Lipase Test Research Articles

Comparative studies on enzymatic efficacy and microbiological properties of Garbage Enzyme produced from various fruits and vegetables peels in biodegradation of cow dung

The present work was conducted to study the enzymatic potentials and microbiological properties of Garbage Enzyme produced from various fruits and vegetables peels. Completely randomized designed experiment was framed with seven treatments each with fruits and vegetable peels separately. All the treatments exhibited positive result for Amylase Test, Lipase Test, Cellulase Test, Urease Test, Protease Test, MR Test and Alcohol and low pH, indicating that Garbage enzyme produced from fruit and vegetable wastes contained mixture of enzymes, alcohol and acid brought about by microbial fermentation. Highest enzymatic efficacy was shown by T3- Pomegranate followed by T6- Banana. GE produced by vegetable wastes was less effective than fruit peels and maximum enzymatic activity exhibited by T1-Radish. A total of 27 amylase producing bacteria, 27 protease producing bacteria, 26 lipase producing bacteria, 26 cellulase producing bacteria 24 urease producing bacteria, 21 pectinase producing bacteria and 01 Amylase producing fungus was screened isolated from all the treatments. Garbage enzyme treatments in tray assay neutralized the alkaline pH of cow dung as garbage enzyme is acidic in nature. Highest Nitrogen (172 Kg/Hec) content was found when treated with garbage enzyme produced with banana peel. It is concluded that Garbage enzyme contains various enzymes, acid, and alcohol, can be utilized as a low cost alternative to biodegrade wastes to reduce pollution load of our environment. Keywords: Garbage Enzyme, vegetable and fruit wastes, enzyme activity, biodegradation

Association between pancreatic lipase levels and coronavirus disease 2019

Aims: Elevated pancreatic enzyme can be observed in the course of coronavirus disease-2019 (COVID-19) due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Here, we aimed to determine the frequency of lipase elevation in the course of COVID-19 and examine its effect on disease outcomes. 
 Methods: Of 42742 patients with the positivity of SARS-CoV-2 reverse transcriptase-polymerase chain reaction test (RT-PCR), 3167 undergoing lipase tests were included. The relationship between patients’ clinical features, development of acute pancreatitis (AP), and mortality rates was investigated. 
 Results: Higher lipase levels than normal limits were found in 399 (12.6%) patients. Lipase levels were three times higher than the normal limit in 119 (3.8%) patients; compared to the rest of the patients, patients’ age (62.8±17.9 vs 52.1±17.9 years, p

Assessment of appropriate use of amylase and lipase testing in the diagnosis of acute pancreatitis at an academic teaching hospital.

Despite evidence-based guidelines stating that lipase alone should be used in the diagnosis of suspected acute pancreatitis, health care providers continue to order amylase or amylase and lipase together. The purpose of this study was to assess the utilization of appropriate laboratory testing related to the diagnosis of acute pancreatitis. The study used a retrospective cross-sectional design. The timeframe was from January 1, 2020, to December 31, 2020. A retrospective chart review was used to collect data for the following: patient-provider encounter notes, patient demographics, provider demographics, differential and final diagnosis, and laboratory test results. Data analysis include stratification of categorical variables and calculation of cost savings. For the 12-month period, this study found 2567 (9.3%) of all amylase and lipase tests to be unnecessary. Amylase tests (1881; 73.2%) made up the most unnecessary tests followed by lipase tests (686; 26.7%). An analysis of test-ordering behavior by providers revealed that 81.5% of all unnecessary tests were ordered by MDs. Finally, this study estimated a total cost savings of $128,350 if all unnecessary tests were eliminated. Our study demonstrated that amylase and lipase tests have been overutilized in the diagnosis of acute pancreatitis.

Differing Practices in Amylase and Lipase Test Ordering Across One Medical Center

Differing Practices in Amylase and Lipase Test Ordering Across One Medical Center

A comparative analysis of canine pancreatic lipase tests for diagnosing pancreatitis in dogs.

Early diagnosis of canine pancreatitis is challenging due to non-specific clinical signs. Currently, abdominal ultrasonography and measurement of canine pancreatic lipase (cPL) have been employed for the diagnosis of pancreatitis. Many qualitative and quantitative commercial cPL tests have been developed and used in veterinary clinics. This study aimed to compare three different methodologies SNAP cPL, Spec cPL, and Vcheck cPL tests to assess the concordance of these assays. Fifty serum samples were collected from 36 dogs with or without pancreatitis and subjected to SNAP cPL, Spec cPL, and Vcheck cPL tests. Agreement and correlation coefficients were calculated between the test results, and correlations were determined during the management of the patients. The results of the three cPL assays were strongly correlated in 47/50 serum samples (94%). Cohen's kappa analysis between the Spec cPL and Vcheck cPL showed near perfect agreement (κ = 0.960, p < 0.001), SNAP cPL and Vcheck cPL (κ = 0.920, p < 0.001), and Spec cPL and SNAP cPL (κ = 0.880, p < 0.001). The correlation coefficients (r) between data from Spec cPL and Vcheck cPL tests was calculated by Spearman's correlation test (r = 0.958, p < 0.001). Furthermore, the patterns of change in serum cPL concentrations determined using Spec cPL and Vcheck cPL were significantly consistent during the monitoring period in 11 patients. Our data illustrated that Spec cPL and Vcheck cPL tests are compatible for clinical use in the diagnosis and monitoring of canine pancreatitis.

Crawling toward obsolescence: The extended lifespan of amylase for pancreatitis.

The correlation between hyperamylasemia and acute pancreatitis was discovered in 1929, yet another test, lipase, was shown to provide better diagnostic performance in the late 1980s and early 1990s. Subsequent studies demonstrated co-ordering amylase with lipase did not provide additional benefit, only added cost. We sought to investigate the impact of studies advocating for the obsolescence of amylase on its clinical demand. We reviewed 1.3 million reportable results for amylase over 14 years (2009-2022). The trend in utilization of amylase over this period declined by 66% along a linear trajectory (R2 = 0.97). Despite demand for amylase decreasing by an average of 17,003 tests per year, the last year of the study (2022) recorded over 100,000 results for amylase. By interpolating the decline of amylase until the utilization reached zero, we calculated amylase orders will continue for 6 more years until 2028. Tests for creatinine and lipase changed <3% over the same period. Despite a multitude of studies advocating for the obsolescence of amylase, robust demand continues. Many important clinical guidelines, a source many practicing physicians rely on, have yet to acknowledge the preference for lipase over amylase. They frequently treat the two tests as equivalent, neglecting their head-to-head comparison studies and subsequent studies advocating against co-ordering both tests simultaneously. To expedite the obsolescence of amylase, which we anticipate lasting 46 years in our case study from its initial call for obsolescence to the last orders placed, metrics created specifically to monitor the utilization of unnecessary tests are also needed.

ISOLATION AND CHARACTERIZATION OF FUNGI ASSOCIATED WITH BODY AND EGG FROM DISEASED AFRICAN CATFISH, Clarias gariepinus

African catfish (Clarias gariepinus) are in high demand in the Malaysian market. However, these species are known to be easily infected with diseases such as fungi, which can cause mortality and economic losses. In addition, fungal infection in fish eggs can reduce their production. The objective of this study was to isolate and identify fungi from infected African catfish and their eggs. Symptoms include a swollen lesion, irregular swimming, darker discoloration, and screening of pathogenic fungi. Isolations, identifications, and extracellular enzymatic assays were performed for the isolated fungi. Potato dextrose agar was used as isolation medium for isolating fungi on African catfish and their eggs. Fungi were identified by macroscopic observation of growth morphology and their structure, followed by microscopic observation after staining with lactophenol cotton blue to observe hyphae. From the result, three fungi were isolated and identified as Mucor sp. (2n) and Trichoderma sp. (1n). All isolated fungi were also analyzed for extracellular enzymes such as proteases, amylases, and lipases to test their ability to produce them as pathogenic fungi. Trichoderma sp. showed positive results in all tests. However, one strain of Mucor sp. reacted positively to the amylase and lipase test, while the other strain of the same species showed no reaction, indicating a negative result. In conclusion, the isolated fungi have virulent properties and can cause mortality if the body and eggs are infected. Therefore, fish farms need comprehensive health management to prevent the spread of fungal diseases

16SrRNA sequencing analysis for identification of Klebsiella pneumoniae isolated from the extreme kitchen environment

Swabs from dishwasher samples were collected and cultured on different media, and then a gram stain was conducted on pure colonies to find whether they were Gram-positive or negative. 32-gram negative Isolates were obtained from the dishwasher; then, we chose isolates under study depending on morphological features on previous media for further investigation. 32 Gram-negative isolates were obtained from a dishwasher, and three isolates of Klebsiella pneumoniae were diagnosed by some phenotypic characteristics and approved by using 16 SrRNA partial sequencing analyses. The 3 isolates deposited in the NCBI database under accession number OK 254156.1 for K.pneumoniae strain NPK 323, OK 247423.1 for K. pneumonia as strain CUMB SAM-61, and OK245427.1 for K. pneumonia strain PD17. The phylogenetic tree for 3 isolates was done by using MEGA II software. Many experiments have been conducted on two isolates (OK 247423.1 and OK245427.1 ) because the OK 254156.1 strain was lost during laboratory work and repeated cultures. A hemolysis test on blood agar and a lipase test on egg–yolk agar were done; both isolates showed negative results for hemolysis blood and producing lipase enzyme, while both isolates showed their ability to produce lecithinase enzyme. The two isolates gave an excellent result in the tube method for the biofilm formation test. Also, a good candidate production test was obtained for these two isolates using L.B. acetate agar medium. Conclusion: Bacterial species differ according to the environments in which they live, as the species that are isolated from clinical sources and possess many virulence factors that make them more dangerous and pathogenic to humans differ about the same species if isolated from a variety of external environments, which makes them virulent or have new characteristics that make them adapted to live in the environments from which they are isolated. Keywords: Klebsiella pneumonia, virulence factor, extreme conditions, phylogenetic tree.

A Systematic Approach to Patients with Elevated Levels of Serum Amylase or Lipase

Serum amylase and lipase tests are routinely performed in patients presenting with abdominal pain or even during regular health screening. Elevated serum levels of these two enzymes are often encountered in clinical practice. The differential diagnosis is broad and includes acute pancreatitis, chronic pancreatitis, gastrointestinal tract obstruction, malignancies, and other disease conditions. In this article, we review the pathophysiology of elevated amylase and lipase, possible conditions that cause the increase, and diagnostic strategies for such patients. We conclude that a systematic approach to patients with elevated amylase and/or lipase is critical to making an accurate diagnosis and initiating appropriate treatment.

Комплексная диагностика острого панкреатита у собак

This article presents typical results obtained from a general clinical blood test in dogs with signs of pancreatic pathology: leukocytosis with a shift to the left, thrombocytopenia, anemia, increased ESR. In the diagnosis of acute pancreatitis, an increase in a-amylase and lipase in the blood serum is considered important indicators. It is believed that the a-amylase activity indicator immediately indicates lesions of the pancreas, however, studies have been conducted that indicated that when the a-amylase level was normal, but the lipase level was elevated, the diagnosis of pancreatitis was confirmed. Therefore, an increase in the lipase enzyme is more specific for the diagnosis of pancreatitis. It is important to determine both enzymes to diagnose pancreatic lesions. The best diagnostic indicator of acute pancreatitis is an increase in lipase, a-amylase and creatinine, which gives up to 98 % accuracy in making a diagnosis. With pathologies of the pancreas, patients often experience disturbances in carbohydrate metabolism. As a rule, this is manifested by signs of diabetes mellitus, i.e. increase in serum glucose. The disorders are explained by damage to the cells of the islet apparatus of the pancreas. Research has shown that the canine pancreatic lipase test (SNAP®cPL) is better than other methods for diagnosing acute pancreatitis in dogs. To better test for pancreatitis in animal examinations, the SNAP®cPL Test also measures cPL concentrations using ELISA technology. Thus, the test for pancreatic lipase gave a 100 % result, which confirms its high sensitivity.

The diagnostic value of laboratory tests in detecting solid organ injuries in pediatric patients with blunt abdominal trauma

BackgroundComputed tomography of the abdomen (CT) is used as the gold standard for detecting solid organ injuries (SOI) after blunt abdominal trauma (BAT). However, patient selection for CT is still controversial due to its potential risks. In this study, we aimed to investigate the usefulness of laboratory tests in the detection or exclusion of SOI in pediatric patients evaluated in the emergency department due to BAT. MethodsThe study was planned as a prospective, observational study and was conducted in the emergency department of a university hospital between February 2018 and February 2019. Patients under the age of 18 who were evaluated for BAT in the emergency department were included in the study. In the study, the diagnostic value of abnormal laboratory tests in detecting SOI was calculated by accepting CT results as the gold standard. ResultsOf the 323 patients included in the study, 118 (36%) were male. There were 283 patients who underwent CT. SOI was detected in 18 (6%) patients. Abnormal alanine aminotransferase, aspartate aminotransferase, amylase and lipase tests were found to be statistically significant in predicting SOI (p < 0.05). However, none of the tests were found to have sufficient sensitivity and specificity. Hemoglobin, hematocrit, lactate and base excess values were not found to be statistically significant in predicting SOI (p > 0.005). ConclusionsThe hematologic laboratory tests are insufficient to rule out solid organ injury in pediatric patient with BAT.

Compliance to endoscopic retrograde cholangiopancreatography according to current guidelines and adverse outcomes of suspected choledocholithiasis in an acute care setting.

Common bile duct (CBD) stones are common among patients who underwent cholecystectomy. However, few studies have investigated the compliance with the guidelines for the prediction of choledochlithiasis (CL). Therefore, we aim to study the compliance with the American Society for Gastrointestinal Endoscopy (ASGE) guidelines for the identification of CL in a major hospital in Saudi Arabia's capital. We conducted a retrospective chart review on adult patients admitted to emergency department at King Abdulaziz Medical City, Riyadh with gallstones between January 2016 and January 2019. Our data collection includes demographics and level of suspicion based on Transabdominal Ultrasound, liver function, amylase, and lipase tests. We then determined the likelihood of CL based on ASGE guidelines in order to assess the adherence to ASGE guidelines, the procedure's outcomes and adverse outcomes. We identified 826 patients who met the study's criteria: 384 (46.4%) were compliant, while 442 (53.6%) were non-compliant with ASGE guidelines. There was a significant association between compliance and the presence of stones on ERCP in high likelihood patients. 48 (21.3%) of total ERCP procedures among all the likelihoods had adverse outcomes. 13 (40.6%) of non-compliant ERCP performed in intermediate likelihood have experienced adverse outcomes. There was a significant association between having adverse outcomes and being non-complaint with ASGE guidelines. Despite ASGE guidelines' recommendations, a third of high likelihood cases and the majority of intermediate likelihood cases were non-compliant. Additionally, the current guidelines for the intermediate group are somewhat vague, giving ample leeway for patients to be placed in the intermediate group, which might subject them to unnecessary interventions. To conclude, there was a great lack of compliance with ASGE guidelines that is significantly associated with adverse outcomes. Hence, reassessing the current guidelines and monitoring healthcare facilities' compliance with the updated guidelines is highly recommended.

Atypical and dual biotypes variant of virulent SA-NAG-Vibrio cholerae: an evidence of emerging/evolving patho-significant strain in municipal domestic water sources

Introduction and purposeThe recent cholera spread, new cases, and fatality continue to arouse concern in public health systems; however, interventions on control is at its peak yet statistics show continuous report. This study characterized atypical and patho-significant environmental Vibrio cholerae retrieved from ground/surface/domestic water in rural-urban-sub-urban locations of Amathole District municipality and Chris Hani District municipality, Eastern Cape Province, South Africa.MethodsDomestic/surface water was sampled and 759 presumptive V. cholerae isolates were retrieved using standard microbiological methods. Virulence phenotypic test: toxin co-regulated pili (tcp), choleragen red, protease production, lecithinase production, and lipase test were conducted. Serotyping using polyvalent antisera (Bengal and Ogawa/Inaba/Hikojima) and molecular typing: 16SrRNA, OmpW, serogroup (Vc-O1/O139), biotype (tcpAClas/El Tor, HlyAClas/El Tor, rstRClas/El Tor, RS1, rtxA, rtxC), and virulence (ctxA, ctxB, zot, ace, cep, prt, toxR, hlyA) genes were targeted.ResultResult of 16SrRNA typing confirmed 508 (66.9%) while OmpW detected/confirmed 61 (12.01%) V. cholerae strains. Phenotypic-biotyping scheme showed positive test to polymyxin B (68.9%), Voges proskauer (6.6%), and Bengal serology (11.5%). Whereas Vc-O1/O139 was negative, yet two of the isolates harbored the cholera toxin with a gene-type ctxB and hlyAClas: 2/61, revealing atypical/unusual/dual biotype phenotypic/genotypic features. Other potential atypical genotypes detected include rstR: 7/61, Cep: 15/61, ace: 20/61, hlyAElTor: 53/61, rtxA: 30/61, rtxC: 11/61, and prtV: 15/61 respectively.ConclusionAlthough additional patho-significant/virulent genotypes associated with epidemic/sporadic cholera cases were detected, an advanced, bioinformatics, and post-molecular evaluation is necessary. Such stride possesses potential to adequately minimize future cholera cases associated with dynamic/atypical environmental V. cholerae strains.

English

BACKGROUND Since the outbreak of coronavirus disease (Covid-19) many patients have presented with a variety of other symptoms along with primary respiratory symptoms. The increased reporting of these extra-pulmonary symptoms has made it necessary for the clinicians to establish a proper cause and relation between coronavirus disease 2019 (Covid-19) and extra-pulmonary symptoms. This study was undertaken to assess if the cause of elevated lipase levels in Covid-19 patients was due to acute pancreatitis. METHODS A retrospective observational study was performed at a local critical care ICU facility in Bathinda, India (MediWin Hospital, Bathinda, Punjab). RT - PCR, Rapid antigen test, CT scans were done to establish the Covid-19 status. Clinical signs and symptoms, CT scans were used to confirm the diagnosis of acute pancreatitis. MRI was preferred in patients with deranged renal function test. RESULTS Lipase test was done in 62 patients and the levels were found elevated in 52 patients. 40 patients were found to have symptoms of the spectrum of acute pancreatitis. 10 patients had symptoms along with signs of1 severe inflammatory response syndrome. Imaging was advised in these 10 patients with1 moderate to severe presentation of acute pancreatitis. 9 patients were advised CT scans which had no significant findings. 1 patient with deranged renal function test was advised2 MRI scan which showed mildly diffusely bulky pancreas. Mild peripancreatic fat stranding and fluid collection, suggestive of acute interstitial pancreatitis. It was associated with poor outcomes and lead to the patient’s death eventually. CONCLUSIONS Hyperlipasemia led to acute pancreatitis in 1 (1.6 %) patient. It was associated with poor outcome and caused eventual death of the patient. The prospects of a Covid-19 patient developing Hyperlipasemia due to acute pancreatitis were found to be statistically insignificant. KEY WORDS Coronavirus, Hyperlipasemia, Pancreatitis, Lipase, RT - PCR, Rapid Antigen Test.

Is the DGGR lipase test as reliable as the Spec cPL test for diagnosing acute pancreatitis in dogs?

Is the DGGR lipase test as reliable as the Spec cPL test for diagnosing acute pancreatitis in dogs?

Confirming diagnoses of acute pancreatitis with commonly available electronic data.

Recorded diagnoses of acute pancreatitis (AP) are often inaccurate resulting in limited utility for case identification in large data sources, especially where electronic medical records (EMR) are not available. Our objectives were to validate diagnoses of AP and to identify an algorithm using additional data to enhance the identification of AP cases in different data sources. We randomly sampled 550 persons with an AP diagnosis from inpatient data or outpatient or emergency department diagnoses immediately preceding a hospitalization and 150 negative controls with a differential diagnosis (cholangitis or cholecystitis). We conducted an EMR review to confirm cases of AP and used logistic regression to develop EMR-based and claims-based algorithms to identify confirmed AP cases with variables typically available in electronic data sources. Algorithm performance was assessed using the C statistic, sensitivity, specificity, and positive and negative predictive value. Of the 550 patients with an AP diagnosis, 467 (84.9%) were confirmed cases. An AP diagnosis alone had high sensitivity (98.9%), modest specificity (63.6%), and a C statistic of 0.813. An EMR-based model using an AP diagnosis, body mass index ≥30 kg/m2 , a serum lipase >3 times upper limit of normal and diabetes attained a C-statistic of 0.914. A claims-based model attained a C-statistic of 0.892 using an AP diagnosis and dichotomous variables for whether a serum lipase test and/or an abdominal ultrasound was performed. Our simple algorithms increased the accuracy of identification of AP cases providing widespread applicability to epidemiological and drug safety studies.

Ultrasonographic Monitoring in 38 Dogs with Clinically Suspected Acute Pancreatitis.

Abdominal ultrasound examinations (AUEs) are commonly used in the diagnostic evaluation of canine acute pancreatitis (AP). The purpose of this retrospective study was to evaluate and monitor the ultrasonographic changes observed in dogs with clinically suspected AP on consecutive AUEs. The study population was constituted by 38 client-owned dogs hospitalized for no less than 48 h from January 2016 to December 2019. Dogs included in this study were suspected of AP based on the clinical examination and abnormal rapid specific canine pancreatic lipase test performed at admission. Dogs were submitted to two AUEs, the first on the first day of hospitalization, and the second between 40–52 h after the first one. Twelve dogs had both AUEs suggestive of AP. Fourteen dogs received an ultrasonographic diagnosis of AP exclusively on the second AUE. Twelve dogs remained negative on both the first and the second AUE. In 26 out of 38 patients the second AUE was suggestive of AP. If a patient is suspected of AP, it is advisable to carry out ultrasonographic monitoring at least within the first 52 h after admission, since ultrasonographic signs of AP may only become observable later after hospitalization.

Do mangrove habitats serve as a reservoir for Medicopsis romeroi, a clinically important fungus

Medicopsis romeroi is one of the frequent pathogens causing subcutaneous infections in immunocompromised patients. In this study, a sexual morph of Medicopsis romeroi was found on a decaying woody stem of the mangrove plant Suaeda monoica and its asexual morph was produced on malt extract agar. The sexual morph connection was established based on both morphological data and multigene phylogenetic analyses. Neomedicopsis chiangmaiensis comb. nov. is proposed by transferring Medicopsis chiangmaiensis to the genus Neomedicopsis based on morphology and multigene phylogenetic analyses. The preliminary pathogenicity tests on Medicopsis romeroi strain demonstrated beta haemolysin and esterase activities, and its ability to grow at 37 °C. It also exhibited strong activity in in vitro tests for aspartyl proteases, extracellular phospholipase, lipase and chitinase and mild activity for amylase and urease suggesting that this strain of Medicopsis romeroi, isolated from a mangrove habitat, could be an opportunistic pathogen to immunocompromised patients.

Antibiofilm Activity of Biosurfactant Produced by Bacterial Strain Isolated from Petroleum-Contaminated Sites

The escalating emergences of drug-resistant strains of Pseudomonas aeruginosa coupled with the decline in the development of new antibiotics have increased the morbidity and mortality rates during the past decades. The aim of the present work was to investigate the antibacterial and antibiofilm activity of biosurfactant produced by bacterial strain IHD19 isolated from hydrocarbon-polluted soil against biofilm forming clinical isolates of Pseudomonas aeruginosa. Isolates from petroleum-contaminated soil sample were screened and evaluated for biosurfactant production. Rapid methods such as drop collapse test, emulsification test, hemolysis test, lipase test were used for screening of biosurfactant production by bacterial strain IHD19. Bacterial strain IHD19 was selected on the basis of its efficiency to produce biosurfactant. Growth study of bacterial strain IHD19 was conducted at different physicochemical conditions aiming to find out the optimal condition for growth of bacterial strain IHD19 to obtain higher biosurfactant production. Thin-layer chromatography and FTIR analyses were done to characterize the biosurfactant produced by bacterial strain IHD19. Subsequently, the antibacterial activity of biosurfactant IHD19 on multidrug-resistant clinical isolates of Pseudomonas aeruginosa was investigated by agar well-diffusion method. Biofilm-forming clinical isolates of Pseudomonas aeruginosa were identified using crystal violet assay. Finally, the antibiofilm activity of biosurfactant IHD 19 was determined using microtiter plate assay and MBIC50 and MBIC90 were calculated. Bacterial strain IHD 19 was found positive for drop collapse test, lipase test and showed β-hemolysis on blood agar. The emulsification efficiency of biosurfactant IHD19 after 24 h (E24%) was 87.5% against engine oil. The thin-layer chromatography and FTIR analysis revealed the polymeric nature of the biosurfactant. Biosurfactant IHD19 displayed significant antibacterial and antibiofilm activity against twenty-five multidrug-resistant clinical isolates of Pseudomonas aeruginosa with more than 50% (MBIC50) in concentration range of 0.5–4 µg/ml and 90% biofilms inhibition (MBIC90) in concentration range of 16–32 µg/ml, respectively. Phylogenetic tree showed biosurfactant producing bacterial strain IHD19 to be relative to Bacillus family. With 16 s rRNA analysis the isolated bacterial strain IHD19 was identified as Bacillus pumilus. The current study proposes potential exploration of biosurfactant to subdue the issue of biofilms formation by MDR Pseudomonas aeruginosa.

Bouveret’s syndrome: A challenging case of gastric outlet obstruction.

Bouveret’s syndrome causes gastric outlet obstruction when a gallstone is impacted in the duodenum or stomach via a bilioenteric fistula. We present case of a 40-year-old female presented with epigastric pain and intractable vomiting for 2 days. Her physical examination and laboratory workup including blood analysis, amylase test and lipase test were normal. Plain abdominal X-ray did not show any signs of small bowel obstruction. A nasogastric tube was placed and drained 2.5 L of gastric contents immediately. Esophagogastroduodenoscopy showed a dilated stomach with excessive secretions and a large blackish-brown hard stone in the duodenal bulb. After failed attempt at endoscopic extraction, patient underwent laparotomy and removal of stone via duodenal incision. Subsequently, the patient exhibited a good postoperative recovery. The condition of the patient has remained stable after being followed up for one year.