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Abstract Objective To determine reference intervals (RI) for fasting blood insulin (FBI) in Brazilian adolescents, 12 to 17 years old, by direct and indirect approaches, and to validate indirectly determined RI. Methods Two databases were used for RI determination. Database 1 (DB1), used to obtain RI through a posteriori direct method, consisted of prospectively selected healthy individuals. Database 2 (DB2) was retrospectively mined from an outpatient laboratory information system (LIS) used for the indirect method (Bhattacharya method). Results From DB1, 29345 individuals were enrolled (57.65 % female) and seven age ranges and sex partitions were statistically determined according to mean FBI values: females: 12 and 13 years-old, 14 years-old, 15 years-old, 16 and 17 years-old; and males: 12, 13 and 14 years-old, 15 years-old, 16 and 17 years-old. From DB2, 5465 adolescents (67.5 % female) were selected and grouped according to DB1 partitions. The mean FBI level was significantly higher in DB2, on all groups. The RI upper limit (URL) determined by Bhattacharya method was slightly lower than the 90 % CI URL directly obtained on DB1, except for group female 12 and 13 years old. High agreement rates for diagnosing elevated FBI in all groups on DB1 validated indirect RI presented. Conclusion The present study demonstrates that Bhattacharya indirect method to determine FBI RI in adolescents can overcome some of the difficulties and challenges of the direct approach.
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Background: Snake bite is a common acute medical emergency faced by rural populations in tropical and subtropical countries. In India, a large proportion of snake bites occur when people are working barefoot in the fields or while walking at night. More than 2,000 species of snakes are known worldwide, of which around 400 are poisonous. These snakes belong to the families Elapidae, Viperidae, Hydrophiidae and Colubridae. Methods: A prospective was done at medicine department of SDH Sawantwadi, Sindhudurgh. Study duration was 3 months (May 2023 to July 2023). Study population included all cases admitted in SDH Sawantwadi with history of snake bite. Sample size was 50. Results: Majority of cases found in the age group of 18-30 years 19 cases (38%) followed by 9 cases in 31-45 age group, 12 in 46-60 age group and 10 cases in 61 and above group. Majority of patients with history of snake bite were males contributing 27 (54%). Snake bites were more common in males as compared to females 23 (46%). 14% snake bite cases have activated partial thromboplastin time (APTT) >30 seconds, 10% of snake bite cases had prothrombin time (PT) >15 sec, 30% had platelet count <100000, increased leucocyte count >11000 was seen in 22% cases and 12% victims showed whole blood clotting test (WBCT) >20 minutes. Clinical outcome was 90% discharged after treatment and 10% death during treatment. Correlation between PT and clinical outcome is significant at p<0.5. Conclusions: Association between PT and mortality among snake bite patients was statistically significant.
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Brain abscess is a rare and often life-threatening sequelae, observed in 5-20% of the patients with cyanotic congenital heart diseases (CHD). Cyanotic heart diseases involve a right-to-left shunt by-passing the pulmonary vascular bed, culminating in tissue hypoxia. We present a case of an uncorrected atrioventricular canal defect (AVCD) with a double outlet right ventricle (DORV) complicated by a brain abscess in a 12-year-old girl. This patient was a known case of CHD diagnosed at 2 years of age and presented to the neurology out-patient department with a holocranial headache, vomiting, and low-grade fever for 5 days. General examination was suggestive of cyanosis and low-set ears. Systemic examination revealed a pansystolic murmur with bilateral extensor plantar reflexes. MRI brain with contrast revealed an abscess in the right temporoparietal lobe with perilesional edema. The patient was managed conservatively. Nine days post-discharge, the patient presented with generalized tonic-clonic seizures and was readmitted and managed accordingly. Subsequently, she was referred to the cardiothoracic surgery department for correction of the CHD. However, the family gave negative consent for the same. The relatives of the case described here were counseled to get a surgical correction done for the cardiac defect at the time of diagnosis but with no success. The aim of publishing this case is to emphasize the need for timely diagnosis and correction of such anomalies to curb serious complications causing profound morbidity and mortality.
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We present the case of a 20-year-old male who presents multiple traumas of the abdomen 26 days prior to his return to the emergency room. Going again to evaluation with frank data of peritoneal irritation, since there is no hemodynamic commitment, a contrasted abdomen computed tomography (CT) scan is requested, finding a grade III splenic lesion, which is why he is admitted for emergency splenectomy. This case reports a splenic injury with the need for delayed splenectomy.
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Background: Lung cancer is the most common cause of cancer mortality worldwide. Smoking is undoubtedly the major risk factor of lung cancer in both genders. Adenocarcinoma is the most common form of lung cancer in both men and women and the most prevalent subtype in non-smokers. Lung cancer in never-smokers is a distinct entity with sparse studies. We studied the clinico-pathologic profile of lung adenocarcinoma and pattern of p53 expression in smokers and non-smokers. Methods: A prospective study involving 100 lung adenocarcinoma cases from January 2020 to June 2021 examined p53 expression using immunohistochemistry. Trucut biopsies, fine needle aspiration cytology (FNAC) cell blocks, and pleural effusion were analyzed to identify the predominant morphological subtype of the lung adenocarcinoma. Results: The most common histological pattern of lung adenocarcinoma was solid, and the presenting symptoms were cough and dyspnoea in both smokers and non-smokers. The incidence of lung adenocarcinoma was higher in non-smokers in the study. p53 expression had a significant correlation with smoking but not with stage of disease or morphological subtype of lung adenocarcinoma. Conclusions: p53 mutation has a statistical correlation with smoking in adenocarcinomas in our population. Among the adenocarcinoma cases in our study, non-smokers predominate (n=53). Even though our study showed the p53 mutation has no statistical correlation with the stage of the disease or histological subtype in adenocarcinoma, more cases need to be studied to prove this observation.
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Neuroendocrine tumors (NETs) have varied pathophysiological characteristics, location, clinical presentation, management & outcome. Unfortunately, most NETs are non-functional and therefore, either remain asymptomatic until incidentally detected or present very late with pressure symptoms, adding up to the associated morbidity and mortality. Here we presented a case of a 43-year gentleman, who presented to gastroenterology OPD with chief complaints of heartburn and pain in the upper abdomen for one year. He had an equivocal clinical examination and laboratory parameters. Upper GI endoscopy and computed tomography revealed multiple nodular growths in the D1 segment and pylorus of the stomach. He was successfully managed by wide local excision of D1 and distal stomach (pylorus) followed by Polya gastrojejunostomy reconstruction. Histopathology confirmed well-differentiated NETs, low Ki67, and positive for chromogranin and synaptophysin. This case draws attention to the early age of presentation of multifocal NETs with vague symptoms and equivocal clinical examination. Coexisting gastric NETs with duodenal NETs in itself is very rare, never the less non-functional status and pre-operative diagnostic dilemma. Here, we have also drawn attention to the pros and cons of various diagnostic tools and how their utility can sometimes limit the approach of clinicians, apart from a high index of suspicion.
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Background: The objective of the present study was to categorize serous effusions in accordance with the Indian Academy of Cytology (IAC) guidelines, evaluate the characteristics of various types of serous effusions using cytological findings, and determine the risk of malignancy within different diagnostic categories. Methods: The study conducted at a tertiary care teaching hospital focused on patients with pleural, and peritoneal effusions/ascitic fluid, using retrospective data from patient records. Samples sent to the pathology department for cytopathological analysis over a one-year period after obtaining approval from institutional ethics committee (IEC). The statistical methods used included descriptive statistics and frequency analysis to examine the different cell types and characteristics present in the effusions. Risk of malignancy was calculated for each category. A Chi-square test was used to assess the relationship between different diagnostic categories, with a p value of <0.05 indicating statistical significance. Results: The findings of the study indicate that out of a total of 161 cases, there were 127 (78.88%) male patients and 34 (21.12%) female patients, resulting in a male to female ratio of 18:5. Ascitic fluid was present in 103 cases (64%) and pleural fluid in 58 cases (36%). The majority of cases, 148 (91.92%), fell into the benign category, followed by 5 cases (3.10%) in category 3, 3 cases (1.86%) in category 5, 2 cases (1.24%) in category 4, and 3 cases (1.86%) in category 1. A statistically significant p value of 0.04 was found among the different diagnostic categories. Conclusions: The IAC has specific guidelines and recommendations for reporting serous effusion cytology to ensure accurate and consistent interpretation of results. In conclusion, reporting serous effusion cytology according to IAC guidelines is essential for accurate diagnosis, prognostic information, quality assurance, communication with the healthcare team, and promoting research and education in the field. Adhering to these guidelines ensures standardized reporting practices and improves patient care outcomes.
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Background: Physical activity (PA) is defined as any bodily movement produced by skeletal muscles that requires energy expenditure. It has been proven that regular physical activity helps control and prevent noncommunicable diseases like diabetes, heart disease, stroke, and several types of cancer. This study aimed to describe the levels of physical activity among female undergraduate students in Mandya and to assess their knowledge, attitude and practice regarding junk food habits. Methods: This cross-sectional study was done in Government women’s degree college, Mandya district, South Karnataka between November 2023 to December 2023 among female undergraduate students in the institute. Global physical activity questionnaire (GPAQ) has been used to describe their physical activity levels. Descriptive statistics like frequency, proportion, mean and standard deviation has been used. Results: The study was conducted among 170 students. Based on the MET values it is found that majority of them had moderate level of PA 81 (47.6%), while 39(22.9%) had high levels and 50 (29.4%) had low PA levels. Of 170 participants, 43 (25%) had junk food intake once a week, 46 (27%) had twice a week, 81 (48%) had thrice or more per week. The association between PA level and junk food was found to be statistically significant (p<0.05). Conclusions: The findings of this study help us in understanding the importance of adopting a healthy lifestyle, including a balanced diet and regular physical activity practice.
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Background: Heart rate is a key indicator of cardiovascular mortality, with ACS having the highest mortality risk when heart rate is elevated. With a target heart rate of <70 bpm, it is crucial to evaluate the effects of medications that lowers heart rate. Methods: In this prospective observational study, 45 patients with ACS were studied, and it was determined whether or not the patients' heart rates at discharge from the hospital were within goal range. Additionally, we looked at demographics, drug-related issues, vitals and then statistical tests were performed. Results: The demographic of 45 patients showed mean adult age was 47 years and most observed ACS was STEMI (53.3%). Patients prescribed with HRLA showed lower mean HR, SBP and DBP at discharge. Evaluated Optimal HR ?70 bpm with HRLA therapy at discharge of the inpatients was achieved in 26.6% (63.5±5.5 bpm). Conclusions: The current study showed HRLA therapy effectively reduced the heart rate at hospital discharge, but despite being on HRLA only 1/4th of patients achieved the optimal heart rate.
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Background: The present study was planned to compare of pre and post donation hematological parameters in healthy donors by plateletpheresis. Also to assess the platelet yield following plateletpheresis procedure with its correlation to pre donation platelet count. Methods: This is a retrospective cross-sectional study carried out in the Blood Centre of a tertiary care hospital in Haryana, India between January to December 2022. Plateletpheresis was done on Trima Accel Automated Collection System with ACD?A as an anticoagulant. The data was collected from the hospital for hematological parameters (Hb, hematocrit, Total WBC count, total platelet count) pre and post donation. Categorical data is presented as frequency, percentage, mean±SD range. Correlation was established between the pre donation platelet count and the platelet yield. Results: A total of 125 donors were included in the study with majority of the donors 69 (55.2%) in the age group 21-30 years. Mean age of the donors included in the study was 31.58±7.5 years. The levels of hemoglobin dropped from 14.16±0.95 to 13.92±1.002 gm/dl, hematocrit dropped from 41.19±1.33 to 40.91±2.89%, total WBC count reduced from 7.64±1.38 to 7.61±1.36 103/ l and platelet count dropped from 279.5±62.96 to 259.9±58.38 lac/ l. There was a significant drop in the levels of platelet post donation by 7.01% compared to pre donation levels. majority of the donors (44%) had a mean platelet yield 2.49±0.33 with a platelet count between 1.5-2.5x1011/l. The maximum platelet yield was 4.93±0.34 in 6% donors with pre-donation platelet count of >4.5 5x1011/l. A linear significant relationship was established between the platelet count and the platelet yield (r=0.99). Conclusions: There were significant changes in the pre donation and post donation hematological parameters among the donors. It was concluded that donors with a high pre-donation platelet count can be considered for better platelet yield.
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Chlamydia comprises the largest proportion of all sexually transmitted infections (STIs) worldwide. It is caused by Chlamydia trachomatis, an obligate intracellular bacterium and exists in two stages; an extracellular elementary body which is an infectious state and an intracellular reticulate body, a dormant state. The elementary body increases the risk of transfer of chlamydial infection during oral, genital or anal sex. On the other hand, the vegetative state of the reticulate body promotes the chance of latent and recurrent infection. In 2020, WHO estimated 129 million new chlamydia infections. Most of the chlamydial infections are asymptomatic (85-90%) which promotes transfer between partners. If untreated, it can lead to an ascending infection which greatly impacts sexual and reproductive health. In addition, it can infect the baby around childbirth and may result in stillbirth or neonatal death. The immuno-pathogenesis of the chlamydial infection is predominantly evoked by major outer membrane protein (MOMP), a dominant chlamydial antigen on the cell wall; along with the chlamydial antigen, heat shock protein 60 (HSP60) triggers host immune responses. The innate and adaptive immune responses result in extensive fibrosis and permanent damage to the fallopian tube resulting in tubal factor infertility and ectopic tubal pregnancy. The improved strategies in screening, diagnosis, treatment and follow up of Chlamydial infection can have noticeable effects on prevention of incidence, retarding the progression and avoiding recurrence of infection leading to a reduction in the global burden of STIs and the consequent adverse neonatal outcome.
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Tacrolimus, a potent calcineurin inhibitor integral to immunosuppressive regimens, exhibits complex pharmacokinetics influenced by diverse factors and understanding these factors is crucial for safety, efficacy and dose optimisation. Genetic variations, particularly in CYP3A enzyme systems and P- Glycoprotein, contribute significantly to inter-individual variability in tacrolimus metabolism. Polymorphisms in these systems alter drug bioavailability, impacting clinical outcomes. Ethnicity further compounds this variability, with distinct genetic profiles leading to differential drug responses. Notably, black patients, often characterized by CYP3A5 expressor status, may have higher drug clearance. Age-related changes in tacrolimus clearance highlights the discrepancies in elderly and paediatric populations. On the other hand, prediction of gender-specific differences is difficult due to lack of evidence. Body composition, specifically variations in fat and muscle mass, significantly impacts drug distribution and clearance. Obesity, associated with altered CYP3A activity, results in decreased drug clearance, emphasizing the importance of accounting for body composition in dosing calculations. Pregnancy -induced physiological changes affect tacrolimus absorption, distribution, metabolism, and excretion, necessitating careful monitoring and dose adjustments in pregnant individuals. Dietary factors and drug interactions, particularly with CYP3A4 and P-glycoprotein, further contribute to the intricate web of variables influencing tacrolimus pharmacokinetics. In conclusion, this review sheds light on the multifaceted factors influencing tacrolimus pharmacokinetics, providing essential insights for clinicians to tailor individualized dosing regimens and enhance therapeutic efficacy while minimizing the risk of adverse events.
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This comprehensive review explores the integration of surgical and dermatological techniques in treating cutaneous aging, highlighting the evolution of anti-aging strategies towards more refined and less invasive methods. As aging skin results from a combination of intrinsic and extrinsic factors, leading to structural and physiological changes, dermatology has advanced to offer multifaceted treatment approaches. We aimed to review advances and evolution in surgical interventions such as facelifts and blepharoplasty. We will discuss noninvasive and minimally invasive techniques, such as Ultherapy and fat grafting, which are widely used and are the best alternatives to traditional surgery. Other techniques, such as thread lifts and novel materials like polydioxanone (PDO) and polylactic acid (PLA) threads, are also reliable techniques for minimally invasive facial rejuvenation.
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Background: Hypertension is a commonest cardiovascular disorder and is major cause of premature death worldwide. An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low and middle-income countries. So present study was undertaken to assess the risk factors for hypertension among First year MBBS students so that suitable preventive measures may be undertaken. Methods: It is cross sectional study conducted among first year MBBS students in DRKGMC Hamirpur. The duration of study is three months. The tools of study used were modified structured pretested self-administered questionnaire; WHO stepwise approach to chronic disease risk factor surveillance (STEPS). Weighing machine, measuring tape, digital BP apparatus and steadiometer. Results: A total of 115 students of MBBS first year participated in the study. There were a total of 31.3% (36) boys and 68.7% (79) girls. Thirty three percent (38) had a family history of hypertension. 16.52% (19) had a BMI more than the normal. Among the study participants only 5 students (4.35%) used to consume alcohol and smoke cigarettes. Most of study participants consume fast food and junk food. Conclusions: High prevalence of different modifiable risk factors for hypertension revealed among the study subjects.There is need to screen the modifiable risk factors from very early age.
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Background: There is emerging evidence with regards to reduced physical performance in patients recovering from COVID- 19 at time of hospital discharge. Assessing various functional parameters at discharge would shed light on the multi-system affection that could be helpful in formulating rehabilitation goals for the patient. Objectives of the study were to assess the physical performance, functional capacity, muscular strength, level of fatigue, and risk of sarcopenia in COVID-19 patients at discharge using short physical performance battery test, 1 minute sit to stand test, grip strength, fatigue assessment scale, SARC-CalF Scale respectively. Methods: This cross-sectional study comprised of 42 patients diagnosed with COVID-19 recruited from a tertiary care hospital. Demographic details and clinical variables were documented. Participants were assessed for physical performance, muscular strength, level of fatigue, functional capacity, and risk of sarcopenia. Data was analyzed using SPSS version 24. Results: The study comprised of 42 participants including 71.43% males (N=30) and 28.57% females (N=12) having mean age of 49.86±15.83 years. Findings of the assessed parameters were as follows: SPPB=7.57±2.84, 1 MSST=13.17±5.79 repetitions, grip strength=19.44±8.38 kg, FAS=19.79±10.83, SARC-CalF score=5.19±4.83. There was a weak positive correlation found between CT severity score and level of fatigue (r=0.325, p=0.036). Conclusions: This study provides a descriptive information about the functional outcomes of COVID -19 patients at discharge which can further be utilized for development of a tailor-made exercise program.
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This comprehensive review studies the multifaceted barriers that delay cancer patients from accessing adequate nutrition throughout their cancer journey. Addressing these barriers is paramount, considering their profound implications on treatment efficacy, patient well-being, and overall outcomes. The analysis encompasses a range of obstacles comprises physiological, psychological, economic, social, and healthcare system factors, highlighting their intricate impact on nutritional intake and patient care. The exploration of nutritional barriers reveals a landscape encompassing challenges such as malnutrition, treatment-related side effects, psychological distress, physical limitations, lack of knowledge, cultural influences, financial constraints, and limited access to specialised nutritional support. These hurdles, if left unaddressed, can lead to adverse consequences including malnutrition, weakened immunity, impaired treatment response, decreased quality of life, and ultimately, poorer prognosis. The intricate interplay between inadequate nutrition and cancer outcomes is underscored, emphasising the pivotal role of proper nutrition in boosting the immune system, supporting treatment effectiveness, and hastening recovery. Strategies to overcome these barriers emerge through multidisciplinary approaches integrating medical and nutritional needs, personalised dietary plans, psychosocial support, and the integration of yoga and wellness practices to foster mindful eating and holistic well-being. This review provides valuable insights into the complexities of nutritional barriers in cancer care and emphasizes the critical need for comprehensive strategies to ensure cancer patients receive the vital nutritional support necessary for optimizing their journey through treatment and recovery.
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Background: Lichen planus is a chronic pruritic immune-mediated disorder involving skin, oral and genital mucosa, nail and hair with several morphological variants. Although not lethal, the chronic nature of the disease have significant impact on patient’s quality of life and their psychological wellbeing. Aim was to find out clinico-epidemiological profile of LP and its variants including Dermoscopic features and its association with systemic diseases like Diabetes, Hypertension and Hypothyroidism. Methods: This is a hospital based retrospective observational study. Medical records of all patients with LP during the period from January to December 2022 were noted. Various clinico-epidemiological and dermoscopic features along with systemic disease association were analysed. Results: A total of 257 cases were reported. Most common age group affected was 41-60 yrs. Male:female ratio was 0.72:1 with female preponderance. LP in children (<18 yrs) was seen in 9.7% of cases. Classical LP was the most common type (29.5%) followed by Mucosal LP (12.45%). More than one variant was seen in 20.6% of cases. LP in association with systemic diseases was seen in 36.1% of cases with DM being the most frequent. Most common dermoscopic features were pigmentation (100%) followed by Wickham’s striae (83.6%) and vascular findings (49.4%). Conclusions: LP is a common papulosquamous disorder affecting middle aged adults with slight female preponderance. Childhood LP contributed to significant number of cases. Classical LP was the commonest clinical variant observed. LP is associated with DM, HTN and hypothyroidism. Dermoscopy is an useful tool in diagnosis and differentiating from other similar conditions.
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Considering the lack of consensus related to the impact of selective IL-6 receptor inhibition on bone remodeling and the scarcity of reports, especially on large bone defects, this study proposed to evaluate the biological impact of the selective inhibitor of interleukin-6 receptor (tocilizumab) in an experimental model of critical calvarial defect in rats. In this preclinical and in vivo study, 24 male Wistar rats were randomly divided into two groups (n=12/group): defect treated with collagen sponge (CG) and defect treated with collagen sponge associated with 2 mg/kg tocilizumab (TCZ). The defect in the parietal bone was created using an 8-mm diameter trephine drill. After 90 days, the animals were euthanized, and tissue samples (skull caps) were evaluated through micro-CT, histological, immunohistochemistry, cytokines, and RT-qPCR analyses. Tocilizumab reduced mononuclear inflammatory infiltration (P<0.05) and tumor necrosis factor (TNF)-α levels (P<0.01) and down-regulated tissue gene expression of BMP-2 (P<0.001), RUNX-2 (P<0.05), and interleukin (IL)-6 (P<0.05). Moreover, it promoted a stronger immunostaining of cathepsin and RANKL (P<0.05). Micro-CT and histological analyses revealed no impact on general bone formation (P>0.05). The bone cells (osteoblasts, osteoclasts, and osteocytes) in the defect area were similar in both groups (P>0.05). Tocilizumab reduced inflammatory cytokines, decreased osteogenic protein, and increased proteases in a critical bone defect in rats. Ninety days after the local application of tocilizumab in the cranial defect, we did not find a significant formation of bone tissue compared with a collagen sponge.
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@#Salmonella enterica subsp. enterica serovar Enteritidis (SE) is a global concern for the poultry industry due to its association with foodborne illnesses. The transmission occurs through the transovarial route which initiates from colonization in oviducts and ascending to ovaries. Though there are studies on cytosine-phosphate-guanine oligodeoxynucleotide (CpG-ODN) and the increase of innate immune response, there is limited research on the intravaginal treatment using CpG-ODN. Previous studies have shown that stimulating CpG-ODN can induce the production of antimicrobial peptide avian beta-defensins (AvBDs) in vaginal cell cultures, there is limited information on the use of intravaginal treatment to induce the innate immune system, particularly in the Kampung Unggul Balitbangtan (KUB-1) chickens (Gallus gallus domesticus). This study investigates the impact of intravaginal CpG-ODN stimulation on the innate immune response in KUB-1 chicken ovaries and oviducts when challenged to SE. A total of 39 KUB-1 chickens were divided into four groups namely T1 (treated with CpG-ODN, n=12), T2 (SE group, n=12), T3 (CpG-ODN and SE, n=12), and Control (without CpG-ODN and SE, n=3). Chickens were observed from day 1 to 4 post-intravaginal (PI) inoculation. The results suggest that intravaginal CpG-ODN treatment modulates AvBD10 production through toll-like receptor (TLR)21, with interleukin (IL)1B and IL10 playing reciprocal roles, providing insights into the potential of this treatment to prevent transovarial Salmonellosis in poultry. The novelty of this study adds valuable insights to the current body of knowledge.
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Assessment of plant medicine for treating infertility and related disorders is making headway universally recent couple of decades to bring out new effective and safe substances as an alternative medicine. Present paper reviews the published literature on plant medicine used for female infertility and related disorders. The 53 research papers or reports shortlisted are based studies under taken in India. Total 459 uses of 202 medicinal plants classified under 84 families. Total 62 trees, 55 shrubs, 79 herbs and 3 climbers are reported. Most used plant parts for making medicine are roots in 111 formulations and leaf in 101 formulations. Medicinal plants used for infertility are 84, while for related disorder like leucorrhoea 79 plants, menorrhagia 53, dysmenorrhea 29, amenorrhea 23 and 22 plants used to regulate menstruation. Additional investigations could be helpful to verify the claims reported using a specific formulations or recipes and which will subsequently result in providing possible the alternative medicine for the treatment of female infertility.