, caused by fungi of the genus Cryptococcus, and which affects immunosuppressed patients, especially those with HIV. Here, we aim to diagnose and characterize the clinical-epidemiological profile of cryptococcosis in patients admitted to two tertiary public hospitals in northeastern Brazil. The study is divided into three moments: (1) the isolation of fungus and diagnosis from biological samples collected between 2017 and 2019, (2) a description of the clinical and epidemiological characteristics of the patients, and (3) the experimental tests related to an in vitro susceptibility antifungal profile. The species were identified by MALDI-TOF/MS. Among the 100 patients evaluated, 24 (24.5%) were diagnosed with cryptococcosis based on positive culture. Clinical-epidemiological analysis showed a slightly higher prevalence in men between 30 and 39 years. When comparing the date of HIV diagnosis and the development of cryptococcosis, it was observed that 50% received the diagnosis of infection by cryptococcosis after or equal to a period of 12 months from being diagnosed with HIV; the other 50% received it within the first 30 days of the HIV diagnosis. Neurocryptococcosis was the most prevalent clinical form, and, at the time of hospital admission, the most common clinical signs were high fever (75%), intense headache (62.50%), and neck stiffness (33.33%). The cerebrospinal fluid showed 100% sensitivity and positivity for direct examination by India ink, and fungal culture. The mortality rate in this study was 46% (11/24), a lower rate than in the other literature. An antifungigram showed that 20 (83.33%) isolates were susceptible to amphotericin B and 15 (62.5%) to fluconazole. Mass spectrometry identified 100% of the isolates as Cryptococcus neoformans. In Brazil, this infection is not mandatory notifiable. Therefore, although there is little information on the subject, it is obsolete and does not express the reality of the facts, mainly in the northeast region, where this information is insufficient. The data obtained in this research contribute to the epidemiological knowledge of this mycosis in Brazil and will serve as a basis for future globally comparative epidemiological studies.

FAT-RICH VS FAT-POOR RENAL AML ON MULTIPARAMETRIC MRI.

Background: The study aims to show the MRI imaging features of Fat-rich and Fat-poor AML using MULTIPARAMETRIC renal MRI protocol. Fat-poor angiomyolipomas (AMLs) are challenging to differentiate from other renal lesions on USG and CT and often necessitate biopsy or surgery for differentiation. The Methods: study group consisted of 9 patients with histologically proven AMLs who underwent MULTIPARAMETRIC renal MRI (T2WI, Chemical Shift imaging, DWI,) before the histopathology. The lesions were reviewed independently by a radiologist and a resident. On T2-weighted images, among Fat rich AML (n=2 i.e. 66%) showed heter Results: ogeneous hyperintense signal and (n=1 i.e. 33%) showed homogenous hyperintense signal as compared to renal cortex. Among Fat Poor AML (n=4 i.e. 66%) showed homogenous hypointense signal and (n=2 i.e. 33%) showed heterogeneous hypointense signal as compared to renal cortex. On Chemical Shift Imaging, among Fat rich AML, mean Signal Intensity drop (%) on out of phase imaging for Fat rich AML in our study was 27.07%±1.65%. Also Fat rich AML (n=3 i.e. 100%) showed Indian Ink Artifact within the mass or at its interface with the kidney. Among Fat Poor AML, mean Signal Intensity drop (%) on out of phase imaging for Fat poor AML in our study was 0.6%±6.7% (p value &lt;0.001). On Diffusion Weighted Imaging, apparent diffusion coefcient (ADC) maps show low ADC values regardless of the types of AML, because fat signal intensity is suppressed. among Fat rich AML mean ADC values of lesion in our study was 0.86±0.09, Among Fat Poor AML, mean ADC values of lesion in our study was 0.96±0.01. Conclusion: Our study enables us to conrm consistent associations of MR imaging features with specic subtypes of AML. In our study, T2 signal intensity, T2 signal intensity ratio, signal drop on out of phase imaging, showed promising results differentiating between fat rich and fat poor AML

Medullary branches of the vertebral artery: microsurgical anatomy and clinical significance.

Since the medullary arteries are of a great neurologic and neurosurgical significance, the aim was to perform a detailed microanatomic study of these vessels, as well as of the medullary infarctions in a group of patients. The arteries of 26 halves of the brain stem were injected with India ink and gelatin, microdissected and measured with an ocular micrometer. Neurologic and magnetic resonance imaging (MRI) examinations were performed in 11 patients. The perforating medullary arteries, averaging 6.7 in number and 0.26mm in diameter, most often originated from the anterior spinal artery (ASA), and rarely from the vertebral (VA) (38.5%) and the basilar artery (BA) (11.6%). They supplied the medial medullary region. The anterolateral arteries, 4.8 in number and 0.2mm in size, most often arose from the ASA and PerfAs, and nourished the anterolateral region. The lateral arteries, 2.2 in number and 0.31mm in diameter, usually originated from the VA and the posterior inferior cerebellar artery (PICA). They supplied the lateral medullary region. The dorsal arteries, which mainly arose from the PICA and the posterior spinal artery (PSA), nourished the dorsal region, including the roof of the 4th ventricle. The anastomotic channels, averaging 0.3mm in size, were noted in 42.3%. Among the medullary infarctions, the lateral ones were most frequently present (72.8%). The obtained anatomic data, which can explain the medullary infarctions symptomatology, are also important in order to avoid damage to the medullary arteries during neurosurgical and neuroradiologic interventions.

Neurological manifestations of scrub typhus: Encephalitis and Acute Inflammatory Demyelinating Polyneuropathy (AIDP) (P2-10.002)

<h3>Objective:</h3> We report a case of a young male with serologically confirmed scrub typhus presenting with fever, eschar, altered sensorium, and progressive quadriplegia to illustrate the neurological complications (central and peripheral) of scrub typhus. <h3>Background:</h3> A young male presented to the emergency with complaint of high-grade fever for the past 12 days and altered sensorium. From the 10th day of illness, he started complaining of worsening weakness in all four limbs. A black, crusted plaque with an erythematous halo, giving a ‘cigarette-burn’ appearance suggestive of an eschar, was noted on the right forearm. On neurological examination, the patient was disoriented to time and place. Neck rigidity was absent. Reduced power of 3/5 in upper limbs and 1/5 in lower limbs was noted. Deep Tendon Reflexes were absent, and plantars were mute. <h3>Design/Methods:</h3> N/A <h3>Results:</h3> CSF analysis revealed no cells, mildly raised proteins (75 mg/dl), and normal glucose. CSF Grams staining, culture, India Ink preparation, and GeneXpert for Tuberculosis, was negative. Blood cultures were sterile. Scrub typhus IgM antibodies were detected using Enzyme-Linked-Immunosorbent-Assay (ELISA). Abdominal ultrasound revealed hepatomegaly. MRI-Brain revealed diffuse gyral swelling and hyperintensity on T2-weighted and FLAIR sequences involving bilateral lobes with no diffusion restriction, consistent with encephalitis. No abnormal post-contrast enhancement was noted. MRI-Spine was normal. Nerve Conduction Studies (NCS) were suggestive Acute Motor Axonal Neuropathy (AMAN) variant of Guillain-Barré-Syndrome (GBS). The patient received doxycycline. IVIG was added after NCS results. His condition gradually improved, and there was regaining of muscle strength in the following weeks with physiotherapy. <h3>Conclusions:</h3> Scrub typhus induced neurological complications are widely reported, with meningoencephalitis being the most common manifestation. However, PNS complications such as GBS are infrequent, and a high degree of clinical suspicion with prompt appropriate therapy and supportive care may prevent morbidity and mortality. <b>Disclosure:</b> Ms. Sood has nothing to disclose. Mr. Modi has nothing to disclose. Dr. Arora has nothing to disclose. Dr. Moudgil has nothing to disclose.

Multiwavelength tissue-mimicking phantoms with tunable vessel pulsation

For the development and routine characterization of optical devices used in medicine, tissue-equivalent phantoms mimicking a broad spectrum of human skin properties are indispensable. Our work aims to develop a tissue-equivalent phantom suitable for photoplethysmography applications. The phantom includes the optical and mechanical properties of the three uppermost human skin layers (dermis, epidermis, and hypodermis, each containing different types of blood vessels) plus the ability to mimic pulsation. While the mechanical properties of the polydimethylsiloxane base material are adjusted by different mixing ratios of a base and curing agent, the optical properties are tuned by adding titanium dioxide particles, India ink, and synthetic melanin in different concentrations. The layered structure of the phantom is realized using a doctor blade technique, and blood vessels are fabricated using molding wires of different diameters. The tissue-mimicking phantom is then integrated into an artificial circulatory system employing piezo-actuated double diaphragm pumps for testing. The optical and mechanical properties of human skin were successfully replicated. The diameter of the artificial blood vessels is linearly dependent on pump actuation, and the time-dependent expansion profile of real pulse forms were mimicked. A tissue equivalent phantom suitable for the ex-vivo testing of opto-medical devices was demonstrated.

Clinical characteristics and prognostic factors of 60 patients with acquired immune deficiency syndrome combined with Cryptococcus neoformans

ObjectiveCryptococcal meningitis (CM) threatens people’s health and is the main cause of opportunistic fungus-related death in acquired immune deficiency syndrome (AIDS) patients. Herein, we investigate the clinical characteristics and prognostic factors of AIDS patients with Cryptococcus neoformans in Wenzhou, Zhejiang Province, China.MethodsOur study enrolled AIDS patients diagnosed with Cryptococcus neoformans infection who were hospitalised in our hospital. They were divided into Group A (32 patients with CM) and Group B (28 patients without CM) according to their diagnosis. The differences between the two groups of patients’ clinical symptoms, imaging examinations and laboratory examinations were observed. Statistical methods were used to analyse the difference in prognosis between the two groups.ResultsHeadache and fever were the most common clinical characteristics for patients with CM, while respiratory symptoms and fever were the most common clinical characteristics for patients without CM. The positive rate of cryptococcal capsular antigen, India ink staining and culture in the cerebrospinal fluid examination was higher in the CM patients than in the non-CM patients. The overall morbidity and mortality rate after systemic antifungal therapy was higher in the CM patients than in the non-CM patients. A higher incidence of headache, impaired consciousness, nuchal rigidity, first intracranial pressure > 200 mmH2O and mortality was observed in the CM patients than in the non-CM patients. Multifactorial logistic regression analysis showed that headache risk factors affecting the patient’s prognosis at 12 weeks.ConclusionPatients with AIDS diagnosed with Cryptococcus neoformans infection have insidious clinical symptoms in the early stage, and their manifestation is often non-specific, resulting in poor prognosis and high mortality among CM patients compared to patients without CM. Therefore, early identification and timely antifungal therapy before the disease progresses to meningitis are of great value in improving the survival rate of patients.

Lack of evidence for longitudinal dissociation of the atrioventricular conduction axis.

Longitudinal dissociation of the aggregated specialized cardiomyocytes within the non-branching portion of atrioventricular conduction axis has proved a controversial topic for both morphologists and electrophysiologists. We have now used morphological methods, including three-dimensional assessment, to revisit, in human, canine, and bovine hearts, the presence or absence of interconnections between the aggregated cardiomyocytes making up the non-branching bundle. We analyzed three datasets from human and canine hearts, and two from bovine hearts, using longitudinal and orthogonal serial histological sections. In addition, we assessed three hearts using translucent India ink injected specimens, permitting assessment of the three-dimensional arrangement of the cardiomyocytes. Using the longitudinal sections, we found numerous oblique interconnections between the groups of specialized cardiomyocytes. When assessing orthogonal sections, we noted marked variation in the grouping of the cardiomyocytes. We interpreted this finding as evidence of bifurcation and convergence of the groups seen in the longitudinal sections. The three-dimensional assessment of the bovine material confirmed the presence of the numerous interconnections. The presence of multiple connections between the cardiomyocytes in the non-branching bundle rules out the potential for longitudinal dissociation. This article is protected by copyright. All rights reserved.

110 Macrophage Cross Talk following Subarachnoid Hemorrhage: Contribution of Peripheral Immune Activation in the Development of Cerebral Vasospasm

INTRODUCTION: Microglia respond to the initial insult of aneurysm rupture, but become overwhelmed by ferritin toxicity. These microglia release inflammatory cytokines that cause vasospasm to facilitate peripheral macrophage diapedesis. This process is dependent on the p-STAT3 pathway. METHODS: The autologous SAH pre-clinical model was utilized and compared to blood and CSF from human patients. Mouse blood was injected along the skull base to c57/bl6 and CCR2/Cx3CR1 mice. Microglia depletion was done with pexidartinib. Ferritin within microglia, TLR4, and NFKb were measured via immunohistochemistry. Vasospasm was measured via India Ink gelatin assay. The Modified Garcia Scale and right turn test was utilized. Clarity assay was utilized to determine association between macrophages and brain microglia. Cerebral doppler was used to measure spreading cortical depressions. p-STAT3 was measured via western blot. For all experiments, saline sham, subarachnoid hemorrhage, and subarachnoid hemorrhage with p-STAT3 inhibitor were utilized. RESULTS: Microglia recruitment occured within parenchyma along the skull base adjacent to subarachnoid blood. Ferritin toxicity was noted by day 5 (r-0.95, p &lt; 0.05) and persisted to day 9 (r-0.98, p &lt; 0.01). A shift in microglia occured following SAH with Cox-2 and INOS predominance (k1 0.76, k2 1.21). Blockade of p-STAT3 resulted in decreased vasospasm (p&lt;0.01), improved modified Garcia scores (p &lt; 0.05), and improved right turn test (p &lt; 0.05) following SAH. Peripheral macrophage diapedesis occured in regions of microglia activation. P-STAT3 blockade improved cerebral blood flow and prevented spreading cortical depressions (p &lt; 0.01). NFKb and TLR4 activation was markedly reduced by p-Stat3 inhibition (p &lt; 0.05). Results correlated closely to human aneurysmal blood and CSF data. CONCLUSIONS: Microglia ferritin toxicity contributes to vasospasm to facilitate peripheral macrophage diapedesis. Targeting the p-STAT3 pathway leads to reduced vasospasm and improved behavioral outcomes.

The effect of preoperative endoscopic tattooing using India ink on lymph node yield in laparoscopic colectomy for stage I right-sided colon cancer.

The purpose of this study is to evaluate the effect of preoperative endoscopic tattooing using India ink (ETI) on the number of retrieved lymph nodes (LNs) dissected during laparoscopic surgery for stage I right-sided colon cancer (RCC). This single-center, retrospective study included stage I RCC patients who underwent laparoscopic surgery between January 2010 and December 2021. The clinicopathological background and number of LNs retrieved were compared between patients managed with and without ETI. A multiple linear regression analysis was used to examine the effect of independent variables on the LN yield. A total of 169 patients were enrolled. Of these, 89 patients (52.7%) were classified into the ETI group, and 80 (47.3%) were classified into the no-ETI group. There were no significant differences in age, sex, body mass index, or tumor progression between the two groups. A univariate analysis showed that the number of LNs retrieved was significantly higher in female (26 vs. 24, p = 0.026), with tumor localization in the ascending or transverse colon (20 in the cecum, 26 in the ascending colon, 27 in the transverse colon, p < 0.001), and with preoperative ETI (28 vs. 21, p < 0.001). In a multivariate linear regression analysis, female sex (p = 0.0011), D3 lymphadenectomy (p = 0.046), and preoperative ETI (p = 0.012) were independently associated with the LN yield. In laparoscopic surgery for stage I RCC, preoperative ETI increased the number of LNs retrieved and allowed for appropriate staging.

Comparative analysis of diagnostic methods for the detection of Cryptococcus neoformans meningitis.

Cryptococcosis is a devastating opportunistic infection in immunocompromised individuals, primarily in people living with HIV/AIDS. This study evaluated a protocol for the early diagnosis of meningitis due to C. neoformans, utilizing established molecular techniques from serum and CSF samples. The 18S and 5.8S (rDNA-ITS) sequence-specific nested PCR assays were compared with direct India ink staining and the latex agglutination test for detection of C. neoformans in serum and cerebrospinal fluid (CSF) from 49 Brazilian suspected meningitis patients. Results were validated with samples obtained from 10 patients negative for cryptococcosis and HIV, and by analysis of standard C. neoformans strains. The 5.8S DNA-ITS PCR was more sensitive (89-100%) and specific (100%) than the 18S rDNA PCR and conventional tests (India ink staining and latex agglutination) for identification of C. neoformans. While the 18S PCR exhibited a sensitivity (72%) similar to that of the latex agglutination assay in serum samples, it was superior to the latex agglutination assay when testing CSF, with a sensitivity of 84%. However, the latex agglutination was superior to the 18SrDNA PCR in specificity in CSF (92%). The 5.8S DNA-ITS PCR yielded the highest levels of accuracy (96-100%) of any test for detection (serological and mycological) of C. neoformans in both serum and CSF. Use of the nested 5.8S PCR was superior to other techniques for the diagnosis of cryptococcosis. The possibility of using serum, a non-invasively collected material, in a targeted 5.8S PCR analysis to identify Cryptococcus spp. is recommended, especially in immunosuppressed patients. Our results indicate that nested 5.8S PCR can increase the diagnostic capability of cryptococcosis, and we suggest its use to monitor patients in the future.

Development of a new surgical technique to infuse kynurenic acid to optic nerves in chickens for studying loss of myelination

Prolonged infusion of a high dose of kynurenic acid (KYNA) reduces the myelin content in the rat spinal cord with preservation of the axonal integrity and without inducing an inflammatory response. We hypothesized that subdural infusion of a high concentration of KYNA can induce myelin loss in the optic nerves (ONs) of chickens. However, existing methods to deliver agents to the ON are inefficient, unlocalized and provide only acute exposure. Thus, we developed a surgical approach for sustained delivery of KYNA to the chicken ON. In brief, the novel surgical technique, which does not include excision of the extraocular muscles, involves incision of the skin and underlying fascial sheath to access the optic nerve within the muscle cone, implantation of a catheter in the dura of the optic nerve, the other end of which exits the orbit under the skin. The catheter runs under the skin near the lateral canthus, over the ears to the back of the neck, where a second incision is made to both implant the osmotic pump and to attach the catheter to the osmotic pump. India ink was used to confirm prolonged sustained administration to the optic nerves and across the chiasm. This surgical model was used to investigate KYNA's effect(s) on myelin loss in the ON. ONs of 7-day old chickens were infused with 50 mM KYNA or phosphate buffered saline (PBS) for seven days. Analysis of KYNA-infused contralateral ON g-ratios and protein levels indicated a reduction in myelin. These findings demonstrate the utility of our surgical approach for sustained delivery of KYNA into the ON and suggest a role for KYNA in modulating CNS myelination.

India Ink Tattooing of Ureteroenteric Anastomoses

While upper tract access through the insensate conduit following urinary diversion takes less time and incurs fewer costs than percutaneous kidney access does for the treatment of ureter and kidney pathology, endoscopic ureteroenteric anastomoses (UEA) identification can be difficult. We injected India Ink into the bowel mucosa near the UEA during ileal conduit diversion (IC) to determine the safety and feasibility of ink tattooing. Patients undergoing IC were prospectively randomized to receive ink or normal saline (NS) injections. The injections were placed 1 cm from UEA in a triangular configuration, and loopogram exams and looposcopy were performed to identify reflux (UR), UEA, the tattooing site and strictures in 10 and 11 patients randomized with respect to ink and NS injections, respectively. Ink patients were older (72 vs. 61 years old, p = 0.04) and had a higher Charlson Comorbidity Index (5 vs. 2, p = 0.01). Looposcopy was performed in three ink and four NS patients. Visualization of UEA was achieved in 100% of the ink and 75% of the NS patients (p = 0.26). The ink ureteroenteric anastomotic stricture (UEAS) rate was higher (N = 3 vs. N = 1) and six patients vs. one patients underwent surgery, respectively, for UEAS (p = 0.31). The study was halted early due to safety concerns. Our pilot study demonstrates that ink can be well visualized following injection near UEA during IC. However, the ink cohort had more UEAS than previously cited in the literature and our prior institutional UEAS rate of 6%. While this study sample is small, the higher incidence of UEAS after ink injection led us to question the utility and safety of ink injection following IC.

Carbon black-containing self-healing adhesive hydrogels for endoscopic tattooing

Endoscopic tattooing with India ink is a popular method for identifying colonic lesions during minimally invasive surgery because it is highly challenging to localize lesions during laparoscopy. However, there is a perceived unmet need for the injection of India ink and carbon particle suspension due to various complications and inconstant durability during the perioperative period. In this study, carbon black-containing self-healing adhesive alginate/polyvinyl alcohol composite hydrogels were synthesized as endoscopic tattooing inks. Alginate (Alg) conjugated with phenylboronic acid (PBA) groups in the backbone was crosslinked with polyvinyl alcohol (PVA) because of the dynamic bonds between the phenylboronic acid in alginate and the cis-diol groups of PVA. The carbon black-incorporated Alg-PBA/PVA hydrogels exhibited self-healing and re-shapable properties, indicating that improved intraoperative localization could be achieved. In addition, the adhesive tattooing hydrogels were stably immobilized on the target regions in the intraperitoneal spaces. These carbon black-containing self-healing adhesive hydrogels are expected to be useful in various surgical procedures, including endoscopic tattooing.

Assessment of Capsule Related Antibiotic Resistance of Pseudomonas aeruginosa Isolated from Patients Attending some Hospitals in Kano State, Nigeria

Resistance to antimicrobial substances by pathogenic microorganisms is on the rise since the beginning of modern medicine. Mechanisms; enzymatic degradation, loss of target and antimicrobial interception are employed by bacteria in resisting antimicrobials. Bacterial capsule is a gelatinous outer layer surrounding a bacterial cell composed primarily of polysaccharide. This study assessed the role that the capsule of Pseudomonas aeruginosa played in carbapenem resistance. P. aeruginosa was isolated from 49 (16%) samples out of 300 samples screened. India ink staining technique was used to detect the capsule. Capsule was detected in 42 (86%) of the isolates whereas 7 (14%) of the isolates were non-capsulated. All the capsulated strains were resistant to the antibiotics (Meropenem, Doripenem and Imipenem) whereas the non-capsulated strains were susceptible to the antibiotics. The results of this study however suggest the involvement of capsule in the resistance of the antibiotics employed.

Arch of Colors in Anatomic Pathology-Are They Most Significant in Inking of Surgical Margins?

Introduction: In surgical pathology various colours are used as a surgical ink margins. The pathologists are known of the various advantages that colored inks contribute to anatomic pathology practice. The margins of each excised gross specimen colouring with different colours, add correctness to margin examination. It showed a three-dimensional microscopic restoration of features of the tumor and also anatomic structures. The use of multiple colours are orientation of grossed and dissected specimens, to re-examine the grossed specimen by the pathologist , if required, and if necessary further sampling of the specimen and also allow the postoperative comparison of tissue planes anticipated by preoperative imaging. Aim and Objective: A comparative study between Mashi(Indian Ink) and acrylic colors used as a surgical ink margin Materials and Methods: The study was done on 350 surgically excised medium, large and formalin-fix specimens. The surgical margins of each specimen were marked with Indian ink and five acrylic colors. The grossed specimens were then processed using routine histopathology techniques and sections were stained with hematoxylin and eosin stain(H&amp;E). The macroscopic and microscopic parameters were used to study the suitability of acrylic colors and Indian Ink (mashi) as surgical ink for margins. Results: The study noticed specific shades of acrylic colors that are easily available and simple to use, with good results on macroscopic and microscopic examination. Conclusion: Colored inks impart accuracy to margin examination. Acrylic colors are more suitable as surgical ink over Indian.