ABSTRACT
OBJECTIVES: Modified shock index (MSI) is a simple bedside tool used in the emergency department. There are a few studies suggesting MSI as a good prognostic indicator than shock index in sepsis patients. However, there is not enough research emphasizing the role of MSI in patients with comorbidities. Hence, this study aims to assess the predictive validity of MSI in predicting the prognosis of sepsis patients with and without co-morbidities. METHODS: From January to December 2020, a prospective observational study was conducted in a tertiary care teaching hospital. Patients with sepsis diagnosed based on systemic inflammatory response syndrome criteria and quick sequential organ failure assessment (qSOFA) were included. The need for mechanical ventilation and step down from the intensive care unit were outcome variables, MSI was considered as a predictor variable, and co-morbidities as an explanatory variable. RESULTS: Among people with co-morbidities, the MSI value on arrival to the emergency department had fair predictive validity in predicting the need for mechanical ventilation after 24 hours, as indicated by the area under the curve of 0.749 (95% CI: 0.600-0.897; p-value = 0.002) and a sensitivity of 68.75% in predicting mechanical ventilation after 24 hours (MSI ≥ 1.59). Among people without co-morbidities, the MSI value on arrival to the emergency department had fair predictive validity in predicting the need for mechanical ventilation after 24 hours, as indicated by the area under the curve of 0.879 (95% CI: 0.770-0.988; p-value <0.001) and a sensitivity of 83.33% in predicting the need for mechanical ventilation after 24 hours (MSI ≥ 1.67). CONCLUSION: MSI can be used as an indicator in predicting the prognosis of sepsis patients in the emergency department. A simple bedside calculation of the MSI can indicate the need for mechanical ventilation and step down from the intensive care unit after 24 hours in patients with co-morbidities and without co-morbidities.
ABSTRACT
Plectranthus barbatus also known by the synonym Coleus forskohlii it is called as forskohlii and Indian coleus. It is a tropical perennial herb belongs to the family Lamiaceae widely cultivated in India used as traditional medicinal crop. Its tuberous roots produce forskolin, an extract useful for pharmaceutical preparations and research in cell biology. The incidence of mosaic with dark and light green patches, mottling, leaf distortion and reduction growth was noticed in commercial cultivation of coleus. For identification of the virus, the infected leaf sample extract was mechanically inoculated to different hosts such as chilli, tobacco, tomato, cucumber, cowpea and Chenopodium amaranticolor. Host range studies revealed that the virus showed severe mosaic symptoms on Nicotiana spp. and Cucumis spp. The virus produced systemic and local lesion symptoms in a different host. The Leaf dip preparation of virus infected leaf extract was observed under an electron microscope showed the presence of isometric particles of 28 nm in size. The healthy and infected samples were tested using DAC-ELISA against antibodies of CMV, GBNV and TSV the infected samples showed strong positive reaction with 1.85 optical density to CMV antibodies indicated the presence of CMV. For molecular identification, total RNA was isolated and used for RT-PCR amplification using CMV specific primers. RT-PCR resulted in the positive amplification in virus infected samples but not from a healthy control. The complete genome of CMV RNA-1 consists of 3360 nucleotides (nt) encoding replicase gene of 807 amino acids (aa). The CMV RNA-2 was 2983 nt in length containing 2a (859 aa) encoding RNA dependent RNA polymerase protein and 2b encoding viral silencing suppressor (112 aa), while RNA-3 encoding 3a movement protein (280 aa) and coat protein (219 aa) was 2223 nt in length. Phylogenetic analyses of nucleotide sequences of coleus CMV isolate is closely related to subgroup IB than to subgroup IA or II with other CMV isolates. In recombination analysis, the recombination event occurs between the subgroups of I, II as well as IA and IB in RNA 1, RNA2 and RNA3 of coleus isolate with other CMV isolates. To best of our knowledge, this is the first report of CMV infection in coleus.
ABSTRACT
Induction of single and multiple shoots was obtained from nodal expiants of 60-80 year-old elite trees of rosewood on Murashige and Skoog's basal medium supplemented with 6-benzylaminopurine (1.0 mg 1(-1)) and δ -Naphthalene acetic acid (0.05 mg 1(-1)) or indole acetic acid (0.5 mg 1(-1)). Multiplication of shoots was obtained on MS (reduced major elements) or Woody Plant Medium supplemented with 6-benzylaminopurine (1.0 mg 1(-1)) and kinetin (0.5-1.0 mg 1(-1)). Excised shoots were rooted on half-strength MS with IBA (2.0 mg 1(-1)) to obtain complete plantlets. The regenerated plantlets have been acclimatized and successfully transferred to the soil.
