Oral actinomycosis in Crohn’s disease patient: a case report

Case Study

Abstract

Patients with Crohn’s disease may present with lesions in their oral cavity. Oral lesions may be associated with the disease itself representing an extraintestinal manifestation, with nutritional deficiencies or with complications from therapy including infections. Actinomycosis is a slowly progressive bacterial infection caused by Actinomyces spp., anaerobic Gram-positive bacteria. These organisms are normal inhabitants of mucous membranes, especially of the oropharynx, and cause opportunistic infections. We report a case of a 30-year-old male with Crohn’s disease presenting with painful oral aphthous ulcers and swelling of the upper lip. A diagnosis of oral actinomycosis was confirmed by histopathological examination. The patient was treated with infliximab and a regimen of amoxicillin 1 g three times a day. He had a marked response to the treatment after 2 weeks. The plan was to continue amoxicillin for at least 6 months with regular follow-up. Physicians should be aware that actinomycosis may be a cause of oral lesions in Crohn’s disease patient, particularly in immunosuppressed patient. Bacterial cultures and pathology are the cornerstones of diagnosis and should be performed in suspected cases to prevent misdiagnosis.

Graphical abstract

Development of the optimal procedure for increasing HbA1c concentration in control materials for external quality assessment

Original Research

Abstract

Background: The research aimed to increase certain HbA1c concentrations at medical decision levels for external quality control samples from healthy donor blood.

Methods: The in vitro study was performed from October 2019 to January 2021 at Quality Control Center for Medical Laboratory at University of Medicine and Pharmacy at Ho Chi Minh City. The study observed on the conditions including the optimal buffer solutions (BAGPM, BPS, Ringer, Saline), temperature (2ºC - 8ºC, 22ºC - 24ºC, 37ºC), and glucose concentration (100 mM, 305 mM, 500 mM) affecting the HbA1c concentration in vitro to make the external quality control samples fell in normal, prediabetes, and diabetes range. At every condition, the HbA1c concentration was measured by Tina Quant method to look for the optimal procedure to increase HbA1c concentration required of the external quality control protocol.

Results: The highest HbA1c concentration (11.57±0.2%) was found in BAGPM solution with 100 mM glucose after 15 days with the baseline HbA1c 5.43±0.13%; the HbA1c level increase dramatically at 37ºC in BAGPM 500 mM glucose solution in fifteen days (40.03±1.05%).

Conclusions: The appropriate conditions were identified to prepare HbA1c standards for prediabetic and diabetic levels. The standards for HbA1c concentrations were recommended to prepare by incubating RBCs from non-diabetic donor blood in BAGPM solution containing glucose at 37ºC for 24 hours. Glucose concentrations should be 100 mM and 500 mM, respectively, for prediabetic level (HbA1c ~ 6.0 ± 0.12%) and diabetic level (HbA1c ~ 9.6 ± 0.17%).

Graphical abstract

Phytochemical compounds of Morus alba as anti-aging agent towards in silico binding to matrix metalloproteinase proteins

Original Research

Abstract

Skin aging is a natural phenomenon which is related to progressive loss of skin structural integrity and physiological function and affects aesthetics which has been of highly interest. Inhibition of matrix metalloproteinases (MMPs) such as MMP-1, MMP-3, MMP-9 is one of the potential approaches for anti-aging treatment as these targets are involved in molecular pathology to skin aging process from sunlight. The aim of the study was to investigate the binding affinity of 9 phytochemical compounds extracted from Morus alba Moraceae into the MMP enzymes leading to potential anti-aging activity by using in silico approaches including molecular docking and molecular dynamics simulations. All the compounds showed binding abilities into the targets. In particular, mulberrofuran H obtained the best docking results on the three MMPs. Molecular dynamics simulations of the complex of  mulberrofuran H and MMP-9 showed that this complex was stable. Combination of molecular docking and molecular dynamics simulations results, there was an important hydrophobic interaction between mulberrofuran H and His401 at the active site of the MMP-9, which determined the MMP-9 inhibitory potential of mulberrofuran H. The ligand mulberrofuran H was also stabilized into the MMP-9 protein by hydrogen bonds with Pro421 with the high occupancy of 77.67%. These results demonstrated the good binding of mulberrofuran H on the protein MMP-9 which highlighted its anti-aging potency.

Graphical abstract

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