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Infection-Associated Ocular Cranial Nerve Palsies
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Hardeep Singh Malhotra, Imran Rizvi, Neeraj Kumar, Kiran Preet Malhotra, Gaurav Kumar, Manoj K. Goyal, Manish Modi, Ravindra Kumar Garg, Vivek Lal
Aspergillus galactomannan enzyme immunoassay, beta-D-glucan detection, and polymerase chain reaction (PCR) based tests may not be absolute or conclusive. The sensitivity and specificity of galactomannan assay and PCR borders 80%. The utility of beta-D-glucan is best reserved to determine invasiveness of a fungal infection as this is not specific for Aspergillus and shares positivity with other invasive fungal infections. CT of paranasal sinuses and orbits may suggest involvement in the form of hyperdensity and bony erosion. It, however, should be noted that even extensive parenchymal forms of aspergillosis may not accompany obvious bony erosion. Gadolinium-enhanced MRI often reveals a polylobulated abscess (hypointense on T1-W; hyperintense on T2-W images) with significant peripheral enhancement; inflammation of the surrounding soft tissue can be noted, in addition. Involvement of surrounding paranasal sinuses, meninges, and bone is usually seen. Angioinvasion is another important feature of this fungus, somewhat greater than mucormycosis. Interestingly, a few patients may have a T2-W hypointense signal which is postulated to be a result of ferromagnetic fungal deposits (like iron, zinc, manganese, etc.) or due to methemoglobin (in the wall of the capsule or the macrophages). A central intermediate signal may be noted on T2-W images, suggestive of coagulative necrosis (Figure 16.8). Mycotic aneurysms have been noted with aspergillosis as a result of direct spread from paranasal sinuses to proximal part of circle of Willis or through hematogenous spread (9).
Applications of Fenugreek in Nutritional and Functional Food Preparations
Published in Dilip Ghosh, Prasad Thakurdesai, Fenugreek, 2022
Ujjwala Kandekar, Rohini Pujari, Prasad Thakurdesai
Fenugreek is one of the most popular sources of nutrients. Fenugreek leaves are composed of many vital nutrients, such as proteins, fats, fibers, and carbohydrates. The chemical composition of fenugreek seeds has been documented in the past scientific literature (Alsebaeai et al. 2017; Bienkowski et al. 2017; Kochhar, Nagi, and Sachdeva 2005). The predominant constituents present in fenugreek are carbohydrate, gum, mucilage, crude fiber, protein, and amino acid (Naidu et al. 2011). Other minor constituents include essential oils; saponins (mainly yamogenin and diosgenin) (Acharya et al. 2006; Taylor et al. 2002); alkaloids (mainly trigonelline); choline, gentianine, and carpine (Mehrafarin et al. 2010); minerals such as calcium, phosphorus, iron, sodium, potassium, and vitamins (mainly A, B1, B2, B3, and C) (Bienkowski et al. 2017; Wani and Kumar 2018). Young seeds contain a small amount of sucrose, fructose, glucose, galactinol, stachyose, and raffinose traces (Leela and Shafeekh 2008). Leaves are a rich source of lysine and other essential amino acids, vitamin C, ß-carotene, and folic acid (Yadav and Sehgal 1997). Galactomannan, a water-soluble polysaccharide present in the seeds, has attracted attention towards its application as an excipient in pharmaceutical products. Almost 14–15% galactomannan was present in the seeds’ endosperm (Majeed et al. 2018). The presence of these vital constituents thus enhances the nutritional and medicinal applications of fenugreek seeds.
Introduction
Published in Brijesh Kumar, Vikas Bajpai, Vikaskumar Gond, Subhashis Pal, Naibedya Chattopadhyay, Phytochemistry of Plants of Genus Cassia, 2021
Brijesh Kumar, Vikas Bajpai, Vikaskumar Gond, Subhashis Pal, Naibedya Chattopadhyay
In the seed extract of C. occidentalis chrysophanol, toxins, 1,4-oxazine derivative n-methyl morpholine has been isolated. Seeds also contain physcion, physciondianthron heterosides and physcion condensed as homodianthrone as well as a mixture of anthraquinones. 1-glucoside of physcion (0.018%) along with physcion (0.0068%) and two new anthraquinones like 1, 8-dihydroxy-2-methyl anthraquinone (0.0014%) and 1,4,5-trihydroxy-3-methyl-7-methoxy anthraquinone (0.0016%), chrysophanol free and as a glycoside were also found in seed samples. A new polysaccharide galactomannan consisting of d-galactose and d-mannose in the proportion of 1:3.1, as well as trace amount of d-xylose was also found in the C. occidentalis seeds. Maltose, lactose, sucrose and raffinose are also detected from seed. Some other compounds identified from the seeds of C. occidentalis are -1,8-dihydroxy-2-methyl anthraquinone, physcion, rhein, aloe-emodin, chrysophanol and steroidal glucosides. An analysis of flowers indicated the presence of anthraquinones, emodin, physcion and physcion-1-O-β-d-glucoside as well as the ubiquitous sterol β-sitosterol (Veerachari and Bopaiah, 2012).
Prevention of acquired invasive fungal infection with decontamination regimen in mechanically ventilated ICU patients: a pre/post observational study
Published in Infectious Diseases, 2023
Nicolas Massart, Florian Reizine, Clarisse Dupin, François Legay, Eleonore Legris, Anne Cady, Guillaume Rieul, Nicolas Barbarot, Eric Magahlaes, Pierre Fillatre
Patients were classified as having possible, putative, probable or proven aspergillosis according to the AspICU, IAPA and CAPA criteria when indicated [10–12]. Fungal culture was performed in respiratory samples in Sabouraud-Chloramphenicol media and species identification was by MALDI-ToF mass spectrometry. Molecular detection was also performed on respiratory samples after DNA extraction with a qPCR assay targeting the mitochondrial gene and the 28S rDNA region. Galactomannan was measured in serum with an index cut-off of 0.5 and in BAL with an index cut-off of 1.0. Chest computed tomographies were analysed by a senior radiologist and was considered compatible with acquired pulmonary aspergillosis when lesions were not present at admission but developed during ICU stay. Candidemia was diagnosed by at least one blood culture positive for a Candida species.
Anticancer and Immunomodulatory Effects of Polysaccharides
Published in Nutrition and Cancer, 2021
Anley Teferra Kiddane, Gun-Do Kim
An acidic sulfated glucoronogalactomannan polysaccharide, extracted from Capsosiphon fulvescence (73), was composed of neutral sugars (49.8%), sulfate (5.7%), uronic acid (4.8%) and protein (0% in mass). The monosaccharide composition of the purified polysaccharide was determined to be mannose (55.4%), galactose (25.3%), glucuronic acid (16.3%), and arabinose (0.8%) in molar percentage. These results certainly proved the showing up of sulfate groups and that the polysaccharide is a heteropolysaccharide, galactomannan, mainly consisting of galactose and mannose. 10 μg/ml of the polysaccharide stimulated macrophages to produce TNF-α which is 80 times higher than normal levels. The polysaccharide obviously induced IL-6 secretion from RAW264.7 murine macrophages in a dose-dependent manner as well. The levels of mRNA expression of iNOS and COX-2 increased in a C. fulvescence polysaccharide dose-dependent manner. Furthermore, 10 µg/ml of the polysaccharide stimulated the expression of iNOS and COX-2 from macrophages measured double higher than the normal by using densitometric estimation. In addition, productions of NO and PGE2 were induced. These results demonstrate that the purified C. fulvescence polysaccharide has valuable and potent significance on immune stimulation.
Alfa-1-antitrypsin deficiency: a predisposing factor leading to invasive infections?
Published in Infectious Diseases, 2020
Sanne De Smet, Jan Dierick, Sophia Steyaert, Marie Schurgers, Christophe Van Steenkiste, Sarah Loof
There was need for non-invasive ventilation to support his respiration. Computed tomography scan (CT scan) of the thorax showed extended bilateral ground glass opacities. The differential diagnosis at this point included viral pneumonia, bacterial pneumonia, opportunistic infection (pneumocystis jirovecii or fungal) and ARDS. A bronchoscopy was performed, showing no endobronchial abnormalities. The PCR on the broncho-alveolar lavage (BAL) fluid was negative for Pneumocystis jirovecii but positive for galactomannan. Galactomannan testing was done by Enzyme-Linked Immuno Sorbent Assay (ELISA) and showed a ratio of 0.88 (reference level < 0.5). Bacterial culture on the BAL fluid remained negative. As the galactomannan was strongly positive in this assumed immunocompromised patient (ICU stay, 10 days treatment with corticosteroids, Listeria infection, AATD), the diagnosis of a probable invasive pulmonary aspergillosis (IPA) could be made. The patient was treated with voriconazole with quick resolution of the respiratory insufficiency and radiological abnormalities, resulting in his discharge from the ICU. Treatment with voriconazole was continued for 6 weeks with therapeutic drug monitoring. His neurological symptoms also improved and finally disappeared after 2 weeks of combined therapy with amoxicillin and gentamycin, after which monotherapy with amoxicillin was continued.