Association Between Leucopenia, Transaminitis, Nonstructural Protein One Antigen (Ns1Ag) Level, and Thrombocytopenia in Adult Dengue Patients in a Tertiary Care Hospital: A Cross-Sectional Study.

BACKGROUND: The dengue virus is present throughout the tropics. Thrombocytopenia is one of the severe manifestations of the dengue virus. We studied the association of thrombocytopenia with serum transaminase level, leucopenia, and nonstructural protein one antigen (Ns1Ag) level. METHODS: Data were taken retrospectively from hospital records after obtaining ethical committee approval. In the study, we included 102 patients with acute febrile illness with clinical features suggestive of dengue fever (dengue Ns1Ag positive, dengue IgM positive, or both). We excluded patients with thrombocytopenia due to other causes. Patients' demographic, clinical, and laboratory parameters were collected. We also noted episodes of bleeding or the need for a platelet transfusion. We did a statistical analysis to find out the correlation between age, sex, leucopenia, transaminitis, Ns1Ag level, and thrombocytopenia and its severity. RESULTS: Multiple regression analysis was used to find thrombocytopenia predictors among aspartate transaminase (AST), alanine transaminase (ALT), Ns1Ag level, and leucopenia. AST and ALT correlated inversely with thrombocytopenia, with p-values of 0.012 and 0.027, respectively. Ns1Ag and leucopenia were not associated with thrombocytopenia, with p-values of 0.802 and 0.532, respectively (p-values significant at 0.01<= p<=0.05). CONCLUSION: Serum AST and ALT levels correlate with thrombocytopenia in dengue fever.

Practicability and environmental impact assessment of synthetic fibre reinforced polymer (SFRP) stirrups in reinforced concrete beams.

In this study, the objective is to explore the practicability of incorporating synthetic fibre reinforced polymer (SFRP) stirrups into reinforced concrete beams. This investigation revolves around evaluating their effectiveness from two key perspectives: their structural performance and environmental impact. To accomplish this, four set of specimens were prepared, each integrating SFRP stirrups, and testing them under a rigorous three-point bending load test. The structural performance analysis entails a comprehensive examination on the critical design factors such as: the load-deflection relationship and the contribution these SFRP stirrups to improve the ductility performance, flexural stiffness, deformability factor, flexural toughness and energy absorption capacity. The findings of this study indicate that the SFRP stirrups exhibit commendable shear capacity, meeting the necessary requirements, and simultaneously demonstrate satisfactory ductility. It is determined, that the optimal design for these SFRP stirrups involves utilizing narrow and thin stirrups placed at relatively larger intervals. Furthermore, this research delves into assessing the environmental impact of incorporating SFRP stirrups. This assessment enables us to comprehensively evaluate the environmental implications of the entire life cycle of these stirrups in structural beam. Moreover, the analysis reveals that, SFRP stirrups yields lower environmental impacts compared to their steel counterparts, they still provide valuable insights into the overall sustainability considerations within the context of reinforced concrete structures.

Comparative evaluation of the effect of L-Arginine and L-Homoarginine supplementation on reproductive physiology in ewes.

L-Arginine (LA) is a well-known amino acid involved in vital physiological processes. However, the physiological function of its methylated form known as L-Homoarginine (LHA), is not well understood. The aim of this study was to study the comparative effects of LA and LHA treatment on selected metabolites and parameters of reproductive physiology in non-pregnant ewes. Twelve Deccani ewes were selected and randomly distributed into 3 groups: Control, LA treated group and LHA group. Blood samples were collected for the evaluation of blood indices and hormone levels. Overall, nitrite, ovary weight, surface follicle number, estrogen, insulin like growth factor-1 (IGF-1), vascular endothelial growth factor (VEGF) showed an increase in the LA and LHA treated animals. On the other side, the levels of progesterone, inteleukin-1 beta (IL-1ß), IL-6, tumor necrosis factor-alpha (TNF-α) were found to be decreased in LA and LHA group. Ovary size was not affected by LA and LHA treatment groups. In comparison with LA, the ovary weight, surface follicle number, estrogen levels and IL-6 expression were higher in LHA treated animals. The expression of VEGF indicated improved angiogenesis in the treated animals. Further, the expression of heat shock protein-27 (HSP-27) and HSP-70 were differentially modulated by LA and LHA. This data reinforces the beneficial role of LA and its metabolites LHA on the ovarian physiology and functionality and also reveals the potent role of LHA as an alternative to LA treatment in enhancing the reproductive ability in non-pregnant ewes.

Casein (CSN) gene variants and parity affect the milk protein traits in crossbred (Bos taurus x Bos indicus) cows in sub-tropical climate.

Genotypes at four casein (CSN) loci-A26181G of CSN1S1, C6227T of CSN1S2, A8101C of CSN2, and A13104C of CSN3-along with non-genetic factors were studied for their effects on various milk protein traits in 100 crossbred cows with major inheritance of Holstein Frisian (Bos taurus) and Tharparkar (Bos indicus). Results demonstrated the presence of all CSN genotypes with a predominance of heterozygotes. At CSN2 (A8101C; His67Pro) locus, the A2 allele, desirable for human health, was present in 62% as heterozygous and 29% in homozygous condition. Among non-genetic factors, parity of the cows had a significant influence on the milk protein traits in these crossbreds. The genotypes at CSN1S1, CSN2, and CSN3 loci were found to influence (p<0.05 to 0.01) the casein and whey protein yields and composition traits. The casein index and total milk yield were most influenced by the CSN1S2 locus. The AA (A1 milk) genotype of CSN2 had significantly higher yields and percentages of casein and whey proteins. Positive influence of CC genotype of CSNS3 on milk proteins of was observed similar to Bos taurus cows; however, such influence of AA genotype of CSN2 locus may be distinctive to the crossbred cows maintained in subtropical condition. Overall, the results revealed the diverse effects of CSN genotypes on milk proteins in crossbred cattle.

Robotic transduodenal excision of duodenal duplication cyst: Case report and review.

Duodenal duplication cysts are rare congenital anomalies that generally present with abdominal pain and vomiting or may have nonspecific symptoms. Surgical excision is the recommended treatment owing to possible complications, including malignancy. However, difficult locations like the periampullary region are problematic and major surgical procedures, for example, pancreaticoduodenectomy is necessary for total resection. These have a high complication rate resulting in a poor quality of life, especially in children and young adults. Here, we describe a case of duodenal duplication cyst managed by robotic (transduodenal) excision along with a brief review of the literature.

Genome-Wide Runs of Homozygosity Revealed Selection Signatures in Bos indicus.

Genome-wide runs of homozygosity (ROH) are suitable for understanding population history, calculating genomic inbreeding, deciphering genetic architecture of complex traits and diseases as well as identifying genes linked with agro-economic traits. Autozygosity and ROH islands, genomic regions with elevated ROH frequencies, were characterized in 112 animals of seven Indian native cattle breeds (B. indicus) using BovineHD BeadChip. In total, 4138 ROH were detected. The average number of ROH per animal was maximum in draft breed, Kangayam (63.62 ± 22.71) and minimum in dairy breed, Sahiwal (24.62 ± 11.03). The mean ROH length was maximum in Vechur (6.97 Mb) and minimum in Hariana (4.04 Mb). Kangayam revealed the highest ROH based inbreeding (FROH > 1Mb = 0.113 ± 0.059), whereas Hariana (FROH > 1Mb = 0.042 ± 0.031) and Sahiwal (FROH > 1Mb = 0.043 ± 0.048) showed the lowest. The high standard deviation observed in each breed highlights a considerable variability in autozygosity. Out of the total autozygous segments observed in each breed except Vechur, > 80% were of short length (< 8 Mb) and contributed almost 50% of the genome proportion under ROH. However, in Vechur cattle, long ROH contributed 75% of the genome proportion under ROH. ROH patterns revealed Hariana and Sahiwal breeds as less consanguineous, while recent inbreeding was apparent in Vechur. Maximum autozygosity observed in Kangayam is attributable to both recent and ancient inbreeding. The ROH islands were harbouring higher proportion of QTLs for production traits (20.68% vs. 14.64%; P≤ 0.05) but lower for reproductive traits (11.49% vs. 15.76%; P≤ 0.05) in dairy breeds compared to draft breed. In draft cattle, genes associated with resistant to diseases/higher immunity (LYZL1, SVIL, and GPX4) and stress tolerant (CCT4) were identified in ROH islands; while in dairy breeds, for milk production (PTGFR, CSN1S1, CSN2, CSN1S2, and CSN3). Significant difference in ROH islands among large and short statured breeds was observed at chromosome 3 and 5 involving genes like PTGFR and HMGA2 responsible for milk production and stature, respectively. PCA analysis on consensus ROH regions revealed distinct clustering of dairy, draft and short stature cattle breeds.

Quality of medical prescriptions in diabetes and hypertension management in Kerala and its associated factors.

BACKGROUND: Kerala is facing challenges in the secondary prevention efforts of non-communicable diseases (NCDs). In spite of being the top performer in health parameters among Indian states, the burden of NCDs, especially diabetes mellitus (diabetes) and hypertension, is higher in Kerala. This research endeavours to identify the role of quality of medical prescriptions in secondary prevention of diabetes and hypertension and suggest corrective measures. METHODS: This cross-sectional study involved collection of prescription data and other details from consenting doctors across seven districts in Kerala. After the quality of prescription was assessed using a checklist, scores were generated, and cutoff points were used to classify the prescriptions. PASW version 18 software, was used for data analysis which included univariate and bivariate analyses and logistic regression. The proportion of quality prescriptions was estimated after adjusting for clustering, and the proportion of doctors writing quality prescriptions was also estimated. Prior to the study, ethical clearance from Independent ethics committee in Health action by People (HAP) and informed consent from all the study participants were obtained. RESULTS: After assessing 9199 prescriptions from 344 doctors, it was found that about 37.2% (95% CI: 34.9-39.4%) of the prescriptions were of good quality, and 48.2% (95% CI: 42.9-53.7%) of the doctors provided quality prescriptions. Factors associated with quality prescriptions were found to be knowledge about NCD guidelines, quality certifications of hospitals and usage of patient data management software. CONCLUSIONS: In the context of rising prevalence of NCDs and the challenges in the secondary prevention efforts, this is one of the first studies in Kerala to evaluate the quality of prescriptions to manage NCDs as prescriptions often reflect the quality of medical management. The study also addresses other factors associated with quality medical management. The findings indicate that the scope for improvement is more than 50%, when considered for the overall quality of prescriptions in diabetes and hypertension management. Further, it was found that appropriate training of doctors, adherence to treatment guidelines and the use of technology may improve the overall quality of prescriptions.