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Background:Post?cardiotomy vasoplegia syndrome (VS) is often linked to an exaggerated inflammatory response to cardiopulmonary bypass (CPB). At the same time, the prognostic role of platelet?leucocyte indices (PLIs) and leucocyte indices (LIs), (platelet?lymphocyte ratio [PLR], systemic immune?inflammation index [SII = platelet neutrophil/lymphocyte], aggregate index of systemic inflammation [AISI = platelet monocyte neutrophil/lymphocyte], and neutrophil?lymphocyte ratio [NLR], systemic inflammation response index [SIRI = monocyte neutrophil/lymphocyte), respectively] has been recently described in diverse inflammatory settings. Methods: The retrospective study was conducted to evaluate the VS predictive performance of PLIs and LIs in 1,045 adult patients undergoing elective cardiac surgery at a tertiary care center. VS was defined by mean blood pressure <60 mmHg, low systemic vascular resistance (SVRI <1,500 dynes.s/cm 5/m2 ), a normal or high CI (>2.5 L/min/m2 ), and a normal or reduced central filling pressure despite high?dose vasopressors. Results: About 205 (19.61%) patients developed VS postoperatively. On univariate analysis, age, diabetes, dialysis?dependent renal failure, preoperative congestive heart failure (CHF), the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, ejection fraction, NLR, PLR, SII, SIRI, AISI, CPB, and aortic cross clamp (ACC) duration, packed red blood cell (PRBC) transfusion, and time?weighted average blood glucose predicted VS. Subsequent to the multivariate analysis, the predictive performance of EuroSCORE II (OR: 3.236; 95% CI: 2.345–4.468; P < 0.001), CHF (OR: 1.04; 95% CI: 1.02–1.06; P = 0.011), SII (OR: 1.09; 95% CI: 1.02–1.18; P = 0.001), AISI (OR: 1.11; 95% CI: 1.05–1.17; P < 0.001), PRBC (OR: 4.747; 95% CI: 2.443–9.223; P < 0.001), ACC time (OR: 1.003; 95% CI: 1.001–1.005; P = 0.004), and CPB time (OR: 1.016; 95% CI: 1.004–1.028; P = 0.001) remained significant. VS predictive cut?offs of SII and AISI were 1,045 1045×109 /mm3 and 137532×109 /mm3 , respectively. AISI positively correlated with the postoperative vasoactive?inotropic score (R = 0.718), lactate (R = 0.655), mechanical ventilation duration (R = 0.837), and ICU stay (R = 0.757). Conclusions: Preoperative elevated SII and AISI emerged as independent predictors of post?cardiotomy VS.
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Background & objectives: The state of Himachal Pradesh is one of the hilly forested states of India. Warming of climate has been evidenced in the state due to the ongoing climate change which may cause the upsurge/introduction of mosquito-borne diseases. To curb disease transmission, an effective vector control strategy will be required. Methods: Insecticide susceptibility status of available malaria vectors was determined using the standard WHO method in six districts Kangra, Una, Mandi, Bilaspur, Solan and Mandi of the state. An. culicifacies and An. fluviatilis were tested against DDT (4%), malathion (5%) and deltamethrin (0.05%) using WHO insecticide susceptibility kits. Results: Overall, An. culicifacies was found resistant to DDT in all the six districts, susceptible to malathion in all districts except Bilaspur and Solan where it showed possible resistance. It was susceptible to deltamethrin in all the study districts. An. fluviatilis was resistant to DDT and susceptible to malathion and deltamethrin in Kangra and Una districts. Interpretation & conclusion: At present, indoor residual spraying (IRS) is not being undertaken in Himachal Pradesh. However, with the information generated through the present study, the state government can plan evidence-based IRS at least for focal spray in limited foci reporting malaria incidence.
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Aims: Present study aims to highlight an accidental death of a male Dwarf Sperm Whale scientifically known as Kogia sima which found to be as Least Concern (LC) as per IUCN Red List data. Kogia sima represents important higher trophics of marine ecosystem which faced the several threats and conservation need in Gulf of Mannar, India. Study Design: The study undertaken during extensive coral reef monitoring survey was carried out in Gulf of Mannar under the CRAM Project of National Centre for Coastal Research (NCCR). The present report emphasize the Morphometric observation of the dead Kogia sima and try to find out possible cause of death by examining in situ investigation. Place and Duration of Study: The field study was taken in Vedalai Sea shore (N09�.626�, E79�.977�) under the Mandapam Union of Ramnathapuram District of Tamil Nadu. The male whale specimen was found on 5th May, 2019 lying dead on the sandy seashore. Methodology: Animal was photographed and morphological attributes were measured to identify the specimen. Several injuries have been highlighted in the paper which helps in investigating the cause of death. Results: The Dwarf Sperm Whale was infant and has mild damage on the mouth parts including scuff off skin from the body and severe blood clotting at major part of the right side near to pectoral fin. Death of this infant is not clear but it is assumed that the male infant has lost from his parents and came to the inshore area of Mandapam where it gets stuck with running boat or boulder rocks as this immature whale limits its diving capabilities. The necessary morphological characters and measures have been listed in Table 1. Conclusion: This unfortunate death clearly indicated that acute information on ecological behavior of Dwarf Sperm Whale is still under data collection stage in India and that previous conservation efforts in country must be reviewed in terms of role of local authorities, live stranded cetaceans and hunting or incidental killing which in future can build a road map for effective action plans to save this marine mammal.
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Background & objectives: Microscopy is considered as the gold standard for malaria diagnosis, however sub-microscopic infections can only be detected by Polymerase chain reaction, which demands high cost and elaborate laboratory setup. The Micro-chip PCR based Truenat Malaria Pv-Pf and Pf assay is a portable solution for detection of sub-microscopic/asymptomatic cases of malaria in the field, three lots of which were evaluated for P. falciparum and P. vivax malaria. Methods: Three lots of Truenat® Malaria Pv-Pf and Pf assay (kits) were assessed using blood samples of P. vivax and P. falciparum as well as malaria negative blood samples. DNA was extracted from the blood samples using the Trueprep Auto v2 Universal Cartridge based sample prep device and real time qPCR was performed using Truelab DUO micro PCR Analyzer with three lots of Truenat® Malaria Pv-Pf and Pf Assays. Mean, Standard deviation and one-way analysis of variance (ANOVA) was used to assess the significance of inter-lot variability in Cycle threshold values. Results: The Truenat® Malaria Pv-Pf and Pf assays identified the malaria parasites with 100% accuracy. Based on the test for variance (ANOVA) the inter-lot variability in cycle threshold values were not significant, indicating a high degree of precision. Interpretation & conclusion: Based on high accuracy and precision between different lots, the Truenat® Malaria Pv-Pf and Pf assays were found to be suitable for the diagnosis of sub-microscopic infections in field conditions to provide support in elimination of malaria.
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Background & objectives: Attractive toxic sugar baits (ATSB) is a novel tool which employs mosquito sugar feeding behaviour to kill them. The potential of ATSB against mosquito vectors has been demonstrated in limited scope around the world including Israel, some of the African countries and USA. But their efficacy against mosquito vectors of India is yet to be ascertained. Therefore, current study was planned to evaluate the efficacy of TSB (without attractant) against two important malaria vectors Anopheles culicifacies and An. stephensi along with major dengue vector Aedes aegypti. Methods: TSB solution was prepared by dissolving different concentrations of boric acid in glucose and tested against each of the mosquito species. Another experiment was done by spraying this boric acid sugar solution on to Calendula officinalis plant. It served as a sole source of mosquito feed and mortality of mosquitoes was counted after 24 hours. Results: The TSB resulted in 100% mortality of Ae. aegypti and An. stephensi at 4% concentration of boric acid while in An. culicifacies 100% mortality was achieved at 3% concentration TSB solution. TSB solution with 2% boric acid, resulted in 99.1% mortality in An. culicifacies while ~95 % mortality of An. stephensi and Ae. aegypti. When TSB solution with 2% boric acid was sprayed on plant, ~89-94% mortality was observed in both An. stephensi and An. culicifacies. Interpretation & conclusion: Based on the results, boric acid based toxic sugar bait solution could be a promising tool for vector control. Further studies are needed to find out its toxicity of TSB against non-target organisms and residual efficacy in field trials in different ecotypes.
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Sacroiliitis caused by Salmonella typhi is an unusual occurrence. Mycobacterium tuberculosis is the usual culprit in our country. We report this case of a 17-year-old young boy who presented with high-grade fever and hip pain. Imaging revealed sacroiliitis and culture grew Salmonella typhi. The patient was treated with parenteral antibiotics and later continued on oral antibiotics
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Background & objectives: The influence of temperature on the life cycle of mosquitoes as well as on development of malaria parasite in mosquitoes is well studied. Most of the studies use outdoor temperature for understanding the transmission dynamics and providing projections of malaria. As the mosquitoes breed in water and rest usually indoors, it is logical to relate the transmission dynamics with temperature of micro-niche. The present study was, therefore, undertaken to understand the influence of different formats of temperature of different micro-niches on transmission of malaria for providing more realistic projections. Methods: The study was conducted in one village each of Assam and Uttarakhand States of India. Temperatures recorded from outdoor (air) as well as indoor habitats (resting place of mosquito) were averaged into daily, fortnightly and monthly and were used for determination of transmission windows (TWs) for Plasmodium vivax (Pv) and P. falciparum (Pf) based on minimum temperature threshold required for transmission. Results: The daily temperature was found more useful for calculation of sporogony than fortnightly and monthly temperatures. Monthly TWs were further refined using fortnightly temperature, keeping in view the completion of more than one life cycle of malaria vectors and sporogony of malaria parasite in a month. A linear regression equation was generated to find out the relationship between outdoor and indoor temperatures and R2 to predict the percentage of variation in indoor temperature as a function of outdoor temperature at both localities. Interpretation & conclusions: The study revealed that the indoor temperature was more than outdoors in stable malarious area (Assam) but fluctuating in low endemic area like Uttarakhand. Transmission windows of malaria should be determined by transforming outdoor data to indoor and preferably at fortnightly interval. With daily recorded temperature, sporogonic and gonotrophic cycles can also be calculated which is otherwise not possible with monthly data. The study highlights that the projections made for malaria in view of climate change need to be seen with limitation of difference in outdoor and indoor temperatures at different locations, highlighting the need for local data generation at least at sub-district level.
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Rotula aquatica Lour is a small branched shrub that grows characteristically among rocks and trailing over gravel in stream beds. It belongs to the family Boraginaceae and widely distributed throughout India. It is commonly called as Pasanabheda. The present study was aimed to evaluate the total phenolics and in vitro antioxidant activity in root and leaf extracts of Rotula aquatica Lour. The dried roots and leaves were subjected to soxhlet extraction utilizing chloroform and methanol followed by preliminary qualitative phytochemical analysis. Total phenolic content was estimated by Folin-Ciocalteu method and in vitro antioxidant assays were performed using various radical scavenging activities viz. DPPH, superoxide anion, nitric oxide, hydroxyl and iron chelating activities at different concentrations. The results of the total phenolic content estimation was expressed in terms of equivalence with standard and the antioxidant potentiality of various scavenging and chelating activity were expressed in terms of IC50 values. The results showed that both root and leaves possess significant antioxidant activity even though the former was found to be superior than the latter in terms of parameters assessed. Further the methanol extracts were proved to be an ideal for the materials subjected to investigation.
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Background and Objective:Horseshoe kidney is themost common renal fusion anomalywith a reported prevalence of 1 in 400 persons with a male to female ratio of 2:1. In many cases its presence may go unnoticed and undiagnosed because the patient may remain asymptomatic throughout life. The objective of our study is to report radiological and anatomical features of horseshoe kidney detected incidentally during retrospective evaluation of multidetector computed tomography scans. Materials and Methods: Contrast enhanced multidetector computed tomography scans of 682 patients, 355 males and 327 females, were reviewed retrospectively. Results: Seven cases of horseshoe kidney were detected incidentally, sixmales and one female,with an incidence of 1.02%. In all cases,malrotation of the kidneyswere observedwith the hilumfacing anteriorly or anterolaterally. The isthmus was made up of parenchymal tissue in all the cases and the fusion was midline in four cases and lateral in three cases. Horseshoe kidney in all cases was supplied by multiple renal arteries, varying from 3 to 6. In three cases symmetrical arterial supply and in the rest asymmetrical supplywas observed. Nephrolithiasis and hydronephrosis were noted in two patients. No other associated congenital anomaly was observed in all seven patients. Conclusion: Contrast enhanced multidetector computed tomography evaluation of patients with horseshoe kidney provide excellent information about its vascularity, collecting system and other associated conditions.
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This review briefly describes the origin, chemistry, molecular mechanism of action, pharmacology, toxicology, and ecotoxicology of palytoxin and its analogues. Palytoxin and its analogues are produced by marine dinoflagellates. Palytoxin is also produced by Zoanthids (i.e. Palythoa), and Cyanobacteria (Trichodesmium). Palytoxin is a very large, non-proteinaceous molecule with a complex chemical structure having both lipophilic and hydrophilic moieties. Palytoxin is one of the most potent marine toxins with an LD50 of 150 ng/kg body weight in mice exposed intravenously. Pharmacological and electrophysiological studies have demonstrated that palytoxin acts as a hemolysin and alters the function of excitable cells through multiple mechanisms of action. Palytoxin selectively binds to Na(+)/K(+)-ATPase with a Kd of 20 pM and transforms the pump into a channel permeable to monovalent cations with a single-channel conductance of 10 pS. This mechanism of action could have multiple effects on cells. Evaluation of palytoxin toxicity using various animal models revealed that palytoxin is an extremely potent neurotoxin following an intravenous, intraperitoneal, intramuscular, subcutaneous or intratracheal route of exposure. Palytoxin also causes non-lethal, yet serious toxic effects following dermal or ocular exposure. Most incidents of palytoxin poisoning have manifested after oral intake of contaminated seafood. Poisonings in humans have also been noted after inhalation, cutaneous/systemic exposures with direct contact of aerosolized seawater during Ostreopsis blooms and/or through maintaining aquaria containing Cnidarian zoanthids. Palytoxin has a strong potential for toxicity in humans and animals, and currently this toxin is of great concern worldwide.
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Animals , Dogs , Humans , Mice , Rabbits , Rats , Acrylamides , Chemistry , Toxicity , Anthozoa , Virulence , Physiology , Dinoflagellida , Virulence , Physiology , Guinea Pigs , Haplorhini , Lethal Dose 50 , Marine Toxins , Chemistry , Toxicity , Seaweed , Virulence , Physiology , Shellfish Poisoning , Sodium-Potassium-Exchanging ATPase , MetabolismABSTRACT
Aim: To evaluate the efficacy of modified temporalis muscle transfer (TMT) by silicone sling for the management of paralytic lagophthalmos. Settings and Design: Prospective interventional study. Materials and Methods: Ten patients of lagophthalmos due to facial palsy underwent modified TMT using silicone sling. The patients were followed‑up for a period of 3 months. Palpebral aperture in primary gaze and during eye closure were assessed both pre‑ and postoperatively along with problems associated with lagophthalmos like exposure keratopathy and lacrimation. Statistical Analysis: Paired t‑test was applied to measure the statistical outcome. Results: Eight patients achieved full correction of lagophthalmos with no lid gap on closing the eye. The mean (standard deviation (SD)) lid gap on eye closure was 7.7 (0.86) mm preoperatively, 0.5 (0.47) mm at 1st postoperative day, and 0.7 (0.75) mm at 3rd month. There was a reduction in mean lid gap on eye closure of 7 mm at 3 months (P < 0.0001) which is highly significant. The mean (SD) vertical interpalpebral distance during primary gaze was 12.05 (1.12) mm preoperatively, 10 (0.94) mm at 1st postoperative day, and 10.35 (1.08) mm at 3rd month. There was a reduction in mean vertical inter palpebral distance of 1.7 mm at 3 months (P = 0.001) which is significant. Exposure keratitis decreased in five out of six patients at 3 months. Conclusion: Modified TMT by silicone sling is a useful procedure with lesser morbidity and good outcomes for the treatment of paralytic lagophthalmos due to long standing facial palsy.
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Bio-ethanol production from cane molasses (diluted to 15 % sugar w/v) was studied using the bacterium, Zymomonas mobilis MTCC 92 entrapped in luffa (Luffa cylindrica L.) sponge discs and Ca-alginate gel beads as the immobilizing matrices. At the end of 96 h fermentation, the final ethanol concentrations were 58.7 ± 0.09 and 59.1 ± 0.08 g/l molasses with luffa and Ca-alginate entrapped Z. mobilis cells, respectively exhibiting 83.25 ± 0.03 and 84.6 ± 0.02 % sugar conversion. There was no statistical significant difference (Fischer's LSD) in sugar utilization (t = 0.254, p <0.801) and ethanol production (t =-0.663, p <0.513) between the two immobilization matrices used. Further, the immobilized cells in both the matrices were physiologically active for three more cycles of operation with less than 15 % decrease in ethanol yield in the 4th cycle, which was due to some leakage of cells. In conclusion, luffa sponge was found to be equally good as Ca-alginate as a carrier material for bacterial (Z. mobilis. cell immobilization for ethanol production. Further, it has added advantages such as it is cheap, non-corrosive and has no environmental hazard.
Subject(s)
Enzyme Activators , Ethanol/analysis , Fermentation , Luffa/growth & development , Molasses/analysis , Zymomonas/isolation & purification , Cells, Immobilized , MethodsABSTRACT
Anatomical variations are common in axilla. These are usually encountered during axillary explorations for breast cancer and other surgical procedures. The most common being the presence of a muscular slip known as the axillary arch. This muscle, usually arises from the latissimus dorsi to be attached to the pectoralis major (which is more common) or to the coracobrachialis or to the fascia over the biceps brachii. This may be single or present as multiple bands and may or may not be clinically apparent. The axillary arch may cause thoracic outlet syndrome like symptoms, may pose difficulty in axillary explorations for various surgical procedures, reconstruction techniques and axillary bypass operations. The current case report is to discuss the features of this variation, with an emphasis on its surgical implications.
Subject(s)
Humans , Axilla/anatomy & histology , Humans , Muscles/anatomy & histology , Pectoralis Muscles/anatomy & histology , Skeletal Muscle VentricleABSTRACT
The article reviews the issue of climate change and health in the Indian context. The importance of climate change leading to estimated loss of above 2.5 million DALYs in southeast Asia, mortality due to heat waves, and the importance of air quality related respiratory diseases, disasters due to excessive floods, malnutrition due to reduction in rice, maize and sorghum crops etc. Latest work undertaken in India, vis-a-vis current scenario and need for further work has been discussed. There is felt need of further studies on assessing the impact on dengue and chikungunya as the transmission dynamics of these diseases involve water availability, storage and life style, etc. Uncertainties and knowledge gaps identified in the studies undertaken so far have also been highlighted. As regards to vector borne diseases, there is a need to concentrate in the areas which are presently free from malaria and with use of best available tools of interventions in already disease endemic areas like northeastern states, the risk of climate change impacts can be minimized.
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Antioxidant activity of methanol extracts of two common legumes, Vigna radiata (Green gram) and Macrotyloma uniflorum (Horse gram) for their seeds and sprouts was investigated by adopting various in vitro models such as reducing power assay, DPPH assay, total phenolic assay and total antioxidant assays. The results showed higher antioxidant abilities in the sprouts than their seeds for the various antioxidant tests performed. Sprouts described above are being used in traditional diet as a beneficial source of food with very high nutritional value and support the concept of functional foods and the results are discussed.
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To evaluate visual field changes in patients with pituitary adenomas following trans-sphenoidal surgery. Eighteen patients with pituitary adenomas underwent a complete ophthalmic assessment and visual field analysis using the Humphrey Field Analyzer 30-2 program before and after trans-sphenoidal surgical resection at the Himalayan Institute of Medical Sciences over a one year period. Visual acuity, duration of symptoms, optic nerve head changes, pattern of visual field defects, and variables such as mean deviation and visual field index were compared. Thirty-six eyes of 18 patients including 10 male and 8 female subjects with mean age of 35.1 +/- 9.9 years and histologically proven pituitary adenoma were included. Mean visual acuity at presentation was 0.29 logMAR which improved to 0.21 logMAR postoperatively [P = 0.305]. Of 36 eyes, 24 [66.7%] had visual field defects including temporal defects in 12 eyes [33.3%], non-specific defects in 10 eyes [27.8%], and peripheral field constriction in 2 eyes [5.6%]. Mean deviation of visual fields at presentation was -14.28 dB which improved to -11.32 dB postoperatively. The visual field index improved from 63.5% to 75% postoperatively. Favorable visual field outcomes were correlated with shorter duration of symptoms and absence of optic nerve head changes at presentation. Visual field defects were present in two thirds of patients at presentation. An overall improvement in vision and visual fields was noted after surgical resection. An inverse correlation was found between the duration of symptoms and postoperative visual field recovery, signifying the importance of early surgical intervention
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The purpose of this investigation was to study the effect of Bacillus subtilis CM5 in solid state fermentation using cassava bagasse for production of Exo-polygalacturonase (exo-PG). Response surface methodology was used to evaluate the effect of four main variables, i.e. incubation period, initial medium pH, moisture holding capacity (MHC) and incubation temperature on enzyme production. A full factorial Central Composite Design was applied to study these main factors that affected exo-PG production. The experimental results showed that the optimum incubation period, pH, MHC and temperature were 6 days, 7.0, 70 percent and 50ºC, respectively for optimum exo-PG production.
O objetivo desta investigação foi estudar a produção de exo-poligalacturonase (exo-PG) por Bacillus subtilis CM5 por fermentação em estado sólido empregando bagaço de mandioca. Empregou-se a metodologia de superfície de resposta para avaliar o efeito de quatro variáveis na produção da enzima: período de incubação, pH inicial do meio, MHC e temperatura de incubação. Os resultados experimentais mostraram que os ótimos de temperatura, período de incubação, MHC e temperatura para produção de exo-PG foram seis dias, 7,0, 70 por cento e 50ºC, respectivamente.
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In this study 250 patients with essential hypertension were investigated in comparison to 218 normotensives for association with epidemiological parameters. Of these DNA samples from 176 patients and 168 controls were analyzed for intron 4 27bp repeat polymorphism of eNOS gene. The study revealed significantly high risk of essential hypertension for individuals who were obese, with a positive family history and with non-vegetarian food habits. Though the intron 4b/a polymorphism of eNOS gene did not reveal any association with essential hypertension in general, males with a/a genotype of the polymorphism did show significantly high risk for developing hypertension.