Fulminant intracranial hypertension due to cryptococcal meningitis in a child with nephrotic syndrome

Cryptococcus neoformans has a worldwide distribution. Meningoencephalitis is the most common manifestation of cryptococcosis. The outcome of a patient with cryptococcal infection depends on the immune status of the host. Patients with nephrotic syndrome are particularly susceptible to cryptococcal infection not only due to innate changes in their immune system but also because of the immunosuppressive agents used in the treatment. We report an 8-year-old boy with nephrotic syndrome, who developed cryptococcal meningitis and died of fulminant intracranial hypertension.     

A case of retropharyngeal Lipoma

Lipomas are one of the most common benign mesenchymal tumors in the body. Usually asymptomatic, they rarely warrant treatment unless they attain enormous size causing cosmetic deformity or pressure effects. Head and neck region is an uncommon site, retropharyngeal space being one of the rarest. Lipomas in this region can produce pressure symptoms demanding surgical excision. This is a case report of retropharyngeal lipoma, extending from skull base to the clavicle. Though tumor was present for 20 yrs it exhibited rapid growth over a period of 2–3 yrs causing respiratory obstruction, dysphagia & dysphonia. Clinically the entire laryngopharynx, trachea and carotid sheath were pushed anteriorly. On imaging, it showed classical features of a lipomatous mass. Patient underwent complete excision which presented a surgical challenge to surgeon and the anaesthetist from intubation to extubation.     

Efficacy of Chrysosporium tropicum metabolite against mixed population of adult mosquito (Culex quinquefasciatus, Anopheles stephensii, and Aedes aegypti) after purification with flash chromatography

Chrysosporium tropicum is a keratinophilic fungus and an effective mosquito control agent. This fungus was grown in Richards broth at 27 ± 2°C and a relative humidity of 75% ± 5% for 15 ± 2 days. Filtration was done with Whatman number 1 filter paper, column chromatography, and flash chromatography. Adulticidal efficacy was performed against a mixed population of mosquitoes including Culex quinquefasciatus, Anophelese stephensii, Aedes aegypti at five different concentrations 5:5, 6:4, 7:3, 8:2, 9:1 by adding fungal filtrate of flash chromatography to methanol in different ratio (metabolite/methanol). The experiment was conducted in the cage with an area of 2 × 2 × 3 ft. The mortality in mosquito population was recorded after 8 hours of exposure, and adulticidal activity was tested by probit analysis. The LC₅₀ was determined to be 4.9921 ml. Results of present study confirm that metabolites of C. tropicum can be utilized as alternative biological control agents for adult mosquitoes.     

Design of Eudragit RL 100 nanoparticles by nanoprecipitation method for ocular drug delivery

The objective of the current study was to prepare positively charged amphotericin-B–loaded nanoparticles providing a controlled release formulation. The particles were prepared by solvent displacement or nanoprecipitation method. The non-biodegradable positively charged polymer Eudragit RL 100 was used to prepare the different formulations with varying ratios of drug and polymer. The formulations were evaluated in terms of particle size, zeta potential, and differential scanning calorimetry measurements. Drug entrapment and release properties were examined also. The antimicrobial activity against Fusarium solani was determined. In vivo eye irritation study was carried out by a modified Draize test. All the formulations remained within a size range of 130 to 300 nm in fresh preparation as well as after 2 months. The zeta potential was positive (+22 to +42 mV) for all the formulations and was suitable for ophthalmic application. A prolonged drug release was shown by all the formulations. The formulation possesses a good antifungal activity against Fusarium solani when tested by disk diffusion method, and no eye irritation on in vivo testing was found.From the Clinical EditorThe objective of the current study was to prepare positively charged amphotericin-B -loaded nanoparticles providing a controlled release formulation. The described formulation displayed good antifungal activity against Fusarium solani when tested by disk diffusion method, and no eye irritation on in vivo testing was found.     

Functional analysis of CaIPT1, a sphingolipid biosynthetic gene involved in multidrug resistance and morphogenesis of Candida albicans

In the present study we describe the isolation and functional analysis of a sphingolipid biosynthetic gene, IPT1, of Candida albicans. The functional consequence of the disruption of both alleles of IPT1 was confirmed by mass analysis of its sphingolipid composition. The disruption of both alleles or a single allele of IPT1 did not lead to any change in growth phenotype or total sphingolipid, ergosterol, or phospholipid content of the mutant cells. The loss of mannosyl diinositol diphosphoceramide [M(IP)(2)C] in the ipt1 disruptant, however, resulted in increased sensitivity to drugs like 4-nitroquinoline oxide, terbinafine, o-phenanthroline, fluconazole, itraconazole, and ketoconazole. The increase in drug susceptibilities of ipt1 cells was linked to an altered sphingolipid composition, which appeared to be due to the impaired functionality of Cdr1p, a major drug efflux pump of C. albicans that belongs to the ATP binding cassette superfamily. Our confocal and Western blotting results demonstrated that surface localization of green fluorescent protein-tagged Cdr1p was affected in ipt1 disruptant cells. Poor surface localization of Cdr1p resulted in an impaired ability to efflux fluconazole and rhodamine 6G. The effect of mannosyl inositol phosphoceramide accumulation in the ipt1 mutant and the absence of M(IP)(2)C from the ipt1 mutant on the efflux of drug substrates was very selective. The efflux of methotrexate, a specific substrate of CaMdr1p, another major efflux pump of major facilitator superfamily, remained unaffected in ipt1 mutant cells. Interestingly, changes in sphingolipid composition affected the ability of mutant cells to form proper hyphae in various media. Taken together, our results demonstrate that an altered composition of sphingolipid, which is among the major constituents of membrane rafts, affects the drug susceptibilities and morphogenesis of C. albicans.     

Adipose-derived mesenchymal cells as a potential cell source for skeletal regeneration

Recent studies suggest that adipose tissue contains pluripotent cells that are similar to those derived from other tissues, such as bone marrow. Mesenchymal cells isolated from adipose tissue are capable of differentiating along osteogenic, chondrogenic, myogenic, adipogenic and possibly neuronal lineages. Current knowledge of adipose-derived mesenchymal cells is reviewed, with a particular focus on efforts to direct these cells towards bone formation. Cell-based therapies using adipose tissue are anticipated to be of great clinical interest for skeletal tissue repair and regeneration.     

Locomotor training progression and outcomes after incomplete spinal cord injury

BACKGROUND AND PURPOSE: The use of locomotor training with a body-weight-support system and treadmill (BWST) and manual assistance has increased in rehabilitation. The purpose of this case report is to describe the process for retraining walking in a person with an incomplete spinal cord injury (SCI) using the BWST and transferring skills from the BWST to overground assessment and community ambulation. CASE DESCRIPTION: Following discharge from rehabilitation, a man with an incomplete SCI at C5-6 and an American Spinal Injury Association (ASIA) Impairment Scale classification of D participated in 45 sessions of locomotor training. OUTCOMES: Walking speed and independence improved from 0.19 m/s as a home ambulator using a rolling walker and a right ankle-foot orthosis to 1.01 m/s as a full-time ambulator using a cane only for community mobility. Walking activity (mean+/-SD) per 24 hours increased from 1,054+/-543 steps to 3,924+/-1,629 steps. DISCUSSION: In a person with an incomplete SCI, walking ability improved after locomotor training that used a decision-making algorithm and progression across training environments.