Insights into the cumulative effect of Colletotrichum gloeosporioides and Fusarium acutatum causing anthracnose-twister disease complex of onion

Colletotrichum is an important plant pathogenic fungi that causes anthracnose/-twister disease in onion. This disease was prevalent in the monsoon season from August to November months and the symptoms were observed in most of the fields. This study aimed to investigate the pathogenicity and cumulative effect, if any of Colletotrichum gloeosporioides and Fusarium acutatum. The pot experiment was laid out to identify the cause responsible for inciting anthracnose-twister disease, whether the Colletotrichum or Fusarium or both, or the interaction of pathogens and GA3. The results of the pathogenicity test confirmed that C. gloeosporioides and F. acutatum are both pathogenic. C. gloeosporioides caused twisting symptoms independently, while F.acutatum independently caused only neck elongation. The independent application of GA3 did not produce any symptoms, however, increased the plant height. The combined treatment of C. gloeosporioides and F. acutatum caused twisting, which enhanced upon interaction with GA3 application giving synergistic effect. The acervuli were found in lesions infected with C. gloeosporioides after 8 days of inoculation on the neck and leaf blades. Symptoms were not observed in untreated control plants. Koch's postulates were confirmed by reisolating the same pathogens from the infected plants.

Efficiency dynamics among onion growers in Maharashtra: a comparative analysis of drip irrigation adopters and non-adopters

BACKGROUND

Onions are economically and nutritionally important vegetable crops. Despite advances in technology and acreage, Indian onion growers face challenges in realizing their full productivity potential. This study examines the technical efficiency of onion growers, the factors influencing it, and the constraints faced by those adopting drip irrigation in the Ghod river basin of western Maharashtra. A sample of 480 farmers including those practicing drip irrigation and those not practicing it, was selected from Junnar, Shirur, Parner, and Shrigonda blocks of the basin. The primary data was collected through semi-structured interviews. Analytical tools such as the Cobb-Douglas production function (represents technological relationship between multiple inputs and the resulting output), a single-stage stochastic frontier model, the Tobit model, and descriptive statistics were used to assess the technical efficiency of onion production at the farm level.

RESULTS

According to the maximum likelihood estimates of the stochastic frontier analysis, drip adopters exhibited a mean technical efficiency of 92%, while for non-adopters it was 65%. It indicates that the use of drip irrigation technology is associated with higher technical efficiency. The association of technical efficiency and socio-economic characters of households showed that education, extension contacts, social participation, and use of information sources had a positive influence on technical efficiency, while family size had a negative influence on the drip irrigation adopters. For non-drip adopters, significant positive effects were observed for landholding, extension contact, and information source use. The major constraints faced by drip system adopters included a lack of knowledge about the proper operating techniques for drip systems and the cost of maintenance.

CONCLUSION

The differences with inputs associated with two irrigation methods showed that the response of inputs to increase onion yield is greater for farmers who use drip irrigation than for farmers who do not, and are a result of the large differences in the technical efficiencies. These inefficiencies and other limitations following the introduction of drip irrigation, such as lack of knowledge about the proper operations, need to be addressed through tailored training for farmers and further interventions.

Elucidating the molecular responses to waterlogging stress in onion (Allium cepa L.) leaf by comparative transcriptome profiling

Introduction

Waterlogging is a major stress that severely affects onion cultivation worldwide, and developing stress-tolerant varieties could be a valuable measure for overcoming its adverse effects. Gathering information regarding the molecular mechanisms and gene expression patterns of waterlogging-tolerant and sensitive genotypes is an effective method for improving stress tolerance in onions. To date, the waterlogging tolerance-governing molecular mechanism in onions is unknown.

Methods

This study identified the differentially expressed genes (DEGs) through transcriptome analysis in leaf tissue of two onion genotypes (Acc. 1666; tolerant and W-344; sensitive) presenting contrasting responses to waterlogging stress.

Results

Differential gene expression analysis revealed that in Acc. 1666, 1629 and 3271 genes were upregulated and downregulated, respectively. In W-344, 2134 and 1909 genes were upregulated and downregulated, respectively, under waterlogging stress. The proteins coded by these DEGs regulate several key biological processes to overcome waterlogging stress such as phytohormone production, antioxidant enzymes, programmed cell death, and energy production. The clusters of orthologous group pathway analysis revealed that DEGs contributed to the post-translational modification, energy production, and carbohydrate metabolism-related pathways under waterlogging stress. The enzyme assay demonstrated higher activity of antioxidant enzymes in Acc. 1666 than in W-344. The differential expression of waterlogging tolerance related genes, such as those related to antioxidant enzymes, phytohormone biosynthesis, carbohydrate metabolism, and transcriptional factors, suggested that significant fine reprogramming of gene expression occurs in response to waterlogging stress in onion. A few genes such as ADH, PDC, PEP carboxylase, WRKY22, and Respiratory burst oxidase D were exclusively upregulated in Acc. 1666.

Discussion

The molecular information about DEGs identified in the present study would be valuable for improving stress tolerance and for developing waterlogging tolerant onion varieties.

Colonization of Serendipita indica promotes resistance against Spodoptera exigua in onion (Allium cepa L.)

Plant-endophyte symbiosis influences plant defense and growth. Serendipita indica is a root endophyte that promotes growth and induces tolerance against biotic and abiotic stress in plants. In this study, we examined the effect of S. indica colonization on herbivore (Spodoptera exigua) resistance of onion (Allium cepa L.). We found that colonization of S. indica in the roots of onion significantly reduced the feeding damage of leaves by S. exigua larvae, and also resulted in a reduction in weight gain of the larvae when fed on S. indica plants. This enhanced resistance is a result of modulation of antioxidant and defense enzymes/genes in the host by S. indica mutualism. Specifically, the activities of enzymes such as Superoxide dismutase, peroxidase, polyphenol oxidase, phenylalanine ammonia-lyase, and H2O2 content were significantly higher in the early stages of S. exigua feeding in the S. indica colonized plants compared to the non-colonized counterparts. Similarly, defense genes also showed modulation in response to this tripartite interaction of onion -S. indica mutualism and S. exigua herbivory. The hierarchical cluster analysis and principal component analysis indicated a clear difference in the onion biochemical responses, which is due to the S. indica symbiosis. Our investigation demonstrates that onion-S. indica symbiosis significantly decreases chewing injury by efficiently modulating antioxidant and defense enzyme activities and gene expression in response to S. exigua herbivory. Therefore, S. indica can be used as a potential biocontrol agent for sustainable management of this important pest of Alliums.

Predicting the potential geographical distribution of onion thrips, Thrips tabaci in India based on climate change projections using MaxEnt

Onion thrips, Thrips tabaci Lindeman, an economically important onion pest in India, poses a severe threat to the domestic and export supply of onions. Therefore, it is important to study the distribution of this pest in order to assess the possible crop loss, which it may inflict if not managed in time. In this study, MaxEnt was used to analyze the potential distribution of T. tabaci in India and predict the changes in the suitable areas for onion thrips under two scenarios, SSP126 and SSP585. The area under the receiver operating characteristic curve values of 0.993 and 0.989 for training and testing demonstrated excellent model accuracy. The true skill statistic value of 0.944 and 0.921, and the continuous Boyce index of 0.964 and 0.889 for training and testing, also showed higher model accuracy. Annual Mean Temperature (bio1), Annual Precipitation (bio12) and Precipitation Seasonality (bio15) are the main variables that determined the potential distribution of T. tabaci, with the suitable range of 22-28 °C; 300-1000 mm and 70-160, respectively. T. tabaci is distributed mainly in India's central and southern states, with 1.17 × 10⁶ km², covering 36.4% of land area under the current scenario. Multimodal ensembles show that under a low emission scenario (SSP126), low, moderate and optimum suitable areas of T. tabaci is likely to increase, while highly suitable areas would decrease by 17.4% in 2050 20.9% in 2070. Whereas, under the high emission scenario (SSP585), the high suitability is likely to contract by 24.2% and 51.7% for 2050 and 2070, respectively. According to the prediction of the BCC-CSM2-MR, CanESM5, CNRM-CM6-1 and MIROC6 model, the highly suitable area for T. tabaci would likely contract under both SSP126 and SSP585. This study detailed the potential future habitable area for T. tabaci in India, which could help monitor and devise efficient management strategies for this destructive pest.

Efficient Elimination of Viruses from Garlic Using a Combination of Shoot Meristem Culture, Thermotherapy, and Chemical Treatment

Garlic (Allium sativum L.) is a clonally propagated bulbous crop and can be infected by several viruses under field conditions. A virus complex reduces garlic yield and deteriorates the quality of the produce. In the present study, we aimed to eliminate Onion yellow dwarf virus (OYDV), Garlic common latent virus (GCLV), Shallot latent virus (SLV), and Allexiviruses from the infected crop using combination of meristem culture, thermotherapy, and chemotherapy. In this study, seven different treatments, namely shoot meristem culture, thermotherapy direct culture, chemotherapy direct culture, chemotherapy + meristem culture, thermotherapy + meristem culture, thermotherapy + chemotherapy direct culture, and thermotherapy + chemotherapy + meristem culture (TCMC), were used. Multiplex polymerase chain reaction (PCR) was employed to detect virus elimination, which revealed the percentage of virus-free plants was between 65 and 100%, 55 and 100%, and 13 and 100% in the case of GCLV, SLV, and OYDV, respectively. The in vitro regeneration efficiency was between 66.06 and 98.98%. However, the elimination of Allexiviruses could not be achieved. TCMC was the most effective treatment for eliminating GCLV, SLV, and OYDV from garlic, with 66.06% plant regeneration efficiency. The viral titre of the Allexivirus under all the treatments was monitored using real-time PCR, and the lowest viral load was observed in the TCMC treatment. The present study is the first to report the complete removal of GCLV, SLV, and OYDV from Indian red garlic with the application of thermotherapy coupled with chemotherapy and shoot meristem culture.

Screening of Onion (Allium cepa L.) Genotypes for Waterlogging Tolerance

Onion production is severely affected by waterlogging conditions, which are created due to heavy rainfall. Hence, the identification of waterlogging-tolerant onion genotypes is crucial for increasing onion production. In the present study, 100 distinct onion genotypes were screened for waterlogging tolerance under artificial conditions by using the phenotypic approach in the monsoon season of 2017. Based on plant survival and recovery and changes in bulb weight, we identified 19 tolerant, 27 intermediate tolerant, and 54 highly sensitive onion genotypes. The tolerant genotypes exhibited higher plant survival and better recovery and bulb size, whereas sensitive genotypes exhibited higher plant mortality, poor recovery, and small bulb size under waterlogging conditions. Furthermore, a subset of 12 contrasting genotypes was selected for field trials during monsoon seasons 2018 and 2019. Results revealed that considerable variation in the morphological, physiological, and yield characteristics were observed across the genotypes under stress conditions. Waterlogging-tolerant genotypes, namely, Acc. 1666, Acc. 1622, W-355, W-208, KH-M-2, and RGP-5, exhibited higher plant height, leaf number, leaf area, leaf length, chlorophyll content, membrane stability index (MSI), pyruvic acid, antioxidant content, and bulb yield than sensitive genotypes under stress conditions. Furthermore, the principal component analysis biplot revealed a strong association of leaf number, leaf area, chlorophyll content, MSI, and bulb yield with tolerant genotypes under stress conditions. The study indicates that the waterlogging-tolerant onion genotypes with promising stress-adaptive traits can be used in plant breeding programs for developing waterlogging-tolerant onion varieties.

Genetic diversity of Indian garlic core germplasm using agro-biochemical traits and SRAP markers

The characterization of garlic germplasm improves its utility, despite the fact that garlic hasn't been used much in the past. Garlic has an untapped genetic pool of immense economic and medicinal value in India. Hence, using heuristic core collection approach, a core set of 46 accessions were selected from 625 Indian garlic accessions based on 13 quantitative and five qualitative traits. The statistical measures (CV per cent, CR per cent, VR per cent) were used to sort the core set using Shannon-Wiener diversity index and the Nei diversity index. In addition, the variation within the core set was tested for 18 agro-morphological and six biochemical characteristics (allicin, phenol content, pyruvic acid, protein, allyl methyl thiosulfinate (AMTHS), and methyl allyl thiosulfinate (MATHS)). Further study of the core set's molecular diversity was performed using sequence related amplified polymorphism (SRAP) markers, which revealed a wide range of diversity among the core set's accessions, with an average polymorphism efficiency (PE) of 80.59 percent, polymorphism information content (PIC) of 0.29, effective multiplex ratio (EMR) of 3.51, and marker index (MI) of 0.99. The findings of this study will be useful in identifying high-yielding, elite garlic germplasm lines with the trait of interest. Since this core set is indicative of total germplasm, these selected breeding lines will be used for genetic improvement of garlic in the future.

Clinical characteristics and outcomes of patients with Corona Virus Disease 2019 (COVID-19) at Mercy Health Hospitals, Toledo, Ohio

IMPORTANCE

The ongoing pandemic of the novel Corona Virus Disease 2019 (COVID-19) is an unprecedented challenge to global health, never experienced before.

OBJECTIVE

This study aims to describe the clinical characteristics and outcomes of patients with COVID-19 admitted to Mercy Hospitals.

DESIGN AND METHODS

Retrospective, observational cohort study designed to include every COVID-19 subject aged 18 years or older admitted to Mercy Saint (St) Vincent, Mercy St Charles, and Mercy St Anne's hospital in Toledo, Ohio from January 1, 2020 through June 15th, 2020. Primary Outcome Measure was mortality in the emergency department or as an in-patient.

RESULTS

470 subjects including 224 males and 246 females met the inclusion criteria for the study. Subjects with the following characteristics had higher odds (OR) of death: Older age [OR 8.3 (95% CI 1.1-63.1, p = 0.04)] for subjects age 70 or more compared to subjects age 18-29); Hypertension [OR 3.6 (95% CI 1.6-7.8, p = 0.001)]; Diabetes [OR 3.1 (95% CI 1.7-5.6, p<0.001)]; COPD [OR 3.4 (95% CI 1.8-6.3, p<0.001)] and CKD stage 2 or greater [OR 2.5 (95% CI 1.3-4.9, p = 0.006)]. Combining all age groups, subjects with hypertension had significantly greater odds of the following adverse outcomes: requiring hospital admission (OR 2.2, 95% CI 1.4-3.4, p<0.001); needing respiratory support in 24 hours (OR 2.5, 95% CI: 1.7-3.7, p<0.001); ICU admission (OR 2.7, 95% CI 1.7-4.4, p<0.001); and death (OR 3.6, 95% CI 1.6-7.8, p = 0.001). Hypertension was not associated with needing vent in 24 hours (p = 0.07).

CONCLUSION

Age and hypertension were associated with significant comorbidity and mortality in Covid-19 Positive patients. Furthermore, people who were older than 70, and had hypertension, diabetes, COPD, or CKD had higher odds of dying from the disease as compared to patients who hadn't. Subjects with hypertension also had significantly greater odds of other adverse outcomes.

Screening of Onion (Allium cepa L.) Genotypes for Drought Tolerance Using Physiological and Yield Based Indices Through Multivariate Analysis

Drought is a leading abiotic constraints for onion production globally. Breeding by using unique genetic resources for drought tolerance is a vital mitigation strategy. With a total of 100 onion genotypes were screened for drought tolerance using multivariate analysis. The experiment was conducted in a controlled rainout shelter for 2 years 2017-2018 and 2018-2019 in a randomized block design with three replications and two treatments (control and drought stress). The plant was exposed to drought stress during the bulb development stage (i.e., 50-75 days after transplanting). The genotypes were screened on the basis of the drought tolerance efficiency (DTE), percent bulb yield reduction, and results of multivariate analysis viz. hierarchical cluster analysis by Ward's method, discriminate analysis and principal component analysis. The analysis of variance indicated significant differences among the tested genotypes and treatments for all the parameters studied, viz. phenotypic, physiological, biochemical, and yield attributes. Bulb yield was strongly positively correlated with membrane stability index (MSI), relative water content (RWC), total chlorophyll content, antioxidant enzyme activity, and leaf area under drought stress. The genotypes were categorized into five groups namely, highly tolerant, tolerant, intermediate, sensitive, and highly sensitive based on genetic distance. Under drought conditions, clusters II and IV contained highly tolerant and highly sensitive genotypes, respectively. Tolerant genotypes, viz. Acc. 1656, Acc. 1658, W-009, and W-085, had higher DTE (>90%), fewer yield losses (<20%), and performed superiorly for different traits under drought stress. Acc. 1627 and Acc. 1639 were found to be highly drought-sensitive genotypes, with more than 70% yield loss. In biplot, the tolerant genotypes (Acc. 1656, Acc. 1658, W-085, W-009, W-397, W-396, W-414, and W-448) were positively associated with bulb yield, DTE, RWC, MSI, leaf area, and antioxidant enzyme activity under drought stress. The study thus identified tolerant genotypes with favorable adaptive traits that may be useful in onion breeding program for drought tolerance.

Patho-epidemiological and risk factor studies for detection of Neospora-associated abortion in cattle and buffaloes in Punjab, India

The diagnosis of abortion in livestock is difficult. In this paper, Neospora caninumassociated abortion in cattle and buffaloes in India is reported for the first time. A total of 184 animals (cattle, n = 133; water buffaloes, n = 51) were randomly selected for seroprevalence studies from 28 farms with a history of abortion. Antibodies to N. caninum were detected using a commercial competitive enzymelinked immunosorbent assay (c-ELISA); the percentage seropositivity was 10.5% for cattle and 21.6% for buffaloes. Risk factors such as species, i.e. buffaloes in comparison to cattle (odds ratio [OR] = 2.33, calculated probability [p] = 0.05), disposal of foetus and foetal membranes by throwing them into the field, in comparison with burning/burial (OR = 2.63, p = 0.03), and origin of the animal, i.e. purchased from outside in comparison to born on the farm (OR = 4.69, p = 0.002), were significantly associated with N. caninum seropositivity in univariate logistic regression. In multivariate analysis, only two risk factors, animal purchased from outside (OR = 6.15, p = 0.001) and buffaloes (OR = 3.20, p = 0.01), were significantly associated with Neospora seropositivity at a p-value < 0.05. Histopathological examination of aborted foetal tissues (cattle, n = 13; buffaloes, n = 8) revealed N. caninum tachyzoites in the heart and liver of three foetuses, and the diagnosis was confirmed by positive immunoreactivity to anti-N. caninum polyclonal antibody in the placenta of one foetus. To the authors' knowledge, this is the first report of confirmed neosporosis abortion in cattle and buffaloes in India.

Comparative transcriptome analyses in contrasting onion (Allium cepa L.) genotypes for drought stress

Onion (Allium cepa L.) is an important vegetable crop widely grown for diverse culinary and nutraceutical properties. Being a shallow-rooted plant, it is prone to drought. In the present study, transcriptome sequencing of drought-tolerant (1656) and drought-sensitive (1627) onion genotypes was performed to elucidate the molecular basis of differential response to drought stress. A total of 123206 and 139252 transcripts (average transcript length: 690 bases) were generated after assembly for 1656 and 1627, respectively. Differential gene expression analyses revealed upregulation and downregulation of 1189 and 1180 genes, respectively, in 1656, whereas in 1627, upregulation and downregulation of 872 and 1292 genes, respectively, was observed. Genes encoding transcription factors, cytochrome P450, membrane transporters, and flavonoids, and those related to carbohydrate metabolism were found to exhibit a differential expression behavior in the tolerant and susceptible genotypes. The information generated can facilitate a better understanding of molecular mechanisms underlying drought response in onion.

Cross-Platform Spillover Effects in Consumption of Viral Content: A Quasi-Experimental Analysis Using Synthetic Controls

To inform product release and distribution strategies, research has analyzed cross-market spillovers in new product adoption. However, models that examine these effects for digital and viral media are still evolving. Given resistance to advertising, firms often seek to promote their own viral content to boost brand awareness. However, a key shortcoming of virality is its ephemeral nature. To gain insight into sustaining virality, we develop a quasi-experimental approach that estimates the backward spillover onto a focal platform by introducing a piece of content onto a new platform. We posit that introducing content to the audience of a new platform can generate word of mouth, which may affect its consumption within an earlier platform. We estimate these spillovers using data on 381 viral videos on 26 platforms (e.g., YouTube, Vimeo) and observe how consumption of videos on an initial “lead” platform is affected by their subsequent introduction onto “lag” platforms. This spillover is estimated as follows: for each multiplatform video, we compare its view growth after being introduced onto a new platform to that of a synthetic control based on similar single-platform videos. Analysis of 275 such spillover scenarios reveals that introducing a video onto a lag platform roughly doubles its subsequent view growth in the lead platform. This positive cross-platform spillover is persistent, bursty, and strongest in the first 42 days. We find that spillover is boosted when the video is consumed more in the lag platform, when the consumption rate peaks earlier in the lag platform, and when the lag platform targets a foreign market. Our findings suggest that firms can sustain the popularity of their viral content by introducing it onto additional platforms (e.g., Vimeo) after posting it on a focal platform (e.g., YouTube). As a result of their posting on the latter platforms, firms can expect subsequent view growth on the focal platform to roughly double. The aforementioned benefits persists for up to five lag platforms. Platforms should also consider that a positive cross-platform spillover may help platforms reinforce each other’s usage, rather than cannibalize each other.

A core outcome set for future endometriosis research: an international consensus development study

OBJECTIVE

To develop a core outcome set for endometriosis.

DESIGN

Consensus development study.

SETTING

International.

POPULATION

One hundred and sixteen healthcare professionals, 31 researchers and 206 patient representatives.

METHODS

Modified Delphi method and modified nominal group technique.

RESULTS

The final core outcome set includes three core outcomes for trials evaluating potential treatments for pain and other symptoms associated with endometriosis: overall pain; improvement in the most troublesome symptom; and quality of life. In addition, eight core outcomes for trials evaluating potential treatments for infertility associated with endometriosis were identified: viable intrauterine pregnancy confirmed by ultrasound; pregnancy loss, including ectopic pregnancy, miscarriage, stillbirth and termination of pregnancy; live birth; time to pregnancy leading to live birth; gestational age at delivery; birthweight; neonatal mortality; and major congenital abnormalities. Two core outcomes applicable to all trials were also identified: adverse events and patient satisfaction with treatment.

CONCLUSIONS

Using robust consensus science methods, healthcare professionals, researchers and women with endometriosis have developed a core outcome set to standardise outcome selection, collection and reporting across future randomised controlled trials and systematic reviews evaluating potential treatments for endometriosis. TWEETABLE ABSTRACT: @coreoutcomes for future #endometriosis research have been developed @jamesmnduffy.

Long-term outcome of diffuse large B-cell lymphoma: Impact of biosimilar rituximab and radiation

INTRODUCTION

Rituximab (R)-CHOP improves survival over CHOP in diffuse large B-cell lymphoma (DLBCL). The availability of biosimilar rituximab in India has increased access of this drug. We report on the impact of treatment on outcomes with special emphasis on the impact of biosimilar rituximab and radiation.

METHODS

Outcomes of adults (age 15-60 years) treated with CHOP+/- Rituximab radiation were analyzed retrospectively to look at baseline features, treatment, and event-free and overall survival (EFS and OS).

RESULTS

In the period 2000-2013, 444 patients (median age 47 years: 15-60; males: 288 [65%]; Stage III/IV: 224 [50%]; age-adjusted international prognostic index [aaIPI] Score 2 or 3 in 50%) received either CHOP (n = 325 [73%]) or RCHOP (n = 119 [27%]) therapy. Biosimilar rituximab and the original were used in 95 (80%) and 24 (20%) patients, respectively. Radiation was given in 134 (30%) patients (Stages I and II, 100/220 [45%] and Stages III and IV, 34/224 [15%]). After a median follow-up of 46 (0.2-126) months, the 5-year EFS and OS were 59% and 68%, respectively. The factors predicting inferior EFS and OS were age> 40 years, performance status 2-4, Stage III/IV, hemoglobin <12 g/dL, the aaIPI Score 2 or 3, and nonuse of rituximab and radiation. Radiation used in early stage disease benefitted all subgroups regardless of bulky disease, use of rituximab, or the number of cycles of chemotherapy. Addition of rituximab improved survival across all categories of aaIPI.

CONCLUSION

Availability of biosimilar rituximab has increased access and survival of patients with DLBCL in India. Radiotherapy improved outcomes in early stages.

Meningioma with Metastatic Malignant Melanoma: An Unusual Coincidence

Simultaneous occurrence of meningioma and brain metastasis as two different histopathologically-proven lesions has been often reported in literature, however, to the best of our knowledge, contiguous occurrence of meningioma and malignant melanoma has not been reported previously in literature. A 50-year-old woman presented with features of raised intracranial pressure and left upper motor neuron signs. Imaging findings were suggestive of right frontoparietal and right parietal extra-axial space occupying extra-axial lesions. Patient underwent right frontotemporoparietal craniotomy with excision of both tumors under general anesthesia. Histopathological analysis was suggestive of transitional meningioma (World Health Organization [WHO] grade I) and malignant melanoma (WHO grade IV). Simultaneous presence of two tumors in the brain might be of the same or different histopathology. In such dual tumors, metastasis cases are varied and one source of it may be melanoma of the skin. Hence, dermatological examination can reveal the primary source of tumor in select cases.

Peripheral Vascular Disease in Patients with Diabetic Foot Ulcers - An Emerging Trend: A Prospective Study from North India

BACKGROUND

Diabetic foot ulcer is one of the chronic complications of diabetes mellitus (DM) with 25% of patients with diabetes developing a foot ulcer during their lifetime leading to amputation. Diabetic foot is classified into 2 main types: neuropathic ulcers (NPU) and neuro-ischemic ulcer (NIU) where in addition to neuropathy peripheral vascular disease (PVD) is also present.

AIMS

We aimed to a) assess the prevalence of Peripheral vascular disease (PVD) in patients of type 2 diabetes mellitus (T2DM) presenting with New Diabetic Foot ulcers (DFU). b) To compare the clinical profile and risk factors responsible for development of NPU and NIU in North Indian population.

SETTING AND DESIGN

Cross sectional study conducted on first 100 T2DM patients presenting with new DFU in tertiary referral institute for one year period from August 2012 to July 2013.

METHODS AND MATERIAL

Detailed relevant clinical history including age, sex and duration of diabetes, history of smoking and hypertension (HTN) and prevalence of other complications like retinopathy, nephropathy, coronary artery disease (CAD) and stroke was obtained. Patients were examined for neuropathy, loss of pulsations, ankle brachial pressure index (ABI) and investigated for HbA1C, blood urea nitrogen (BUN) and serum creatinine. Statistical analysis used: t test, Fisher exact test and univariate analysis.

RESULTS

NIU was present in 30 and NPU in 70 out of 100 patients. NIU were commoner among males as compared to females (21/64 males vs 9/36 females). Strong association of smoking (20/30 patients), hypertension (24/30 patients) and longer duration of DM (14 vs 8 years) with NIU was found. Even other complications of DM like CAD (8/30 patients), stroke (4/30 patients), retinopathy (24/30 patients) and nephropathy (15/30 patients) were more prevalent in patients with NIU.

CONCLUSIONS

Prevalence of PVD is 30% in our study which is more than previous studies showing an increasing trend. NPU are two times more common than NIU. Hypertensive male patients with smoking habits and longer duration of T2DM are most prone to develop NIU. NIU share the similar risk factors with CAD and coexist with other complications of DM which should be looked for and treated.

Comparison of diagnostic tests for the detection of bovine brucellosis in the natural cases of abortion

Rapid and precise diagnosis in natural field cases of bovine abortion caused by Brucella abortus warrants the use of the most sensitive and reliable diagnostic methods. In the present study, bacterial isolation, serology, gross, histopathology, immunohistochemistry and polymerase chain reaction technique(s) were applied. Sero-prevalence studies showed the rate of 28.86% positive cases using the competitive ELISA. Histopathological changes were mainly seen in the placenta, fetal lungs, kidney, liver and spleen. Immunohistochemical (IHC) staining of Brucella spp. was evident as brown, finely granular intracytoplasmic staining in trophoblasts of placental sections and in section(s) of liver, lung, kidney and spleen. Twenty-eight out of the 103 samples (17 from stomach contents, 3 from placental cotyledons, 2 from vaginal discharges and 6 from pooled fetal tissues) produced 193 bp amplicon specific for Brucella genus. Moreover, the species-specific primers amplified a 498 bp amplicon which corresponded to B. abortus. Comparison of diagnostic tests revealed PCR and IHC provide a reliable test for the diagnosis of bovine brucellosis in aborted fetal tissue and placental cotyledons whereas serology is most important for detection of Brucella positive animals in a herd.

Epidemiological and immunopathological studies on Porcine parvovirus infection in Punjab

Aim:

The aim of this study was to get the first-hand knowledge about the seroprevalence of Porcine parvovirus (PPV) in Punjab and a diagnosis of PPV from abortion cases of swine using gross, histopathological, and immunohistopathological techniques to observe the tissue tropism of the virus strain.

Materials and Methods:

Tissue samples from the reproductive tract of pig (n=32), placental tissue (n=10), and aborted fetuses (n=18) were collected from Postmortem Hall of the Department of Veterinary Pathology, GADVASU, field outbreaks and from butcher houses in and around Ludhiana. These samples were processed for histopathological and immunohistochemical (IHC) studies. For seroprevalence study, 90 serum samples of different sex and age were collected from 15 swine farms of Punjab and were subjected to indirect enzyme linked immunosorbent assay using commercial kit.

Results:

Overall, seroprevalence of PPV was found to be 41.1%. Sex and age related difference in the prevalence was noted. In abortion cases grossly congested and emphysematous lungs, congested internal organs with fluid in abdominal cavity and congestion in brain, changes were noted in fetuses, while diffuse hemorrhages and edema was observed in placental tissue. Histopathologically, the most frequent fetal lesions in aborted fetuses were noted in lungs, liver, and brain. IHC staining revealed PPV antigens in sections of heart, liver, lung, spleen, brain, lymph node of fetuses, placenta, and uterus of sow. Gross, histopathological, and IHC examination of the samples confirmed 5 fetus, 2 placenta and 3 female reproductive samples positive for parvovirus infection.

Conclusions:

Seroprevalence results may serve as a support either in prevention or control of the disease. IHC is the sensitive technique for diagnosis of PPV associated with the reproductive tract of swine and was found to supplement the gross and histopathological alterations, respectively, associated with the disease.

Gender Based Differences in Risk Factor Profile and Coronary Angiography of Patients Presenting with Acute Myocardial Infarction in North Indian Population

INTRODUCTION

Coronary Artery Disease (CAD) among women presents atypically with atypical chest pain, neck pain, nausea, fatigue and dyspnoea. Co-existing co-morbidities such as Diabetes Mellitus (DM) and hypertension along with difference in risk factor prevalence makes it necessary to have a gender specific approach.

AIM

To study gender specific differences in diagnosing and treating Acute Myocardial Infarction (AMI) in North Indian population.

MATERIALS AND METHODS

Fifty consecutive men and women presenting with AMI were studied. A detailed history including symptoms, history of DM, hypertension, smoking and dyslipidaemia was obtained. ECG, evaluation of cardiac enzymes (CPK-MB, Troponin I), RBS, lipid profile, two dimensional transthoracic echocardiography and coronary angiography were performed. The data was statistically analysed.

RESULTS

Among 100 patients (50 males and females each), we found a later age at presentation (62 y vs 56.5 y) and higher prevalence of diabetes (52% vs 24%, p=0.004) and hypertension (46% vs 28%) among females but more dyslipidaemia (34% vs 26%), smoking (44% vs 0%, p=0.0) and higher BMI (25.58 vs 23.74, p=0.019) among males. More females presented with atypical symptoms (16% vs 6%) and were detected to have insignificant CAD (14% vs 2%) than males.

CONCLUSION

North Indian women with presentation at a later age, with atypical symptoms, more incidences of risk factors such as diabetes and hypertension along with lesser dyslipidaemia and BMI than males need a higher index of suspicion while evaluating them for CAD. Misdiagnosis is more likely because of atypical presentation. A milder disease on angiography and a lower incidence of multiple vessel disease is a common finding. We recommend more and larger Indian studies to acquire more data so that this growing prevalence of CAD in women can be curbed.

Adverse drug reactions profile of antimicrobials: A 3-year experience, from a tertiary care teaching hospital of India

AIM OF STUDY

To evaluate adverse drug reaction (ADR) profile of antimicrobials over 3-year period.

MATERIAL AND METHODS

A retrospective cross-sectional study was undertaken using suspected adverse drug data collection form available under Pharmacovigilance Programme of India (PvPI).

RESULTS

A total of 2,586 ADR events were recorded in 3 years, out of which 392 (15.15%) were because of antimicrobials. Male: female was 1.02:1. Medicine department contributed maximally (98.97%). The intravenous (IV) route of drug administration accounted maximum ADRs (53.32%), followed by oral route (45.41%). Monotherapy was responsible for 80.87%, whereas combination therapy for 19.13%. Combinations therapy was irrational in 79.67%. The most common antibiotic resulting in ADRs was injection ceftriaxone (35.71%), followed by tab. azithromycin (7.39%), tab. ofloxacin+ornidazol (5.35%), ofloxacin (3.57%), ciprofloxacin (2.29%), amoxicillin (2.55%), tab. cefixime (2.29%), inj. linezolid (2.04%). Rash remained the most common ADR, followed by diarrhoea and gastritis. Most common organ system involved was dermatological (47.44%), followed by gastrointestinal (GI) (39.28%), central nervous system (CNS) (5.35%), cardiovascular system (CVS) (3.57%) and renal and genitourinary (1.78%). While 47.96% ADR's were latent, 26.785% were acute and 25.26% were sub-acute. Moreover, 89.79% of ADRs were moderate in nature, whereas 26.88% were severe and 3.33% mild in nature. Furthermore, 92.86% were non-serious and 7.14% serious in nature. Also, 65.06% of antimicrobial caused ADRs were type A and 34.64% were type B reactions. As per World Health Organization-The Uppsala Monitoring Centre (WHO-UMC) scale, 73.98% of ADRs were probable/likely and 26.02% as possible. However, 99.47% of ADRs required intervention.

CONCLUSION

The current study suggest that ADRs due to antimicrobials is a significant health problem.

Giant parietal lobe infantile gliosarcoma in a 5-year-old child

The relative frequency of pediatric gliosarcoma (GSM) is 1.9% among glioblastomas and 0.5% among pediatric central nervous system tumors. A 5-year-old female child came to us with history of fever and loss of appetite since 2 weeks and right sided weakness since 4 days. Magnetic resonance imaging showed a large heterogeneously enhancing space occupying lesion in the left parieto-occipital region. A parieto-occipital craniotomy with radical excision of tumor was performed. The patient was given adjuvant therapy following surgery and survived until 9 months following surgery. The etiopathogenesis, treatment modalities and prognosis of GSM is discussed.

Phase II study of interim PET-CT-guided response-adapted therapy in advanced Hodgkin's lymphoma

BACKGROUND

Combination chemotherapy ABVD (doxorubicin, bleomycin, vinblastine and dacarabazine) cures ∼70% of patients with advanced Hodgkin's lymphoma (aHL, stages IIB, III and IV) while more toxic escalated BEACOPP (EB, combination of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisolone) increases cure rates to 85%. Patients with a positive interim positron emission tomography-computerized tomography (PET-CT) scan after two cycles (PET-2) of ABVD have very poor outcomes with continued ABVD. Intensifying therapy with EB in PET-2-positive patients ('response-adapted therapy') may improve cure rates, whereas the negative patients can continue ABVD alone.

PATIENTS AND METHODS

Eligible patients with newly diagnosed aHL received two cycles of ABVD and underwent PET-2 (scored with semi-quantitative 5-point visual criteria, 'Deauville score'). PET-2-negative patients continued four additional cycles of ABVD, whereas PET-2-positive patients received four cycles of EB. A phase II sample size of 50 was estimated keeping the lower and higher proportion of rejection of the event-free survival (EFS) as 70% and 85%, respectively.

RESULTS

Fifty patients [median age 28 (12-60) years; male : female: 39 : 11; stages: IIB-3 (6%), III-29 (58%) and IV-18 (36%); International Prognostic Score (IPS): 0-3: 34 (68%); 4-7: 16 (32%)] were enrolled; 49 underwent PET-2. Eight (16%) were PET-2-positive, whereas 41 (84%) were negative. Forty-seven were evaluable for EFS and all 50 for overall survival (OS). The 2-year EFS was 76% (95% CI: 68-83) and OS was 88% (95% CI: 82-94). PET-2 was strongly prognostic-2-year EFS, negative versus positive: 82% versus 50%; P = 0.013.

CONCLUSION

PET-2 response-adapted strategy could not achieve EFS of 85% in aHL. However, escalated therapy improved outcomes in PET-2-positive patients compared with historical data.

TRIAL REGISTRATION

CTRI/2012/06/002741 (http://www.ctri.nic.in) and NCT01304849 (http://www.clinicaltrials.gov).

Evaluation of lateral flow assay as a field test for investigation of brucellosis outbreak in an organized buffalo farm: A pilot study

Aim:

The aim was to evaluate lateral flow assay (LFA) as a field test for investigation of brucellosis outbreak in organized buffalo farm.

Materials and Methods:

A total of 153 serum samples were tested to detect the presence of brucella antibodies by LFA and three other serological tests i.e. rose bengal plate test (RBPT), protein G based indirect enzyme-linked immunoassay (iELISA), and competitive ELISA (cELISA). The performances of LFA and other serological tests were evaluated using OIE complaint cELISA as the gold standard.

Results:

Serological tests revealed 50% of the animals were seropositive for Brucella antibodies and correlated with clinical history of abortions, infertility, and productive failures. The newly developed assay showed 87.1% and 92.6% sensitivity and specificity, which was even higher than the specificity of RBPT.

Conclusions:

The investigation proved the potential usefulness of LFA for field diagnosis of brucellosis in the regions where laboratory facilities are limited.

Histopathological changes associated with E. granulosus echinococcosis in food producing animals in Punjab (India)

Cystic echinococcosis due to Echinococcus granulosus is a serious public health and economic concern in India. The disease is endemic in most of the food producing animals such as cattle, buffalo, sheep, goat and pigs in the country. In this study, tissues comprising of pieces of liver and lungs were collected in 10 % formal buffered saline. The formalin fixed tissues (liver and lungs) from 10 cattle, buffalo, sheep, goat and pigs each were selected and further processed by acetone benzene method for histopathological examinations. The cysts were surrounded by outer fibrous layer over the inner germinal layer and filled with clear hydatid fluid. Echinococcal protoscolices were also noticed in some of the sections. Histologically, slight hemorrhage, leucocyte infiltration and mild hepatocellular degeneration in the liver were noticed. The adjacent hepatic paraenchyma showed atrophy, variable degeneration and infiltration. The parenchyma adjacent to cysts was markedly congested and showed multiple small haemorrhagic areas. In lungs, there was proliferation of fibrous connective tissue and infiltration of mononuclear cells.

Evaluation of factors contributing to excessive nitrate accumulation in fodder crops leading to ill-health in dairy animals

A study was conducted to estimate nitrate content in commonly used fodder crops, viz., berseem (Trifolium alexandrinum), bajra (Pennisetum glaucum), maize (Zea mays), oats (Avena sativa), sorghum (Sorghum vulgare) and toriya (Brassica napus), collected from the fields of different villages of Punjab and farms of the university, and to evaluate the factors associated with nitrate accumulation in these crops. The nitrate level was highest in sorghum on dry matter basis, followed by oats and toriya, berseem, maize and bajra. The nitrate content was also determined in fodder samples harvested from young and mature stages and in different parts of plants. The stem part of forages had higher content than leaves; however, concentrations were low in mature crops as compared to immature ones. The environmental and soil factors associated with it are discussed and correlated with the experimental findings.

Should ultrasound guided percutaneous renal biopsy in children be done in a day care setting?

Percutaneous renal biopsy (PRB) is an important diagnostic tool in pediatric nephrology units. But controversy exists whether the procedure can be done in the day care setting. This study was done to document complications of PRB done with automated gun under continuous ultrasonographic guidance and to find whether the procedure can be undertaken as a day care procedure. Retrospective analysis of 67 PRBs is presented. A total of 44% (n = 30) minor and 12% (n = 8) major complications such as gross hematuria, perinephric hematoma, and hemodynamic instability were observed through the study period. All major and 90% of minor complications were detected within four hours in the current study. The procedure may be undertaken in the day care setting with strict pre and postprocedure monitoring up to eight hours in children with normal blood pressures, renal functions, hemoglobin concentrations, and coagulation parameters.

Financing health care for all: challenges and opportunities

India's health financing system is a cause of and an exacerbating factor in the challenges of health inequity, inadequate availability and reach, unequal access, and poor-quality and costly health-care services. Low per person spending on health and insufficient public expenditure result in one of the highest proportions of private out-of-pocket expenses in the world. Citizens receive low value for money in the public and the private sectors. Financial protection against medical expenditures is far from universal with only 10% of the population having medical insurance. The Government of India has made a commitment to increase public spending on health from less than 1% to 3% of the gross domestic product during the next few years. Increased public funding combined with flexibility of financial transfers from centre to state can greatly improve the performance of state-operated public systems. Enhanced public spending can be used to introduce universal medical insurance that can help to substantially reduce the burden of private out-of-pocket expenditures on health. Increased public spending can also contribute to quality assurance in the public and private sectors through effective regulation and oversight. In addition to an increase in public expenditures on health, the Government of India will, however, need to introduce specific methods to contain costs, improve the efficiency of spending, increase accountability, and monitor the effect of expenditures on health.

Nanoporous Titanium Oxide Morphologies Produced by Anodizing of Titanium

A quick and dependable technique has been developed that allows us to selectively produce anodized TiO2 in the form of nanotubes. The process employs mild chemical conditions and ambient temperature. The method can consistently produce nearly 100% surface coverage of nanotubes within 10 min of anodizing. Anodizing in relatively high pH electrolytes for 1 hour permitted us to produce nanotubes of 2μm length. We attribute the repeatability of our results to a brief pre-anodizing etching step that consistently leads to excellent anodizing results. Without this etching step, we experienced very poor consistency in that only small patches of titania nanotubes were formed.

White coated corruption

This essay documents the state of the medical profession which was once a respected line of work but today is corrupted at every level, from medical education to medical practice, and ir both the private and government sectors. It calls for doctors, thE government and the public to act against dishonest doctors restore the dignity of the profession and work for the benefit of society.

Optimizing local control in anorectal melanoma

BACKGROUND

Wide local excision (WLE) of anorectal melanoma is associated with a high incidence of local recurrence. There is a paucity of literature on adjuvant radiation in this malignancy.

AIM

To identify the optimal method of local treatment in anorectal melanoma.

SETTINGS AND DESIGN

Retrospective study in a tertiary cancer centre.

MATERIALS AND METHODS

Records of 63 patients who presented between 1980 and 2004 were reviewed.

RESULTS

Of the 63 patients, 18 were treated by either surgery with or without adjuvant radiation, or by radiation alone. The remaining had advanced disease and were offered only symptomatic treatment. The median overall survival in stage I patients was 12 months, while it was seven and four months in those with stage II and III disease respectively. The median survival in patients treated by WLE with adjuvant radiation (RT), WLE alone or Abdominoperineal resection (APR) was 34, 12 and 10 months respectively. Patients in whom the disease was confined to the mucosa had a better median overall survival than those in whom it had infiltrated beyond the mucosa (102 vs 11 months). The pattern of recurrence following WLE with adjuvant RT or APR was similar. None of the patients who received adjuvant RT after wide excision had a local or nodal recurrence.

CONCLUSION

Local treatment of anorectal melanoma should be individualized. WLE with adjuvant radiation seems to offer good locoregional control without reducing the survival and may be an option of treatment for patients with small, superficial anorectal melanoma. However, APR should be offered for patients with locally advanced disease or as a salvage following recurrence.

Variability of nutritional and cooking quality in bean (Phaseolus vulgaris L) as a function of genotype

Screening of natural biodiversity for the better quality traits are of prime importance for quality breeding programs. The objective of this investigation was to select candidate accession of bean having high concentrations of protein as well as macro and micro minerals with good cooking quality for use as parents in breeding programme for these compounds. Thirty-five accessions of bean (Phaseolus vulgaris L) were field grown and their seeds were analyzed for their cooking quality and nutritional composition. Wide variations were observed in most of the measurements e.g. protein (18.7-26.2%), iron (79.4-137.6 ppm) and hardness after cooking (4.65-9.88 Kg) suggesting that there are considerable levels of genetic diversity. Across all accessions the concentration of potassium was negatively correlated with protein (r = -0.43, P < 0.05). Concentrations of protein was significantly greater in accessions VIII, XIII and XIX compared to other accessions analyzed. Iron concentrations were greatest (137 ppm) in XIX and lowest (79 ppm) in XXVII. Lines with less cooking time were line III, X, XXVI, XXX and XXXI. Bean line XIX contains high protein (24.9%) with high zinc (33.3 ppm) and highest iron (137.6 ppm), but it has high hardness after cooking (7.32 kg). Four clusters were computed by cluster analysis that explained quite a good variation in the traits. The great variability for these attributes suggests that these selected accessions may be useful as parents in hybridization programs to produce bean with value-added traits. This information was also potentially useful for pulse breeders working on the development of new varieties.