Alcohol abuse is associated with both potentiating and antagonizing hemostatic states. Liver cirrhosis is an independent causal factor for many bleeding complications. The long-term effects of alcohol abuse coupled with advanced liver cirrhosis are additive in favor of bleeding. We report the case of a patient with a history of alcohol abuse who presented with liver cirrhosis and nontraumatic muscle hematoma diagnosed as a spontaneous hematoma of the gastrocnemius muscle. He was managed conservatively with infusions of fresh frozen plasma and platelets, which resulted in resolution of the hematoma. The pathogenesis of ‘spontaneous' muscle hematoma remains anecdotal, but since it is reported in patients on anticoagulant therapy or with hemostatic disorders, it is hypothetically related to severely deranged coagulation. Here we review the relevant literature pertaining to the pathogenesis, presentation and treatment options available for treating this often fatal complication of bleeding diatheses.

A primary cardiac angiosarcoma is a rare type of soft-tissue sarcoma with a high mortality rate. This report describes a young woman who presented with chest pain and worsening shortness of breath over the course of a year. She was diagnosed with and treated for latent tuberculosis and autoimmune pericarditis over the last year, however, her condition kept worsening. Further workup revealed a large pericardial and right atrial mass associated with multiple lung nodules. The biopsy from the lung mass showed angiosarcoma, and she was diagnosed with primary metastatic angiosarcoma of the pericardium. She was treated with doxorubicin and Ifosfamide (AIM-75 regimen), which led to a partial response. However, soon after completion of six cycles, the tumour progressed rapidly, leading to cardio-respiratory failure. In this report, we will discuss the clinical challenges and treatment options (surgical and medical) that are available for treating patients with angiosarcoma of the heart.

Interaction of plant growth promoting microorganisms (PGPMs) with plants involves interplay at physical, physiological and molecular levels. Proliferation and root colonization of PGPMs manipulate the rhizosphere to optimize plant functions. This benefits plant by nutrient enrichment and induction of plant vigor and defense system. The present work aims to decipher the rhizosphere modulations promoted under different fertilization regimes by an organic acid producing Trichoderma koningiopsis strain (NBRI-PR5). Chickpea was selected as the host plant for the study since it responds well to the application of in/organic fertilizers and PGPMs. Microbial communities associated with the rhizosphere were studied by determining culturable population of heterogeneous microflora, and rhizosphere functions were studied by determining the soil enzyme activities and HPLC profiles of organic acids in root exudates. Application of NBRI-PR5 induced changes in rhizosphere in consent with the amendments. The changes observed in microbial populations were found to be associated with the rhizosphere enzymes. The inhibitory effect of chemical fertilizers on rhizosphere microflora was evident from least bacterial CFU observed in the NPK treatments. No detection of alkaline phosphatase enzyme in all the treatments with NBRI-PR5, with organic or inorganic amendments evidently represents the acidified rhizosphere. Similarly, an opposite trend in DHA and protease enzyme activities in the rhizosphere of FYM and FYM+PR5 treated plants showed that NBRI-PR5 had reframed microbial activities to facilitate nutrient uptake in plants rather than fix in the microbes. It is concluded from the study that NBRI-PR5 fatefully modulates rhizosphere activities, specific to different fertilization regimes by varying the enzyme activities to maximize the utilization of available nutrients.

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Background: Upfront docetaxel (UD) with androgen deprivation therapy (ADT) has been demonstrated to improve survival outcomes in metastatic castration-sensitive prostate cancer (mCSPC). However, existing studies have included predominantly Caucasian patients. Study Question: To compare the efficacy of addition of UD to ADT in mCSPC to ADT alone among minority patients. Study Design: Retrospective study of mCSPC patients. Measures and Outcomes: Patients treated with UD and ADT between January 2014 and December 2017 (UD + ADT, n = 44) were compared with those treated with ADT alone between January 2008 and January 2017 (ADT, n = 38); patients of Caucasian ethnicity were excluded. The outcome of interest was progression-free survival (PFS), which was estimated using Kaplan–Meier analysis and Cox proportional hazard analysis. Results: Overall, 63 (76.8%) patients were African American and 16 (19.5%) were Hispanic. Fifty-five (67%) patients had high-volume mCSPC. The median follow-up was 14 months [95% confidence interval (CI): 10.4–16.5] for UD + ADT and 42 months (95% CI: 17–66.9) for ADT. Median PFS did not differ between groups: UD + ADT: 16 versus ADT: 18 months [hazard ratio (HR) for UD + ADT = 0.88, 95% CI: 0.48–1.62; P = 0.70]. In patients with high-volume disease, median PFS remained similar (UD + ADT: 16 vs. ADT: 14 months (HR for UD + ADT = 0.64, 95% CI: 0.33–1.25; P = 0.19). On multivariable analysis, prolonged time to nadir PSA, HR = 0.83 (95% CI: 0.76–0.90), was independently associated with PFS. The most common toxicities in UD + ADT were anemia and fatigue. Major limitations include small sample size and potential for selection bias due to the retrospective study design. Conclusions: In this retrospective review of a minority mCSPC cohort, UD + ADT was not associated with improved PFS compared with ADT alone. Although further study with larger sample size is needed, these results underscore the importance of ensuring accrual of minorities in clinical trials, reflective of the real-world setting.

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Endophytes are plant inhabitants acting as its extended genome. The present study highlights the importance of maintaining plant endophytes for sustainable disease resistance in plants.

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