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The purpose of this study was to examine the hepatoprotective efficacy of Whole plant extract of Adiantum capillus against Paracetamol induced liver damage in rats. Wistar albino rats were orally fed 500 mg/kg of body weight of Methanolic and Acetonic extract of Adiantum capillus Whole plant, with Silymarin serving as the reference. By restoring functional parameters, physical parameters, biochemical parameters, and decreasing blood enzymes alkaline phosphatase (ALP) and total bilirubin (TBL) in the selected animal, the methanolic and Acetonic extracts exhibited a potent hepatoprotective effect. The plant's chemical composition includes, among others, alkaloids, flavonoids, glycosides, steroids, terpenoids, phenolics, and saponins. The overall experimental data suggest that bioactive phytoconstituents, such as flavonoids and alkaloids, present in the Methanolic and Acetonic extracts of Adiantum capillus plant may be responsible for the plant's significant hepatoprotective effect. The results thus support the use of Adiantum capillus plant as a hepatoprotectant.

Night jasmine, often called Parijat, is the common name for Nyctanthes arbortristis Linn. The plant belongs to the Oleaceae family. The shrub is native to the tropics and subtropics of the globe. It may seem like a pretty shrub, but it really has a lot of useful medicinal and pharmacological characteristics. The plant's distribution, phytochemical make-up, and pharmacological actions are all covered in this review article.

Medical science still faces difficulties in developing side-effect-free medications for diabetes management. This has increased the need for safe and effective natural remedies that may lower blood sugar levels. The purpose of this study is to determine whether or not an ethanolic extract of Nyctanthes arbor­tristis Linn. leaves reduces blood sugar levels in alloxan-induced diabetic albino rats. Nyctanthes arbor­tristis Linn. Ethyl Acetate extract activity was compared to that of the glibenclamide (0.5mg/kg p.o.) standard antidiabetic medication. Normal rats were given oral dosages of an Ethyl Acetate extract of Nyctanthes arbor­tristis Linn. leaf. At a dosage of 200 mg/kg, the Ethyl Acetate extract was significantly (p0.05) hypoglycemic. Leaves extracted with ethyl acetate from the Nyctanthes arbor­tristis linn plant have anti-diabetic effects on a par with those shown in diabetic control mice. Nyctanthes arbor­tristis linn leaf extract in ethyl acetate has been shown to have potent and non-toxic anti-diabetic properties.

Plants offer a large range of natural compounds belonging to different molecular families which have various properties to humans. These molecules possess interesting biological activities which attracted several researchers to their elucidation to provide knowledge that will lead to advancement medicine. The present paper deals with the screening of various phytochemical present in various extract viz., Aqueous, Ethanolic, Ethyl Acetate, chloroform and petroleum ether of Sida Spinosa

Adiantum capillus (AC) Linn (Family: Adiantaceae) commonly known as “Hansraj” It is used in common cold, cough, pyrexia inflammation, acts as purgative. It improves digestion and renal function. This study was performed to investigate the hepato-defensive potential of Adiantum capillus in contradiction of carbon tetrachloride tempted hepatic damage in rats. The rodents were dosed with Acetonic extract (AEAC, 500mg/kg) extract of Adiantum capillus against Carbon Tetrachloride induced hepatic damage. Results shows thst Carbon Tetrachloride elevated the level of hepatic markers like SOPT, SGPT, bilirubin and ALP as well as altered the antioxidant enzymes. The level of hepatic biomarkers, as well as antioxidant enzyme, were recovered after the administration of at 500mg/kg, p.o., which was further confirmed by the histopathological. From above results it was concluded that The Acetonic extract (500 mg/kg, bw) extract of Adiantum capillus (ACE) recover the biochemical as well as antioxidant parameters, which were affected by Carbon Tetrachloride. The histopathological analysis supports the outcomes of antioxidants parameters. Key Words: Adiantum capillus, , , x,

The aim of present investigation was to develop efficient controlled release floating tablet (CRFT) of Spirapril. Floating dosage form for gastric retention has potential to use as controlled-release drug delivery systems which providing opportunity for both local and systemic drug action. The tablets were prepared by using wet granulation techniques using PVP K 30, SFG and Acrypol 934. A 32 full factorial design (CCD) was applied to optimize two independent variables at three different levels by varied response variables. Two independent variables i.e. amount of SFG (i.e., polymer X1) and amount of Acrypol 934 (i.e., polymer X2) were varied at three different levels that was coded for low, medium and high (-1, 0, 1 respectively). The response variables T6 (cumulative % amount of drug released in 6 hr) (Y1), T12 (cumulative % amount of drug released in 12 hr) (Y2), Q50 (time in minutes required to 50 % of drug released) (Y3), FLT (Y4), TFT (Y5), and Swelling Index after 12 hr (Y6) were selected for present study. ANOVA study was also employed to optimize for best fitted quadratic model. Compressed matrices exhibited Super case-II transport drug release kinetics approaching zero- order, as the value of release rate exponent (n) varied between 0.9430 and 1.0133. Formulation A4 was the optimized best formulation from the response surface plot and contour plot of all the formulation.

In the present investigation, rats will be given the liver-damaging drug RIF+INH, and the methanol (MESV) extract of the leaves of Sida veronicaefolia will be tested to see how well it protects the rats' livers from damage caused by RIF+INH. The hepatoprotective effects of MESV at a dose of 250 & 500 mg/kg were estimated by using liver function tests and serum profiles. According to the results, the extracts of Sida veronicaefolia at a dose of 250 & 500 mg/kg, not only have a strong hepatoprotective effect by lowering the levels of serum transaminases (SGPT and SGOT), alkaline phosphate, and total bilirubin in the blood, but they also increase the levels of total protein by a lot. The effects of MESV were very similar to those of silymarin, which is given as standard drug treatment.

Background Extrapulmonary tuberculosis (EPTB) is quite prevalent in India, ranging from 8.3% and 13.1%. Diagnosis of EPTB is often challenging as it resembles other granulomatous conditions pathologically. TB culture remains the gold standard for definitive diagnosis, but it takes longer time and WHO has recommended the use of GeneXpert Ultra for rapid diagnosis. This study aims the utility of GeneXpert Ultra for diagnosis of tubercular adenitis. Methods This prospective study included the suspected tubercular adenitis patients with lymphnode size of ≥ 20mm. Patients diagnosed with other aetiology of adenitis were excluded. Excision biopsy was performed in all patients. Tissue samples were sent for Ziehl Neelson (ZN) stain, GeneXpert Ultra, histopathology and mycobacterial culture (BACTEC). The sensitivity, specificity, positive predictive value (PPV), and Negative predictive value (NPV) of GeneXpert Ultra were analysed in comparison with culture results. Results A total of 85 patients Lymph node were included, of which 60% (n=51) had cervical LN, 15%(n=13) abdominal LN, 12%(n=11) mediastinal LN, and 15%(n=11) others. Most of the patients (97%) HPE findings of granulomatous inflammation of which only 20%(n=17) were ZN stain Positive. TB culture showed positivity of 56.47%(n=48) . Mycobacterial tuberculosis was detected in 69%(n=59) of patients by GeneXpert Ultra & none of them showed Rifampicin resistance. The Sensitivity, specificity, PPV & NPV for GeneXpert Ultra were found 85.4%, 51.3%, 25.06% and 94.8%, respectively. Conclusion GeneXpert Ultra showed excellent sensitivity and negative predictive value for the diagnosis of TB Lymphadenitis. Further this method detects Rifampin sensitivity which is crucial for initiation of appropriate antitubercular drugs. Disclosures All Authors: No reported disclosures.

In the current research, rats will be given RIF+INH (hepatotoxic), and the hydoethanol (HEESV) extract of the leaves of Sida veronicaefolia will be tested to see how well it protects the rats' livers from damage caused by the RIF+INH. Liver function tests and serum profiles were used to provide an estimate of the hepatoprotective effects of HEESV at a dose of 500 mg/kg. According to the findings, the extracts of Sida veronicaefolia not only provide a strong hepatoprotective impact by lowering blood levels of serum transaminases (SGPT and SGOT), alkaline phosphate, and total bilirubin, but they also considerably enhance the levels of total protein. The effects of HEESV were quite similar to those of the standard medication silymarin.

This study of the antioxidant properties of Adina cardifolia ware successfully investigated using DPPH radical scavenging, nitric oxide radical scavenging, Superoxide anion radical scavenging, total antioxidant activity by ABTS*+ radical scavenging and lipid peroxidation inhibitor assays and compared with the standards. Also the anti-neoplastic activity was study by MTT assay using MCF7 Cell line. Percentage growth inhibition by MTT assay using MCF-7 cell line ware found to be 65.54±1.05 by PEAC extract respectively compared to 83.03±1.0% by standard drug Methotrexate.

In the current research, rats will be given paracetamol (hepatotoxic), and the hydoethanol (HEESV) extract of the leaves of Sida veronicaefolia will be tested to see how well it protects the rats' livers from damage caused by the paracetamol. Liver function tests and serum profiles were used to provide an estimate of the hepatoprotective effects of HEESV at a dose of 500 mg/kg. According to the findings, the extracts of the chosen plant not only provide a strong hepatoprotective impact by lowering blood levels of serum transaminases (SGPT and SGOT), alkaline phosphate, and total bilirubin, but they also considerably enhance the levels of total protein. The effects of HEESV were quite similar to those of the standard medication silymarin.

Fungal endocarditis is a rare and fatal condition, most frequently caused by species of the genera Candida and Aspergillus. Fever and changing heart murmur are the most common clinical manifestations. The diagnosis of fungal endocarditis is challenging, with prosthetic valve endocarditis being extremely difficult to diagnose. The optimal management of the condition still remains debatable. We present a case of prosthetic valve endocarditis caused by Candida parapsilosis, managed empirically with liposomal amphotericin B, which was later shifted to combination therapy with high-dose echinocandin and fluconazole, but had a fatal outcome because the patient could not undergo timely surgical intervention. Treating C. parapsilosis endocarditis cases is difficult because of their biofilm production on native and prosthetic heart valves. A combined approach consisting of a high index of clinical suspicion, early diagnosis using serological markers followed by culture or PCR and prompt initiation of appropriate antifungals may aid in improving outcomes.

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Introduction Invasive aspergillosis is one of the potentially life-threatening diseases in immunocompromised patients. Early diagnosis and prompt treatment improve patient survival. The gold standard method—conventional microscopy and culture have low sensitivity and a long turnaround time. Serum Galactomannan (GM), a polysaccharide that forms a major component of Aspergillus cell wall and is released by the fungus during invasive growth is established as a reliable biomarker, which is available as Enzyme Linked Immunoassay (ELISA). The limitations of ELISA are high cost, expertise, and difficulty in assay standardization. To overcome these limitations, a qualitative Galactomannan Lateral Flow Assay (GM-LFA) a sandwich immunochromatographic test, recently approved by European CE, is evaluated in our study. Objective To establish the diagnosis of Invasive Aspergillosis according to EORTC/MSGERC Definitions of Invasive Fungal Diseases 2021 guidelines and comparison of GM-LFA with conventional microscopy and culture. Method We performed a retrospective study from October 2021 to March 2022 on serum and bronchoalveolar lavage fluid (BAL) samples. GM-LFA (IMMY sōna Aspergillus Galactomannan LFA) was performed and the results are read after 10 mins with a cube reader according to the manufacturer’s instructions and compared with conventional microscopy and culture. Result During the 6 months study period, 185 samples (14 BAL and 171 Serum) were collected from 148 patients. A total of 17/185 (9.18%) samples from 16 patients were positive by GM-LFA, of those 5 (29.41%) are BAL, and 12 (70.58%) are serum samples. One patient tested positive for Galactomannan on both BAL and serum. Among Assay positive samples, 3/17 (17.64%) samples were positive by microscopy and culture, which grew 2 Aspergillus fumigatus and 1 Aspergillus niger. Treatment details of 5 patients could be traced, of which 4 patients improved clinically and radiologically after Inj. voriconazole and 1 patient died before starting treatment. According to EORTC/MSGERC Definitions of Invasive Fungal Diseases 2021 guidelines, 17 patients belong to the proven and probable Invasive aspergillosis category, in which 16 patients were GM-LFA-positive and the remaining 131 patients had no evidence of invasive aspergillosis disease. Conclusion GM-LFA is a cost-effective, easy, convenient, and rapid procedure. We recommend its use for the diagnosis of invasive Aspergillosis in routine healthcare settings, especially where GM-ELISA is not available or affordable.

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objective To determine the species distribution of causative agents causing dermatophytosis, and their antifungal susceptibility pattern for terbinafine and itraconazole in trichophyton spp among samples collected in patients with dermatophytosis clinical suspicion during the period of December 1, 2020 to January 31, 2022. Materials and Methods This is a prospective study conducted in the Department of Microbiology of a tertiary care super specialty and referral Centre of western Rajasthan from December 1, 2020 to January 31, 2022. Skin scraping, nail clipping, and hair pluckings were collected in mycology lab from clinically suspected cases of dermatophytosis presenting to the department of dermatology for conventional identification, and antifungal susceptibility testing. The specimens were subjected to direct KOH and calcofluor white microscopy and conventional fungal culture on SDA at 25 ͦ C and 37 ͦ C. The cultures positive for dermatophytes were speciated by microslide culture lactophenol cotton blue mount, hair perforation test, and urease test. The isolates identified as Trichophyton spp were taken up for antifungal susceptibility testing against terbinafine and itraconazole by microbroth dilution according to CLSI-M38 A2 guidelines. Further terbinafine resistance gene evaluation for detection of C1191A and T1189C single nucleotide polymorphism in Squalene epoxide by Amplified Refractory Mutation System-Polymerase chain Reaction (ARMS-PCR) is undergoing for trichophyton spp. Results Over the 14-month study period, the laboratory processed total of 174 specimens: 134 skin scraping, 36 nail clipping, and 4 hair pluckings. Of them, 106 (61.62%) specimens were microscopy positive and 111 (63.79%) were culture positive. Out of the 111 culture-positive agents isolated, 94 (84.68%) were found to be dermatophytes. On isolate profiling of 94 dermatophytes T. mentagrophyte was found to be most common 45 (48%) followed by T. rubrum 27 (29%), T. tonsurans 20 (21%), T. verrucosum 1 (1.1%), and Microsporum spp 1(1.1%). Antifungal susceptibility of 93 Trichophyton spp against terbinafine showed resistance among 58.06% isolates with 83.33% isolates among terbinafine resistant cases showing ≥4 μg/ml minimum inhibitory concentration. There was no resistance detected for itraconazole with microbroth dilution. Conclusion A total of (54.02%) skin, hair, nail infections were found to be caused by dermatophytes. On isolate profiling, T. mentagrophyte, T. rubrum, and T. tonsurans were found to be predominant species among our isolates showing altered trend of local isolates from T. tonsurans being second most common spp isolated in past. On antifungal susceptibility >55% isolates showed resistance for Terbinafine with >80% having higher MIC of ≥4 μg/ml on the contrary there was no observed resistance for itraconazole. There is a need for encouraging dermatologists for prescribing routine fungal microscopy, culture, and AFST for dermatophytes in Western Rajasthan, to reduce the indiscriminate use of antifungals.

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Introduction The rare but increasingly identified infections caused by Mucorales are always detrimental to the patient due to rapid vascular invasion and the need for thorough surgical debridement and definitive antifungal therapy for its cure. Among the Mucorales, maximum cases have been reported among Mucor spp. and Rhizopus spp. Case: Here we present a case of a 9-year-old immunocompetent child presenting with abdominal pain and distension of 1-month duration followed by swelling of bilateral lower limbs, which was gradual in onset. Ultrasonography of the abdomen and pelvis was done which revealed a pelvic mass on the left side. The child developed acute urinary retention during the hospital stay, which was evaluated to reveal a fistulous connection between urethra and rectum for which transverse colostomy was done. The USG-guided biopsy of the left pelvic mass showed broad aseptate hyphae in Hematoxylin and Eosine staining whereas the KOH mount and culture were negative. The follow-up imaging with CT showed circumferential thickening of the recto-sigmoid region and involvement of the posterior bladder wall. Considering the rapidity of the spread of the infection, injection liposomal Amphotericin B at the dose of 5 mg/kg/d, i.v. was started and given for one week with minimal improvement. However, with this clinical picture and patient profile the diagnosis was strongly suspected to be of Basidiobolomycosis of rectosigmoid region. Treatment also was revised to injection of voriconazole at a dose 8 mg/kg/d, i.v. after loading dose which was later shifted to oral dose after 7 days. A repeat USG-guided biopsy was planned for gene sequencing, which identified the organism as Rhizopus arrhizus. On follow-up, patient showed no clinico-radiological improvement and in view of the mycological evidence, the anti-fungal was changed from voriconazole after 2 weeks to oral isavuconazole at the dose of 200 mg/d following the loading after which significant improvement was achieved and patient was discharged. Conclusion Mold infection in the form of spreading rectosigmoid mass in an immunocompetent child usually suggests the picture of Basidiobolomycosis. Treating patients only on clinical grounds without mycological confirmation may lead to overlooking of Mucormycosis and may result in adverse outcomes. The diagnosis of Mucormycosis should always be considered as a differential for a fungal infection in the form of mass lesion in abdomen.

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objectives The study was undertaken over a 9-month study period at a tertiary care and super specialty hospital situated in Jodhpur, Western Rajasthan, India, with the following objectives: Methods Automated blood culture bottles (BD BACTEC 960) that flagged positive were taken up for gram staining. Those bottles which showed gram-positive budding yeast with or without pseudohyphae were selected as the study isolates for candidemia. All such bottles were subcultures on Sabouraud's dextrose agar and incubates aerobically at 37°C for 2-5 days. Creamy, pasty, off-white colonies of Candida were further taken up for identification by germ tube testing, CHROM agar, and VITEK-MS. Antifungal susceptibility testing was performed for all isolates by VITEK 2 against fluconazole, caspofungin, voriconazole, micafungin, flucytosine, and amphotericin B. Results During the study period May 1, 2021-January 31, 2022, the microbiology laboratory received a total of 10 841 automated blood culture bottles, of which, overall, 1051 flagged positive. Budding yeasts were seen in 92 bottles. The prevalence of candidemia was found to be 1.49%. Budding yeasts made up 8.75% of all positive blood cultures. Conventional and automated identification methods showed the non-albicans Candida made up the majority (85.87%) of isolates. Candida tropicalis (43.47%) was the most common species overall, followed by C. parapsilosis (17.37%), C. albicans (14.13%), C. guilliermondi (5.43%), C. glabrata (5.43%), and C. auris (4.34%). Two isolates each of C. kruzei, C. utilis, C. rugosa, and Trichosporon spp. were also obtained. The antifungal susceptibility testing results for the commonest species C. tropicalis showed susceptibility of 90% against caspofungin and micafungin, 82% against fluconazole and voriconazole, 45% for flucytosine, and 47.5% against amphotericin B. C. albicans showed 100% susceptibility to fluconazole, and caspofungin, while C. parapsilosis showed a lower susceptibility percentage against all drugs in the panel. The two strains of C. auris were solely susceptible to caspofungin. Demography of the patients showed a male preponderance (M:F ratio was 2:1). The mean age of patients was 44 years. Conclusion The prevalence of candidemia in Jodhpur, Western India was found to be 1.45%, a figure much less than that reported from most other tertiary care centers of the country. The commonest isolate was C. tropicalis (43.47%), same as that reported from most Indian studies. Our isolates were largely (>90%) susceptible to the drug of choice caspofungin, including the multidrug-resistant C. auris strains. The study findings reflect a low prevalence of candidemia, indicating adequate antibiotic and antifungal stewardship practices at Jodhpur.

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Mycetoma has been classified as a neglected tropical disease by the WHO. ‘Madura foot’ is a prominent presentation of phaeoid fungi Madurella complex in India. Maduromycotic mycetoma is frequently encountered in Western Rajasthan, where it is endemic. A high prevalence in this area is due to the desert climate of prolonged hot sunshine and scanty annual rainfall. The classic clinical ‘triad of Mycetoma’ involves a painless hard swelling, multiple fistulas, and discharge of grains. We report two cases of eumycetoma from Western Rajasthan: Case Report 1: A 41-year-old male, farmer presented a history of progressive swelling of the left foot in the last 4 years following trauma to the left sole 5 years ago. Patient took multiple treatments with no improvement. General examination showed a pallor and inguinal lymphadenopathy. Local examination revealed tumefaction with multiple sinuses discharging serosanguinous fluid with occasional black granules. Laboratory tests revealed hemoglobin of 6.2 g/dL. Serology was positive for Hepatitis B virus. Direct 40% KOH microscopy of the crushed grains shows septate branching phaeoid hyphae. Whitish brown dry colonies with diffusible brown pigment were seen on Sabouraud Dextrose Agar at 25°C. Lactophenol Cotton Blue Stain showed dark septate hyphae with chlamydoconidia. Histopathological studies confirmed Eumycetoma. X-rays of his foot showed large destructive bony lesions. Initial therapy given to patient was to correct anemia followed by specific antifungal treatment. A below knee amputation of left leg was performed once the anemia was corrected. Case Report 2: A 55-year-old borderline diabetic male daily-wage worker presented with multiple nodular discharging lesions over the anterior shin of the right leg for past 7 years. The lesion started in leg as a small nodule that ruptured discharging black grains intermittently. He could not recall any significant trauma to his foot. Patient took multiple treatments with temporary relief but the disease recurred. Direct microscopy of 40% potassium hydroxide mount of the crushed grains showing thin septate branching phaeoid hyphae and on Sabourad Dextrose Agar at 25°C. White to brown color colony growth with diffusible brown pigment was seen after 2 weeks of incubation. X-rays indicated no bony involvement. Ultrasonographic study of lesions was suggestive of mycetoma. Patient was treated with itraconazole 400 mg/day for 4 days in the hospital and discharged subsequently. Discussion The foot is commonly involved in those with outdoor occupations. The combination of the clinical specific lesions, typical grains, microscopy, and histopathological studies are characteristic of the diagnosis. Radiodiagnosis is useful to determine the extension of the lesions in bone and other tissues. Combined medical and surgical treatment is recommended. Amputation is indicated in advanced mycetoma not responding to medical treatment with a severe secondary bacterial infection. Conclusion We hope to spread awareness regarding fungal eumycetoma due to Madurella spp, an endemic but neglected tropical disease in Western Rajasthan. Clinical suspicion coupled to direct KOH microscopy, fungal culture, and histopathology can yield a definitive diagnosis. Commencement of medical and/or surgical treatment at an early stage is necessary to prevent complications.