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Background: Pantoea species, traditionally considered opportunistic pathogens, have emerged as significant causes of infections, particularly in neonatal and immune compromised populations. This study aims to investigate the prevalence, clinical impact, and antimicrobial resistance patterns of Pantoea species over a five-year period in a tertiary care center located in the Konkan region of the Western Ghats, Maharashtra. Material and Methods: Detailed records of 40 Pantoea isolates, primarily from blood cultures, were gathered from various clinical samples. The study assessed the yearly trend of Pantoea infectios, identified associated risk factors, and outlined antimicrobial susceptibility profile. Results: The majority of isolates (87%) were from blood samples, with significant occurrences in neonates with underline predisposing factors like low birth weight, intrauterine growth retardation (IUGR), and meconium aspiration syndrome (MAS). The study observed a marked decrease in cases during the COVID-19 lockdown period (2020-2021), followed by a resurgence in 2022. Antimicrobial susceptibility testing revealed decreased sensitivity to third-generation cephalosporins Piperacillin Tazobactam, and Meropenem, indicating a trend towards multidrug resistance. Conclusion: The finding underscore the emerging threat of Pantoea infections and the need for vigilant antimicrobial stewardship. Monitoring environmental factors, such as the use of Pantoea species as biofertilizers and traditional practices like giving rice water to newborns, is crucial to prevent potential large-scale outbreaks. Futures sequencing based studies are recommended to gain a deeper understanding of the epidemiology and resistance mechanisms of Pantoea species in this region.

Introduction: According to the World Health Organisation (WHO), the American College of Cardiology (ACC), and the American Heart Association (AHA), the issued prediction charts can be used to make an absolute prediction of a study variable’s Cardiovascular Disease (CVD) risk. This study aimed to examine the combined effects of gender, Family History (FH) of CVD, tobacco use, alcohol consumption, smoking, physical activity levels, and other health conditions on the presence of CVD confirmed by angiography. Predicting CVD risk is crucial; particularly because young individuals aged 25 to 40 are affected by these diseases and from the foundation of any nation. Moreover, CVDs significantly contribute to human mortality compared to other ailments. This approach sought to identify the risk factors for CVD. Aim: To investigate the impact and the association between hereditary characteristics, behaviour, and self-control factors on coronary angiography findings among the study participants from a statistical viewpoint. Materials and Methods: An observational cross-sectional study related to angiography report of 274 study participants visiting the Department of cardiology at Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, Maharashtra with complaints of CVD was conducted from January 2023 to May 2023. Statistical Analysis was performed with the help of Statistical Package for Social Sciences (SPSS) version 28.0, InStat and Microsoft Excel. Chi-square test was applied to study association of demographic study parameters with CVD. Logistic regression was carried out to develop the regression model. Results: Angiography significant CVD was associated with father’s history of CVD (40, 71.42%), alcohol consumption (68, 70.8%), tobacco chewing (115, 69.7%), no exercise (89,79.46%), diabetes (83,75.45%), and diabetic with medication (14,93.33%) showed significant associations with CVD. Logistic regression analysis identified these variables as the best predictors of CVD. Genetics, lifestyle choices, and co-morbidities all contribute to the risk of Coronary Artery Disease (CAD). Conclusion: The study effectively identifies and quantifies the relationships between hereditary characteristics, behavioural factors, and self-control measures with coronary angiography findings. Exercise and diabetic status are significant predictors of the outcome, while tobacco-chewing leans towards significance and other studied variables are at their reference levels. This predictive model will help clinicians, patients, and their families in mentally preparing for confirmation of the disease’s presence or absence.

Background: Spirituality and religious resources support and enhance both overall and emotional well-being during adversity such as diagnosis of breast cancer. Breast cancer patients are at higher risk of developing severe anxiety, depression, and potential mood disorders. Aim: The aim is to assess, compare, and correlate spiritual well-being and religious coping in patients with breast cancer with and without psychiatric disorders (anxiety and depression). Materials and Methodology: Recently diagnosed 90 treatment-naïve breast cancer patients were selected in adherence to the inclusion and exclusion criteria. Hospital Anxiety and Depression Scale (HADS), Spiritual Assessment Scale, and Brief Religious Coping Scale were applied to the sample population. The study population was divided into two groups depending on scores of HADS, those having psychiatric disorders, and those who did not have. The data were analyzed using Mann‒Whitney test and Pearson’s correlation coefficient in the SPSS version 21. Results: More than half (61.1%) of the females suffered from psychiatric disorders after diagnosis of breast cancer. About 50% and 38.9% of the study population developed significant emotional distress, leading to the diagnosis of cases of anxiety and depression, respectively. Females suffering from psychiatric disorders have significantly lower spirituality, positive religious coping, and significantly higher negative religious coping than females without any psychiatric disorder. Total spirituality score (P = 0.034) is making a significant contribution toward predicting depression. Negative religious coping is making a significant contribution toward predicting both anxiety (P = 0.008) and depression (P = 0.045). Conclusion: The study suggests that spirituality and religion-based coping facilitates adaptive psychological adjustment to cancer and decreases the prevalence of anxiety and depression.

Decades of previous efforts to develop renal-sparing polyene antifungals were misguided by the classic membrane permeabilization model1. Recently, the clinically vital but also highly renal-toxic small-molecule natural product amphotericin B was instead found to kill fungi primarily by forming extramembraneous sponge-like aggregates that extract ergosterol from lipid bilayers2-6. Here we show that rapid and selective extraction of fungal ergosterol can yield potent and renal-sparing polyene antifungals. Cholesterol extraction was found to drive the toxicity of amphotericin B to human renal cells. Our examination of high-resolution structures of amphotericin B sponges in sterol-free and sterol-bound states guided us to a promising structural derivative that does not bind cholesterol and is thus renal sparing. This derivative was also less potent because it extracts ergosterol more slowly. Selective acceleration of ergosterol extraction with a second structural modification yielded a new polyene, AM-2-19, that is renal sparing in mice and primary human renal cells, potent against hundreds of pathogenic fungal strains, resistance evasive following serial passage in vitro and highly efficacious in animal models of invasive fungal infections. Thus, rational tuning of the dynamics of interactions between small molecules may lead to better treatments for fungal infections that still kill millions of people annually7,8 and potentially other resistance-evasive antimicrobials, including those that have recently been shown to operate through supramolecular structures that target specific lipids9.

Background: This study optimizes and evaluates transferosomes containing Nebivolol Hydrochloride to enhance the drug's bioavailability and therapeutic efficacy. Ultra-deformable vesicles called transferosomes help to increase drug administration via the skin. Methodology: Using a thin-film hydration technique, beta-blocker Nebivolol Hydrochloride, which has antihypertensive properties, was added to transferosomes. To attain the ideal vesicle size (between 200 to 300 nm), entrapment efficiency, and deformability, the formulation was adjusted by adjusting the amounts of phosphatidylcholine, Span 80, and hydration time using a Box-Behnken experimental design. Particle size analysis, zeta potential measurement, and in vitro drug release tests were performed to characterize the transferosomes. Results and discussion: The optimized formulation demonstrated notable deformability, an entrapment effectiveness of 50%, and a vesicle size of 265 nm. The Box-Behnken design made it easier to evaluate the interactions between variables systematically. In vitro drug release studies showed a drug diffusion that persisted for a whole day, suggesting that transferosomes may have long-lasting therapeutic effects. Stability studies at room temperature and accelerated conditions over six months confirmed the formulation's robustness. Conclusion: The results imply that Nebivolol Hydrochloride transferosome-based delivery may be a viable strategy for improving the drug's bioavailability and effectiveness, as nearly 100% of drugs diffuse within 24 hr, perhaps leading to a breakthrough in the management of hypertension.

Background: Oteseconazole is a new molecule launched for human treatment. However, the information is not available in the public domain for analyzing blood samples. This study describes the method development and validation using LC-MS/MS to measure the concentration of Oteseconazole in rat plasma. Methodology: The analysis method was developed using a phenyl column, which was utilized to accomplish separation. Furthermore, the mobile phase was a combination of acetonitrile and 0.1% formic acid in water, with a ratio of 30:70 (v/v). The sample was introduced into the system at a 1.0 mL/min flow rate, and the injection volume was 10 μLand analyzed for five minutes using mass spectrometer +ESI mode. Results and discussion: MRM is used to quantify Oteseconazole and Posaconazole by analyzing the transitions of their respective m/z values. The concentration ranges of Oteseconazole were 5-100 ng/mL. The correlation coefficient of Oteseconazole was found to be 0. 999. HQC, MQC, LQC, and LLQC precision and accuracy were determined to be 98.60%, 98.69%, 96.11%, and 94.48%, respectively. Respectively, the accuracy recovery of Oteseconazole was determined to be 97.48%. In pharmacokinetic studies, it was observed that Oteseconazole exhibited an average AUC0-t value of 1386 ng-hr/ml and a Cmax value of 44.864 ng/ml in rats. Conclusion: The validated approach has effectively demonstrated the determination of pharmacokinetic parameters after the oral administration of Oteseconazole in Wister rats.

Background: Nebivolol hydrochloride, a β1-receptor antagonist known for its antihypertensive properties, boasts a plasma half-life of 10 hours and an oral bioavailability of 12%. In this study, we aimed to enhance the therapeutic effectiveness of Nebivolol hydrochloride and circumvent its extensive hepatic first-pass metabolism by developing transdermal matrix patches. Methodology: Utilizing Central Composite Design (CCD), nine formulations were devised, comprising Hydroxypropyl methylcellulose K15M and Eudragit S100 as independent variables, with 10% w/w triethyl citrate as the plasticizer. Key dependent variables were evaluated, including folding endurance, moisture content, tensile strength, in vitro drug release, and flux. Fourier transform infrared spectroscopy (FTIR) assessed the compatibility between the drug and polymer. Results and discussion: Among the formulations, FP8 demonstrated the highest drug release (85.88% over 24 hours), attributed to its elevated concentration of hydrophobic polymer. The optimized formulation was determined based on the results of dependent variables. Conclusion: These findings suggest that the developed matrix transdermal film holds promise as a potential candidate for sustained drug release over a 24-hour.

Background: Troponin-I is conventionally correlated with myocardial injury, but its relevance in assessing the severity of coronavirus disease 2019 (COVID-19) and its implications for patient management remains an area of ongoing investigation. This study was designed to assess the correlation between troponin-I levels and the disease severity among patients with COVID-19. Materials and Methods: This retrospective study was conducted at a tertiary care center in India between April 2020 and November 2021. The patients with reverse transcription-polymerase chain reaction who tested positive for COVID-19 infection, and who underwent troponin-I examination at presentation were included in the study. A comparison of baseline clinical characteristics among patients who survived and who did not survive post-COVID-19 was done, and risk factors associated with mortality among hospitalized patients were analyzed. Results: A total of 1673 patients were enrolled in this study. Of these, 1431 patients survived, and 242 patients did not survive post-COVID-19. The mean age of the patients with troponin-I levels ≤0.06 ng/ml was 49.66 ± 17.88 years and that of patients with troponin-I levels >0.06 ng/ml was 60.13 ± 20.04 years. The nonsurvival rate was high in patients aged >50 years compared to the patients aged ≤50 years (81.4% vs. 18.6%; P < 0.001). The mortality rate was high in patients with troponin-I levels >0.06 ng/ml compared to the patients with troponin-I levels ≤0.06 ng/ml (51.7% vs. 48.3%; P < 0.001). Breathlessness (odds ratio [OR]: 26.901; P < 0.001), cut-off troponin-I levels (OR: 8.246; P < 0.001), and other comorbidities (OR: 8.246; P < 0.001) were independently correlated with mortality among hospitalized patients with COVID-19. Conclusion: This study demonstrated that elevated troponin-I level at presentation was associated with disease severity and increased mortality in patients with COVID-19.

Abstract Background Cancer patients are vulnerable to infections due to immunosuppression caused by cancer itself and its treatment. The emergence of antimicrobial-resistant bacteria further complicates the treatment of infections and increases the mortality and hospital stays. This study aimed to investigate the microbial spectrum, antimicrobial resistance patterns, risk factors, and their impact on clinical outcomes in these patients. Methods A prospective study was conducted at a tertiary care cancer hospital in Patna, Bihar, India, which included cancer patients aged 18 years and older with positive microbial cultures. Results This study analysed 440 patients, 53% (234) of whom were females, with an average age of 49.27 (± 14.73) years. A total of 541 isolates were identified, among which 48.01% (242) were multidrug resistant (MDR), 29.76% (150) were extensively drug resistant (XDR), and 19.84% (112) were sensitive. This study revealed that patients who underwent surgery, chemotherapy, were hospitalized, had a history of antibiotic exposure, and had severe neutropenia were more susceptible to MDR and XDR infections. The average hospital stays were 16.90 (± 10.23), 18.30 (± 11.14), and 22.83 (± 13.22) days for patients with sensitive, MDR, and XDR infections, respectively. The study also revealed overall 30-day mortality rate of 31.81% (140), whereas the MDR and XDR group exhibited 38.92% and 50.29% rates of 30-day mortality respectively (P

Introduction: Assessing satisfaction with healthcare services is one of the cornerstone methods to evaluate success and identify obstacles during the process for the patients. Identifying crucial information helps in course correction and better healthcare delivery to the patients. Apli Chikitsa is a novel PPP model-based free of cost laboratory service made available to the patients by the municipal corporation. Around 150 blood tests are offered free of cost and through peripheral dispensaries to the patients. The present study was undertaken to assess the satisfaction of patients with the service and service-related aspects. Methodology: A cross-sectional observational urban health center-based study was undertaken to assess the satisfaction of patients toward the Apli Chikitsa laboratory service. Institutional ethics committee clearance was obtained before commencing the study. Four hundred patients availing of the laboratory services were enrolled by alternate sampling method. A semistructured questionnaire was administered; five-point Likert scale was used to assess satisfaction toward the service and related aspects. Results were summarized using tables and charts, and percentages and proportions were used wherever necessary. Data were analyzed using Microsoft Excel. Results: Among the study participants, overall satisfaction was observed among 71.25%, and 100% satisfaction was observed in relation to cost of service, maintenance of privacy and confidentiality, and getting all the requested tests done. The problem of overcrowding (96.75%) was observed by a majority. Satisfaction was low regarding the cleanliness of toilets (48.75%). Conclusion: Based on the findings, it can be concluded that the overall satisfaction is the Apli Chikitsa laboratory service is good, and it is a good model for replication for laboratory service delivery in peripheral areas away from tertiary care centers. Overcrowding should be managed, and cleanliness of toilets to done at frequent intervals, along with proper and visible use of signages, should be done to improve the satisfaction of the patients.

Abstract Background Phellinus fastuosus is a wood-eating medicinal fungus from Western Ghats of India. Therefore, we investigated hypoglycemic and hepatoprotective effects of P. fastuosus aqueous extract on streptozotocin-induced diabetic and carbon tetrachloride (CCl4) induced hepatotoxicity in rats, respectively. Result As compared to the diabetic control group, a 400 mg/kg dose had significant hypoglycemic effects, including a reduction in blood glucose (24.44%) and gain in body weight. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activity reduced by 31.81% and 32.84%, respectively, were also noted, along with decreases in triglycerides (24.32%) and cholesterol (25.89%) levels. The albumin, bilirubin and creatinine levels were also significantly reduced after administration of P. fastuosus extract in diabetic rats. Administration of P. fastuosus extract showed a substantial decrease in the activity of ALT, AST, alkaline phosphatase (ALP), catalase (CAT) and superoxide dismutase (SOD) in addition a decrease in the level of lipid peroxidation (LPO) as compared to CCl4-intoxicated rats. The cumulative effect of CCl4 increased the erythrocyte membrane peroxidation, whereas P. fastuosus extract reduced the cholesterol and increased phospholipid, thus preventing the alteration of membrane fluidity as compared to CCl4-intoxicated rats. FTIR and HR-LC-MS-based metabolic profiling revealed the presence of various functional groups and bioactive metabolites. Conclusion The extract showed the hypoglycemic and hepatoprotective effects due to the presence of various bioactive metabolites. Exploration of therapeutic potential of P. fastuosus using bioassay-guided fractionation is needed.