Clinical Profile and Outcome of Children Admitted with Multisystem Inflammatory Syndrome (MIS-C) in a Tertiary Hospital

Background Most children infected with SARS-CoV-2 infection, are asymptomatic or develops mild to moderate symptoms. Few weeks later, few children develops delayed hyper inflammatory syndrome known as Multisystem inflammatory syndrome in children (MIS-C). Objective To describe various demographic features of children with Multisystem inflammatory syndrome in children. To analyze common clinical presentation, clinical and laboratory markers of severity and outcome of children with Multisystem inflammatory syndrome. Method This study was prospective observational study conducted on children with Multisystem inflammatory syndrome in children. This was conducted in Department of Pediatrics of Nobel Medical College during 12 months period from July 2021 to June 2022. Basic demographic features, common clinical presentation in children with Multisystem inflammatory syndrome in children and its severity and outcome were analyzed. Independent sample t-test and chi square test was used for comparison of means and categorical variables. Logistic regression was done to assess the relationship between clinical variables and outcome. Result A total of 36 children were included in our study. Maximum number of cases were male (61.11%) and age group > 10 years (58.33%). Fever, gastrointestinal symptoms, shock and renal dysfunction were common clinical features. Children requiring mechanical ventilation had higher C-reactive protein (CRP), lower platelets, higher d-Dimer and lower ejection fraction. Vasoactive Inotropic score (VIS > 10) was associated with higher chances of mechanical ventilation and prolonged pediatric intensive care unit (PICU) stay. Mortality rate in our study was 5.55% and three children developed coronary aneurysm.

Valley-Tunable Even-Denominator Fractional Quantum Hall State in the Lowest Landau Level of an Anisotropic System

Fractional quantum Hall states (FQHSs) at even-denominator Landau level filling factors (ν) are of prime interest as they are predicted to host exotic, topological states of matter. We report here the observation of a FQHS at ν=1/2 in a two-dimensional electron system of exceptionally high quality, confined to a wide AlAs quantum well, where the electrons can occupy multiple conduction-band valleys with an anisotropic effective mass. The anisotropy and multivalley degree of freedom offer an unprecedented tunability of the ν=1/2 FQHS as we can control both the valley occupancy via the application of in-plane strain, and the ratio between the strengths of the short- and long-range Coulomb interaction by tilting the sample in the magnetic field to change the electron charge distribution. Thanks to this tunability, we observe phase transitions from a compressible Fermi liquid to an incompressible FQHS and then to an insulating phase as a function of tilt angle. We find that this evolution and the energy gap of the ν=1/2 FQHS depend strongly on valley occupancy.

Polymeric prosthetic heart valves: A review of current technologies and future directions

Valvular heart disease is an important source of cardiovascular morbidity and mortality. Current prosthetic valve replacement options, such as bioprosthetic and mechanical heart valves are limited by structural valve degeneration requiring reoperation or the need for lifelong anticoagulation. Several new polymer technologies have been developed in recent years in the hope of creating an ideal polymeric heart valve substitute that overcomes these limitations. These compounds and valve devices are in various stages of research and development and have unique strengths and limitations inherent to their properties. This review summarizes the current literature available for the latest polymer heart valve technologies and compares important characteristics necessary for a successful valve replacement therapy, including hydrodynamic performance, thrombogenicity, hemocompatibility, long-term durability, calcification, and transcatheter application. The latter portion of this review summarizes the currently available clinical outcomes data regarding polymeric heart valves and discusses future directions of research.

Differential expression of inflammatory cytokines, prostaglandin synthases and secretory leukocyte protease inhibitor in the endometrium and circulation in different graded CEH-pyometra in bitch

Cystic endometrial hyperplasia (CEH)-pyometra (CEH-P) is one of the most common reproductive disorders in bitches, posing a risk to both future fertility and life. The aims of the current study were to elucidate the differential expression patterns of inflammatory mediators at transcript and protein levels in the endometrium and to assess the concentrations of key inflammatory mediators in the peripheral circulation of bitches with different graded CEH-P. A total of 25 client-owned intact mixed breed bitches of 3-10 years presented to the outpatient department of RVP-TVCC of the institute were considered for the study. Of which, 22 cases suggestive of pyometra and 3 cases of CEH obtained during routine elective ovariohysterectomy were subjected to histopathological examination. Uteri were categorized into CEH (n = 3), moderate CEH-P (mCEH-P, n = 9), severe CEH-P (sCEH-P, n = 6) and atrophic pyometra (AT-P, n = 7). A group of age matched (n = 12) bitches without pyometra served as control. Endometrial transcripts such as IL6, IL8, PTGS2, PGFS, and SLPI were expressed differentially in the CEH and CEH-P bitch. In addition, a strong immunoreactivity (IR) of IL6, IL8, PTGS2, and mPGES1 was recorded in the sCEH-P uterus, while expression of IL10 was noticed in AT-P. In circulation, serum IL6 was the most relevant marker with high sensitivity of 96.2% and specificity of 84.6% at a cut off concentration 8.5 pg/mL followed by SLPI with 95.2% sensitivity, and 84.6% specificity at cut off concentration of 1.3 ng/mL. Serum IL10, PGFM and SLPI concentration in the peripheral circulation were 1.5-2.23 fold higher in mCEH-P, 0.87-2.5 fold higher in sCEH-P and 2.9-3.5 fold higher in AT-P than that of control. It is concluded that monitoring the serum concentration of IL6, IL10 and SLPI would be useful adjunct to the established hematobiochemical parameters in the management of pyometra in the bitch with critical illness.

Nature, pattern, and changes in alcohol consumption among men in India: Insights from NFHS-4 and NFHS-5

The consumption pattern of alcohol varies between cultures and different communities. Moreover, alcohol consumption pattern depends on age, religion, education, type of drink, and other socio-economic parameters. Alcohol use has reportedly declined in most developed counties, but developing countries still witnessed an increasing trend. The study investigated socio-economic drivers, nature, and patterns of alcohol use among adult men in India. We have also investigated the state-level alcohol prevalence in India better to understand the impact of state-level alcohol prohibition policies. We have retrieved the data from the National Family Health survey's fourth and fifth-round, which was conducted in 2015-2016 and 2020-2021, respectively. We used the bi-variate technique to estimate that percentage of men who consume alcohol. Furthermore, a multivariate logistic regression model was applied to assess the association of each background characteristic with alcohol consumption. It is observed that 19 percent of men aged 15 and above currently drink alcohol, including 20 percent in rural and 17 percent in urban areas. The consumption of tadi/madi/country liquor/homemade liquor was high in rural areas than in urban areas in both rounds of the survey. Additionally, beer or wine consumption is higher in urban areas than in rural areas in NFHS-4 and NFHS-5. Among the 35-49 years of age group, around 6 and 8 times more likely to consume alcohol in NFHS-4 and NFHS-5, respectively. Rural men were 18 and one percent less likely to consume alcohol in NFHS-4 & 5 compared to urban (OR: 0.82 and 0.99 in NFHS-4 & 5 respectively). Despite an overall reduction in alcohol consumption among men, lowering alcohol consumption remains the main priority of policymakers. There is a need to target the most vulnerable socio-economic segments where alcohol consumption is still a problem, one of the primary reasons for violence against women.

Quantifying the burden of Hypercholesterolemia among Adolescents in India

 

Hypercholesterolemia is a kind of hyperlipidemia in which an individual's blood contains excessive non-high-density lipoprotein (non-HDL) cholesterol and low-density lipoprotein (LDL) cholesterol, which has emerged as a significant covariate of coronary heart disease. Descriptive, bivariate and multivariable regression analyses were used to unearth the current hypercholesterolemia levels, probable risk factors, and its impact on other metabolic diseases among adolescents using data on 35,830 adolescents aged 10-19 years from the Comprehensive National Nutrition Survey, India, 2016-18. Findings suggest that the mean lipid levels for total cholesterol, LDL, HDL, and triglycerides were 140.6, 84.1, 47.3, and 95.3, respectively, with females bearing the higher burden. The study further identified early adolescents, urban residents, and overweight individuals at a higher risk of having elevated non-HDL. Western and Eastern regions bore higher LDL levels. Further, for a unit increase in TSFT risk of having high LDL increased by 2.55 times. Zinc deficits are at 2.13 times higher risk compared to zinc sufficient. Adolescents consuming unhealthy diets were at higher risk of elevated LDL. The study contends that it is essential to prevent the increasing levels of lipid profiles among Indian adolescents. Vitamin and mineral deficiencies and unhealthy dietary habits are significantly associated with high LDL and non-HDL levels. In the longer run, this might cause the early onset of complex cardiometabolic disorders, which would disrupt the individual's social and economic well-being. Hence, appropriate interventions are needed to curtail these early onsets by primarily focusing on adolescents.

Key messages

Even-Denominator Fractional Quantum Hall State at Filling Factor ν=3/4

Fractional quantum Hall states (FQHSs) exemplify exotic phases of low-disorder two-dimensional (2D) electron systems when electron-electron interaction dominates over the thermal and kinetic energies. Particularly intriguing among the FQHSs are those observed at even-denominator Landau level filling factors, as their quasiparticles are generally believed to obey non-Abelian statistics and be of potential use in topological quantum computing. Such states, however, are very rare and fragile, and are typically observed in the excited Landau level of 2D electron systems with the lowest amount of disorder. Here we report the observation of a new and unexpected even-denominator FQHS at filling factor ν=3/4 in a GaAs 2D hole system with an exceptionally high quality (mobility). Our magnetotransport measurements reveal a strong minimum in the longitudinal resistance at ν=3/4, accompanied by a developing Hall plateau centered at (h/e^{2})/(3/4). This even-denominator FQHS is very unusual as it is observed in the lowest Landau level and in a 2D hole system. While its origin is unclear, it is likely a non-Abelian state, emerging from the residual interaction between composite fermions.

Groundwater quality assessment and modeling utilizing water quality index and GIS in Kabul Basin, Afghanistan

Groundwater stands as a unique source of water supply in Kabul city, Afghanistan. In this investigation, 35 samples of groundwater were comprehensively analyzed to determine its hydrogeochemical characterizations, quality, water types, and its acceptability as drinking sources. A portable digital multiparameter instrument (LAB MAN Scientific instrument) was used to measure the total dissolved solids (TDS), hydrogen potential (pH), and electrical conductivity (EC). Total hardness, chloride, and bicarbonate were examined via a titrimetric approach. Sodium, calcium, magnesium, and potassium concentrations were measured with a flame photometer. Fluoride was determined by using a digital portable multiparameter. UV-VIS spectrophotometers were employed to count sulfate and nitrate concentrations. The distribution pattern of measured parameters and the Water Quality Index (WQI) in groundwater were spatially modeled utilizing the ArcGIS tool. The findings provide insight into the main anions and cations, which are found in ascending sequence F < NO₃ < SO₄ < Cl < HCO₃ and K < Ca < Na < Mg, respectively. Based on the measurements of ion concentrations, bicarbonate (71.4%), chloride (14.28%), nitrate (2.85%), magnesium (80%), sodium (82.85%), calcium (5.71%), and potassium (17.14%) were all determined to be over the World Health Organization (WHO) limits of drinking water. Using the Piper trilinear diagram, two significant hydrochemical facies (CaNaHCO₃ and NaHCO₃) were discovered. Based on the mathematical model of WQI outputs, 88.57% of the research region has excellent to good water, whereas 11.43% has poor to very poor water.

Fungal Planet description sheets: 1383-1435

Novel species of fungi described in this study include those from various countries as follows: Australia, Agaricus albofoetidus, Agaricus aureoelephanti and Agaricus parviumbrus on soil, Fusarium ramsdenii from stem cankers of Araucaria cunninghamii, Keissleriella sporoboli from stem of Sporobolus natalensis, Leptosphaerulina queenslandica and Pestalotiopsis chiaroscuro from leaves of Sporobolus natalensis, Serendipita petricolae as endophyte from roots of Eriochilus petricola, Stagonospora tauntonensis from stem of Sporobolus natalensis, Teratosphaeria carnegiei from leaves of Eucalyptus grandis × E. camaldulensis and Wongia ficherai from roots of Eragrostis curvula. Canada, Lulworthia fundyensis from intertidal wood and Newbrunswickomyces abietophilus (incl. Newbrunswickomyces gen. nov.) on buds of Abies balsamea. Czech Republic, Geosmithia funiculosa from a bark beetle gallery on Ulmus minor and Neoherpotrichiella juglandicola (incl. Neoherpotrichiella gen. nov.) from wood of Juglans regia. France, Aspergillus rouenensis and Neoacrodontium gallica (incl. Neoacrodontium gen. nov.) from bore dust of Xestobium rufovillosum feeding on Quercus wood, Endoradiciella communis (incl. Endoradiciella gen. nov.) endophytic in roots of Microthlaspi perfoliatum and Entoloma simulans on soil. India, Amanita konajensis on soil and Keithomyces indicus from soil. Israel, Microascus rothbergiorum from Stylophora pistillata. Italy, Calonarius ligusticus on soil. Netherlands, Appendopyricularia juncicola (incl. Appendopyricularia gen. nov.), Eriospora juncicola and Tetraploa juncicola on dead culms of Juncus effusus, Gonatophragmium physciae on Physcia caesia and Paracosmospora physciae (incl. Paracosmospora gen. nov.) on Physcia tenella, Myrmecridium phragmitigenum on dead culm of Phragmites australis, Neochalara lolae on stems of Pteridium aquilinum, Niesslia nieuwwulvenica on dead culm of undetermined Poaceae, Nothodevriesia narthecii (incl. Nothodevriesia gen. nov.) on dead leaves of Narthecium ossifragum and Parastenospora pini (incl. Parastenospora gen. nov.) on dead twigs of Pinus sylvestris. Norway, Verticillium bjoernoeyanum from sand grains attached to a piece of driftwood on a sandy beach. Portugal, Collybiopsis cimrmanii on the base of living Quercus ilex and amongst dead leaves of Laurus and herbs. South Africa, Paraproliferophorum hyphaenes (incl. Paraproliferophorum gen. nov.) on living leaves of Hyphaene sp. and Saccothecium widdringtoniae on twigs of Widdringtonia wallichii. Spain, Cortinarius dryosalor on soil, Cyphellophora endoradicis endophytic in roots of Microthlaspi perfoliatum, Geoglossum lauri-silvae on soil, Leptographium gemmatum from fluvial sediments, Physalacria auricularioides from a dead twig of Castanea sativa, Terfezia bertae and Tuber davidlopezii in soil. Sweden, Alpova larskersii, Inocybe alpestris and Inocybe boreogodeyi on soil. Thailand, Russula banwatchanensis, Russula purpureoviridis and Russula lilacina on soil. Ukraine, Nectriella adonidis on overwintered stems of Adonis vernalis. USA, Microcyclus jacquiniae from living leaves of Jacquinia keyensis and Penicillium neoherquei from a minute mushroom sporocarp. Morphological and culture characteristics are supported by DNA barcodes. Citation: Crous PW, Boers J, Holdom D, et al. 2022. Fungal Planet description sheets: 1383-1435. Persoonia 48: 261-371. https://doi.org/10.3767/persoonia.2022.48.08.

Hydrogen sulphide ameliorates hexavalent chromium toxicity in two cereal crops: Role of antioxidant enzymes and proline metabolism

Chromium pollution in soils is a major threat as it reduces crop yields. Hence, researchers seek methods/strategies which could curtail such losses. We report the role of H₂ S in alleviating hexavalent chromium [Cr(VI)] stress in two cereals crops, i.e. wheat and rice seedlings, by estimating various physiological attributes. Cr(VI) reduced shoot and root length in both cereals through increased accumulation of Cr(VI) in root tips and increased in oxidative stress markers, i.e. superoxide radicals (SOR), H₂ O₂ and lipid peroxidation (as MDA equivalent). Supplementation with H₂ S alleviated Cr(VI) toxicity in both cereal crops. Application of H₂ S increased tolerance to Cr(VI) stress by protecting photosynthesis and enhancing activity of antioxidant enzymes, particularly glutathione-S-transferase and content of proline. Rice was more resistant to Cr(VI) than wheat seedlings.

Prospecting potential of endophytes for modulation of biosynthesis of therapeutic bioactive secondary metabolites and plant growth promotion of medicinal and aromatic plants

Medicinal and aromatic plants possess pharmacological properties (antidiabetes, anticancer, antihypertension, anticardiovascular, antileprosy, etc.) because of their potential to synthesize a wide range of therapeutic bioactive secondary metabolites. The concentration of bioactive secondry metabolites depends on plant species, local environment, soil type and internal microbiome. The internal microbiome of medicinal plants plays the crucial role in the production of bioactive secondary metabolites, namely alkaloids, steroids, terpenoids, peptides, polyketones, flavonoids, quinols and phenols. In this review, the host specific secondry metabolites produced by endophytes, their therapeutic properties and host-endophytes interaction in relation to production of bioactive secondry metaboloites and the role of endophytes in enhancing the production of bioactive secondry metabolites is discussed. How biological nitrogen fixation, phosphorus solubilization, micronutrient uptake, phytohormone production, disease suppression, etc. can play a vital role in enhacing the plant growth and development.The role of endophytes in enhancing the plant growth and content of bioactive secondary metabolites in medicinal and aromatic plants in a sustainable mode is highlighted.

Impact of Venoarterial Extracorporeal Membrane Oxygenation Flow on Outcomes in Cardiogenic Shock

Venoarterial extracorporeal membrane oxygenation (VA ECMO) is used to provide cardiopulmonary support in cardiogenic shock; however, high extracorporeal flow may increase left ventricular (LV) afterload leading to LV distention and intracardiac stasis. It is unclear how ECMO flow affects patient outcomes and complications related to ECMO. Retrospective review of patients at a single institution placed on VA ECMO from 2007 to 2018 was performed. Patients were divided into full flow (flow index > 2.2 L/min/m2) and partial flow (flow index < 2.2 L/min/m2) groups. In-hospital mortality and markers of end-organ perfusion were compared between groups balanced for risk factors using propensity score inverse probability of treatment weighting. ECMO-related complications such as LV distention, limb ischemia, and bleeding were recorded. There were 488 patients included, 405 (83%) in the partial flow group, and 83 (17%) in the full flow group. No major differences in age, gender, or comorbidities were found. There was no difference in in-hospital mortality between groups (51% vs. 55%, p = 0.59). At 72 hours post-ECMO initiation, there was no difference in the change in renal, hepatic function, or lactate from baseline nor in the rates of continuous venoveno hemofiltration initiation (p = 0.41). There was a trend towards the decreased incidence of LV distention requiring LV vent placement in the partial flow group (12% vs. 7%, p = 0.16). Compared with full flow VA ECMO, partial flow VA ECMO in carefully selected patients results in similar in-hospital mortality and provides similar end-organ perfusion for the treatment of refractory cardiogenic shock.

MN/CA9 gene expression as a potential tumor marker for renal cell carcinoma

MN/CA9 is a cell surface glycoprotein and a tumor-associated antigen. It plays a crucial role in the regulation of cell proliferation and oncogenesis. There is no ideal tumor marker currently available for renal cell carcinoma (RCC) with sufficient sensitivity and specificity. Therefore, we studied MN/CA9 gene expression in the tumor tissue, apparently normal kidney tissue, preoperative blood, and urine samples of patients with RCC. We included thirty cases of renal tumors (26 RCC and 4 benign tumors) in the study. We applied an RT-PCR assay for MN/CA9 gene expression to 26 RCC kidney tumor samples and four benign kidney tumor tissue samples. We also evaluated MN/CA9 gene expression in preoperative blood and urine samples of 15 of these cases. Additionally, thirty-five grossly normal renal tissue samples, including 21 from kidneys with RCC, were also evaluated for gene expression. The RT-PCR analysis revealed that twenty-one out of 26 RCC tissue samples showed MN/CA9 gene expression compared to three out of 35 non-malignant renal tissue samples (p < 0.05). Two out of four benign renal tissue samples also expressed this gene. We also observed MN/CA9 gene expression in nine out of 15 blood samples and four out of 15 urine samples. All patients with urinary MN/CA9 gene expression showed expression in blood and tumor tissue samples. We found a correlation in terms of MN/CA9 expression between blood and tumor tissue samples of RCC patients as those who exhibit MN/CA9 expression in blood were also positive at the tumor tissue levels. The difference in MN/CA9 gene expression in tumor tissue, blood, and urine samples in relation to the stage of the disease, nuclear grade, and histological cell-type was not statistically significant. However, all the three patients who had metastatic RCC had MN/CA9 gene expression in their blood. The existence of a tumor-associated antigen such as MN/CA9 may present a possible target for molecular diagnosis and management of RCC.

An evaluation of remineralised MIH using CPP-ACP and fluoride varnish: An in-situ and in-vitro study

BACKGROUND

Molar incisor hypomineralization (MIH) affected teeth have enamel with altered mineral content like decreased calcium and phosphorus and increased carbon content leading to porous enamel and subsequent post-eruptive breakdown.

AIM

An in situ study was conducted to evaluate and compare the effects of a Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP)-based cream and fluoride varnish on the remineralization of MIH affected teeth.

METHODS

Enamel slabs were prepared from MIH affected teeth that had been extracted for various reasons and inserted in appliances of 30 participants who were undergoing interceptive orthodontic therapy. They were randomly divided into two groups using block randomization technique: Group A-daily single application of CPP-ACP cream (n = 15); Group B-professional application of fluoride varnishes every 3 months (n = 15). After 6 months of regular wear of the appliance, the enamel slabs were placed under Field Emission Scanning Microscope (FESEM) and Energy-Dispersive Spectroscopy (EDS) for evaluation of ultra structure and mineral content, respectively.

RESULTS

A significant increase in calcium and phosphorus content, and a decrease in carbon content was observed within the 6 months period, suggesting remineralization in both the groups. On comparing the Ca:P and Ca:C ratios, a significant increase in the Ca:C ratio was evident in the two groups. No significant difference was seen in the Ca:P ratio in the CPP-ACP group at six months. The inter-group comparison did not reveal any significant difference between the two groups either at baseline or at 6 months post-intervention.

CONCLUSION

Remineralization can be achieved in MIH affected teeth with the use of remineralizing agents.

Full coverage crowns for rehabilitation of MIH affected molars: 24 month randomized clinical trial

BACKGROUND

Teeth affected with severe molar incisor hypomineralization (MIH) require extensive restorations, which do not last for a long time and often require treatment in the form of onlays or full coverage restorations.

AIM

To evaluate and compare the clinical performance of zirconia, lithium disilicate, and cast metal crowns as full-coverage restorations on MIH-affected first permanent molars (FPMs).

METHODS

60 MIH affected FPMs requiring full-coverage crowns were identified in children aged 8-15 years and were randomly allocated to the three treatment groups according to the type of full coverage restoration received using block randomization technique. After an adequate removal of the MIH defect and restoration with composite resin, the tooth preparation was done followed by fabrication of crown and its cementation using resin cement. The intergroup comparison was done on the basis of USPHS criteria, gingival, plaque scores, patient and parents acceptance through a visual analog scale to decipher their clinical performance at 6, 12, 24 months.

RESULTS

After 24 months, the crowns showed similar clinical success in terms of the criterias used to compare their clinical performance. The retention, marginal adaptation, relief from hypersensitivity, proximal contact, gingival health with no statistically significant difference among the three groups.

CONCLUSION

Based on the observations, Lithium disilicate, Zirconia and full cast metal crowns showed similar clinical success in rehabilitation of First permanent molars with severe MIH over 24 months of evaluation. The clinical success is not influenced by the material of the restoration. However, prospective studies with a longer follow-up are required to reach a more definitive conclusion.

Free-roaming dog population dynamics in Ranchi, India

Rabies causes approximately 20,000 human deaths in India each year. Nearly all of these occur following dog bites. Large-scale, high-coverage dog rabies vaccination campaigns are the cornerstone of rabies elimination strategies in both human and dog populations, although this is particularly challenging to achieve in India as a large proportion of the dog population are free-roaming and unowned. Further, little is known about free-roaming dog ecology in India which makes defining optimum vaccination strategies difficult. In this study, data collected using a mobile phone application during three annual mass vaccination and neutering (surgical sterilisation of both males and females) campaigns of free-roaming dogs in Ranchi, India (during which a total of 43,847 vaccinations, 26,213 neuter surgeries and 28,172 re-sight observations were made) were interrogated, using two novel approaches to estimate the proportion of neutered dogs that were lost from the city (assumed due to mortality or migration) between campaign years. Analysis revealed high losses of neutered dogs each year, ranging from 25.3% (28.2-22.8) to 55.8% (57.0-54.6). We also estimated that the total population declined by 12.58% (9.89-15.03) over the three-year period. This demonstrates that there is a high turnover of free-roaming dogs and that despite neutering a large number of dogs in an annual sterilisation campaign, the decline in population size was modest over a three-year time period. These findings have significant implications for the planning of rabies vaccination campaigns and population management programmes as well as highlighting the need for further research into the demographics of free-roaming, unowned dogs in India.

The effects of probiotic Lactobacillus acidophilus and/or prebiotic mannan oligosaccharides on growth performance, nutrient utilization, blood metabolites, faecal bacteria, and economics of crossbred calves

Background

The ban on antibiotics as growth promoters paved the way for probiotics and prebiotics as growth promoters in animal production.

Aims

The present study was conducted to evaluate the effect of probiotic Lactobacillus acidophilus and/or prebiotic Mannan oligosaccharides on growth performance, blood biochemical variables, and faecal bacterial count in crossbred calves.

Methods

Fifteen-day-old crossbred calves (n=24) were divided into four groups, each consisting of six calves, and subjected to different experimental diets. The control group (T₀) received a basal diet without any additives. The T₁ and T₂ groups received the basal diet and the probiotic (L. acidophilus, 2 × 10¹⁰ cfu/g) @ 1 g/calf per day and prebiotic (Mannan oligosaccharide) @ 4 g/calf per day, respectively. Calves of the T₃ group were offered a basal diet and synbiotic (L. acidophilus, 0.5 g + Mannan oligosaccharide, 2 g/calf per day). The feed additives were mixed in milk.

Results

The results of 90 days feeding trial showed that calves of the T₃ and T₁ groups had higher (P<0.05) body weight (BW) gain and dry matter digestibility than the control. Feeding the probiotic showed a positive effect (P<0.05) on body length at the first, second, and third months, compared to the control. The blood serum total protein and globulin concentrations in the T₁ group, on days 30 and 90, and T₃ group, on day 90, were higher (P<0.05) than those of the control. All the treatment groups (T₁, T₂, and T₃) showed a reduction (P<0.05) in faecal coliform and E. coli count, compared to the control, on the 15th and 30th days of the study. Additionally, the T₂ group showed a significant coliform count reduction on days 45 and 60 of the study.

Conclusion

The dietary addition of L. acidophilus, 2 × 10¹⁰ cfu/g @ 1 g/calf per day and the combination of L. acidophilus, 0.5 g + Mannan oligosaccharide, 2 g/calf per day improved growth performance, serum biochemical values, and favourable gut microbiota.

Predicting Quadruple Semitendinosus Graft Size for Anterior Cruciate Ligament Reconstruction by Patient Anthropometric Variables: A Cohort Study of 280 Cases

Introduction:

Pre-operative identification of patients with inadequate hamstring graft for anterior cruciate ligament reconstruction is still a subject of interest. The purpose of this study is to correlate dimension of a harvested dimensions graft with patient physical anthropometric variables.

Materials and methods:

This cohort study included 280 patients (male = 226, female = 54) scheduled for primary anterior cruciate ligament (ACL) reconstruction. Interrelationships between quadruple semitendinosus (ST) graft and anthropometric parameters (age, sex, height, weight, and BMI) were assessed using Pearson Correlation test and regression analysis. Difference among gender was analysed using Mann Whitney and t test. The observed graft diameter was also compared with the literature using Bland – Altman plot.

Results:

Mean age of cohort was 29 years (range, 17-50 years), mean height was 1.69m (range, 1.6-1.9m), mean weight was 75 kg (range, 50-116kg) and mean BMI was 26kg/m2 (range 16.65-40.40kg/m2). Mean quadruple length of harvested ST graft was 7cm (7.1±0.6 cm, range, 5.6-8.8cm) and mean diameter was 8mm (8.2±0.8mm, range, 6.5-10mm). Only height and weight were significantly correlated with graft length and diameter in both sex (p value <0.05). Female, compared to male, had significantly smaller (p<0.0001) and thinner graft (p<0.0001). There was a strong agreement between the literature and our observed graft diameter, but with an overestimated graft diameter in 18.5% of the cases.

Conclusion:

Among anthropometric parameter, only height and weight had moderate positive correlation with graft diameter. Males had longer and wider ST graft in contrast to age-matched female group.

Expression of kisspeptin and its receptor in different functional classes of ovarian follicle in the buffalo (Bubalus bubalis)

Recently, we reported the differential expression of kisspeptinergic system in the bubaline hypothalamus and corpus luteum. Here, we document the expression of kisspeptin (Kp) and its receptor (Kiss1r) in the ovarian follicles of the buffalo with respect to the functional status. Follicles of ≥10 to ≤13 mm diameter (n = 45) were retrospectively categorized into active (n = 18), intermediate (n = 16) and atretic (n = 11) follicles based on the concentrations of intrafollicular progesterone (P₄) and estradiol (E₂). The P₄:E₂ ratio was significantly lower in the active follicle (0.43 ± 0.08) than that of the intermediate (3.46 ± 0.53) and atretic (28.4 ± 10.6) follicles (P < 0.05). Relative fold change in the transcripts of kisspeptin (Kiss1), Kiss1r, gonadotrophin receptors, steroid acute regulatory protein (StAR), cytochrome P450 family 11 subfamily A member 1 (CYP11A1), cytochrome P450 Family 19 subfamily A member 1 (CYP19A1), insulin like growth factor -1 (IGF-1), apoptotic factors (caspase 3 and B-cell lymphoma 2, BCL2) was calculated using qPCR in the follicular wall of the three categories of follicle (n = 8/group). In another experiment, histological sections of the ovary (n = 41) were used to group the follicles as described above and immunostaining of Kp, Kiss1r and aromatase was done. A significant upregulation of StAR, CYP11A1 and CYP19A1 in the active follicles supported the endocrine basis of follicular classification. The transcripts of Kiss1 and Kiss1r were upregulated by 19.45 fold and 4.25 fold, respectively in the active follicle as compared to other groups. Immunolocalization studies revealed that Kp and Kiss1r were localized to the basal and antral granulosa cells (GC) of the active and intermediate follicles; however, the staining intensity was stronger in the former group. Strong expression of CYP19A1 in the GC layer of active follicle supported the histological basis of defining the functional status of the follicle. It is concluded that the follicular compartment of the bubaline ovary expressed the constituents of kisspeptinergic system. The expression of Kp and Kiss1r was influenced by the functional status of the follicle with intense localization in the GC layer of the active follicles.

Antibiotic resistance in patients with chronic ear discharge awaiting surgery in Nepal

SETTING

Biratnagar Eye Hospital, Biratnagar, Nepal, which offers ear surgery for chronic suppurative otitis media (CSOM).

OBJECTIVE

In patients with CSOM awaiting surgery, to determine the 1) sociodemographic characteristics 2) bacterial isolates and their antibiotic resistance patterns and 3) characteristics of those refused surgery, including antibiotic resistance.

DESIGN

A cohort study using hospital data, January 2018-January 2020.

RESULTS

Of 117 patients with CSOM and awaiting surgery, 64% were in the 18-35 years age group, and 79% were cross-border from India. Of 118 bacterial isolates, 80% had Pseudomonas aeruginosa and 16% had Staphylococcus aureus. All isolates showed multidrug resistance to nine of the 12 antibiotics tested. The lowest antibiotic resistance in P. aeruginosa was for vancomycin (29%) and moxifloxacin (36%), and for S. aureus, this was vancomycin (9%) and amikacin (17%). Fourteen (12%) patients underwent surgery: myringoplasty (n = 7, 50%), cortical mastoidectomy with tympanostomy (n = 4, 29%) and modified radical mastoidectomy (n = 3, 21%). Those infected with P. aeruginosa and with resistance to over six antibiotics were significantly more likely to be refused for surgery.

CONCLUSION

Patients awaiting ear surgery were predominantly infected with multidrug-resistant P. aeruginosa and were consequently refused surgery. This study can help inform efforts for improving surgical uptake and introducing cross-border antimicrobial resistance surveillance.

Antimicrobial resistance in neonates with suspected sepsis

SETTING

Nobel Medical College and Teaching Hospital, Biratnagar, Nepal.

OBJECTIVE

To determine the pattern of antimicrobial resistance and hospital exit outcomes in neonates with suspected sepsis in a tertiary neonatal intensive care unit (NICU).

DESIGN

This hospital-based cohort study was conducted to follow patients from January to December 2019. All identified cases of suspected sepsis were enlisted from hospital records.

RESULTS

Sepsis was suspected in 177 (88%) of the 200 cases admitted in the NICU; 52 (29%) were culture-positive. Pseudomonas was the predominant organism isolated (n = 40; 78%), followed by coagulase negative staphylococcus (n = 12, 23%). Nine (17%) of the 52 isolates were resistant to the Access and Watch group of antibiotics, including some resistance to Reserve group drugs such as imipenem and linezolid. Most treated cases (n = 170, 96%) improved, although 7 (4%) left against medical advice.

CONCLUSION

Most of the pathogens were resistant to WHO Access and Watch antibiotics and occasional resistance was observed to Reserve group drugs. Most sepsis was caused by Gram-negative bacilli. Improving turnaround times for antibiotic sensitivity testing using point-of-care testing, and a greater yield of culture-positive results are needed to enhance the management of neonatal sepsis.

A comprehensive review of groundwater vulnerability assessment using index-based, modelling, and coupling methods

Groundwater has become increasingly vulnerable to quality degradation. An elaborate understanding of its flow, draft, recharge and pollutant transport processes needs to be developed to understand its risk to contamination. This paper has discussed different tools and methods that are used to map groundwater vulnerability around the world. To maintain the quality and impact of the study, rigorous search for relevant literature published in high impact scientific journals has been done, and the comprehensive information on groundwater vulnerability assessment methods being used, has been compiled. The GIS based overlay and index-based methods like DRASTIC, GALDIT, GOD, COP and PI takes into consideration various thematic layers, overlays them to calculate weighted index and identifies vulnerability classes. They have been criticised for the lack of numerical basis in their formulation. Therefore, over the years, many of the proposed indices have been modified to provide quantitative estimates of groundwater potential to degrade and deplete. However, where the data and software are not a constraint, the use of numerical based simulation models can be done for more elaborate and numerical based quantification of the vulnerability. These numerical models typically require extensive data and are exceedingly becoming more sophisticated with the introduction of new parameters. This study concludes that integrating the GIS with numerical models offers the advantage of data management and assists to spatially analyse the datasets. The difficulties that are associated with the differences between GIS and numerical model's data structures should be thoroughly understood, prior to coupling, to develop uniform conversion software.