Burkholderia cepacia complex (Bcc) is an emerging nosocomial pathogen, with violet-pigmented strains representing a rare and possibly neglected but clinically important subset. We report a case of a 62-year-old man with end-stage renal disease on dialysis who presented with fever and cough. Blood cultures from central and peripheral lines grew violet-pigmented, non-lactose fermenting colonies on MacConkey agar, later identified as Burkholderia contaminans sequence type 922 (ST922) via a multimodal approach. Initial phenotypic methods (VITEK-2, API20NE and MALDI-ToF) and 16S rDNA sequencing were inconclusive; however, multilocus sequence typing confirmed ST922, a strain previously reported in India and associated with nosocomial outbreaks. The isolate was susceptible to ceftazidime, trimethoprim/sulfamethoxazole, minocycline, and meropenem. The patient responded well to intravenous ceftazidime, with subsequent blood cultures yielding no growth. Notably, antimicrobial susceptibility varied geographically, with some ST922 isolates resistant to third-generation cephalosporins. This case illustrates the diagnostic challenges in Bcc speciation and highlights the value of molecular tools such as MLST. The detection of this strain in Malaysia raises concerns about global dissemination, potentially via contaminated medical devices or water systems. Early recognition of violet-pigmented Bcc in resource-limited settings can facilitate prompt, targeted treatment. This report underscores the need for environmental surveillance and antimicrobial stewardship to prevent spread, while reinforcing Bcc’s ecological adaptability and clinical significance, especially in immunocompromised individuals.

Opioid drugs are the first line of defense in severe pain but the adverse effects associated with opioids are considered as a serious issue worldwide. Acupuncture/electroacupuncture is a type of Chinese medicine therapy which is an effective analgesic therapy, well documented in animals and human studies. Electroacupuncture stimulation could release endogenous opioid peptides causing analgesia in a variety of pain models. It can be used as an alternative therapy to control the opioid crisis.

Background: Acute appendicitis is one of the most common surgical emergencies. However, its proper diagnosis is complicated. This study aims to evaluate the ability of the neutrophil-to-lymphocyte ratio (NLR) to diagnose acute appendicitis in pre-operative state. Methods: Histopathological examination of appendicectomies conducted between 2016 and 2017 in Melaka Hospital, Malaysia were traced and categorised into three groups: i) G1 (normal appendix), ii) G2 (acute appendicitis) and iii) G3 (perforated appendicitis). The reports were randomised and a total of 338 samples were collected. NLR values were compared between the three different groups and analysed. Results: The median values of NLR for G1, G2 and G3 were 2.37, 5.25 and 9.27, respectively. We found a statistically significant difference in NLR between G1 and G2 (P < 0.001), and G2 and G3 (P < 0.001). The diagnostic values of NLR for acute appendicitis and perforated appendicitis were 3.11 (sensitivity: 75.23%, specificity: 68.70%) and 6.17 (sensitivity: 76.32%, specificity: 58.72%), respectively. There was a substantial correlation between NLR and disease severity, and a moderate correlation between NLR and duration of admission. Conclusion: NLR, with a sensitivity of 75.23% and specificity of 68.70%, is a useful and reliable adjunct in diagnosing acute appendicitis. Hence, it will help in reducing the rate of negative appendicectomies.

Aims: Bifidobacteria is a non-motile, Gram-positive, strictly anaerobic and non-spore-forming bacteria that can produce exopolysaccharide (EPS). EPS is a polymer of sugars, long chained polysaccharide which have been shown to give benefit towards human health. The optimum conditions for EPS production by Bifidobacterium are still scarce. Therefore, a study was conducted to optimize the growth conditions (pH, temperature and cultivation time) for a better improvement of EPS production. Methodology and results: Three Bifidobacterium strains were cultured and the highest EPS producing strain was selected for optimization. Response Surface Methodology (RSM) was used to optimize the growth conditions for a maximum EPS production. Subsequently, EPS was characterized by using FT-IR and GC-MS. Based on the result obtained, B. pseudocatenulatum KAKii had the highest EPS production compared to the other two strains namely B. pseudocatenulatum ATCC 27919 and B. animalis. Meanwhile, the optimization of the three factors towards selected strain found that EPS produced crucially depends on time of cultivation (23.59 h) other than pH (5.0) and temperature (34.75 °C). The validation showed that the predicted and experimental values were not significantly different (P > 0.05), indicating that the developed model is fitted well for the optimization. Meanwhile, FT-IR and GC-MS results showed that the EPS was composed of D-glucose, mannose, galactose, maltose and acetic acid as by-product. Conclusion, significance and impact of study This result showed that the EPS produced by B. pseudocatenulatum KAKii is from hetero-exopolysaccharide group with acetic acid as by-product made them a possible anticancer agent in future.

The National Cancer Institute had projected breast cancer (BC) as one of the topmost prevalent malignancies around the globe. In many cases, BC becomes resistant to chemotherapy, radiation and hormonal therapies. Traditional BC therapies are associated with adverse side effects, drug resistance and recurrence. Extensive research work has shown that these dietary phytochemicals (DPs) may exert therapeutic effects by regulating the miRNA expression. A large number of DPs have been researched as miRNA regulatory agents against BC and some other DPs have not yet been tested against BC. We have discussed the effects of curcumin, diallyl disulphide, 3,3′ diindolylmethane, ellagic acid, genistein, indole-3-carbinol, quercetin, resveratrol, and sulforaphane on regulation of expression of BC miRNAs in a wide range of in vitro and in vivo models. We have also shown some of the possible DPs (Oleanolic acid, capsaicin, benzyl isothiocyanate, epigallocatechin gallate, phenethyl isothiocyanate and ursolic acid) that have shown miRNA regulatory activities and have not yet been tested against BC miRNAs. Finally, current limitations, challenges, future perspectives of DPs and BC research are also critically discussed.

A number of orthopedic injuries can occur during epileptic seizures. Anterior shoulder dislocation is one such orthopedic injury that is quite rare. The shoulder dislocation may injure the brachial plexus. Besides seizures, the nerves can also be damaged by anticonvulsive therapy. Muscle wasting following a seizure can misguide a clinician to investigate only neural or muscular pathologies. We report here an individual with epilepsy who was referred to us for electrodiagnostic evaluation of proximal muscle wasting related to a suspected proximal neuropathy. He was found to have a normal electrodiagnostic evaluation and later on discovered to have had bilateral shoulder dislocation on X-rays. This report advocates a thorough clinical appraisal, radiographs, and electrodiagnostic evaluation in a case with muscle wasting following a seizure.

This study presents the intercomparison of the outdoor environmental gamma dose rates measured using a NaI (Tl) based survey meter along with thermoluminescent dosimeters (TLDs) and estimation of excess lifetime cancer risk (ELCR), for the inhabitants of Poonch division of the Azad Kashmir, Pakistan. CaF2: Dy (TLD-200) card dosimeters were installed at height of 1 m from ground at fifteen different locations covering the entire Poonch division comprising of three districts. During three distinct two month time periods within the six month study period, all the installed dosimeters were exposed to outdoor environmental gamma radiations, retrieved and read out at Radiation Dosimetry Laboratory, Health Physics Division, PINSTECH laboratory, Islamabad. The ambient outdoor gamma dose rate measurements were also taken with NaI (Tl) based portable radiometric instrument at 1 m above the ground. To estimate the annual gamma doses, NaI (Tl) based survey data were used for one complete year following the deployment of the dosimeters. The mean annual gamma dose rates measured by TLDs and survey meter were found as 1.47±0.10 and 0.862±0.003 mGy/y respectively. Taking into account a 29% outdoor occupancy factor, the annual average effective dose rate for individuals was estimated as 0.298±0.04 and 0.175±0.03 mSv/y by TLDs and survey meter, respectively. For outdoor exposure, the ELCR was calculated from the TLD and survey meter measurements. The environmental outdoor average annual effective dose obtained in present study are less than the estimated world average terrestrial and cosmic gamma ray dose rate of 0.9 mSv/y reported in UNSCEAR 2000. The possible origins of gamma doses in the area and incompatibilities of results obtained from the two different measurement techniques are also discussed.
Gamma Rays ; adverse effects ; Humans ; Neoplasms ; etiology ; Pakistan ; Radiation Monitoring ; instrumentation