Assessment of KaraShieldTM properties in supporting the immune health of healthy subjects: a randomized, parallel, double-blind, placebo-controlled clinical study

Background: This study aims to investigate whether a novel herbal extract blend, KaraShieldTM could be used to help build a healthy immune system that could reduce the number of incidences or severity of common upper respiratory tract infections (URTIs). Methods: A randomized, parallel, double-blind, placebo-controlled clinical study of 60 days was done on 120 healthy subjects allocated to a treatment arm (500 mg/day, KaraShieldTM) or placebo arm (500 mg/day). Results: A 500 mg daily dosage of KaraShieldTM significantly improved the subjects' immune health as measured by parameters such as the frequency and severity of upper respiratory tract conditions, the serum IgG level, mean ISQ raw score, WURSS scale score, CRP level in the serum and WHOQOL-BREF score at the end of the study period of sixty days from the baseline compared to that of the placebo. The investigated product was found to be safe and well tolerated by the subjects. Conclusions: KaraShieldTM may represent a promising safe and effective formulation for building a healthy immune system that could then counteract URTIs.

Constraints and Suggestions of Fruit Crop Growers of Vijayapura District, India

The study was conducted in Vijayapura district of Karnataka during 2019-20 to analyse the constraints and suggestions of fruit crop growers. Forty each grape, lime and pomegranate growers were selected by use of simple random sampling technique. Thus, making a total sample size of 120. Personal interview method was used to collect data and appropriate statistical tools were applied to analyse the data. The findings revealed that, with respect to the constraints faced by fruit crop growers in fruit crop production, production constraints were lack of irrigation facilities (87.50%) followed by high cost of inputs (73.33%). Major financial constraints were non-availability of credit at right time (73.33%) followed by inadequate credit (70.83%). High wages (70.00%) and non-availability of labourer (61.67%) were the main issues relating to labour constraints. Regarding marketing constraints, fluctuating price (87.17%) followed by delayed cash payment and exploitation by middlemen (77.50%) were the major constraints. The suggestions offered by the fruit crop growers are provision for irrigation facility (85.00%) followed by provision of timely and adequate market information (76.67%), protection from exploitation by middlemen (75.00%). Provision for suitable market infrastructure, timely and adequate credit, timely and adequate cash payment, continuous power supply, interest free credit and longer repayment period for credit were other suggestions offered to improve the returns from fruit crop cultivation.

Weed Management Practices on Growth, Yield and Economics of Kharif Grain Sorghum

In the Kharif grain sorghum growing areas of Karnataka, the sorghum production suffers greatly due to weed problem, which offers limitations to crop. It was found that weed infestation become unmanageable throughout the growing period by the traditional methods of interculturing and manual weeding due to continuous and heavy rains during entire vegetative and early reproductive stages of Kharif sorghum. Hence, integration of herbicides with some cultural operations and use of pre-emergence, post-emergence herbicides in combination with mechanical methods can prove to be more successful. A field experiment entitled “Weed management in kharif grain sorghum” was conducted during Kharif 2019 at ARS, Hagari in deep black soil with neutral reaction (pH 7.50), organic carbon (5.5 g kg-1), available nitrogen (248.00 kg ha-1), available phosphorus (36.75 kg ha-1) and available potassium (312.00 kg ha-1). An experiment was laid out in Randomized Complete Block Design (RCBD) with three replications. There were fourteen treatments comprising of weed management practices. The dominant weeds observed in the experimental fields were among grasses Brachiaria reptans, while in broad leaved weeds, Amaranthus viridis and among sedges, Cyperus rotundus. Significantly lower population of grasses, sedges, and broad leaved weeds, weed dry weight, weed index (%) and higher weed control efficiency throughout the crop growth period was noticed in sequential pre-emergence application of atrazine 50 WP @ 0.50 kg a.i. ha-1 as PE fb 2,4-D Na Salt 80 WP @ 0.75 kg a.i. ha-1 as PoE at 25 DAS except weed free treatment. Atrazine 50 WP @ 0.50 kg a.i. ha-1 as PE fb 2,4-D Na Salt 80 WP @ 0.75 kg a.i. ha-1 as PoE at 25 DAS recorded significantly higher plant height, dry matter accumulation, leaf area, test weight, grain yield, straw yield, harvest index, gross return, net return and benefit cost ratio (160.8 cm, 183.4 gplant-1, 24.1 dm2 plant-1, 30.53 g, 4195 kg ha-1, 9891 kg ha-1, 29.80 %, Rs. 1,03,675ha-1, Rs. 71,636 ha-1and 3.24, respectively) except weed free and it was on par with atrazine 50 WP @ 0.50 kg a.i. ha-1 as PE fb IC at 25 DAS and HW at 25 DAS and IC at 40 DAS.

Effect of Nano Nitrogen on Growth, Yield and Nutrient Uptake of Bt Cotton

Aims: Foliar application of nano nitrogen is aimed to reduce the soil application of conventional nitrogen. Nano fertilizers enhance crop growth, yield and quality while enhancing the faster nutrient uptake and reducing costs. They provide precise nutrient management, matching crop growth stage and offer increased surface area for metabolic reactions. This boosts photosynthesis, leading to higher dry matter production and crop yield. Foliar application of nano urea (liquid) at flowering, boll initiation and boll development stages in cotton fulfills the nitrogen requirement and reflects higher crop productivity and quality. Higher productivity of crops in sustainable manner could be achieved applying appropriate combination of conventional fertilizer and nano fertilizers. Study Design: The experiment was laid out in split design with three replications.Place and Duration of Study: A field experiment was conducted in shallow black soils at Main Agricultural Research Station, Raichur, during kharif 2022.Methodology: There were fifteen treatment combinations, consisting of different doses of RDN (50 % N, 75 % N and 100 % N) with different concentrations of nano urea sprayed at 90, 100 DAS and 135 DAS for US-7067 BG-? hybrid of Bt cotton.Results: Application of 100% RDN has recorded significantly higher plant height, sympodial branches plant-1 and total dry matter accumulation (176.9 cm, 27.1 and 430.31g plant-1, respectively) followed by 75 % RDN (168 cm, 26.7 and 426.91 g plant-1, respectively) which found on par with each other. It also produced higher number of bolls plant-1 (50.3), boll weight (5.81 g) and seed cotton yield (3388 kg ha-1) followed by 75 % RDN (50.2, 5.36 g and 3376 kg ha-1, respectively) which found comparable with each other. Foliar application of nano urea @ 0.6 per cent each at 90, 100 and 135 DAS has recorded significantly higher plant height (180.8 cm), sympodial branches plant-1 (28.5), total dry matter accumulation (429.42 g plant-1), number of bolls plant-1 (52.2), boll weight (5.93 g) and seed cotton yield (3485 kg ha-1) followed by foliar spray of nano urea @ 0.4 per cent each at 90, 100 and 135 DAS (173.3 cm, 28, 428.52 g plant-1, 51.8, 5.67 g and 3465 kg ha-1, respectively) which found on par with each other. Similar trend was recorded with regard to nutrient uptake by cotton.Conclusion: Foliar application of nano urea reduced the dosage of conventional nitrogen by 25 per cent. There was linear increase in seed cotton yield (kg ha-1) with increasing levels of nitrogen levels.

Bio-Efficacy of Post Emergent Herbicides on Weeds in Direct Seeded Rice (Oryza sativa L.)

A field experiment was conducted to study the bio-efficacy of post emergent herbicides on weeds in direct seeded rice in medium black clay soil at Agricultural Research Station, Dhadesugur, University of Agricultural Sciences, Raichur, Karnataka during Kharif 2022. The experiment was laid out in Randomized complete block design with three replications. There were eight treatments consisting of five post emergent herbicides sprayed at 25 DAS, hand weeding at 20 and 40 DAS, weed free check and weedy check in direct seeded rice and the variety RNR 15048 was used in this trial. Application of cyhalofop butyl 5.1 % + penoxsulam 1.02 % OD @ 2000 ml ha-1 recorded significantly lower weed density, weed dry weight, weed index and higher weed control efficiency compared to all the other treatments. It also produced higher number of productive tillers (409.4 m-2), panicle weight (3.89 g), filled grains per panicle (243.1), lower number of unfilled grains per panicle (8.4), higher grain yield (6058 kg ha-1) and straw yield (6935 kg ha-1) in direct seeded rice. So it can be concluded that application of cyhalofop butyl 5.1 % + penoxsulam 1.02 % OD @ 2000 ml ha-1 at 25 DAS (weeds at 2-3 leaf stage) was most effective in managing the weeds with higher weed control efficiency. It also resulted in higher growth and yield components of direct seeded rice leading to higher grain yield.

A study on awareness regarding universal precautions among medical students of tertiary teaching hospital, Bengaluru

Background: Health care staffs are at increased risk of acquiring various infection as they are exposed to infectious agents at their workplace hence having awareness regarding Universal precautions help them protect themselves and provide better health care services. Methods: Descriptive study was conducted on 220 medical students of 5th, 7th and 8th term for a period of 2 months. Medical students were selected based on probability proportional to size sampling method. Semi-structured questionnaire was used to interview the study subjects Results: Assessment regarding awareness on Universal Precautions among Medical students was done by administering questionnaire on Universal Precautions. Awareness on Hand hygiene among medical students was 92% (195/220). 98.1% (208/220) of them had awareness regarding gloves usage, 45.6% (124/220) of them were unaware about safe needle practices. Conclusions: Medical students lack awareness regarding safe needle practices. They were aware of other aspects such as hand hygiene and gloves usage.

Effect of Nano Fertilizers on Growth, Yield, Nutrient Uptake and Soil Microbiology of Kharif Sorghum

Aims: Foliar nutrition is aimed to eliminate the problems of fixation and immobilization of nutrients. Hence, foliar nutrition is being recognized as a significant way of fertilizing modern agriculture, especially under rainfed conditions. Nano fertilizers because of smaller size and higher surface area are efficient as compared to conventional and produce better results when used in combined form.Study Design: The experiment was laid out in Randomized complete block design with three replications.Place and Duration of Study: A field experiment was conducted in medium black soils at Agricultural Research Station, Hagari, during Kharif 2022.Methodology: There were ten treatment combinations, consisting of different doses of RDF (50 % RNP, 75 % RNP and 100 % RDF and absolute control) with different doses of nano urea and Dap sprayed at 30 and 45 DAS for CSH-16 hybrid of sorghum.Results: Application of 75% RNP as basal + nano urea & DAP spray @ 1.5 ml l-1 each at 30 and 45 DAS recorded significantly higher number of leaves, leaf area and leaf area index. It also produced higher earhead length (35.9 cm), number of grains earhead-1 (2207), grain weight (57 g plant-1) and test weight (29.3 g 1000 grains-1). Nutrient content and uptake also showed higher values for the same treatment along with the nutrient use efficiency indices. Whereas, significant reduction in soil microbes was noticed by the application of treatment.Conclusion: Combined application of conventional and nano fertilizers helped to increase growth, growth attributes like number of leaves, leaf area, leaf area index, yield attributes, nutrient content, nutrient uptake and nutrient use efficiency of sorghum.

Antibacterial efficacy of Acacia nilotica, Aegle marmelos herbal extracts against Enterococcus faecalis: an invitro study

Background: Our objective was to evaluate the antibacterial efficacy of Acacia nilotica, Aegle marmelos herbal extracts against Enterococcus faecalis- an invitro study. Methods: The extraction of Acacia nilotica bark powder and Aegle marmelos leaf powder was done with following three solvents (Ethanol, methanol and acetone) keeping vancomycin as a positive control. Then the study groups were assigned as follows: group I: Acacia nilotica, group II: Aegle marmelos, group III: Combination of Acacia nilotica and Aegle marmelos, group IV: vancomycin. Preparation of the E. feacalis inoculum with the help of Mueller Hinton Broth. Antimicrobial efficacy was evaluated by agar well diffusion assay to determine the zone of inhibition and Minimum inhibitory concentration was evaluated. Results: Statistical analysis was performed by using one-way analysis of variance and compared by the Mann-Whitney test using the Statistical Package for the Social Sciences (SPSS) software, version 20.0. No zone of inhibition was identified for Aegle marmelos. Highest inhibitory zone against E. faecalis was seen for vancomycin (mean of 28.6 mm) followed by Acacia nilotica. Conclusions: Among the test groups, vancomycin exhibited highest antimicrobial efficiency. Compared with the herbal extracts which was statistically significant. The use of herbal alternatives might prove to be advantageous considering the several undesirable characteristics of vancomycin.

Comparison of Post-transcriptional Gene Silencing (PTGS) Strategies for Developing Transgenic Plants Resistant to Tomato Leaf Curl Virus (ToLCV)

Tomato (Solanum lycopersicum L.), an economically important crop is host to many whitefly transmitted geminiviruses including tomato leaf curl virus (ToLCV). Genetically engineering resistance of pathogen through Post-transcriptional gene silencing (PTGS/RNAi) is a powerful strategy that can provide alternative to existing methods of producing virus resistant plants. We cloned and characterized ToLCV-replicase (TRP) gene from a local Dharwad, Karnataka, India ToLCV isolate for development of transgenic tomato plants. Plant expression vectors carrying viral replicase (rep) gene in sense, antisense, ihp (intron spaced hairpin) and HUTR (inverted repeats of heterologous 3΄-untranslated region) were constructed. Transgenic tomato plants carrying rep gene in different strategies when challenged with whiteflies carrying ToLCV showed varied degrees of resistance. Such plants were confirmed through PCR, GUS, Dot blot, Southern blot and semiquantitative PCR analysis. High degree of resistance was observed in the construct carrying both sense and antisense strand interrupted by intron (ihp). Our results demonstrate that, transgenic plants with simultaneous expression of sense and antisense strands are more efficient in gene silencing of ToLCV than those expressing either sense or antisense strand alone.

Application Methodology and Physiological Insights of Melatonin Hormone for Water Stress Alleviation in Black Pepper (Piper nigrum L.)

Black pepper is highly sensitive to water deficit stress especially during summer, resulting in significant losses in yield; therefore, strategies aimed at enhancing water stress tolerance are essential. Melatonin improves stress tolerance in plants; however, its method of application and optimum concentration in black pepper under water deficit stress remains unclear. Therefore, we conducted a two pot culture experiment during March and April, 2022 (var. Panniyur-1) to investigate the effects of foliar-sprayed and root-irrigated melatonin (50, 100 and 150 µM L-1) on the recovery per cent and physiological mechanism under water stress. The treatment details were, WW - Well-watered; WS - Water stressed; FM50 - Waterstress+50µM Melatonin (Foliar spray); FRM50 - Water stress + 50µM Melatonin (Foliar spray + Soil drenching @ 50ml/plant); FM100 - Water stress + 100µM Melatonin (Foliar spray); FRM100 - Water stress + 100µM Melatonin (Foliar spray + Soil drenching @ 50ml/plant); FM150 - Water stress + 150µM Melatonin (Foliar spray); FRM150 - Water stress + 150µM Melatonin (Foliar spray + Soil drenching @ 50ml/plant). The melatonin-induced enhanced stress tolerance could be attributed to improved recovery %, leaf relative water content, photosynthetic pigments, activity of antioxidant enzymes (SOD, POD, and CAT), and ultimately significantly relieved the inhibitory effects of water stress on leaves. After rehydration, melatonin-treated plants recovered more quickly than untreated plants. In addition, melatonin counteracted the water stress induced accumulation in proline content. Overall, the results of this study demonstrated that melatonin at 100 µM L-1 (Foliar spray and root irrigation) significantly alleviated the adverse effects of water deficit stress compared untreated plants. In addition, application of exogenous melatonin combined with root and foliar application is superior than foliar spraying alone.

Lipid Profile as an Indicator of Severity in Cirrhosis of Liver: Hospital based Cross-sectional Study

Background: Various scoring systems are available to assess the severity of cirrhosis, that is, the Child-Pugh score and Model for End-Stage Liver Disease (MELD) score. Since the liver is the major site for converting excess carbohydrates into various lipids, the deranged lipid profile can act as a prognostic biomarker of cirrhosis. We assessed the lipid profile abnormalities among patients with cirrhosis of the liver and correlated them with the severity of cirrhosis. Materials and methods: This is an analytical cross-sectional study on lipid profile as an indicator of severity in cirrhosis of the liver among patients admitted to the medical ward of a tertiary care teaching hospital in Tamil Nadu. Following detailed investigation and confirmation of cirrhosis, a fasting serum lipid profile was measured in all eligible patients with cirrhosis. Total serum cholesterol, triglyceride (TGL), and high-density lipoprotein (HDL) were measured by direct method and serum low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL) were calculated by using the Friedwald formula. Results: A total of 120 patients were studied. Of them, 76 (63%) were male. Of them, alcohol (84, 75.0%), hepatitis B (8, 7.1%), and nonalcoholic steatohepatitis (NASH) (6, 5.4%) were the most common cause of cirrhosis. A clear dose-response relationship (decreasing trend) is seen in the levels of lipids for increasing severity based on the Child-Pugh score and MELD score (except for a score of ?10). Further, the cholesterol, LDL, and HDL were significantly lower among patients with ascites or with spontaneous bacterial peritonitis compared to their respective groups. However, none of the lipid profiles significantly differed based on the presence of upper gastrointestinal (UGI) bleeding. Conclusion: This study observed that there is a significant reduction in levels of lipid profile parameters like serum total cholesterol, LDL, VLDL, TGL, and HDL in patients with cirrhosis as the severity increases. Further formulation of the scoring system in association with a preexisting scoring system may provide a better assessment of patients’ prognosis in view of morbidity and mortality. We recommend it is necessary to assess the fasting lipid profile in all patients with cirrhosis and prognosticate their disease progression.

Anticancer potential of Solanum lycopersicum L. extract in human lung epithelial cancer cells A549

The study aimed to reveal the phytochemical profile, free radical scavenging potential, and anticancer activity of Solanum lycopersicum L. leaf extract (SLLE). According to the study, SLLE contains plant secondary metabolites that are beneficial for health, like phenolics, flavonoids, ascorbic acid, alkaloids, and terpenoids. The SLLE has shown potential free radical scavenging potential in DPPH and ABTS free radical scavenging analysis and its EC50 values (concentration required to inhibit 50% of free radicals) were determined as 481.29 ± 33.82 and 527.56 ± 20.34 µg/mL, respectively. The SLLE has the ability to scavenge free radicals and could be used to treat illnesses brought on by oxidative stress. The anticancer activity of SLLE was assessed by MTT, LDH, micro-morphological, live/dead dual staining, and caspase-3 analysis. In the MTT assay, the IC50 value (concentration required to inhibit 50% of cell viability) of SLLE was determined as 190.41 ± 4.77 µg/mL. Furthermore, SLLE has shown potential anticancer activity by adversely affecting the plasma membrane integrity and escalating the caspase-3 levels. In the biomedical field, SLLE could be highly useful to treat cancer.

Characteristics of injuries resulting from falls from height in the construction industry

INTRODUCTION@#Falls from heights contribute to 34% of fatal accidents in Singapore. Of these, 51% of the accidents occur in the construction industry. This retrospective review, of all persons falling from heights in the construction industry from 2006 to 2012 and attending a major hospital, analysed injury patterns and related them to mechanisms and contributory factors.@*METHODS@#Information collected included injury and casualty characteristics, safety measures, pre-existing medical conditions and clinical outcomes.@*RESULTS@#Of 1,085 patients, 951 were male with a mean age of 39.8 years, mean height of 165.9 cm and mean weight of 69.7 kg. Most of the casualties fell between 0800 and 2000 hours. Among the severely injured patients, 2.4% had head injuries, 54.9% had chest injuries and 39.2% had abdominal and pelvic injuries. For these casualties, the mortality rate was 60.8%. For patients with less than major trauma, the commonest injuries were in the lower limbs (41.8%), upper limbs (40.8%) and spine (22.2%). All the casualties survived. Falls from scaffolding, formwork and platforms were the most common causes of severe injuries (41.1%). Safety helmets and harnesses were reported to be used in 1.8% and 4.1% of instances of falls, respectively.@*CONCLUSION@#Studying the patterns of injuries following falls at construction sites has the potential for injury prevention through safe practices, use of safety equipment and targeted training.

Hepatoprotective effect of obeticholic acid on acetaminophen induced hepatotoxicity in mice

Acetaminophen (APAP) is commonly used as analgesic and antipyretic drug for relieving mild and moderate pain, but at high doses produces hepatic necrosis. Though, Obeticholic acid (OCA) has been tested in range of diseases, its therapeutic potential against APAP-induced hepatic injury remains to be elucidated. Thus, in this study, we investigated the preventive effect of OCA along with N-acetylcysteine (NAC) and Silymarin (SIL) against acetaminophen-induced hepatotoxicity in mice. SIL (100 mg/kg, po) and OCA (30 mg/kg, po) were administered continuously for six days prior to APAP administration. After sixth dose, animas were fasted for 12 h and treated with 300 mg/kg APAP and then received SIL (100 mg/kg, po), NAC (500 mg/kg, ip) and OCA (30 mg/kg, po) at 1 h after APAP. Mice were sacrificed 6 h after APAP injection. Analysis of serum Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP), liver glutathione (GSH) and histopathology were employed for assessment of hepatotoxicity. APAP group showed a significant increase in ALT, AST, ALP and centriolobular hepatic necrosis with a significant decrease in glutathione in comparison to control group. All these parameters were significantly improved in all the three treated groups when compared to APAP group. In conclusion, Obeticholic acid (OCA), Silymarin (SIL) and N-acetylcysteine (NAC) are suggested to protect against APAP-induced hepatotoxicity in mice by ameliorating liver enzymes, antioxidant effect and decreasing liver necrosis.

Comparison of COVID-19 Infection in Children During the First and Second Wave

Concerns have been raised in the media that ‘the third wave’ will severely afect children. Here, an experience of SARSCoV-2 infection in children is reported. Of the 8,626 SARS-CoV-2 RT-PCR tests performed in children (0–17 y) from March 2020 to July 2021 at the authors' institute, 1470 (17%) were positive, [711/4821 (14.7%) during the frst wave (July 2020 to January 2021), and 759/3583 (21.2%) during the second wave (February 2021 to July 2021)]. The children in both waves were similar in presentation (74.1% mildly symptomatic versus 80.2% mildly symptomatic; rest asymptomatic). None of them had COVID pneumonia. Five children died (0.3%), all of a serious primary non-COVID disease. Seventy-three cases of MIS-C during August 2020 to July 2021, with low mortality (2.7%) were also identifed. The similarity in COVID-19 infection in children between the frst and the second waves seems to suggest that the likelihood of the ‘third wave’ hitting children hard is low.

Media Reporting of Suicide in the Bengaluru E-Edition of Three Major Indian Dailies: An Archival Study

India has the world’s largest newspaper market, with over 100 million copies sold daily. The media scapegoat, simplify, speculate, and sensationalize suicide?related news instead of signposting people to seek help. Suicide affects individuals, families, and communities and is worthy of responsible reporting. This study examined the quality of newspaper coverage of suicides from January to December 2017 in three popular English dailies in Bengaluru, South India. Three hundred and ninety?five online suicide reports were evaluated for compliance with the 2017 WHO recommendations for responsible suicide reporting by media professionals. The secondary data were obtained from digital newspaper archives and analyzed. Ahandful of the sampled articles met key recommendations. While reporting on suicide in the Indian media, three critical areas that require the most attention are reducing sensationalism, providing help-seeking information, and educating the public on suicide prevention without perpetuating myths.

Steep increase in myopia among public school-going children in South India after COVID-19 home confinement

Purpose: Novel coronavirus has brought huge changes in lifestyle, especially among children. Reports indicate that the prevalence of refractive errors among children has increased due to home confinement. Hence, this study was done to understand the current status of refractive errors among children from public schools in southern India. Methods: This cross-sectional study was conducted as part of school eye screening conducted between September and October 2021. Children between 14 and 17 years of age from public schools underwent a three-phased comprehensive eye examination. Children identified with refractive errors and an equal proportion of children without any refractive errors underwent a survey on outdoor activities. Prevalence estimates and 95% confidence interval were calculated. Chi-square tests and regression analysis were used to understand the association between refractive error and other variables. Results: From the data of 3,850 (90.69%) children, the prevalence of vision impairment, refractive errors, and myopia in at least one eye was found to be 12.83% (n = 494), 21.51% (n = 828), and 19.53% (n = 752), respectively. The average myopic spherical equivalent error was found to be -2.17 ± 1.11D (range:-0.50 D to -14.00 D). Almost 96.82% of girls had less than 3 h of outdoor activities. Refractive errors were 7.42 and 2.77 times more (95% CI: 3.51-15.70), P < 0.001) among children who had outdoor activities less than 3 h per day and sleep less than 7 h per day. Conclusion: Comparing to previous studies from North Indian and South Indian public schools, this study reports a three- to six-fold rise in myopia post-home confinement among public school children from India.

Multisystem inflammatory syndrome in neonate with skin lesions—A rare case report

Multisystem inflammatory syndrome in children is a serious condition that occurs due to postinfectious immune-mediated hyperinflammatory reaction seen in children, which develops after 4–6 weeks of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection; it is rare in neonates. We present here a case of a term newborn with fever, respiratory distress, and necrotic skin lesion that gradually progressed to multisystem dysfunction. Reverse transcription polymerase chain reaction for SARS-CoV-2 was negative for both mother and the baby. SARS-CoV-2 IgG titer was negative in the mother but was found to be positive in the newborn. The diagnosis of multisystem inflammatory syndrome in neonate was made and was successfully treated with intravenous immunoglobulin and corticosteroids.

Profile of ocular conditions from school eye screening in Southern India

Purpose: To profile the presentation of ocular conditions among school children aged 6 to 17 years from the south Indian state of Tamil Nadu. Methods: The study was conducted as part of a school eye health program in Kanchipuram district, Tamil Nadu that aimed to address the refractive needs of children (6–17 years) between July 2016 and June 2019. The study followed a three?phase protocol, which included visual acuity test, modified clinical test, color vision test, binocular vision assessment, objective and subjective refraction, dispensing spectacles, posterior segment evaluation using direct ophthalmoscopy, and referral to the base hospital. The demographics, clinical details, and ocular conditions (classified under 16 categories) were analyzed. Profiling and association of ocular conditions among different locations, types of schools, class grades, and gender were presented. Results: Data of 2,45,565 children were analyzed from 1,047 schools, of which 4,816 (1.96%) children were identified with ocular conditions other than refractive errors. The common reasons for referral were high myopia 901 (0.37%), strabismus 819 (0.33%), and amblyopia 691 (0.28%). Retinal problems (odds ratio [OR]: 1.65, 95% confidence interval [CI]: 1.22–2.22, P = 0.001) and strabismus (OR: 1.41, 95% CI: 1.21–1.65, P < 0.001) were the conditions prevalent in the rural location. Cataract and related conditions (OR: 5.73, 95% CI: 4.10–8.01, P < 0.001) and retinal problems (OR: 4.76, 95% CI: 3.37–6.72, P < 0.001) were common in children studying in public schools. Of the 16 categories, 13 conditions were seen among primary school children. Vernal keratoconjunctivitis (OR: 3.64 95% CI: 2.12–6.23 P < 0.001) was common among males. Conclusion: The study profiled ocular conditions among school children. Most ocular conditions warrant prolonged care and specialty eye care services. Ensuring the availability of such services and follow?up after school eye screening would safeguard the visual development of these children.

Threshold of Inotropic Score and Vasoactive–Inotropic Score for Predicting Mortality in Pediatric Septic Shock

Objective To determine the threshold of the inotropic score (IS) and vasoactive–inotropic score (VIS) for predicting mortality in pediatric septic shock. Method This retrospective cohort study included children aged 1 mo to 13 y with septic shock, requiring vasoactive medication. The area under curve receiver operating characteristic (AUROC) was calculated using mean IS and mean VIS to predict PICU mortality, and Youden index cut points were generated. Sensitivity, specifcity, and binary regression analysis were performed. Results A total of 176 patients were enrolled (survivor, n=72, 41% and nonsurvivor, n=104, 59%). For predicting the PICU mortality, AUROC (95% CI) of IS was 0.80 (0.74–0.86) [sensitivity of 88.5 (80.7–94) and specifcity of 58.3 (46.1–69.8)] and AUROC of VIS was 0.88 (0.82–0.92) [sensitivity of 83.7 (75.1–90.2) and specifcity of 80.6 (69.5–89)]. The respective cutof scores of IS and VIS were 28 and 42.5. On regression analysis (adjusted odds ratio, 95% CI), illness severity (PRISM-III) (1.12, 1.05–1.12), worst lactate value (1.31, 1.08–1.58), IS (>28) (3.98, 1.24–12.80), and VIS (>42.5) (4.66, 1.57–13.87) independently predicted the PICU mortality (r 2=0.625). Conclusion Threshold of inotropic score (>28) and vasoactive–inotropic score (>42.5) were independently associated with PICU mortality. In addition to IS and VIS, severity and worst lactate value independently predicted septic shock mortality in PICU.