Histomorphological evaluation of placenta in SARS-CoV-2 patients: A cross-sectional study

Background: SARS-CoV-2 has emerged as a major pandemic of the century and little is known about the impact of maternal infection on placental histopathology. Histopathologic examination of placental tissue can contribute to significant information regarding the pathophysiology of the disease and how it affects the fetal outcome. Materials and Methods: This was a cross-sectional study conducted at the Department of Pathology, Government Doon Medical College and Hospital, Dehradun, on the placenta of 50 coronavirus disease 2019 (COVID-19)-positive pregnant females confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR) from August 2020 to October 2020. Fifty term historical placentas were taken as control. Placenta sections were fixed in formalin, processed into paraffin blocks, stained with hematoxylin and eosin (H and E) stain, and visualized for any abnormality. Results: The most prominent histological finding in the placenta of pregnant women affected by COVID-19 was chorangiosis, which is a feature of fetal vascular malperfusion seen in 28 (56%) cases. Other features included maternal vascular malperfusions (MVM) such as villous crowding and agglutination in 12 (24%) cases. Tenney–Parker change was seen in 13 (26%) patients. Intervillous fibrinoid deposition and intervillous hemorrhage were seen in 37 (74%) patients and 7 (14%) patients showed significant calcification. Other findings observed were less common. Conclusion: Infection with SARS-CoV-2 may be associated with a significant impact on fetal and maternal circulation causing features of fetal and maternal malperfusion such as chorangiosis, villous crowding, and agglutination. Indicating that the infection could cause a potential rise in the risk of adverse perinatal outcomes such as intrauterine fetal growth retardation, preterm birth, or stillbirth.

Study of nutritional assessment of children between 6 months to 5 years

Background: Nearly half of all deaths in children under 5 are attributable to under nutrition. Under nutrition puts children at greater risk of dying from common infections, increases the frequency and severity of such infections, and contributes to delayed recovery. The WHO recommends the use of Z scores or standard deviation score (SDS) for evaluating anthropometry, so as to accurately classify individuals with indices below the extreme percentile. In India most paediatricians use IAP classification to classify malnutrition. The aim of the study is to assess the nutritional status of children between 6 months to 5 years of age attending tertiary rural hospital according to WHO criteria and to compare the result of this study with IAP classification for grading malnutrition. The objectives of the study is to assess the knowledge of mothers regarding feeding practices among these children particularly below 2 years of age and to observe associated clinical problems and state of other nutrient deficiencies. Materials and methods: A cross sectional and observational study of 200 children admitted in pediatric ward and NRC (nutritional rehabilitation centre) of Dhiraj Hospital were taken for the study, Piparia, Waghodia, Vadodara. Study was carried for a period of 18 months from April 2015 to September 2016 to assess the nutritional status of children according to WHO criteria and to compare it with IAP classification. Assessment of the nutritional status was done by clinical examination and anthropometry. Interrogation was done with children’s mothers in the language they understood regarding young children feeding practices and accordingly their knowledge was assessed. Data was compiled, categorized and analyzed by appropriate statistical method in consultation with a statistician. Pathak S, Yadav T, Joshi C, Sharma N, Gulabani S, Gandhi D. Study of nutritional assessment of children between 6 months to 5 years. IAIM, 2017; 4(2): 42-52. Page 43 Results: Total 200 patients were taken in the study. Result shows that out of 200 patients 108(54%) were males and 92(46%) were females. The distribution of patients was more in age group between 13 and 36 months with 86(43%), of which distribution of males more than females were. Distribution of patients according to SAM and MAM (WHO classification) shows 127(63.5 %) fall under SAM and73 (36.5%) fall under MAM. Distribution of patients according to SAM and MAM (WHO classification) was studied. Result shows that out of 200 children taken in the study 127(63.5 %) fall under SAM and73 (36.5%) fall under MAM according to WHO classification. Distribution of children according to IAP classification in the present study interprets that 103 (51.5%) of the total children came under grade II of IAP classification. WHO classification detected more children with malnutrition than IAP classification, which was true for both boys and girls. Comparison of MUAC (WHO) with WHO (SAM and MAM) of children taken in the present study interprets that 67 (33.5%) had SAM and 95 (47.5%) had MAM according to MUAC criteria, remaining 19% did not fall under SAM and MAM. Comparison of MUAC (SAM) with WHO (SAM) of children in present study interprets that only 67 (52.75%) children came under SAM according to MUAC criteria out of the 127 children of SAM according to WHO classification. Comparison of MUAC (WHO) and IAP classification of children in the present shows that 67 children had MUAC <11.5 cm, out of 67 children (with SAM according to MUAC criteria) 28 (41.79%) came under grade II and 21 (31.3 %) came under grade III of IAP classification. Out of 95 children (MUAC between 11.5 cm and 12.5 cm) 18 (18.94%) came under grade I and 58 (61.05%) came under grade II of IAP classification. Associated co morbidities among children in the present study shows that among 200 patient 152 (76%) had anaemia, 44 (22%) had diarrhoea, 14 (7%) had pedal oedema, 12 (6%) had vitamin A deficiency, 44 (22%) had URTI and 24 (12%) had LRTI. Knowledge Aptitude and Practice study was done among 50 mothers and the result shows that mothers had less knowledge regarding what to be given in complementary feed, importance of immunization, birth spacing interval, and danger signs indicating illness. Conclusion: The present study shows that WHO classification detected more children with malnutrition than IAP classification, which was true for both boys and girls. There was also disparity among results of WHO criteria IAP classification and MUAC classification. Single criteria can’t be justified in assessing malnutrition. KAP study reveals that mother’s knowledge is important in combating malnutrition

A New Era in the Diagnosis of Oral Cancer – ‘Salivary Biomarkers’ : A Brief Review.

Sensitive and reliable early diagnostic markers for oral squamous cell carcinoma (OSCC) remain unavailable. Early identification of recurrence for OSCC is also a challenge. Unlike the other deep cancers, OSCC is located in oral cavity. The DNA, RNA, and protein derived from the living cancer cells and inflammatory cells can be conveniently obtained from saliva. High-throughput genomic and proteomic approaches have been carried out to identify the potential biomarkers in body fluids such as saliva and blood for diagnosis and prognosis of OSCC. Using saliva for disease diagnostics and health surveillance is a promising approach as collecting saliva is relatively easy and noninvasive. This article reviewed the recently identified biomarkers from saliva for OSCC. Effective screening to identify high-risk patients can allow the clinician to provide the appropriate treatment without delay and to reduce the recurrence of OSCC.

Qualitative and quantitative assessment of Theileria annulata in cattle and buffaloes Polymerase Chain cattle and buffaloes Polymerase Chaincattle and buffaloes Polymerase Chain Reaction

Bovine tropical theileriosis caused by Theileria annulata is a tick-borne disease associated with high morbidity and mortality in the livestock. The conventional method of diagnosis is by the demonstration of the parasite stages by microscopic examination. This method suffers from low sensitivity, making it even more difficult to detect piroplasms in the carriers. PCR based assays are known to be more sensitive. The present study was undertaken to detect and quantify T. annulata in the blood of clinically infected and carrier animals using a quantitative PCR protocol targeting the gene encoding the major merozoite piroplasm surface antigen Tams 1. A total of 116 samples were collected from infected as well as apparently healthy cattle and buffaloes. Of these, 74 samples (63.79%) were positive for T. annulata by real-time PCR, including the 15 samples that were positive by Giemsa staining. The parasite load ranged from 1.39 x 106 to 3.35 x 109 and 0.35 x 106 to 2.83 x 107 ml-1 of blood in cattle and buffalo samples, respectively by qPCR. Our study suggests that real-time PCR assay can be used to detect and quantify the load of T. annulata in the blood of cattle and buffaloes. It also serves as a support to clinical diagnosis and assessment of carrier status in apparently healthy animals.

Incidence of Instrument Fall During Caesarean Section: An Enigma.

Objective: The aim of the study was to analyse and compare statistically the incidence of accidental fall of instruments during elective and emergency caesarean section. Material and Methods: A prospective study was carried out at (V. C. S. G. G. Medical Sciences and Research Institute) Srinagar, Pauri Garhwal, India over a period of 24 months. The instrument fall during elective and emergency caesarean sections was observed. The observer counted the number of times an instrument fell during surgery. The personnel responsible were identified. A note of the nature of instrument falling was made. Results: We observed 362 surgeries which included 242 emergency caesarean sections and 120 elective caesarean sections. There were a total of 159 falls. Falls were classified as major and minor. There were 22 falls (18.33%) during elective caesarean sections and 137 falls (56.61%) during emergency caesarean sections. There were 53 major and 106 minor falls. Two or more falls were noted in 31 surgeries. In 96 instances (60.37%) the operating surgeon was responsible for the fall. In 37 cases (23.27%) assisting surgeon and in 17 cases (10.69%) the scrub nurse was responsible for the fall of the instruments. Nine falls (5.66%) were unaccountable. Most falls in elective caesarean section were in later half of the surgery while in emergency caesarean section, they were before and during the extraction of the baby. The surgeries were delayed, on an average by 5.7 minutes after a major fall of an instrument. Conclusions: Falling of instruments in the theatre is a common problem all over the world. This leads to increase in operating time, more resources and quality compromise. The operating surgeon was mainly responsible for the fall. Ashort training programme in instrument handling should be conducted for operating surgeons which may be helpful in preventing such avoidable falls.

Molecular identification of methanogenic archaea from Surti buffaloes (bubalus bubalis), reveals more hydrogenotrophic methanogens phylotypes

Methane emissions from ruminant livestock are considered to be one of the more potent forms of greenhouses gases contributing to global warming. Many strategies to reduce emissions are targeting the methanogens that inhabit the rumen, but such an approach can only be successful if it targets all the major groups of ruminant methanogens. Therefore, a thorough knowledge of the diversity of these microbes in breeds of buffaloes, as well as in response to geographical location and different diets, is required. Therefore, molecular diversity of rumen methanogens in Surti buffaloes was investigated using 16S rRNA gene libraries prepared from pooled rumen contents from three Surti buffaloes. A total of 171 clones were identified revealing 23 different sequences (phylotypes). Of these 23 sequences, twelve sequences (12 OTUs, 83 clones) and 10 sequences (10 OTUs, 83 clones) were similar to methanogens belonging to the orders Methanomicrobiales and Methanobacteriales, and the remaining 1 phylotype (5 clones) were similar to Methanosarcina barkeri. These unique sequences clustered within a distinct and strongly supported phylogenetic group. Further studies and effective strategies can be made to inhibit the growth of Methanomicrobiales and Methanobacteriales phylotypes to reduce the methane emission from rumen and thus help in preventing global warming.

Immunotoxicity induced by subacute acephate exposure in white leghorn cockerels.

Acephate (Ace) is an organophosphate foliar spray insecticide of moderate persistence with residual systemic activity of about 10–15 days. This study was designed to evaluate the immunotoxic effect of oral subacute acephate exposure in 125-day old WLH Cockerel chicks for 28 days. The experimental birds were randomly divided into five groups (C1, C2, T1, T2 and T3), each comprising 25 birds. The birds of group C1 were given no treatment and served as control. Group C2 was administered groundnut oil (1ml/kg) and served as control (vehicle). Group T1 was given ALD50/40 (21.3 mg/kg), and Group T2 was put on ALD50/30 (28.4 mg/kg), while group T3 received ALD50/20 (42.6 mg/kg) of acephate suspended in groundnut oil. Experimental birds of all groups were vaccinated with New Castle disease vaccine at day 7. Blood was collected at two-week intervals for evaluation of humoral immune response. Parameters such as TLC, TP, antibody titre against ND vaccine, DNCB dye test, and histopathology of immune organs were studied to evaluate immunotoxicity. The results were statistically compared (p<0.05) with the control. Acephate produced decreased humoral immune response in terms of New Castle disease vaccine antibody titre, total protein, serum globulin, and serum albumin. Cell mediated immune response was checked with 1-chloro 2, 4 dinitrobenzene dye dermal sensitization test, and it did not reveal any significant differences. Lymphoid organs such as thymus, spleen, bursa, and liver were weighed during necropsy for calculation of organ weight: body weight ratio. After 28 days of acephate exposure, organ:body weight ratios of immune organs were significantly reduced except liver:body weight ratio on 14 days of exposure, which was increased in all treatment groups as compared to control groups. Histopathologically, bursa and spleen showed mild depletion of lymphocytes. To further identify the specific type of cell death as apoptotic or necrotic, DNA ladder assay was performed. DNA fragmentation assay detected ladder pattern (180bp) in DNA from hepatocytes and splenocytes of acephate-treated birds. It is concluded that acephate is immunotoxic, and exerts its immunotoxicity through induction of apoptosis and alteration of immunological parameters.

Clinical profile of leptospirosis in South gujarat.

BACKGROUND: South Gujarat has been witnessing increasing incidence of leptospirosis for the last few years. AIM: To study the clinical profile of leptospirosis in South Gujarat. SETTINGS AND DESIGN: Prospective study during July-September 2000 at the New Civil Hospital, Surat, Gujarat. PATIENTS AND METHODS: All the consecutive cases with clinical suspicion of leptospirosis were screened for lgM antileptospira antibody on the first and the fourteenth day. A four fold or greater increase in agglutinin antibody titre on paired samples was considered diagnostic. If the patient died before the fourteenth day then initial titre greater than 1:15 was considered diagnostic. RESULTS: Total number of patients referred to the hospital were fifty, of which thirty-eight [33 males, with age 14-50 (30 +/- 10.51)] were diagnosed as having leptospirosis. Most common organs involved were liver (27, 71.05%) and kidney (24, 63.15%). Cardio-vascular (12, 31.5%), pulmonary (10, 26.35%), neurological (2, 5.26%) and haematological (8, 21%) involvements were less common. Six patients died because of pulmonary involvement in the form of alveolar haemorrhage, while one died because of cardiac involvement. CONCLUSION: Liver and kidney were the most commonly involved organs in severe leptospirosis. Pulmonary involvement, though uncommon, led to high mortality.

A comparative study of various surgical treatments of hepatic hydatidosis with special reference to capitonnage.

Nine patients treated by different modalities of surgical treatment were evaluated and the results were compared in terms of complications and total number of hospitalisation days. Most common complaint was pain abdomen and the commonest finding was an abdominal lump. After initial treatment of the cavity with a scolicidal agent the cyst was deroofed and the remaining cyst was dealt with in 3 different ways: (a) Three patients underwent simple drainage. (b) Marsupialisation was done in 3 cases. (c) Remaining 3 patients had capitonnage offered to them as the form of treatment. Complication rates in group (a) and (b) were 33% and 67% respectively and the average hospital stay was 13 and 20 days respectively while group (c) had no complication and the average hospital stay was 8.3 days.

Volvulus of descending colon with anomalous mesocolon.

Volvulus of the cecum, transverse colon and sigmoid colon is common. A patient with isolated volvulus of the descending colon, leading to gangrene of that segment, is reported.