Articles

Extended Spectrum β-Lactamase: Tackling Antibiotic Resistance and Overcoming Treatment Challenges

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Antibiotics, also known as antibacterials, kill or inhibit bacterial growth but are ineffective against viruses, fungi, or parasites, often leading to misuse. They are categorized by molecular structure, mode of action, and spectrum of activity. Antimicrobial Resistance (AMR) occurs when pathogens no longer respond to antimicrobial drugs, arising naturally or through acquisition. Resistance mechanisms include enzymatic (most common), genetic and physical. Bacteria produce various β-lactamases, such as Extended Spectrum β-lactamases (ESBLs), AmpC enzymes, and carbapenemase to exert resistance to Beta-Lactam (βL) class of antibiotics. ESBL families include TEM, SHV, and CTX-M, with E. coli being the most prevalent host. Any Gram-Negative Bacteria (GNB) can be an ESBL producer, but most common ones are the Enterobacteriaceae including Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Proteus mirabilis. ESBL-producing Enterobacteriaceae (ESBL-E) resist penicillin, aztreonam, and cephalosporins except cephamycins and carbapenems, posing a significant public health risk. Genetic resistance mechanisms involve random mutations and horizontal gene transfer through either of the following processes namely conjugation, transformation, transduction. Physical mechanisms include efflux pump production and decreased porin channels. In some microbiological laboratories, ESBL production are often not determined, rather resistance based on MIC values to third generation Cephalosporins are considered as resistance due to ESBL production. Antibiotic use in agriculture and medicine has increased Multi-drug resistant (MDR) ESBL-producing E. coli and evidenced in retail meat and among meat shop employees. Community-acquired ESBL-E infections are a growing concern, with hospital transmission primarily occurring among patients sharing rooms with ESBL carriers. Empirical and definitive therapies for ESBL-E infections must be adjusted based on Antibiotic Susceptibility Testing (AST). The MERINO trial identified urinary tract infections as the most common source of ESBL-E bacteremia, with E. coli being predominant. For critically ill patients with non-urinary tract infections, Meropenem or Imipenem-cilastatin are recommended. For uncomplicated UTIs, Nitrofurantoin, Cotrimoxazole, and Piperacillin-Tazobactam (Pip-Taz) are effective, while Cotrimoxazole, Fluoroquinolones, and Ceftolozane-tazobactam are suitable for complicated UTIs. New β-lactamase inhibitors like avibactam, vaborbactam, and relebactam are promising for treatment. Misuse of antibiotics, such as inappropriate dosing and duration, contributes to AMR, a growing global challenge. Deaths from AMR, estimated at 1.27 million in 2019, could reach 10 million by 2050. ESBLs drive the use of broad-spectrum antibiotics, accelerating resistance development. Inadequate therapy exacerbates infections, leading to prolonged hospital stays, complications, and increased mortality. Balancing new drug development with resistance emergence is crucial to combat AMR.

 

Recent Advances in the Treatment of Irritable Bowel Syndrome: Addressing Diarrhea, Constipation, and Abdominal Pain

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Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. This paper aim was to provide an overview of recent advancements in the treatment of IBS, focusing on the management of its main symptoms: diarrhea, constipation, and abdominal pain.

For individuals with IBS-D, various therapeutic options are available, including rifaximin, peripheral opioid agonists, mixed opioid agonists/antagonists, bile acid sequestrants, and serotonin 5-HT3 receptor antagonists. Rifaximin, a nonabsorbable antibiotic, has demonstrated significant effectiveness in reducing IBS symptoms, such as bloating and loose stools, with good tolerability and safety. Also the repeated use of rifaximin for managing recurrent IBS symptoms. In IBS-C patients, bulking agents, osmotic laxatives, and prokinetic agents like lubiprostone have shown efficacy in improving constipation and overall symptoms. Linaclotide, a drug that increases intestinal chloride secretion, has demonstrated significant improvement in bowel movements and abdominal pain in IBS-C patients. However, it may cause diarrhea in some individuals. IBS-M, characterized by alternating constipation and diarrhea, poses a challenge in terms of specific drug treatments. A comprehensive assessment of potential underlying causes and careful history taking is crucial for effective management. Abdominal pain is a common symptom in IBS, regardless of subtype. Antispasmodic drugs, peppermint oil, and trimebutine have shown effectiveness in reducing pain and improving symptoms. Antidepressants, such as tricyclic antidepressants and selective serotonin reuptake inhibitors, may offer relief by modulating pain pathways and influencing gastrointestinal motility. Benzodiazepines, particularly dextofisopam, have shown potential in improving stool consistency but require further evaluation.

In conclusion, recent advancements in the treatment of IBS have provided a range of therapeutic options targeting its main symptoms. However, further research is needed to develop tailored treatments for specific IBS subtypes and to explore the efficacy of potential alternatives, including benzodiazepines. Improved management of IBS symptoms can significantly enhance the quality of life for affected individuals.

The Peculiarities of the Use of Activated Charcoals Obtained from Native Plum Pips in the Treatment of Wastewater of Industrial Enterprises

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The purpose of the article is to treat the wastewater of industrial enterprises with the help of activated charcoals with high adsorptive properties obtained from the waste of native plum pips, a local raw material grown in large quantities in our country. The research methods were carried out on the basis of samples presented in the literature and GOST standard indicators. According to the results, carbon activated by steam at 800 0C showed its efficiency with higher adsorption properties compared to the samples activated by acid and alkali. The results of water purification showed that the adsorption activity of the selected carbon was almost 30 times higher. The effect of activated carbon on cations and anions in water and on water hardness, color, smell, taste and pH indicators was determined in wastewater treatment by selected activated carbon.

A Literature Review of Undenatured type II collagen (UC-II) in Joint Health and Disease

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Undenatured type II collagen (UC-II) is supplementary which is from chicken sternum cartilage. (Lugo, J. P., Saiyed,…,2015) UC-II has undenatured type II collagen componentand. The safety and capability of UC-II in adjusting joint discomfort in Osteoarthritis and Rheumatoid arthritis support by previous preclinical and clinical studies. (Lugo, J. P., Saiyed,…,2013) Osteoarthritis (OA) is atrophy joint disease affecting the quality of life of the elderly population. A lot of evidence that nutraceuticals from natural herbs may play essential part in inflammation and joint catastrophe in OA. Moreover, various studies these supplements have been found to be proficient in OA. None of these supplements have reported side effects. However, questions connected to their capability and safety for OA prevention and treatment is quality trials are needed to give absolute answers. (Vaishya, R., Agarwal,…,2018)

Integrated Nutrient Management in Bottle gourd [Lagenaria siceraria (Mol) Standl.] variety Kashi Ganga under Malwa condition of Madhya Pradesh

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The present experiment “Integrated Nutrient Management in Bottle gourd [Lagenaria siceraria (Mol) Standl.] variety Kashi Ganga under Malwa condition of Madhya Pradesh” was carried out during Kharif season of 2019 -2020 at the Horticulture Experimental Field, College of Agriculture, RVSKVV, Indore (M.P.). The objective of the trial is to study efficacy of soil amendment on growth, yield and quality traits. The experiment consist of 15 treatments and three replication under randomized block design. The treatment T10 (50% NPK+25% Vermicompost +25% Compost) was found significantly superior as compared to other of treatments in following characters like vine length(cm), length of internode /vine (cm), no of primary branches. Treatment T0 (No application of INM control) observed minimum as compares to other of treatments. The treatment T10 (50%NPK+25%Vermicompost+25%Compost) was found significantly good result in phenological characters like no of node /vine up to first male and female flowers, days to first appearance of male and female flower, Treatment T0 ( No application of INM control) observed minimum as compares to other of treatments. The results regarding the yield parameters like days to first picking , avg. fruit weight at every picking (g) ,fruit length (cm) , fruit diameter (cm) , fruit yield /plot (kg), fruit yield (q/ha) number of seeds per pod, pod yield per plant(g) and pod yield (q/ha) were significantly affected by the application of different combination of integrated nutrient management. The maximum result was noted in treatment T10 (50% NPK + 25% Vermicompost + 25% Compost) However, minimum result was noted in T0 (No application of INM control).

Endocrine Disorders and Hormonal Therapy for Adolescent Acne

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Acne vulgaris is a worldwide disease which is mostly found in teenagers. This has a crucial impact on their life’s quality, particularly when endocrine disorders have been implicated. Current consideration regarding antibiotic stewardship, failing with antibiotic utilization, and the improvement of antibiotic-resistant Propionibacterium acnes, there are many treatment alternatives for pimple therapy have been acknowledged. A following analysis investigates hormonal treatments for the therapy of acne vulgaris.

Surgical Treatment of Gallstones in Patients Undergoing Gastric Bypass Surgery as a Treatment of Obesity

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Introduction: Sustained weight loss after gastric bypass is achieved by a combination of gastric restriction and a variable degree of malabsortion and has therefore a greater risk for gallstone development than purely restrictive procedures like adjustable gastric banding.

Objectives: The main objective of the study is to analyse the surgical treatment of gallstones in patients undergoing gastric bypass surgery as a treatment of obesity.

Material and methods: This randomized control trial was conducted in Jinnah Hospital, Lahore during 2021 to 2022. Patients who underwent bariatric surgery for obesity were included in the study. Those who had cholecystectomy before bariatric surgery, those who underwent concomitant cholecystectomy (CC) during bariatric surgery, those with concomittant gall stoness and those who did not attend their follow-up regularly were excluded from the study.

Results: The data was collected from 100 patients and we reviewed records from all patients treated for acute biliary pancreatitis. The average age was 36.43±9.52 years and, the ratio of women/men was 151 (81.6%)/34 (18.4%). Mean BMI was determined as 44.16±5.09. When comorbidities were evaluated, 116 (62.7%) patients had comorbidity, while 69 (37.3%) patients did not. Conclusion: It is concluded that prophylactic and selective management can be safely performed and the only significant difference with patients not submitted to concomitant cholecystectomy is mostly observed in operative times that are higher in those who do undergo cholecystectomy.