Perinatal Transmission and Outcomes of SARS-CoV-2 Infection

Maternal SARS-CoV-2 infection can adversely afect the birth and neonatal outcomes. The authors prospectively enrolled 196 neonates born to 193 SARS-CoV-2–positive mothers to determine the rate of mother-to-baby transmission of SARSCoV-2 and its efect on short-term neonatal outcomes in Indian population. Nineteen babies turned out to be RT-PCR– positive for SARS-CoV-2, carrying a perinatal transmission rate of 9.8%. Rates of prematurity and low birth weight were 12.8% and 18.9% in the neonatal group, respectively. On comparing SARS-CoV-2–positive (n=19) and negative (n=177) neonatal groups, rate of prematurity, hospital admission rate, and death rate were higher in the former group. The placental positivity rate for SARS-CoV-2 was 8.1%, but no relation was found between placental and neonatal infection.

Impact of antibiotic stewardship program on usage of higher range of antibiotics in patients of intensive care units in a tertiary care hospital, India

Background: The aim of the study was to monitor the changes in antimicrobial use after implementation of Antibiotic Stewardship Programmed (ASP) and pattern of use of antimicrobials in the respective ICU抯.Methods: The study was conducted in three ICU抯 Adult ICU(AICU), Paediatric ICU (PICU), Neonatal ICU (NICU) -Six bedded each) over a period of six months from September 2018 to February 2019 in a tertiary care hospital. Antibiotics monitored over total 155 patients and antibiotics selected for the study are ?-lactam inhibitors, Carbapenem derivatives and ColistinResults: Out of total 155 patients 51% were males and the definitive therapy (Implementation of antibiotics according to the antibiotic policy of the hospital) in the respective ICU抯 showed increase from 66.7% to 83.3% after implementation of ASP activity in that particular duration. Antibiotic consumption showed fluctuation in the whole duration of the study (p value <0.05).Conclusions: Analysis of the study shows a positive impact on implementation of ASP programme in intensive care units, brought an effective increase in appropriate use of antimicrobials.

Role Of Rasayana Chikitsa In The Management Of Female Infertility W.s.r. Hypothyroidism- A Case Study

Ayurveda is the Ancient system of Medicine which gives equal importance to preventive and curative aspects of treatment. Rasayana Chikitsa plays a key role in the treatment of all the diseases (both in curative and preventive). There is nothing painful and stressful to women, for not being conceived. In the present modern era, female infertility is raised to the alarming extent due to diet & lifestyle modifications. Couples suffering from the infertility are approaching the infertility centres and going for the artificial reproductive techniques (IUI, IVF, ICSI-ET, Sarogasy). Ayurveda, through its unique line of treatment approaches, paves the way for fertility management through the medicines along with diet & lifestyle modifications. The Commonest cause for fertility being the Hypothyroidism in females (in this present study, I have considered hypothyroidism as Rasa pradosaja vyadi), clinical study was done at OPD, DR. BRKR Govt Ayurvedic College, Hyderabad and treated the patient with Dipana, Pachana, Rasayana Chikitsa and the patient conceived. In this present article an attempt is made to review and understand the concept of Rasayana chikitsa in the management of infertility with special reference to hypothyroidism (Dhatupradosja vyadi).

Ameloblastic fibro-odontoma in a 14 year old girl: A case report

Ameloblastic fibro-odontoma (AFO) is a benign, epithelial odontogenic tumor with odontogenic mesenchyme having the histologic characteristics of both ameloblastic fibroma and complex odontoma. This report describes the case of a 14-year-old girl with AFO on the right posterior mandibular region that mimics complex odontoma on incisional biopsy due to the presence of atypical dentin- and cementum-like areas. On histological examination, sections of excisional biopsy showed odontogenic epithelial islands with embryonic connective tissue and decalcified sections showed atypical dentin with dentinal tubules and islands of cementum. These features led to the diagnosis of AFO.

Day time sleepiness in medical undergraduates: social media the culprit?

Background: Medical undergraduates have been seen to be suffering from sleep disturbances, especially daytime sleepiness. Social Media usage or social networking has also tremendously increased over the past few years in adolescents. It has also increased in the day-to-day lives of medical students. Authors therefore tried to find out the association, if any, between social Media usage and daytime sleepiness in medical undergraduates and whether daytime sleepiness can affect their academic performance. The objective of the present study was to ascertain the association between daytime sleepiness and usage of social media among medical students and to look for any association of daytime sleepiness with academic performance.Methods: A self-administered, questionnaire-based study was conducted on medical undergraduate students to assess social media usage. Epworth sleepiness score was determined. ‘Analysis of variance’ was done to look for any association between (a) social media usage and daytime sleepiness (b) daytime sleepiness and academic performance.Results: The majority of students (77.14%) used social media for 2-5hours per day and whatsapp was the most commonly used medium by them. Highly significant association was observed between the usage of social media and daytime sleepiness among the medical undergraduates. Daytime sleepiness was also significantly related to the academic performance of the participating students.Conclusions: Sleep disturbance particularly daytime sleepiness is significantly associated with the usage of social media among first year medical undergraduates and can significantly affect their academic performance.

Isolation and Characterization of a Lactose-Binding Lectin from Ocimum sanctum.

A novel lectin has been isolated from Ocimum sanctum and purified to homogeneity by gel filtration chromatography, which eluted as a single symmetrical peak from a Biogel P-100 column with a molecular mass of 66 kDa. The lectin had a special agglutinating activity with human erythrocytes at a minimum concentration of 0.7 ug/ml. The lectin was stable in the pH range 5-12 and temperature 80 °C for 30 min. Ocimum sanctum had shown highest agglutinating activity at pH7 and 250C temperature after one hour incubation. Of the various sugars tested, even at 1000 mM sugar concentration, no inhibition was observed. The isolated lectin was found to be lactose-biding lectin sugar moieties and contain 2.6 mg/ml total sugar and 9.3 mg/ml of total protein.

Considerações nutricionais para cirurgia plástica em paciente após cirurgia bariátrica / Nutritional considerations for plastic surgery in post-bariatric surgery patients

A cirurgia bariátrica continua a ser o tratamento mais efetivo para obesidade mórbida e a mais associada a outras condições metabólicas tais como diabetes tipo 2, doença refluxo gastroesofágico, e apneia do sono obstrutiva. Na população obesa, deficiências nutricionais comuns incluem vitaminas A, C, D, e B12, folato, tiamina, ferro, ferritina, zinco e selênio. Com a perda de peso ponderal, muitos pacientes podem utilizar o contorno corporal para deformidades. Após perda de peso ponderal seguida de cirurgia bariátrica, os pacientes geralmente desenvolvem deficiência nutricional significante que aumenta o risco de morbidade e mortalidade pós-operatória com quaisquer cirurgias subsequentes. Alguns pacientes requererem avaliação adicional durante a doença, ou quando candidatos eletivos pré-cirurgia, devido a alterações no trato alimentar com objetivo de melhorar os resultados e prevenir complicações devido a deficiências nutricionais.

Bariatric surgery continues to be the most effective treatment for morbid obesity and most other associated metabolic conditions such as type 2 diabetes mellitus, gastroesophageal reflux disease, and obstructive sleep apnea. In the obese population, common nutritional deficiencies include vitamins A, C, D, and B12, folate, thiamine, iron, ferritin, zinc, and selenium. With massive weight loss, many patients may utilize body contouring for deformities. After massive weight loss following bariatric surgery, patients often develop significant nutritional deficiencies that increase the risk of postoperative morbidity and mortality with any subsequent surgeries. Some unique patients will require additional evaluation during illness or when considering elective surgery due to alterations to the alimentary tract, in order to optimize outcomes and prevent complications from nutritional deficiencies.

Evaluation of an immunochromatographic test for discrimination between Mycobacterium tuberculosis complex & non tuberculous mycobacteria in clinical isolates from extra-pulmonary tuberculosis.

Background & objectives: Accurate diagnosis of tuberculosis (TB) is crucial to facilitate early treatment of the patients, and to reduce its spread. Clinical presentation of Mycobacterium tuberculosis complex (MTBC) and non tuberculous mycobacteria (NTM) may or may not be the same, but the treatment regimen is always different for both the infections. Differentiation between MTBC and NTM by routine laboratory methods is time consuming and cumbersome. This study was aimed to evaluate an immunochromatographic test (ICT), based on mouse monoclonal anti-MPT64, for simple and rapid discrimination between MTBC and NTM in clinical isolates from extra-pulmonary tuberculosis cases. Methods: A total of 800 clinical samples were collected from patients suspected to have extra-pulmonary tuberculosis. Preliminary diagnosis has been done by direct Ziehl–Neelsen (ZN) staining followed by culture in BACTEC system. A total of 150 clinical isolates, which were found positive in BD 460 TB system during September 2009 to September 2010 were selected for the screening by ICT test. p-nitro-α-acetylamino- β-hydroxy propiophenone (NAP) test was performed for differentiation of MTBC and NTM. M. tuberculosis complex was further confirmed by IS6110 PCR of BACTEC culture positive isolates, this served as the reference method for MTBC identification and comparative evaluation of the ICT kit. Results: Of the 150 BACTEC culture positive isolates tested by ICT kit, 101 (67.3%) were found positive for MTBC and remaining 49 (32.7%) were considered as NTM. These results were further confirmed by IS6110 PCR that served as the reference method for detection of MTBC. H37Rv reference strain was taken as a control for ICT test and IS6110 PCR. The reference strain showed the presence of MPT64 antigen band in the ICT test. Similar bands were formed in 101 of 102 MTBC isolates tested, proving 99.1 per cent sensitivity and no bands were detected in 48 (100%) NTM isolates tested, proving 100 per cent specificity of the ICT kit. Interpretation & conclusions: Our findings show that ICT test can be used on direct culture positive specimens. It does not require any special equipment, is simple and less time consuming. It can easily discriminate between MTBC and NTM and thus can help in appropriate management of tuberculosis.

Tuberculin specific T cell responses in BCG vaccinated children.

The effector mechanisms of BCG protection were examined 5-7 years after vaccination. The in vitro lymphoproliferation, following stimulation with tuberculin, in normal, (A) vaccinated and (B) unvaccinated children and children with tuberculosis (C), were assayed. The mean stimulation index (SI) of lymphocyte transformation in normal subjects were significantly (P < 0.05) higher than those with tuberculosis. The ratio of tuberculin-specific CD4 to CD8 cells in short-term cultures were significantly (P less than 0.05) higher in the vaccinees. In group (A), 70 % had positive ratios as against 20 %and 0 %in groups (B) and (C), respectively. Secretion of IL-2 by the cells was significantly (P < 0.05) high in the vaccinated. None of the unvaccinated children had positive levels of IL-2. The vaccinees also had highly significant (P < 0.01) levels of IFN-)in the supernatants of cell-cultures, following tuberculin stimulation. In majority of the BCG vaccinated children, the stimulation of specific TH1 cells seem to be considerably high, in short-term in vitro cultures. While these responses were not so marked in the unvaccinated, they were almost totally absent in the patients.

Immunohistochemical localization of macrophage CD68+, HLA-DR+, L1+ and CD44+ subsets in uterine endometrium during different phases of menstrual cycle.

Different tissue macrophage subsets were immunohistochemically examined in normal endometrial samples collected from proliferative (n=4), peri-ovulatory (n=6) and secretory (n=8) phases of menstrual cycles in women. The different macrophage subsets, namely CD68 (pan macrophage marker), CD44 (transmembrane adhesion molecule), HLA-DR (transmembrane heterodimeric protein involved in antigen presentation) and L1 (calprotectin)-positive cells, as well as, CD45 (common leucocytic antigen)-positive cells were examined on the basis of immunohistochemical staining, and areas of immunoprecipitation were analyzed morphometrically using computer-assisted video imaging system. The stage-specific distribution of receptors for estrogen (ER) and progesterone (PR) in endometrial cells were examined and morphometrically analyzed. There was an increase in the number of CD45+ cells (P < 0.01) and CD68+ cells (P < 0.05) in secretory phase endometrium compared with proliferative and peri-ovulatory phases. There was no remarkable cycle dependent pattern in HLA-DR+ and L1+ cells. However, there was an increase in CD44 immunopositive area in peri-ovulatory (P < 0.05) and in secretory (P < 0.01) phases of endometrium compared with proliferative phase endometrium. A higher (P < 0.01) degree of immunopositivity for ER was observed during peri-ovulatory phase, and for PR, during peri-ovulatory (P < 0.05) and secretory (P < 0.01) phases compared with proliferative phase of cycle. Positive correlations between areas occupied by (i) CD68+ cells and PR (P < 0.01), (ii) HLA-DR+ and L1+ cells (P < 0.05), (iii) CD45+ and CD68+ cells (P < 0.01), (iv) CD45+ and L1+ cells (P < 0.05), and (v) PR and L1+ cells (P < 0.05) were obtained. It appears that the recruitment of different macrophage subsets in human endometrium involves a complex set of endocrine and paracrine factors.

A new species of phyllobothrium parasite from rhinoptera javanica from Waltair Coast of Andhra Pradesh in India

Se describe una nueva especie de un cestode, perteneciente al género phyllobothrium, obtenida de la valva espiral del pez elasmobraquio rhinoptera javanica. Fueron observadas notables diferencias en relación a otras especies conocidas de phillobothrium, por poseer un escolex grande, botridias bifurcadas y sésiles, número de testículos y características de las proglótidas. Se da el nombre de phyllobothrium rhinoptera a la nueva especie

Studies on the new species anthrobothrium loculatum parasite from dasyatis (himantura) uarnak (forskal)

Se describe anthobothrium loculatum, una nueva especie de cestode encontrada en la válvula espiral del intestino del pez dasyatis uarnak. Este gusano tiene la especial característica de poseer 4-5 pares de notables hendiduras en cada surco del escólex. Difiere de otras especies de anthobothrium en muchos aspectos tales como su tamaño, dimensiones de las botrias y número de testículos

Description of the new species acanthobothrium satyanarayanaraoi from rhinobatus granulatus from Waltair coast, India

Se describe la nueva especie de cestode parásito acanthobothrium satyanarayanaraoi del huésped elasmobranquio rhinobatus granulatus. Este gusano se diferencia de otras especies conocidas del género acanthobothrium en su mayor tamaño, escólex más grande, botridias y en algunas otras características