Management of community-acquired bacterial pneumonia in adults: Limitations of current antibiotics and future therapies.

Community-acquired bacterial pneumonia (CABP) is one of the leading causes of morbidity and mortality in India and worldwide. Evidence indicates that Gram-positive, Gram-negative, and atypical bacteria are encountered with near-equal frequency. Despite guideline recommendations and antibiotic options for the management of CABP, burden of morbidity and mortality is high, which is attributable to a variety of factors.

A Rare Case Report of Biloma After Cholecystectomy.

Biloma is an encapsulated collection of bile outside or inside the biliary system within the abdominal cavity. It is a rare condition with an incidence of 0.3%-2%.

Cardiac Tamponade in the Setting of a Thymoma.

Thymoma is the most common neoplasm originating in the anterior mediastinum and accounts for a quarter of all mediastinal tumors. A pericardial effusion is an uncommon initial manifestation present in approximately 20% of patients. However, our patient had hemorrhagic pericardial effusions causing a cardiac tamponade with bilateral pleural effusions, nodular left pleural based masses, and ascites.

Idiopathic Lateral Rectus Myositis Without Signs of Orbital Inflammation.

Idiopathic orbital inflammation (IOI), also known as orbital pseudotumor, is a nonspecific term that represents inflammation of unknown etiology that could affect various orbital structures. We report a case of IOI with an atypical presentation mimicking other clinical conditions. Our patient did not show the typical signs of inflammation that are usually seen in patients with orbital pseudotumor and are paramount in its diagnosis.

Bronchiectasis in India: results from the European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) and Respiratory Research Network of India Registry.

Background: Bronchiectasis is a common but neglected chronic lung disease. Most epidemiological data are limited to cohorts from Europe and the USA, with few data from low-income and middle-income countries. We therefore aimed to describe the characteristics, severity of disease, microbiology, and treatment of patients with bronchiectasis in India.

A Challenging Diagnosis of Systemic Lupus Erythematosus with Status Epilepticus.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder of unknown pathogenesis. In SLE, the body's immune system mistakenly attacks healthy tissues and organs thereby involving multiple body systems including joints, skin, blood, brain, heart, and lungs. SLE has a wide variation in the symptoms, hence making the diagnosis more challenging at the time of initial presentation.

Active pulmonary tuberculosis presenting with acute respiratory failure.

Four patients with active pulmonary tuberculosis (PTB) presenting with respiratory failure are reported here. Bronchogenic PTB, simulating an acute febrile illness or diffuse interstitial lung disease with short duration of symptoms, as a cause of acute respiratory failure is less recognized. If diagnosed and treated early, it has good prognosis.

Gene expression patterns of COX-1, COX-2 and iNOS in H. Pylori infected histopathological conditions.

Background: Research indicates that Helicobacter pylori can inflict severe histological damage through the modulation of host-related genes. The current study investigated the effect of H. pylori genotypes in the outcome of disease, and the expression of anti-apoptotic related genes, COX-1, COX-2, and iNOS genes in benign, pre-malignant, and malignant lesions of gastric carcinogenesis.

Atypical Hemolytic Uremic Syndrome: A Case Report.

Hemoytic uremic syndrome (HUS) is a rare type of thrombotic microangiopathies. Manifestations include thrombocytopenia, microangiopathic hemolytic anemia, and thrombi in small blood vessels. The prognosis is poor.

Improving breast cancer screening rates in a primary care setting.

Biannual mammogram has been recommended for all women aged 50-74 years by USPSTF. Our aim was to improve the screening rates of biannual mammogram among women aged 50-74 years in a primary care clinic. Medical records were reviewed.

Engineering bio-mimetic humanized neurological constructs using acellularized scaffolds of cryopreserved meningeal tissues.

Spinal cord injury (SCI) is one of the most precarious conditions which have been one of the major reasons for continuous increasing mortality rate of SCI patients. Currently, there is no effective treatment modality for SCI patients posing major threat to the scientific and medical community. The available strategies don't mimic with the natural processes of nervous tissues repair/regeneration and majority of the approaches may induce the additional fibrotic or immunological response at the injury site and are not readily available on demand.

A Bibliometric Analysis of the Top 30 Most-cited Articles in Gestational Diabetes Mellitus Literature (1946-2019).

Objective The aim of this bibliometric analysis is to evaluate the importance and impact of the articles that have been published with the title gestational diabetes mellitus (GDM) in the specialty of obstetrics & gynecology and endocrinology during the period 1946-2019. It also reveals that the area of GDM has received increased attention and interest by researchers, research funding institutions, and practitioners. Material and methods A thorough database search of Scopus and Web of Science was performed and the articles pertaining to gestational diabetes mellitus that were published between 1946 and 2019 were reviewed by two reviewers, Iftikhar PM and Ali F, with respect to their year of publication, authors, country of origin, journal of publication, and the affiliated institutions of the authors as well as journals.

Plasma cell leukemia - one in a million: A case report.

Background: Plasma cell leukemia (PCL) is diagnosed by the presence of an absolute plasma cell count of > 2 × 10/L or 20% plasma cells in the peripheral blood. Because the incidence of PCL is relatively low, our case report study presents a rare opportunity to describe the clinical and pathological characteristics of this leukemia, as well as different modalities of treatment and outcomes of primary PCL (pPCL).

Case Summary: A 56-year-old male with a history of hypertension complained of pain in the left flank area which started four months prior to admission.

A Rare Case of Crohn's Disease Manifesting as a Large Liver Abscess.

Liver abscess is a rare complication seen in Crohn's disease (CD) and has been rarely reported. Our aim is to illustrate a case of liver abscess in a patient with CD and the importance of a complete history and physical examination in identifying the potential cause of a hepatic abscess in an immune competent individual in who the diagnosis of CD was apparently ignored for two years before she presented to us. Although the manifestation of a hepatic abscess without any perianal abscess or fistula in CD is extremely rare, recognition of this would facilitate the diagnosis and appropriate management of abscess and CD.

Intraperitoneal transplantation of bioengineered humanized liver grafts supports failing liver in acute condition.

Acute liver failure (ALF) is one of the most devastating fatal conditions which have posed crucial challenges to the clinicians and researchers for identifying permanent cure. Currently liver transplantation has been considered as the only managerial option. However it's wider applicability has been limited owing to non-availability of quality donor organs, cost-intensiveness, surgical hitches, life-long use of immunosuppressive drugs and long-term complications.

Association and gene-gene interaction analyses for polymorphic variants in CTLA-4 and FOXP3 genes: role in susceptibility to autoimmune thyroid disease.

Purpose: Polymorphic variants of cytotoxic T-lymphocyte antigen-4 (CTLA-4) and forkhead box protein P3 (FOXP3) genes are implicated in dysregulated immune homeostasis and autoimmune disorders. We analyzed the association between CTLA-4 rs231775 and FOXP3 rs3761548, rs3761549 polymorphisms and predisposition to autoimmune thyroid disease (AITD), inclusive of Hashimoto's thyroiditis (HT) and Graves' disease (GD) in South-Indian population.

Methods: A total of 355 AITD subjects (comprising 275 HT and 80 GD) and 285 randomly selected age- and sex-matched control subjects were genotyped for the aforementioned polymorphisms by PCR-RFLP method.

Consensus on the Management of Posterior Urethral Valves from Antenatal Period to Puberty.

The need for successful management of posterior urethral valves always captivates the minds of pediatric surgeons. Its success, however, depends on several factors ranging from prenatal preservation of upper tracts to postoperative pharmacological compliance. Regardless of measures available, some cases do not respond and progress to end stage.

Activation of integrated stress response pathway regulates IL-1β production through posttranscriptional and translational reprogramming in macrophages.

Immune cells sense and programme its cellular machinery appropriately to the environmental changes through the activation of cytoprotective adaptive pathway so-called the "integrated stress response (ISR)". However, the mechanisms implicated in ISR-induced protective responses are poorly understood. Here, we show that ISR activation by arsenite (Ar) results in suppression of IL-1β production in macrophages and inhibition of DSS-induced colitis in a murine model through a novel posttranscriptional and translation regulatory (PTR) mechanism.

Bioengineered functional humanized livers: An emerging supportive modality to bridge the gap of organ transplantation for management of end-stage liver diseases.

End stage liver diseases (ESLD) represent a major, neglected global public health crisis which requires an urgent action towards finding a proper cure. Orthotropic liver transplantation has been the only definitive treatment modality for ESLD. However, shortage of donor organs, timely unavailability, post-surgery related complications and financial burden on the patients limits the number of patients receiving the transplants.

Bioengineering Human Neurological Constructs Using Decellularized Meningeal Scaffolds for Application in Spinal Cord Injury.

Spinal cord injury (SCI) is one of the most devastating conditions echoes with inflammation, enhanced fibrosis and larger axonal gaps due to destruction of neurological cells which has caused continuous increasing mortality rate of SCI patients due to absence of suitable treatment modalities. The restoration of structural and functional aspect of damaged neurological tissues at the lesion site in spinal cord has been challenging. Recent developments have showed tremendous potential of neural stem cell-based strategies to form a neuronal relay circuit across the injury gap which facilitates some levels of improvement in SCI condition.

Study of therapeutic efficacy of febuxostat in chronic kidney disease stage IIIA to stage VD.

Hyperuricemia [serum uric acid (SUA) >7.0 mg/dL] which is common in chronic renal diseases is associated with augmented vascular events. In addition to nonpharmacological therapy, hypouricosuric drugs reduce UA levels.

Transcriptome meta-analysis identifies immune signature comprising of RNA binding proteins in ulcerative colitis patients.

Ulcerative colitis (UC) is a persistent inflammatory illness, which is clinically categorised as Inflammatory bowel disease (IBD), affecting millions of people worldwide. The precise cause behind the pathology of the disease remains unknown. However, the involvement of multiple factors including genetic predisposition, immunological deregulations, microbiota imbalance, and environmental triggers has been suggested.