International Journal of Medical Sciences and Education (IJMSE)
Vol. 9 Issue: 1 (Jan -Dec. 2022), Date of Publication: 01.01.2023

1.ASSESSMENT OF BACTERIAL DIVERSITY ASSOCIATED WITH ATHEROSCLEROTIC PLAQUE IN STROKE
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Lokendra Bahadur Yadav, Atulabh Vajpeyee, Manisha Vajpeyee, Shivam Tiwari                   PDF FULL TEXT

ABSTRACT

Background:We aimed to investigate the microbial features of cerebral thrombi retrieved via Mechanical thrombectomy in stroke patients. The microbial compositions of all samples were compared using 16S rRNA gene amplicon next-generation sequencing.Materials and Methods: Enrollment of 18 Acute ischemic stroke (AIS) patients was done who underwent mechanical thrombectomy in which 12(66.66%) male and 33.3% (n=6) female. The patients' median age was 51±14.6 years old, and they were male and female. During the window of acute stroke with symptomatic carotid stenosis and blockage of the ipsilateral middle cerebral artery, all were submitted to mechanical thrombectomy. After mechanical thrombectomy we extracted the DNA from thrombus sample. Results:All of the thrombi retrieved for bacterial DNA in qPCR from the18 patients who had thrombectomy for ischemic stroke were positive. We discovered more than 25 bacteria in plaque that included Pseudomonas putida, Staphylococcus epidermidis, Staphylococcus hominis, and Finegoldia magna and other. Additionally, members of the genera Propionibacterium and the unclassified Burkholderiales were frequently the most important taxa for all atherosclerotic plaque. Conclusion:Large bacterial diversity was found in thrombus in ischemic stroke patients in this study, which also indicated that microbes present in thrombus also played role in formation of plaque and Bacteria have direct mechanisms such as acidification and local inflammation of the plaque milieu with lactobacillus, biofilm dispersion leading to inflammation with pseudomonas fluorescence, the gut microbiota, could all lead to thromboembolic and cause stroke.
Keywords: Stroke, Mechanical Thrombectomy, Thrombus, Microbiome, MetagenomicsKeyword: Postoperative analgesia patient-controlled epidural analgesia patient-controlled intravenous analgesia.

2.   PREDICTIVE ROLE OF CELL FREE DNA AND HS-CRP AS A BLOOD BIOMARKER IN ACUTE ISCHEMIC STROKE PATIENTS                                                                                                                                            7-10

    Shivam Tiwari, Atulabh Vajpeyee, Manisha Vajpeyee, Lokendra Bahadur Yadav                 PDF FULL TEXT

ABSTRACT

Background: Stroke being an important health issue, several blood biomarkers of stroke are being evaluated. High sensitivity C-reactive protein (hsCRP), an indicator of inflammation and cell free- DNA (cf-DNA) released from damaged neurons in stroke patients can be helpful to assess stroke prognosis. We planned to assess the role of. Cell free DNA (cf-DNA) and High sensitivity CRP.  Previous studies showed that C-reactive protein (CRP), an inflammatory marker, was associated with stroke severity and long-term outcome. Material & Methods: This study comprised of 154 acute ischemic stroke patients. The plasma (cf-DNA level) was estimated with real-time PCR assay for the β-globin gene (Qiagen- Roter- Gene Q MDX, Germany), while hsCRP was measured by immunoturbidimetric method (Roche Cobas C311, Fully automatic). The clinical assessment was done with National Institutes of Health Stroke Scale (NIHSS) at the time of admission. After a period of three months from the onset of stroke, the modified Rankin scale (MRS) scores were estimated. Results: Elevated levels of cf-DNA and hsCRP were found in patients with higher NIHSS admission score and MRS 3-month scores (p<0.05).  Favorable stroke outcome was consistent with cf-DNA level <10000 kilogenome-equivalents/L or hsCRP <6mg/L (p<0.05). Conclusion: The estimation of Cf-DNA and hsCRP can contribute to the clinical evaluation and optimal management of ischemic stroke patients.
Keywords: Cell-Free DNA, hsCRP, Modified Rankin Scale, Acute Ischemic Stroke, Prognosis.