Monitoring the feeding and parental care behavior of a pair of free-living owls (Tyto furcata) in the nest during the reproductive period in Rio de Janeiro, Brazil

Abstract The American Barn Owl (Tyto furcata) lives in urban, periurban and wild environments and feeds mainly on small rodents, meaning it has great importance in the biological control of pests. The aim of this work was to describe the reproductive, parental and eating habits of a pair of American barn owls naturally living outside a residence in the urban area of the municipality of Campos dos Goytacazes, Rio de Janeiro state, Brazil. A wood box was installed on an outside wall of the home, monitored by a video camera. A spreadsheet was created to keep track of the observations recorded. The female laid four eggs, and after an incubation period of 30-32 days all the eggs hatched, but only two chicks survived after cannibalism among the chicks. Initially, the male provided the food to the chicks and the female remained in the nest caring for the brood. After approximately a month, the female also began to leave the nest and return with prey, which was offered to the chicks, with the male also continuing this behavior. The chicks left the nest in September, 2017. The data obtained show the existence of cooperation and division of tasks between male and female owls during the reproductive period.

Resumo A coruja-das-torres americana (Tyto furcata) vive em ambientes urbanos e se alimenta principalmente de pequenos roedores, sendo de grande importância no controle biológico de pragas. O objetivo deste trabalho foi descrever os hábitos alimentares, parentais e reprodutivos de um casal de corujas-das-torres americanas, naturalmente vivendo fora de uma residência na zona urbana do município de Campos dos Goytacazes, estado do Rio de Janeiro, Brasil. Uma caixa de madeira foi instalada em uma parede externa da casa, monitorada por uma câmera de vídeo. Uma planilha foi criada para manter o controle das observações registradas. A fêmea pôs quatro ovos, e após período de incubação de 30-32 dias todos os ovos eclodiram, mas apenas dois filhotes sobreviveram após o canibalismo entre os filhotes. Inicialmente, o macho fornecia a comida aos filhotes e a fêmea permanecia no ninho cuidando da ninhada. Depois de cerca de um mês, a fêmea também começou a sair do ninho e voltar com a presa, que era oferecida aos filhotes, com o macho também continuando com esse comportamento. Os filhotes deixaram o ninho em setembro de 2017. Os dados obtidos mostram a existência de cooperação e divisão de tarefas entre corujas machos e fêmeas durante o período reprodutivo.

Ferulic acid as major antioxidant phenolic compound of the Tetragonisca angustula honey collected in Vera Cruz - Itaparica Island, Bahia, Brazil

Abstract The antioxidant activity of Tetragonisca angustula honey (TAH) and its ethanolic extract (TAEE) were investigated. The total levels of phenolic (TPC) and flavonoids (TFC) were also evaluated. The results for TPC were 19.91 ± 0.38 and 29.37 ± 1.82 mg GAE g-1 and for TFC 0.20 ± 0.02 and 0.14 ± 0.01 mg QE g-1 of TAH and TAEE, respectively. Antioxidant activities were 73.29 ± 0.49% and 93.36 ± 0.27% in the DPPH assay and 71.73 ± 4.07% and 97.86 ± 0.35% in ABTS+ for TAH and TAEE, respectively. The total reducing activity was determined by the method of reducing power (PR) and iron ion (Fe III) and the results varied in PR from 151.7 ± 25.7 and 230.7 ± 25.2 mg GAE L-1, for TAH and TAEE respectively and for (Fe III) in EC50 0.284 in TAEE and 0.687 in TAH. Chemical analysis by HPLC-DAD of the ethanolic extract (TAEE) revealed the presence of ferulic acid as majority phenolic component in the extract. The 1H NMR analysis confirmed this structure and showed the also presence of glucose, citric acid, succinic acid, proline and hydrocarbon derivatives. In addition, the botanical origin was also investigated and showed a multifloral characteristic, having found 19 pollen types with a botanical predominance of the Anacardiaceae family, with Tapirira pollen occurring as predominant (42.6%) and Schinus as secondary (25.7%). The results showed that T. angustula honey is an interesting source of antioxidant phenolic compounds due to its floral origin and can act as a protector of human health when consumed.

Resumo A atividade antioxidante do mel de Tetragonisca angustula (TAH) e seu extrato etanólico (TAEE) foram investigados. Os níveis totais de fenólicos (TPC) e flavonóides (TFC) também foram avaliados. Os resultados para TPC foram 19,91 ± 0,38 e 29,37 ± 1,82 mg GAE g-1 e para TFC 0,20 ± 0,02 e 0,14 ± 0,01 mg QE g-1 de TAH e TAEE, respectivamente. As atividades antioxidantes foram 73,29 ± 0,49% e 93,36 ± 0,27% no ensaio DPPH e 71,73 ± 4,07% e 97,86 ± 0,35% no ABTS+ para TAH e TAEE, respectivamente. A atividade redutora total foi determinada pelo método de poder redutor (PR) e íon ferrico (Fe III) e os resultados variaram em PR de 151,7 ± 25,7 e 230,7 ± 25,2 mg GAE L-1, para TAH e TAEE respectivamente e para (Fe III) em EC50 0,284 em TAEE e 0,687 em TAH. A análise química por HPLC-DAD do extrato etanólico (TAEE) revelou a presença de ácido ferúlico como componente majoritário no extrato. A análise de RMN 1H confirmou esta estrutura e mostrou a presença de glicose, ácido cítrico, ácido succínico, prolina e derivados de hidrocarbonetos no TAEE. Além disso, a origem botânica também foi investigada e apresentou característica multifloral, tendo encontrado 19 tipos polínicos com predomínio botânico da família Anacardiaceae, sendo o pólen Tapirira predominante (42,6%) e o Schinus secundário (25,7%). Os resultados mostraram que o mel de T. angustula é uma interessante fonte de compostos fenólicos antioxidantes devido à sua origem floral e pode atuar como protetor da saúde humana quando consumido.

Monitoring the feeding and parental care behavior of a pair of free-living owls (Tyto furcata) in the nest during the reproductive period in Rio de Janeiro, Brazil / Monitoramento do comportamento alimentar e cuidado parental de um casal de corujas de vida livre (Tyto furcata) no ninho durante o período reprodutivo no Rio de Janeiro, Brasil

Abstract The American Barn Owl (Tyto furcata) lives in urban, periurban and wild environments and feeds mainly on small rodents, meaning it has great importance in the biological control of pests. The aim of this work was to describe the reproductive, parental and eating habits of a pair of American barn owls naturally living outside a residence in the urban area of the municipality of Campos dos Goytacazes, Rio de Janeiro state, Brazil. A wood box was installed on an outside wall of the home, monitored by a video camera. A spreadsheet was created to keep track of the observations recorded. The female laid four eggs, and after an incubation period of 30-32 days all the eggs hatched, but only two chicks survived after cannibalism among the chicks. Initially, the male provided the food to the chicks and the female remained in the nest caring for the brood. After approximately a month, the female also began to leave the nest and return with prey, which was offered to the chicks, with the male also continuing this behavior. The chicks left the nest in September, 2017. The data obtained show the existence of cooperation and division of tasks between male and female owls during the reproductive period.

Resumo A coruja-das-torres americana (Tyto furcata) vive em ambientes urbanos e se alimenta principalmente de pequenos roedores, sendo de grande importância no controle biológico de pragas. O objetivo deste trabalho foi descrever os hábitos alimentares, parentais e reprodutivos de um casal de corujas-das-torres americanas, naturalmente vivendo fora de uma residência na zona urbana do município de Campos dos Goytacazes, estado do Rio de Janeiro, Brasil. Uma caixa de madeira foi instalada em uma parede externa da casa, monitorada por uma câmera de vídeo. Uma planilha foi criada para manter o controle das observações registradas. A fêmea pôs quatro ovos, e após período de incubação de 30-32 dias todos os ovos eclodiram, mas apenas dois filhotes sobreviveram após o canibalismo entre os filhotes. Inicialmente, o macho fornecia a comida aos filhotes e a fêmea permanecia no ninho cuidando da ninhada. Depois de cerca de um mês, a fêmea também começou a sair do ninho e voltar com a presa, que era oferecida aos filhotes, com o macho também continuando com esse comportamento. Os filhotes deixaram o ninho em setembro de 2017. Os dados obtidos mostram a existência de cooperação e divisão de tarefas entre corujas machos e fêmeas durante o período reprodutivo.

Ferulic acid as major antioxidant phenolic compound of the Tetragonisca angustula honey collected in Vera Cruz - Itaparica Island, Bahia, Brazil / Ácido ferúlico como principal composto fenólico antioxidante do mel de Tetragonisca angustula coletado em Vera Cruz - Ilha de Itaparica, Bahia, Brasil

Abstract The antioxidant activity of Tetragonisca angustula honey (TAH) and its ethanolic extract (TAEE) were investigated. The total levels of phenolic (TPC) and flavonoids (TFC) were also evaluated. The results for TPC were 19.91 ± 0.38 and 29.37 ± 1.82 mg GAE g-1 and for TFC 0.20 ± 0.02 and 0.14 ± 0.01 mg QE g-1 of TAH and TAEE, respectively. Antioxidant activities were 73.29 ± 0.49% and 93.36 ± 0.27% in the DPPH● assay and 71.73 ± 4.07% and 97.86 ± 0.35% in ABTS●+ for TAH and TAEE, respectively. The total reducing activity was determined by the method of reducing power (PR) and iron ion (Fe III) and the results varied in PR from 151.7 ± 25.7 and 230.7 ± 25.2 mg GAE L-1, for TAH and TAEE respectively and for (Fe III) in EC50 0.284 in TAEE and 0.687 in TAH. Chemical analysis by HPLC-DAD of the ethanolic extract (TAEE) revealed the presence of ferulic acid as majority phenolic component in the extract. The 1H NMR analysis confirmed this structure and showed the also presence of glucose, citric acid, succinic acid, proline and hydrocarbon derivatives. In addition, the botanical origin was also investigated and showed a multifloral characteristic, having found 19 pollen types with a botanical predominance of the Anacardiaceae family, with Tapirira pollen occurring as predominant (42.6%) and Schinus as secondary (25.7%). The results showed that T. angustula honey is an interesting source of antioxidant phenolic compounds due to its floral origin and can act as a protector of human health when consumed.

Resumo A atividade antioxidante do mel de Tetragonisca angustula (TAH) e seu extrato etanólico (TAEE) foram investigados. Os níveis totais de fenólicos (TPC) e flavonóides (TFC) também foram avaliados. Os resultados para TPC foram 19,91 ± 0,38 e 29,37 ± 1,82 mg GAE g-1 e para TFC 0,20 ± 0,02 e 0,14 ± 0,01 mg QE g-1 de TAH e TAEE, respectivamente. As atividades antioxidantes foram 73,29 ± 0,49% e 93,36 ± 0,27% no ensaio DPPH● e 71,73 ± 4,07% e 97,86 ± 0,35% no ABTS●+ para TAH e TAEE, respectivamente. A atividade redutora total foi determinada pelo método de poder redutor (PR) e íon ferrico (Fe III) e os resultados variaram em PR de 151,7 ± 25,7 e 230,7 ± 25,2 mg GAE L-1, para TAH e TAEE respectivamente e para (Fe III) em EC50 0,284 em TAEE e 0,687 em TAH. A análise química por HPLC-DAD do extrato etanólico (TAEE) revelou a presença de ácido ferúlico como componente majoritário no extrato. A análise de RMN 1H confirmou esta estrutura e mostrou a presença de glicose, ácido cítrico, ácido succínico, prolina e derivados de hidrocarbonetos no TAEE. Além disso, a origem botânica também foi investigada e apresentou característica multifloral, tendo encontrado 19 tipos polínicos com predomínio botânico da família Anacardiaceae, sendo o pólen Tapirira predominante (42,6%) e o Schinus secundário (25,7%). Os resultados mostraram que o mel de T. angustula é uma interessante fonte de compostos fenólicos antioxidantes devido à sua origem floral e pode atuar como protetor da saúde humana quando consumido.

What do retina fellows-in-training think about the vitreoretinal surgical simulator: A multicenter survey

Purpose: To profile vitreoretinal (VR) fellows?in?training from India exposed to the Eyesi surgical simulator, to identify potential barriers to voluntary use, and enumerate the most preferred tools and tasks before incorporating them into a formal skill?transfer curriculum. Methods: A questionnaire consisting of 22 questions was designed and circulated through an online portal (surveymonkey.com) to four different institutes of India having a VR surgical fellowship program and using a functional Eyesi (Haag–Streit) simulator. All fellows and trainees who were exposed to the simulator were eligible to participate, irrespective of time spent on the simulator and exposure to training steps on real patients. The responses collected were private and anonymous. Results: Of the 37 respondents, most (n = 25, 68%) considered surgical simulators to be the best training tool before operating on the human eye. A majority (n = 35, 94.5%) of participants spent <3 h per week on the simulator, which, most (n = 30, 81%) felt was not enough time. The main reasons for this underutilization were work?hour limitations (54.8%), lack of a structured training program (19.3%), or a dedicated supervisor (16.1%). Again, the majority (n = 33, 89%) of participants responded that VR surgical skills acquired during simulator training were transferrable to the operating room, which was reflected by their response (n = 31, 83.7%) that simulator?based training should be made mandatory before operating room exposure. Conclusion: This study gives an insight into the overall practice patterns and preferences in simulation training of surgical VR fellows?in?training across India. It indicates that the simulator is extremely helpful to fellows and if adopted, VR surgical simulators with organized, directed, and supervised sessions will considerably improve the surgical training experience.

A series of fetal reductions and their outcomes at a tertiary care center in North Karnataka: Fetal reduction series: A boon?

Fetal reduction is a novel method that aims to reduce a higher-order gestation to lower-order pregnancy to reduce both maternal and perinatal adverse outcomes. One of the methods of fetal reduction is by intracardiac injection of KCl under ultrasound guidance. Here, we present a case series ofeight women who had undergone fetal reduction. All of them were trichorionic triamniotic triplets at the time of reduction. In seven women, the reduction was done to twin gestation, whereas one reduction was to singleton pregnancy. Out of eight cases, only one carried to full term and underwent vaginal delivery. One case was lost to follow-up and 2 women underwent expulsion. A total of nine live births were reported with 8 babies going to the neonatal intensive care unit for low birth weight and preterm care. Fetal reduction is an important method that needs to be widely practiced and reported to improve maternal and perinatal outcomes in multifetal gestation.

A study on the microbial spectrum of otitis externa in a tertiary care teaching hospital

Background: Otitis externa is frequently seen illness by ENT practitioners predominantly in children and old age people. The severity sometimes varies from it ranges in severity from a trivial infection to dangerous malignant otitis externa. Furthermore, due to absurd consumption of antibiotics, though there is a fall in development of complications, there is a rise in resistance to various infectious organisms. Mostly, we start treating patients with empirical therapy where sometimes, it leads to occurrence of various antibiotic-resistant infections. For that reason, recent evidence about the organism which is mostly involved in infection and also most importantly the pattern of their response to various pharmacological agents is crucial for the sensible use of the medications for the management. Aim and Objectives: Our study was planned to evaluate and find out the causative organism which is most commonly seen in otitis externa, particularly focusing on drug sensitivity for those organisms, so that efficient management of otitis externa can be done. Materials and Methods: It is a retrospective study conducted in acute otitis externa patients from Novemver 2019 to January 2020. Patients who all presented with ear discharge within 3 months of period, samples were collected with clinically diagnosed acute otitis externa and sent for culture in blood agar, chocolate agar, and Mcconkey medium in vitro and drug sensitivity pattern was identified for individual organisms. Inclusion criteria: Patients more than 18 years having ear discharge within 3 months were included in the study. Exclusion criteria: Chronically discharging ear >3 months were excluded from the study. Results: Pseudomonas organism was frequently encountered pathogen in our study, trailed by Staphylococcus aureus. The organisms identified were very much sensitive to drugs like fluoroquinolones particularly Ciprofloxacin, and Aminoglycosides like Amikacin and almost all were responding to treatment with Piperacillin-Tazobactam, these drugs have an cidal activity over pathogens and are suitable for any age and safety-wise better too. Conclusion: Intermittent assessment and awareness of the bacteriological summary and their drug response profile in a particular geographical area will only help in rational drug prescription. Furthermore, rational usage of drugs will help in reducing any morbidity due to infection which may sometimes develop when treated inappropriately, further decreasing development of dangerous drug resistance.

Post-mortem pulmonary tuberculosis: comparison of available diagnostic methods

@#Tuberculosis (TB) caused by Mycobacterium tuberculosis remains a serious public health threat with the World Health Organisation (WHO) reporting 5.8 million cases and 1.3 million deaths in the year 2020 due to TB. TB can be diagnosed by imaging, histopathological and bacteriological methods with culture remaining the gold standard. This study was performed to look at the sensitivity and specificity of post-mortem computed tomography (PMCT) imaging when compared to culture in diagnosing pulmonary tuberculosis. This was a retrospective comparative study looking at post mortem cases where lung tissue samples sent for TB culture at Hospital Kuala Lumpur were compared against PMCT imaging. Exclusion criteria included contaminated samples, decomposed cases, immunocompromised subjects and those below 18 years of age. Subjects included 80 medico-legal autopsy cases at the National Institute of Forensic Medicine, Hospital Kuala Lumpur, Malaysia who had whole body PMCT done in accordance with the Institute’s protocol and tissue samples sent for bacteriology culture for tuberculosis. PMCT findings were positively associated with acid-fast organisms in 23.5 out of 33 cases (71.2%). Our study also showed that PMCT had a sensitivity of 71.3% and specificity of 54.3% (95% CI: 39.5–68.4) in diagnosing TB based on the protocol set in this study. This study showed that there was relatively good agreement between radiological PMCT findings and bacterial culture, suggesting that radiological examination is a relatively reliable tool for preliminary screening and possible diagnosis of TB prior to a postmortem examination which would be beneficial in reducing the risk of transmission of TB to health workers during autopsy.

A framework to assess potential health system resilience using fuzzy logic / Marco para evaluar la resiliencia potencial de un sistema de salud mediante la lógica difusa / Estrutura de avaliação do potencial de resiliência dos sistemas de saúde utilizando a lógica fuzzy

ABSTRACT Objectives. To develop and test a framework to assess the potential of public health systems to maintain a resilient performance. Methods. Quantitative data from public databases and qualitative data from technical reports of Brazilian health authorities were used to develop the framework which was assessed and modified by experts. Fuzzy logic was used for the mathematical model to determine scores for four resilient abilities - monitoring, anticipation, learning, and response - and an aggregated coefficient of resilient potential in health care. The coefficient measures used data from before the coronavirus disease 2019 (COVID-19) pandemic. These were compared with measures of the actual performance of health systems in 10 cities in Brazil during the pandemic. Results. The coefficient of resilient potential in health care showed that the cities most affected by COVID-19 had lower potential for resilient performance before the pandemic. Some local health systems had adequate response capabilities, but other abilities were not well developed, which adversely affected the management of the spread of COVID-19. Conclusions. The coefficient of resilient potential in health care is useful to indicate important areas for resilient performance and the different types of resilience capacities that can be considered in different contexts and levels of public health systems. Regular assessment of the potential of health systems for resilient performance would help highlight opportunities for continuous improvement in health system functions during chronic stress situations, which could strengthen their ability to keep functioning in the face of sudden disturbances.

RESUMEN Objetivos. Elaborar y examinar un marco para evaluar el potencial de los sistemas de salud pública de mantener un desempeño resiliente. Métodos. Para elaborar el marco, se emplearon datos cuantitativos de bases de datos públicas y datos cualitativos de informes técnicos de las autoridades de salud brasileñas. A continuación, este marco fue evaluado y modificado por expertos. Se utilizó la lógica difusa en el modelo matemático empleado para determinar la puntuación de cuatro capacidades resilientes (seguimiento, anticipación, aprendizaje y respuesta) y un coeficiente agregado de potencial resiliente en la atención médica. Para las medidas del coeficiente se emplearon datos previos a la pandemia de la enfermedad por el coronavirus del 2019 (COVID-19), que se compararon con las medidas del desempeño real de los sistemas de salud en diez ciudades de Brasil durante la pandemia. Resultados. El coeficiente de potencial resiliente en la atención de salud indicó que las ciudades más afectadas por la COVID-19 presentaban un menor potencial de desempeño resiliente antes de la pandemia. En algunos sistemas de salud locales la capacidad de respuesta era adecuada pero otras capacidades no estaban suficientemente desarrolladas, lo que afectó de manera negativa el manejo de la propagación de la COVID-19. Conclusiones. El coeficiente de potencial resiliente en la atención de salud es útil para indicar aspectos importantes del desempeño resiliente y los diferentes tipos de capacidades de resiliencia que pueden considerarse en diferentes contextos y niveles de los sistemas de salud pública. La evaluación periódica del potencial de los sistemas de salud para tener un desempeño resiliente ayudaría a poner de relieve las oportunidades de mejora continua de las funciones del sistema de salud en situaciones de estrés crónico, lo que podría fortalecer su capacidad para seguir funcionando frente a perturbaciones repentinas.

RESUMO Objetivos. Desenvolver e testar uma estrutura de avaliação do potencial dos sistemas de saúde pública de manter um desempenho resiliente. Métodos. Dados quantitativos de bancos de dados públicos e dados qualitativos de relatórios técnicos das autoridades sanitárias brasileiras foram utilizados para desenvolver a estrutura, que foi avaliada e modificada por especialistas. A lógica fuzzy foi utilizada na criação de um modelo matemático para determinar a pontuação em quatro capacidades de resiliência (monitoramento, antecipação, aprendizagem e resposta) e um coeficiente agregado do potencial de resiliência na atenção à saúde. O coeficiente foi calculado utilizando dados anteriores à pandemia da doença provocada pelo coronavírus de 2019 (COVID-19). Esses dados foram comparados com medidas do desempenho real dos sistemas de saúde em 10 cidades brasileiras durante a pandemia. Resultados. O coeficiente de potencial de resiliência na atenção à saúde revelou que as cidades mais afetadas pela COVID-19 tinham menor potencial de desempenho resiliente antes da pandemia. Alguns sistemas de saúde locais tinham capacidades de resposta adequadas, porém as outras capacidades não estavam bem desenvolvidas, o que prejudicou o gerenciamento da propagação da COVID-19. Conclusões. O coeficiente de potencial de resiliência na atenção à saúde é útil para indicar áreas importantes para um desempenho resiliente e os vários tipos de capacidade de resiliência que podem ser considerados em diferentes contextos e níveis dos sistemas de saúde pública. Uma avaliação periódica do potencial de desempenho resiliente dos sistemas de saúde ajudaria a assinalar oportunidades para melhorias contínuas das funções desses sistemas durante situações de estresse crônico, o que poderia aumentar sua capacidade de continuar funcionando diante de perturbações repentinas.

Effect of Agnikarma in Perianal Subcutaneous Fistula- A Case Report

Fistula-in-ano is a debilitating disease affecting anorectal region. It is an abnormal tract lined with fibrous tissue and unhealthy granulation tissue. It usually begins from a perianal abscess caused by cryptoglandular infection. The abscess burst spontaneously and forms fistula-in-ano. It may also seen in association with other diseases like Crohn’s disease, lymphogranuloma venereum, actinomycosis, malignancy and TB. It is distressing to the patient and the surgeon due to its recurrent nature and the complications like postoperative incontinence. The disease can be classified as low anal and high anal fistulae on the basis of its internal opening. Perianal subcutaneous fistula is included under low anal fistula. Generally, the modern treatment measures for fistula-in-ano include fistulectomy, fistulotomy, advancement flaps, fistula clip closure, LIFT technique, VAAFT procedure, anal fistula plug repair, fibrin glue and seton technique. The prime aim of the treatment is to eradicate the tract and drain the site of infection while preserving anal continence. In Ayurveda, Fistula-in-ano can be correlated with Bhagandara on the basis of signs and symptoms. Since it is difficult to treat, Acharya Susruta considered it as one among Ashtamahagada. He described the treatment as Shastra Karma, Kshara Karma, Agni Karma. In the present case study, a 35-year old male patient visited the OPD with perianal subcutaneous fistula was selected for Agnikarma after fistulotomy to reduce the treatment period and to improve the quality of living. Daily dressing was done with Jathyadi ghrta and the patient was cured within 21 days of intervention. The follow up was done for next 3 months and no complications were noted.

Post-COVID multisystem inflammatory syndrome in adults: a study from a tertiary care hospital in south India

Background & objectives: There are limited data from India on the post-COVID multisystem inflammatory syndrome in adults (MIS-A). The objective of the present study was to evaluate the clinical profile of patients with MIS-A admitted to a tertiary care centre in southern India. Methods: This single-centre retrospective study was conducted from November 2020 to July 2021, and included patients aged >18 yr admitted to the hospital as per the inclusion and exclusion criteria. Results: Nine patients (5 male, mean age 40±13 yr) met the criteria for MIS-A. Five patients had proven COVID-19 infection or contact history 36.8±11.8 days back. All patients were positive for SARS-CoV-2 IgG antibody, negative for COVID-19 PCR, and had negative blood, urine and sputum cultures. All patients had fever and gastrointestinal (GI) symptoms, and five patients had left ventricular dysfunction. All patients had neutrophilic leucocytosis at presentation and elevated biomarkers such as C-reactive protein serum procalcitonin, D-dimer and ferritin. The majority of the patients (7/9 i.e. 77.78%) were treated with intravenous hydrocortisone (50-100 mg q6h-q8h). Six patients recovered completely whereas three patients expired. Interpretation & conclusions: Fever and GI symptoms were the most common presentation of MIS-A. Elevated serum procalcitonin may not be useful in differentiating bacterial sepsis from MIS-A. Most patients responded to corticosteroids.

NEGATIVE PRESSURE WOUND THERAPY (NPWT): OUR EXPERIENCE USING HOSPITAL WALL SUCTION

Study Design: Prospective case series Delayed wound healing is a significant concern, particularly in Introduction: complex wounds and the elderly with co-morbidities. It leads to pain, morbidity, prolonged treatment, and requires major reconstructive surgery, which imposes an enormous social and financial burden. Negative Pressure Wound Therapy (NPWT) was used to cover large wounds, decubitus ulcers, and open fractures that cannot be closed either primarily or secondarily and often require a complex reconstructive procedure to protect the injury. NPWT is an alternative method of wound management, which uses the negative pressure to prepare the wound for spontaneous healing or by lesser reconstructive options. We applied NPWT on pa Materials and Methodology: tients with open fractures, decubitus ulcers, neglected wounds, fasciotomies, and large wounds. Compared to the patented VAC system, ours include pre-sterilized PVA foam, cling drape (Surgiwear TM), nasogastric tube or an infant feeding tube, and a hospital wall suction. There Results: were three cases of soft tissue injury of the foot with wound defect, one case of fasciotomy for compartment syndrome, one case of the decubitus ulcer, one case of open fractures, and three cases of degloving injuries of the foot. In our study, the NPWT was changed every five days, the average number of NPWT changes was 3-4, length of time NPWT applied before the closure was 14-21 days. The most frequent coverage mode is Split Thickness Skin Graft obviating the need for more complex flaps and microvascular reconstructive procedures. Negative Conclusion: pressure therapy stabilizes the wound environment, reduces wound edema/bacterial load, improves tissue perfusion, and stimulates granulation tissue and angiogenesis. NPWT appears to be simple and more effective than conventional dressings for managing complex wounds, reducing wound volume, depth, treatment duration, and cost.

FUNCTIONAL EVALUATION OF PROXIMAL HUMERUS FRACTURES TREATED BY PHILOS PLATING

Introduction Proximal humeral fractures are now recognized as an increasingly common fracture, accounting for 4%–5% of all fractures and 45% of all humeral fractures [1,2]. It is the third most common fracture, in people above 65 years of age, after fractures of the hip and distal radius [3]. These fractures have a bimodal distribution occurring either in young people after high energy trauma or in those older than 50 years with low- velocity injuries like simple fall [3]. 85% of these fractures are minimally displaced and are effectively treated with immobilization followed by early motion. The remaining 15% of these are either displaced or unstable. These fare poorly with non-operative treatment and are better treated with surgical intervention. Surgical treatment is necessary especially in young patients and active elderly people in order to prevent minimal dislocations of tuberosity or articular surface from compromising the long-term articular function. This study was planned to evaluate the outcome of proximal humerus fractures managed with PHILOS plate after approval by the Institutional Ethical Board. To evaluate the ef?cacy of PHILOS plate in the treatment of Aims And Objectives proximal humeral fractures and assess its functional outcome. To assess any complications that could arise postoperatively Early rehabilitation of the patient Hospital Based Prospective study. Methods And Materials Study Design: Study Period: October 2019 to September 2022. Study is conducted in Department of Orthopaedics, Andhra Medical College, Study Setup: Visakhapatnam. Patients attending emergency/orthopaedic OP and admitted in department of Study Population: orthopaedics in King George Hospital, Visakhapatnam with proximal humerus fractures and are classi?ed according to Neer's Classi?cation 30 patients admitted in the Department of Orthopaedics, King George Hospital, Visakhapatnam Sample Size: with proximal humerus fractures in the above said period. We have included 30 proximal humeral fractures in our Results study. Males dominated and left side is more common than right. Domestic falls are common than road traf?c accidents. 2-part fractures are more common than 3- and 4-part fractures. All of them are treated with PHILOS stable angled plate. Complications like stiffness, screw penetration and super?cial infection occurred in our study which are dealt appropriately. Signi?cantly, we could prevent varus malunion which is notable in our study. Rehabilitation started early with pendulum exercises and could achieve good range of useful movements for most of the cases. Average range of radiological union is 13.5 weeks PHILOS plate, stable, angled construct is used in all our cases and the results evaluation done with . Conclusion Constant Murley score which ranged 54 to 87. Our average score is 67.43 which is in concurrence with few of the studies. The rehabilitation after operation started early with pendulum exercises as soon as the patients compliance within the limits of pain. The range of movements in our study, abduction maximum range obtained is 120 to 150 degrees and forward ?exion 90 to 120 degrees and rotations average score is 7. Though we have few complications like stiffness of shoulder (5), AVN (1), intra- articular screw penetration (1), super?cial infection (1) and subacromial impingement (1), we have dealt with all these complications appropriately. Signi?cantly, varus malunion did not occur in our study

House dust mite fauna characterization in the city of Rio de Janeiro and its importance in allergy diagnosis / Caracterização da fauna dos ácaros de poeira na cidade do Rio de Janeiro e sua importância em diagnósticos de alergias

Introduction: The home environment is one of the most favorable spaces for the development of mites because of its low light, humidity, and temperature. Thus, it contributes to the growing cases of allergies among atopic individuals. Objective: To investigate the faunal profile of house dust mites in the city of Rio de Janeiro and the allergenic potential in this region. Methods: Thirty dust samples were collected from homes in the city of Rio de Janeiro, and the species found were classified according to their morphology, family, and genus by classification key. For the collection region, the total protein level was assessed by the Lowry method and electrophoresis under denaturing conditions (SDSPAGE). Results: There was a predominance of Pyroglyphidae mites, accounting for 84.9% of samples; Tyrophagus putrescentiae accounted for 8%, Blomia tropicalis for 6%, Cheyletus malaccensis for 1%, and Acarus siro for 0.1%. The allergen protein content of the samples was the following: group 1 ­ 25 kDa (Der 1, Der p 1, and Blo t 1), group 2 ­ 15 kDa (Der f 2, Der 2, Tyr p 2, and Blo t 2), and group 3 ­ 29-30 kDa (Der f 3 and Blo t 3), which indicates that people in this region are susceptible to sensitization to these mites. Conclusion: Knowledge of the mite fauna in the region under study allows the guidance of health care professionals to perform skin tests for specific mites and conduct treatment according to the pool of mite extracts containing antigens, making immunotherapy more effective.

Introdução: O ambiente domiciliar é um dos espaços favoráveis para o desenvolvimento de ácaros, tendo em vista a baixa luminosidade, umidade e temperatura, o que contribui para os crescentes casos de alergias em indivíduos atópicos. Objetivo: Investigar o perfil faunístico dos ácaros na cidade do Rio de Janeiro e o potencial alergêncio para essa região. Métodos: Foram coletadas 30 amostras de poeira em residências na cidade do Rio de Janeiro, e as espécies encontradas foram classificadas quanto à morfologia, família e o gênero por chave de classificação. Para as regiões das coletas, a carga total de proteínas contendo os alérgenos foi determinada pelo método de Lowry e eletroforese em condições desnaturantes (SDS-PAGE). Resultados: Os resultados mostram a predominância de 84,9% de ácaros da família Pyroglyphidae; para os demais ácaros o percentual corresponde a 8% Tyrophagus putrescentiae, 6% Blomia tropicalis, 1% Cheyletus malaccensis, e 0,1% de Acarus siro. O conteúdo proteico alergêncio constituinte das amostras foram, grupo 1: 25 kDa (Der 1, Der p 1 e Blo t 1); grupo 2: 15 kDa (Der f 2, Der 2, Tyr p 2 e Blo t 2); e para o grupo 3: 29-30 kDa (Der f 3 e Blo t 3), o que indica uma região passível à sensibilização de indivíduos por estes ácaros. Conclusão: O conhecimento da acarofauna nas regiões em estudo permite orientar a comunidade médica quanto à realização de testes cutâneos, além da terapêutica a partir do pool de extratos de ácaros contendo os antígenos, a fim de tornar a imunoterapia mais eficaz.

A cross sectional study on the evaluation of MCH services provided by “ASHA” working at Urban Health Centers of Ahmedabad City, Gujarat

Introduction: National Rural Health Mission (NRHM) was launched by Indian Government with key feature of introduction of a new designated health care worker – “Accredited Social Health Activist” (ASHA) who acts as interface between community and public health system. Objectives: To assess knowledge about MCH related functions and to estimate status of support to beneficiaries by “ASHAs”, To Assess Quality of Home Based New Borne Care performed by ASHA and to find out impact of number of modular training rounds on knowledge and practices of ASHAs. Methodology: A cross-sectional study was conducted during February 2019 to December 2020 using a mixed approach, with a combination of quantitative and qualitative research methods after approval of institutional Ethics committee. All Urban Health Centres (UHC) under Municipal Corporation in Ahmedabad were covered. From each UHC, 2 ASHAs were selected by lottery method. So, total 144 ASHAs were selected from 72 UHCs. Performance assessment was done by direct interview with ASHA and their beneficiaries. Results: All 144 ASHAs were aware about responsibilities of Antenatal-women registration and Immunization. Nearly all ASHAs (99.3%) knew about task of PNC registration. Escorting to delivery and tertiary care centre, if complications arise was facilitated by 61.8% and 29.2% ASHAs respectively. Conclusion: All ASHAs were aware of their major responsibilities related to MCH and also providing same in their field area. Statistically significant association was observed between number of rounds for modular training undertaken by ASHAs and knowledge and practice of ASHAs in context to various components of MCH care.

Review: Use of Herbal Medicinal Products in Skin Treatments

Traditional medicine covers the rescue of the methodologies and techniques of cure, therapy, and prevention of diseases using medicinal plants. The objective of this paper is to conduct a literature review on the use of herbal medicines in skin treatment. The methodology used was a literature review conducted between 2015 and 2022 in national journals. The databases used were Google Scholar, SciELO, VHL, PubMed, and LILACS, using the following descriptors: "use of herbal medicines in skin treatments", "herbal medicines in skin treatments" and, "phytotherapy". The most commonly used medicinal plants were babosas (Aloe vera L.), arnica (Arnica acaulis L.), and barbatimão (Stryphnodendron adstringens (Mart.) Coville), confrei (Symphytum officinale L.), calendula (Calendula arvensis L.) and melaleuca (Melaleuca alternifolia L.). The most commonly used parts were leaves and bark, and infusion (tea) was the most commonly used preparation method. Most of the medicinal plants cited have their healing power evidenced by the scientific literature, thus favoring the quality of life of the individual who uses them. Thus, this article, obtained expressive results for human health, moreover, they establish an important step of bioprospecting, assisting in the choice of target plants for pharmacological verifications.

Cost of delivering primary healthcare services through public sector in India

Background & objectives: Public health spending on primary healthcare has increased by four times (in real terms) over the last decade and continues to constitute more than half of the total public health expenditure. The present study estimated the cost of providing healthcare services at sub centre (SC) and primary health centre (PHC) level in four selected States of India. Methods: A total of 51 SCs and 33 PHCs were selected across the four States (Himachal Pradesh, Odisha, Kerala and Tamil Nadu) of India. The economic cost of delivering health services at these facilities was assessed using bottom-up costing methodology during the reference year of 2014-2015. The cost of capital items was annualized and allocation of shared resources was based on appropriate apportioning statistics. Results: The mean annual cost of providing health services at SC and PHC was ? 0.69 million (US$ 11,392) and ? 5.1 million (US$ 83,837), respectively. Nearly 3/4th and 2/3rd of this cost at the level of SC (74%) and PHC (63%) were spent on salaries. In terms of unit cost, the costs per antenatal care and postnatal care visit were ? 221 (173-276) and ? 333 (244-461), respectively, at SCs. Similarly, the costs of per patient outpatient consultation and per bed day hospitalization at PHC level were ? 121 (91-155) and ? 1168 (955-1468), respectively. Interpretation & conclusions: The cost estimates from the present study can be used in economic evaluations, assessing technical efficiency and also for providing valuable information during scale-up of health facilities.

Report on Death of Dwarf Sperm Whale, Kogia sima (Order: Cetacea: Family: Kogiidae) in Vedalai Shore of Mandapam, Gulf of Mannar

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.

Small mammals in the diet of Barn Owls (Tyto furcata) in an urban area in Rio de Janeiro state, Brazil, with a new record of the dwarf mouse opossum (Cryptonanus) / Pequenos mamíferos na dieta da coruja-suindara (Tyto furcata) em uma região urbana do estado do Rio de Janeiro, Brasil, com um novo registro da catita do gênero Cryptonanus

Several studies emphasize the use of owl pellets in small mammal inventories in natural areas harboring high richness of rare species, but few Brazilian Atlantic forest localities have been surveyed by this method. The present study documents the species composition and abundance of small mammals in the diet of Tyto furcata in an urban area of the municipality of Campos dos Goytacazes, Rio de Janeiro, Brazil, remarking on a new record of the dwarf mouse opossum genus Cryptonanus in the Atlantic forest. We analyzed 265 pellets regurgitated by a pair of T. furcata from November 2016 to September 2017 found in a nesting box. Analysis of the samples enabled finding a total of 596 individuals of four small mammal species. Mus musculus was predominant among the prey items (98.3%), while the native rodents Necromys lasiurus (1.3%) and Holochilus brasiliensis (0,17%) were much rarer. A single specimen of Cryptonanus sp. was identified among the diet items based on distinctive dental characters. The identification of this genus in the present study represents the second record in the state of Rio de Janeiro, and the sixth in the Atlantic Forest biome, suggesting that this marsupial occupies a wider ecological and biogeographic range. The present study underscores the relevance of owl pellets for small mammal surveys, even in urban and highly disturbed areas.

Vários estudos enfatizam o uso de pelotas de coruja em inventários de pequenos mamíferos em áreas naturais com elevada riqueza de espécies raras, mas poucas localidades da Mata Atlântica brasileira têm sido inventariadas por esse método. O presente estudo documenta a composição de espécies e abundância de pequenos mamíferos na dieta de Tyto furcata em uma área urbana do município de Campos dos Goytacazes, Rio de Janeiro, Brasil, discutindo a relevância de um novo registro de um raro marsupial do gênero Cryptonanus na Mata Atlântica. Foram analisadas 265 pelotas regurgitadas por um casal de T. furcata entre novembro de 2016 e setembro de 2017, encontradas abaixo de uma caixa de nidificação. A análise das amostras permitiu encontrar o total de 596 indivíduos de quatro espécies pequenas de mamíferos. O roedor exótico Mus musculus foi predominante entre os itens alimentares (98,3%), enquanto os roedores nativos Necromys lasiurus (1,3%) e Holochilus brasiliensis (0,17%) foram bem mais raros. Um único espécime de Cryptonanus sp. foi identificado entre os itens com base em caracteres dentários. A identificação desse gênero no presente estudo representa o segundo registro no estado do Rio de Janeiro e o sexto no bioma Mata Atlântica, sugerindo que este marsupial ocupa uma ampla faixa ecológica e biogeográfica. O presente estudo destaca a relevância dos pellets de coruja para pesquisas com pequenos mamíferos, mesmo em áreas urbanas e altamente perturbadas.

Yersinia massiliensis (Enterobacteriales: Enterobacteriaceae) in the host Anaphes nitens (Hymenoptera: Mymaridae): first report of association with insects / Yersinia massiliensis (Enterobacteriales: Enterobacteriaceae) no hospedeiro Anaphes nitens (Hymenoptera: Mymaridae): primeiro relato de associação com insetos

Endosymbiont bacteria can affect biological parameters and reduce the effectiveness of natural enemies in controlling the target insect. The objective of this work was to identify endosymbiont bacteria in Anaphes nitens (Girault, 1928) (Hymenoptera: Mymaridae), the main natural enemy used to manage Gonipterus platensis (Marelli, 1926) (Coleoptera: Curculionidae). Genomic DNA from six A. nitens populations was extracted and polymerase chain reactions (PCR) were performed with the primers to detect endosymbiont bacteria in this insect. The PCR products were amplified, sequenced, and compared with sequences deposited in the GenBank for the bacteria identification. All A. nitens populations had the bacterium Yersinia massiliensis (Enterobacteriales:Enterobacteriaceae). This bacterium was originally described as free-living, and it is associated with and composes part of the A. nitens microbiota. This is the first report of Y. massiliensis in an insect host.

As bactérias endossimbiontes podem afetar os parâmetros biológicos e reduzirem a eficácia de inimigos naturais no controle do inseto alvo. O objetivo deste trabalho foi identificar bactérias endossimbiontes em Anaphes nitens (Girault, 1928) (Hymenoptera: Mymaridae), o principal inimigo natural usado no manejo de Gonipterus platensis (Marelli, 1926) (Coleoptera: Curculionidae). O DNA genômico de seis populações de A. nitens foi extraído e as reações em cadeia da polimerase (PCR) realizadas com os primers para detectar bactérias endossimbiontes neste inseto. Os produtos de PCR foram amplificados, sequenciados e comparados com as sequências depositadas no GenBank para identificação das bactérias. Todas as populações de A. nitens tinham a bactéria Yersinia massiliensis (Enterobacteriales: Enterobacteriaceae). Esta bactéria foi originalmente descrita como de vida livre e está associada e compõe parte da microbiota de A. nitens. Este é o primeiro relato de Y. massiliensis em um hospedeiro.