The therapeutic efficacy of human neutrophil peptide 1 (HNP-1) against experimental tuberculosis in mice on the basis of numbers of CFU has been examined. Mice infected with 1.5 ؋ 10 4 CFU of Mycobacterium tuberculosis H 37 Rv and treated with different doses of HNP-1 injected subcutaneously exhibited significant clearance of bacilli from lungs, livers, and spleens. There were time-and dose-dependent decreases in the bacillary load in lungs, livers, and spleens of the HNP-1-treated animals compared to that in controls (untreated animals). These observations strongly suggest the therapeutic activity of HNP-1 against tuberculosis.The recent resurgence in the incidence of tuberculosis and its association with human immunodeficiency virus infection and AIDS warrants the development of new therapeutic strategies for the effective control of tuberculosis. Despite the outbreaks of multidrug-resistant strains of Mycobacterium tuberculosis and calls for new drug development, truly novel compounds, which would significantly improve treatment, continue to elude us. Antibiotic peptides from higher eukaryotes have gained considerable attention as an alternative to conventional antibiotics owing to their potent antimicrobial activities in vitro (for a recent review see reference 2). The defensins are a family of small antimicrobial peptides having six highly conserved cysteine residues, resulting in three disulfide linkages. Human neutrophil peptide 1 (HNP-1) is one of the four types of defensins present in the azurophilic granules of polymorphonuclear neutrophils. HNP-1 has been demonstrated to exhibit potent in vitro bactericidal activity against a wide variety of microbes, including mycobacterial species (5). Recently, we have reported the ability of HNP-1 to kill M. tuberculosis in vitro as well as ex vivo (6, 7). To date, no study has been carried out to investigate the therapeutic efficacy of HNP-1 against M. tuberculosis infections. In the present study, the in vivo therapeutic potential of HNP-1 against experimental tuberculosis in a mouse model was investigated.Six-to eight-week-old pathogen-free Laca (inbred) strain mice were infected intravenously with 1.5 ϫ 10 4 CFU of M. tuberculosis H 37 Rv per mouse. After 15 days of challenge, establishment of infection was confirmed by Ziehl-Neelsen staining of whole-tissue homogenates of lungs, livers, and spleens from four animals. Chemically synthesized HNP-1 with the same primary structure and the same disulfide linkages (i.e., between Cys-2 and Cys-30, Cys-4 and Cys-19, and Cys-9 and Cys-29) as native HNP-1 (obtained from Peptide Institute Inc., Osaka, Japan) was used in this study. It was dissolved in 0.01% acetic acid and stored as a stock solution of 100 g/ml at Ϫ20°C (dissolved peptide was used within 3 weeks, as the aqueous solution was stable for a few weeks only). To investigate the therapeutic potential of HNP-1, infected animals were divided into three groups (at least four animals in each group) and were injected subcutaneously with two different doses of HNP-1...
Smartphone-based telestroke services may be a much cheaper alternative to video-conferencing-based telestroke services and are more portable with less technical glitches. To the best of our knowledge, this is the first telestroke model being reported from India. It seems to be the way forward in providing timely treatment in acute ischemic stroke in underserved and resource poor settings.
In order to study the neurological manifestations in adult patients suffering from scrub typhus, 323 patients aged over 18 years, admitted with a positive diagnosis, were screened for neurological dysfunction; 37 patients with symptoms and/or signs suggestive of neurological dysfunction were included in the study. Of these, 31 (84%) patients had altered sensorium, four (11%) had cerebellitis, one (2%) patient had acute transverse myelitis and one (2%) had bilateral papilloedema without focal neurological deficit. Of the 31 patients with altered sensorium, 15 (40%) had meningoencephalitis, three (8%) had seizures, two (5%) had cerebral haemorrhages, one (2%) had a presentation likened to neuroleptic malignant syndrome (NMS) and one (2%) had a 6th nerve palsy with inflammation of the right cavernous sinus. Cerebrospinal fluid (CSF) analysis was abnormal in 23 patients (raised lymphocytes in 68%, raised protein in 80%). All patients improved with anti-rickettsial therapy.
Background:The present understanding of the clinical course, complications, and outcome of myasthenic crisis (MC) is based chiefly on observational studies and retrospective case series.Aim:To study the baseline demographic and clinical variables, risk factors, complications, outcome, and mortality in patients of MC.Materials and Methods:All patients of myasthenia gravis (MG) who presented with myasthenic crisis between July 2009 and December 2010 were included.Results:Ten patients of MC were included in this study. The median age of the patients was 40.5 years (range 14-71 years). Seven were females and three were males. Nine had generalized MG and one patient had oculobulbar involvement only. Median duration of disease was 3 years (range 1 month to17 years). Two patients had thymoma. Two patients had history of thymectomy in the past. Infection was the most common triggering factor accounting for five cases (50%) followed by inadequate treatment/drug withdrawal in three (30%) and steroid initiation and hypokalemia in the remaining two patients (20%). Median duration of MC was 12 days (range 3-28 days). Mortality was in 3 out of 10 (30%) during MC. Management in the intensive care unit (ICU) and treatment with plasma exchange/intravenous immunoglobulins were associated with good outcome.Conclusions:Ventilator support and management in intensive care unit are the most important components in the management of MC. The high mortality rate seen in present study may be more reflective of the actual ground reality in resource constrained developing countries, however, larger prospective studies are needed to confirm these findings.
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