Greener production of compost from agricultural biomass residues amended with mule dung for agronomic application.

In this study agro-waste (Agwt) was aerobically composted using cow dung (CD) and mule dung (MD). Totally six different sets of compost treatments were prepared, as T1 (Agwt + CD, 1:1), T2 (Agwt + MD, 1:1), T3 (Agwt + CD, 1:3), T4 (Agwt + MD, 1:3), T5 (Agwt + CD, 3:1) and T6 (Agwt + MD, 3:1) in individual containers. All the compost treatments were degraded for 90 days. The organic wastes in the treatment containers were maintained with proper moisture level. All the final composts reached good manural stability and maturity index after 90 days. Among the six treatments, the T2 with Agwt + MD in 1:1 proportion attained a 10:1 C/N ratio and a near neutral pH (7.3). Indigenous microbes isolated and identified from the T2 compost sample showed protease, cellulase, amylase and lipase activities. The germination of Raphanus sativus L. seeds and vigorous plant growth parameters confirmed the non-pathogenic phytotoxic-free nature of finished composts. The radish crops supplied with T2 compost showed healthy tuber growth parameters (16.6 cm width, 35.6 cm length) compared with other treatments. The results from the experiments established that, the composts derived are eco-friendly amendment to plants and it has also improved the soil fertility due to its stability and maturity index. Thus, the present study concluded that composting agricultural crops waste with animal manure, especially mule dung promoted excellent biodegradation of organic complexes. It is a nature friendly solution for the management of solid waste such as agro-wastes utilizing mule dung.

Predictors of unfavorable responses to therapy in rifampicin-sensitive pulmonary tuberculosis using an integrated approach of radiological presentation and sputum mycobacterial burden.

INTRODUCTION: Despite the exalted status of sputum mycobacterial load for gauging pulmonary tuberculosis treatment and progress, Chest X-rays supplement valuable information for taking instantaneous therapeutic decisions, especially during the COVID-19 pandemic. Even though literature on individual parameters is overwhelming, few studies have explored the interaction between radiographic parameters denoting severity with mycobacterial burden signifying infectivity. By using a sophisticated approach of integrating Chest X-ray parameters with sputum mycobacterial characteristics, evaluated at all the three crucial time points of TB treatment namely pre-treatment, end of intensive phase and completion of treatment, utilizing the interactive Cox Proportional Hazards model, we aimed to precisely deduce predictors of unfavorable response to TB treatment. MATERIALS AND METHOD: We extracted de-identified data from well characterized clinical trial cohorts that recruited rifampicin-sensitive Pulmonary TB patients without any comorbidities, taking their first spell of anti-tuberculosis therapy under supervision and meticulous follow up for 24 months post treatment completion, to accurately predict TB outcomes. Radiographic data independently obtained, interpreted by two experienced pulmonologists was collated with demographic details and, sputum smear and culture grades of participants by an independent statistician and analyzed using the Cox Proportional Hazards model, to not only adjust for confounding factors including treatment effect, but also explore the interaction between radiological and bacteriological parameters for better therapeutic application. RESULTS: Of 667 TB patients with data available, cavitation, extent of involvement, lower zone involvement, smear and culture grade at baseline were significant parameters predisposing to an unfavorable TB treatment outcome in the univariate analysis. Reduction in radiological lesions in Chest X-ray by at least 50% at 2 months and 75% at the end of treatment helped in averting unfavorable responses. Smear and Culture conversion at the end of 2 months was highly significant as a predictor (p<0.001). In the multivariate analysis, the adjusted hazards ratios (HR) for an unfavorable response to TB therapy for extent of involvement, baseline cavitation and persistence (post treatment) were 1.21 (95% CI: 1.01-1.44), 1.73 (95% CI: 1.05-2.84) and 2.68 (95% CI: 1.4-5.12) respectively. A 3+ smear had an HR of 1.94 (95% CI: 0.81-4.64). Further probing into the interaction, among patients with 3+ and 2+ smears, HRs for cavitation were 3.26 (95% CI: 1.33-8.00) and 1.92 (95% CI: 0.80-4.60) while for >2 zones, were 3.05 (95% CI: 1.12-8.23) and 1.92 (95% CI: 0.72-5.08) respectively. Patients without cavitation, zonal involvement <2, and a smear grade less than 2+ had a better prognosis and constituted minimal disease. CONCLUSION: Baseline Cavitation, Opacities occupying >2 zones and 3+ smear grade individually and independently forecasted a poorer TB outcome. The interaction model revealed that Zonal involvement confined to 2 zones, without a cavity and smear grade up to 2+, constituting "minimal disease", had a better prognosis. Radiological clearance >50% along with smear conversion at the end of intensive phase of treatment, observed to be a reasonable alternative to culture conversion in predicting a successful outcome. These parameters may potentially take up key positions as stratification factors for future trials contemplating on shorter TB regimens.

Secondary acute myeloid leukemia in a child treated for retinoblastoma: A case report with review of literature.

The most devastating late adverse effect of childhood cancer treatment is development of second malignancies. Retinoblastoma is the most common ocular malignancy of childhood and has a very good cure rate. Children with hereditary retinoblastoma have an increased risk of developing second malignancies due to the genetic cancer predisposition status and the additional risk factors are exposure to chemotherapy (alkylating agents and topoisomerase II inhibitors) and external beam radiotherapy during treatment. The common chemotherapy regimen of retinoblastoma consisting of etoposide, an epipodophyllotoxin is associated with risk of secondary AML (s-AML). We report a case of child with bilateral retinoblastoma who developed secondary AML after being treated for retinoblastoma.