Spread and impact of goat pox ("sagolay bohonta") in a village smallholder community around Kaziranga National Park, Assam, India

During September and October 2017, a highly fatal outbreak of a disease clinically indistinguishable from goat pox occurred in the villages around the Kaziranga National Park, Assam, India. This was investigated through clinical examination of affected animals, individual interviews with goat keepers and participatory village meetings. Laboratory confirmation was impractical due to the isolation and poverty of the affected community and unnecessary due to the specific nature of the clinical signs. Respondents reported not having encountered the disease previously, and it would appear that a naïve local population developed within an endemically affected region because of a trend to avoid purchasing animals from outside the village. Local grazing practices appear to have had a role in both the spread and control of the outbreak. Goats are an important form of savings and cash income to people in the locality, and the outbreak may result in considerable financial hardship for affected goat keepers. We provide a detailed description of the clinical disease and the spread of the outbreak in the locality. Awareness of the disease with reference to farming practices will provide opportunities for future disease control to enhance animal welfare and rural prosperity.

Efficacy of COVID-19 vaccines: a systematic review and network meta-analysis of phase 3 randomized controlled trials

Several vaccines have been approved for the prevention of COVID-19. However, no head-to-head trials comparing their clinical efficacy have been performed. This network meta-analysis aims to identify those, among the competing existing vaccines, conferring the maximum protection against COVID-19. A literature search was done in Medline (via PubMed), Embase and Cochrane Library databases for phase 3 randomized controlled trials evaluating the efficacy of different COVID-19 vaccines. Search results were screened and eligible studies were included to perform a network meta-analysis in software 'R' version 4.1.2 using a random effect model. Cochrane's 'Risk of Bias tool (RoB2)' was used for quality assessment. Raw data from the included studies was used for network meta-analysis. Assessment of inconsistency was not possible as no study compared two or more vaccines directly. A forest plot for indirect comparison of various COVID-19 vaccines was obtained. Rankogram and 'P' scores were obtained to rank the vaccines based on the indirect evidence of their comparative efficacy. A total of 17 randomized controlled trials evaluating the efficacy of 16 COVID-19 vaccines, were included in the network meta-analysis. A total of 361,386 participants was included in this network meta-analysis. Overall risk of bias among included studies was of 'some concern'. All the COVID-19 vaccines had a statistically significant reduction of risk for contracting symptomatic SARS-CoV-2 in comparison to the placebo, however, the maximum protection (RR 0.05) was with BNT126b2. The indirect comparison also revealed BNT126b2 vaccine confers the highest protection against symptomatic SARS-CoV-2 infection in comparison to all others included, with a 'P' score of 0.9771 followed by mRNA-1273, rAD26 & rAD5 and NVX-CoV2373. The evidence generated from this network meta-analysis indicates the good efficacy of all the included vaccines in preventing symptomatic COVID-19 as compared to placebo. The BNT126b2 vaccine was found to provide the highest protection against symptomatic SARS-CoV-2 among all included followed by mRNA-1273, rAD26 & rAD5, NVX-CoV2373 and others.

Colostrum provision and care of calves among smallholder farmers in the Kaziranga region of Assam, India

Smallholder cattle farming in Assamese villages is sub-optimal in terms of calf survivability, growth, age at first service, and milk yield. Proper understanding of the local situation is essential to formulate appropriate, locally driven, livestock keeper education to sustainably improve animal health, welfare and productivity. In-depth interviewing and direct observation were used to understand the farming strategies, husbandry practices and challenges to health and productivity in a cluster of typical villages in the Kaziranga region of Assam, India, where resource use is balanced between the needs of humans and livestock, with competition from wild species. Knowledge of the importance of colostrum consumption by calves is poor. Timely consumption of sufficient colostrum (locally called “phehu”) by calves was clearly sub-optimal in the majority of households. The reasons behind this are nuanced, but the practice of collecting colostrum from newly calved cows to make confectionery for human consumption is an important contributory factor. Care of the umbilicus of the newborn is not routine practice in the locality. Local women are the key group assisting with young and sick animals, including cases of simple dystocia and retained foetal membranes. Cows are usually milked once daily, to attempt to balance the needs for milk of household with those of the calf, which can result in suboptimal nutrition for calves. There are clear opportunities to improve animal health and productivity through locally provided farmer education, particularly with reference to colostrum provision, and the engagement of women farmers in any such programme is key to success.

Response of modified microclimates on growth, yield, and incidence of rhizome rot disease of ginger in Assam, India

Field experiments were conducted at Biswanath, Assam, India (26° 42' N and 93° 15' E), during 2016, 2017, and 2018, to evaluate the effect of microclimates on growth, yield, and disease incidence in the ginger crop. The ginger variety Nadia was grown under six microclimates, viz., under shade net for the entire crop season (T1), under shade net from planting to mid-October (T2), with pigeon pea (T3), with maize (T4), with okra (T5), and as a sole crop (T6) in three replicated RBD. Photosynthetically active radiation (PAR), net radiation (Rn), temperature above the ginger canopy, soil temperature, and soil moisture were measured during the critical crop growth period under different microclimates. Recording of rhizome rot disease incidence was done periodically and genomic analysis of pathogen was carried out. PAR recorded above the ginger canopy under T6 was 1688.1 μ mol s-1 m-2, which was attenuated up to 80.1% in other microclimates. The Rn load of the ginger canopy was maximum (446.4 W m-2) under T6, which reduced to below 50 W m-2 under both T3 and T4. Both air temperatures above the ginger canopy and soil temperatures under T3 and T4 were reduced by 3.3 °C and 4.6 °C, respectively, as compared to T6. The pathogen causing the disease in the experimental site was identified as Fusarium oxysporum. Considerable increase in soil and air temperature and soil moisture favored disease incidence (90.3%) under shade net (T1 and T2) treatments, while opposite reason causing significant reduction in disease incidence (16.1%) was observed under T3 and T4. More yield of ginger recorded in treatments T3 (6.21 t ha-1) or T4 (6.48 t ha-1) was attributed to better crop growth and diminutive disease incidence, while the crop was almost damaged due to severe disease incidence under shade net (T1 and T2) treatments.

Efficacy, Safety and Treatment Satisfaction of Glimepiride vs Sitagliptin in Combination with Metformin in Type 2 Diabetes Mellitus

INTRODUCTION

Metformin is a preferred drug for starting treatment in type 2 diabetes mellitus. But, eventually most of the patients need additional drug to control blood sugar level. The choice of drug depends upon several factors including patient specific criteria, economical factors and treatment satisfaction.

AIM

The aim of the present study is to investigate the effects of adding sitagliptin or glimepiride on efficacy, safety and treatment satisfaction in patients with type 2 diabetes mellitus.

MATERIALS AND METHODS

It was a retrospective observational study on 50 patients each in sitagliptin and glimepiride group, who are receiving treatment for at least 12 weeks and are stable on respective treatment regimen. Glycated haemoglobin (HBA1c) was the primary measure of efficacy. Safety was assessed by checking weight gain/loss, hypoglycaemia episodes and other laboratory investigations. Patient satisfaction was assessed by Diabetes Treatment Satisfaction Questionnaire.

RESULTS

The HbA1c level after 12-24 weeks of treatment was not found to be significant compared to each other or from baseline. Compared to baseline fasting plasma glucose & postprandial plasma glucose were lower in glimepiride group. Sitagliptin was associated with less episodes of hypoglycaemia. Weight gain was associated with glimepiride but it was non-significant (p=0.08). Overall treatment satisfaction score were better for sitagliptin but were not statistically significant.

CONCLUSION

The efficacy of sitagliptin was comparable. Sitagliptin had superior adverse effect profile with less chances of hypoglycaemia and weight gain. Questionnaire scores were higher for sitagliptin indicating better treatment satisfaction compared to glimepiride.

Species composition of mosquito breeding in bamboo stumps in Sikkim, India

BACKGROUND & OBJECTIVES

Sikkim is a part of Eastern Himalayan biodiversity hotspot of India rich in bamboo flora harbouring over 30 different bamboo species. The present study was aimed to investigate the larval mosquito diversity in the bamboo stumps of Gangtok, Sikkim. Besides, efforts were also made to evaluate the propensity of particular species of mosquito towards specific bamboo species (if any).

METHODS

A total of 75 bamboo stumps of four genera were surveyed and screened at five different sampling sites of Gangtok from July to October 2017. Mosquito species similarity between the five sampling sites and the four varieties of bamboo species was calculated using the Bray-Curtis similarity index.

RESULTS

A total of 216 larvae were collected from 25 different bamboo stumps studied. The species identified were Aedes albopictus, Ae. atlanticus, Ae. aegypti, Orthopodomyia signifera, Oclerotatus japonicus, Oc. taeniorhynchus, Armigeres subalbatus, and Toxorhynchites splendens. The Oc. japonicus (34.5%) was found to be the most abundant species having distribution in Phyllostachys assamica, Dendrocalamus hamiltonii and Bambusa nutans. On the other hand, genus Armigeres subalbatus and Tx. splendens were found to breed only in the stumps of P. assamica. Based on Bray-Curtis similarity index highest species similarity was recorded between D. hamiltonii and P. assamica bamboo species.

INTERPRETATION & CONCLUSION

The study may help to understand the bioecology of the mosquito larvae which may help to devise suitable mosquito control programmes. Future studies including the survey of large number of bamboo stumps both in urban and rural areas of Sikkim may provide better insight into the mosquito diversity in the bamboo stumps of Sikkim.

Pharmacokinetics-Based Optimization of Phototherapy in Neonates Undergoing Treatment for Hyperbilirubinemia

Introduction: Neonatal jaundice results from combined effects of both increased production of bilirubin and decreased hepatic excretory capacity in neonates. Since its discovery, phototherapy is the most widespread treatment used in neonatal jaundice. In this work, we try to search for a relationship between exposure to phototherapy and decrease in serum bilirubin (linearity vs proportionality). Methods:The present research was non-randomized prospective study conducted in the Neonatal Intensive Care Unit (NICU), Department of Paediatrics, AIIMS, New Delhi, and the Department of Pharmacology, AIIMS, New Delhi, India. Subjects were recruited from neonates admitted in NICU AIIMS, which meets our selection criteria. Infants were given a low dose of either phototherapy continuously or phototherapy for the first six hours and a double dose of phototherapy for the next six hours. Samples were collected before the beginning of the study (0 hours) and then at six and 12 hours. Bilirubin concentration was measured using HPLC and (LC-MS/MS). Results and conclusion:The percentage of reduction during the 6-12-hour interval was compared with that during the 0-6-hour interval if all experimental conditions were kept unchanged. A relationship curve between percentage of reduction and irradiance was created based on the percentage of reduction in serum bilirubin during the 0-6-hour and 0-12-hour intervals. The present study suggests that the relationship between efficacy, as measured by percentage of reduction in serum bilirubin, and irradiance is unlikely to be linear. Collected data are insufficient to clearly distinguish between proportionality and saturation point, considering that the results may be possible with both of these hypotheses.

BACTERIA ASSOCIATED WITH NON-ALCOHOLIC FERMENTED BAMBOO SHOOT FOOD PRODUCT

Pure bacterial cultures were isolated from fermented products collected from two locations of North East India (Assam and Arunachal Pradesh). Forty four variants were identified by 16S rRNA gene sequencing. The dominant microbial genera found were Bacillus, Paenibacillus followed by Oceanobacillus and Lactobacillus in Assam and Bacillus, Enterococcus, Lactobacillus in Arunachal-Pradesh food products. Bacillus isolates showed extracellular enzyme production (amylases, proteases and lipases) as analyzed through plate assay. GC-MS analysis showed beneficial chemical components like organic acids, esters, aminoacids, vitamins in fermented bamboo shoot products. Probiotic attributes of culturable bacterial isolates from bamboo fermentations gives promiscuity for human consumption. Beneficial microorganisms from bamboo shoot fermented food products of North-Eastern region of India were explored and compared using bioinformatics tools.

Development of a novel plant system as biosensor for detecting environmental hazards and bioactive molecules through distinct responses

Currently, chemicals are used excessively in medicine, industry, and agriculture throughout the world. Because of the current rise in environmental pollutants and hazardous exposures of human beings, there is an imperative need for monitoring the environment for biosafety. In addition, the importance of natural products with novel activity for drug or agrochemical scopes is being more and more realized. We report on a novel test system that can act as biosensors for detecting useful compounds while simultaneously monitoring or forecasting the biohazard exposure of organisms to chemicals as well as to physical factors in a given environment. Using different compounds and factors with known biological and cytotoxic activities, a detail plant test procedure has been developed that can be used in detecting and analyzing the value and/or danger of any given compound or treatment, including cell division inhibition, cytotoxicity, growth inhibition, and anticancer activities. The method provides a highly efficient single biosensor system that can replace several individual biotesting procedures. This plant assay procedure is a highly sensitive system for monitoring physical stress factors in the environment, including ionizing and nonionizing radiation. The procedure can be followed throughout the year because of the rapid growth rate of the plant used and its regeneration in ambient conditions. Therefore, the described system is highly useful to thoroughly monitor the environment and detection of new chemicals/compounds.

Effectiveness of Stem Cell Therapy for Diabetic Foot Ulcers: A Systematic Review and GRADE Compliant Bootstrapped Meta-Analysis of Randomized Clinical Trials

Diabetic foot (DF) represents a severe complication of diabetes mellitus, imposing substantial psychological and economic burdens on affected individuals. This investigation sought to assess the therapeutic efficacy of stem cell interventions in the management of DF complications. A comprehensive systematic search across PubMed, Embase, CINAHL, Scopus, and the Cochrane library databases was conducted to identify pertinent studies for meta-analysis. Outcome measures encompassed ulcer or wound healing rates, amputation rates, angiogenesis, ankle-brachial index (ABI), and pain-free walking distance. Dichotomous outcomes were expressed as risk differences (RDs) with 95% confidence intervals (CIs), while continuous data were articulated as standardized mean differences (SMDs) with corresponding 95% CIs. Statistical analyses were executed using RevMan 5.3 and Open Meta, with bootstrapped meta-analysis conducted through OpenMEE software. A total of 20 studies, comprising 24 arms and involving 1304 participants, were incorporated into the meta-analysis. The findings revealed that stem cell therapy exhibited superior efficacy compared to conventional interventions in terms of ulcer or wound healing rate [RD = 0.36 (0.28, 0.43)], pain-free walking distance [SMD = 1.27 (0.89, 1.65)], ABI [SMD = 0.61 (0.33, 0.88)], and new vessel development [RD = 0.48 (0.23, 0.78)], while concurrently reducing the amputation rate significantly [RD = -0.19 (-0.25, -0.12)]. Furthermore, no statistically significant difference in adverse events was observed [RD -0.07 (-0.16, 0.02)]. The Grading of Recommendations, Assessment, Development, and Evaluation assessment indicated varying levels of evidence certainty, ranging from very low to moderate, for different outcomes. Bootstrapping analysis substantiated the precision of the results. The meta-analysis underscores the significant superiority of stem cell therapy over conventional approaches in treating DF complications. Future investigations should prioritize large-scale, randomized, double-blind, placebo-controlled, multicenter trials, incorporating rigorous long-term follow-up protocols. These studies are essential for elucidating the optimal cell types and therapeutic parameters that contribute to the most effective treatment strategies for DF management.

Prosthesis for Unilateral Isolated Proximal Focal Femoral Deficiency: A Case Report and Review of the Literature

A 14-month-old female child was brought to us by her parents with the complaint of progressive shortening of her right lower limb since birth. Born to non-consanguineous parents from a poor socioeconomic background, her birth and antenatal history were uneventful. Physical examination revealed no facial dysmorphism; however, her right thigh was short and bulky, and there were restrictions in hip, knee, and ankle movements. The pediatric evaluation showed normal growth and development. X-rays confirmed proximal femoral focal deficiency (PFFD) of the right lower limb. After extensive parental counseling regarding the condition, potential interventions, and outcomes, the parents opted for prosthetic management due to concerns about surgical costs, risks, and cosmetic outcomes. A custom-made extension prosthesis was prepared for the limb and was fit. At a follow-up of one year, the child exhibited a normal gait pattern with stable hip, knee, and ankle motion, and the parents expressed satisfaction with the prosthetic management, preferring it over surgical intervention for the time being.

A Narrative Review of Antiviral Drugs Used for COVID-19 Pharmacotherapy

PURPOSE

A number of research articles has been published evaluating safety and efficacy of drugs against COVID-19. This study was undertaken to collate and review the information regarding common proposed anti- viral drugs for easy reference.

METHODS

The literature was search was done using terms like severe acute respiratory syndrome or SARS-CoV-2 or 2019-nCoV or SARS-CoV or COVID-19 in combination with drugs or treatment or pharmaco-therapy using PubMed and google scholar to identify relevant articles.

RESULTS

Despite showing good early results, hydroxychloroquine and lopinavir-ritonavir has not shown clinical benefit in randomized controlled trials. However lopinavir in combination with other drugs specially interferon is being investigated. Remdesivir has shown positive effect in terms of clinical improvement and continued to being investigated alone or in combination with other drugs. Favipiravir has shown mixed results and more data from adequately powered study is needed to prove its efficacy.

CONCLUSIONS

Many drugs which showed positive effect in initial studies could not replicate the same benefit in large randomized controlled trials. There is need to evaluate efficacy and safety of drugs based on high quality evidence before allowing it to be used in general population.