Evaluation of phytochemicals from Thymus serpyllum as potential drug candidates to manage oxidative stress in transition dairy cows.

Dairy cows undergo immense stress and experience autoimmune reactions during the transition period, majorly due to the generation of ROS in the body. So, pharmacological approaches are needed to manage oxidative stress in the transition cows. Recently, the use of phytochemicals as feed additives in cows' nutrition has gained interest in managing various disease conditions. In the current study, we have evaluated the potential effects of phytochemicals derived from methanolic extract of Thymus serpyllum against oxidative stress and autoimmunity via inhibition of bovine nuclear factor kappa B (NF-κB). The free radical scavenging activity of Thymus serpyllum seed and leaf extracts was 71.8 and 75.6%, respectively at 100 µg/mL concentration. Similarly, both extracts displayed radicals reducing power and inhibition of lipid-peroxidation maximally at 100 µg/mL. A total of 52 bioactive compounds were identified when the plant extract was characterized by the GC-MS analysis, and five (Thymol, Luteolin 7-o-glucuronide, Rosmarinic acid, Apigenin 6,8-di-c-glucoside, Kaempferol) had binding free energy values of -11.6433, -10.002, -8.2615, -7.1714, -6.4870, respectively, in complexes with bovine NF-κB. Through computational analysis, the screened compounds showed good pharmacokinetic parameters, including non-toxicity, non-carcinogenic, high gastrointestinal absorption and thus can serve as potential drug candidates. MD simulation studies predicted the stability of complexes and the complex of Kaempferol was most stable based on RSMD value and MM/GBSA binding energy. The biochemical assays and computational studies indicated that Thymus serpyllum could be used as a promising feed additive in dairy cows to manage oxidative stress during the transition period.Communicated by Ramaswamy H. Sarma.

Higher harmonics and supercontinuum generated from the Kerr response time in different states of matter from a universal electromagnetic model.

There is a need for a universal model to describe higher harmonic generation (HHG) in different states of matter. Based on an electromagnetic model (EM), the generation of odd higher harmonic (HHG) and supercontinuum (SC) from intense fs and ps pulses for visible, NIR, and MIR lasers is simulated based on the parameters from experimental observation. HHG and SC depend critically on the different Kerr material response times τ from the ultrafast on the order of 100 as for electronic cloud distortion to fast ~ 10 fs from plasma and molecular redistribution and to the slower picoseconds rotational and vibrational molecular processes. The number of odd HHG generated is shown to depend critically on the fastest Kerr response time on the order of ~ 1 fs from electronic self-phase modulation (ESPM). In this study, different states of matter from noble gas Argon to condensed matter ZnO and LBG are simulated showing the dependence on the Kerr response time to produce HHG for various applications in Physics, Chemistry, Biology, and Engineering. The EM model is universal to produce HHG and SC in different states of matter.

Impact of grape (Vitis vinifera) seed extract on egg production traits, nutrients digestability, lipid peroxidation and fertility of golden laying hens (Gallus gallus) during early stage of production.

Grape by-products represent outstanding alternatives to replace conventional and unsustainable feed sources, given the substantial quantities generated annually by the winery industry. Regrettably, the majority of these by-products are wasted, resulting in significant environmental and economic repercussions. This study was conducted to assess the growth performance, feed efficiency, egg production and quality, lipid peroxidation, fertility and hatchability of reproductive laying hens during their early production stage. A total of 720 golden laying hens, all approximately 25 weeks old and with similar body weights, were randomly assigned to four experimental treatments (six replicates) as follows: control group receiving only the standard diet, (2) a group receiving the standard diet supplemented with grape seed extract at a rate of 250 g/kg (GSE1), (3) a group receiving the standarddiet supplemented with grape seed extract at a rate of 500 g/kg (GSE2), and (4) a group receiving the standarddiet supplemented with grape seed extract at a rate of 750 g/kg (GSE3). There were no significant change (p > 0.05) in feed intak, body weight gain and feed conversion ratio between the control and the experimental groups. Egg weight, egg shell thickness and egg shell weight were significantly (p < 0.05) higher in GSE250 GSE500 and GSE750 compared to the control. The results showed that hen day egg production was also significantly higher (p < 0.05) in GSE500 and GSE 750 compared to the control. Fertility level of GSE 500 and GSE750 was significantly (p < 0.5) higher compared to the control. The MDA level decreased significantly (p < 0.05) in the GSE supplemented birds compared to the control. From these findings, we concluded that GSE 750 had positive impact on egg production, reducing lipid peroxidation and improving fertility in golden laying hens.

A series of 777 pellet gun ocular injuries over a 4-month period in Kashmir.

Purpose: To examine the incidence, clinical findings and management of pellet gun-related ocular injuries that occurred during protests in Kashmir region. Methods: This retrospective study included records from 777 patients diagnosed with pellet gun-related ocular injuries admitted to a tertiary hospital in Srinagar, India, between July and November 2016. By reviewing the clinical records, the following data were collected: demographics, clinical information pertaining to the injury, imaging reports including computer tomography and ultrasonography B-scan, management in the emergency setting, and follow-up treatment. Results: Mean age was 22.3 ± 7.2 years and majority patients were male (97.7%). In terms of laterality, 94.3% and 5.7% of the patients sustained monocular and binocular injuries, respectively. In terms of the nature of injury, 76.3% of the eyes had open globe injury while 23.7% of the eyes had closed eye injury. Emergency surgical exploration was performed in 67.7% of closed globe injuries while emergency primary repair was done in 91.1% of open globe injuries. The vast majority of patients (98.7%) who required surgery underwent surgical intervention on the day of admission or the next day. Final best-corrected visual acuity (BCVA) after treatment was counting fingers or worse in 82.4% of the eyes. Conclusion: Pellet gun-related ocular injuries resulted in significant ocular morbidity, mostly manifesting as open globe injuries. Treatment often required surgical interventions, but despite expeditious management, visual prognosis remained poor for most of the patients.

Clinical spectrum and functional outcome of firearm pellet-related eye injuries: A prospective follow-up study.

PURPOSE: To determine the prognostic significance of various clinical features and surgical techniques concerning anatomical and visual outcomes in shotgun pellet-inflicted ocular trauma. METHODS: This prospective follow-up study was done at a tertiary care institute in Kashmir, India. Six hundred sixty-four eyes of 643 patients with firearm pellet-related ocular trauma were followed up for 6 months. RESULTS: Ocular injury involved one eye in 622 (96.7%) patients and both eyes in 21 (3.3%) patients. Open globe injury (OGI) occurred in 451 (67.9%) eyes with perforating injury being the commonest type (248 eyes, 54.9%). For perforating injuries, entry wounds in the cornea and limbus had the worst prognosis. Closed globe injury (CGI) occurred in 213 (32.1%) eyes. An anatomical success rate of 66.3% (n = 250) was achieved for 56.8% (377/664) eyes requiring an average of 2.8 (SD 0.5) surgeries per eye. OGI was associated with poor outcomes in 259 (57.4%) and CGI with good outcomes in 200 (93.9%) eyes. The visual outcome had a significant association with grade and zone of injury both in OGI and CGI, and with the type of injury in OGI (p < .0001 each). Ocular trauma score (OTS) had a significant association with the degree of vision impairment (p < .0001). WHO category 0 visual impairment was seen in 270 (40.7%) eyes, category 1 in 85 (12.8%), category 2 in 35 (5.3%), category 3 in 30 (4.5%), category 4 in 172 (25.9%), and category 5 in 72 (10.8%) eyes irrespective of type of injury at 6 months post-treatment. CONCLUSIONS: The perforating injury was the commonest type of injury caused by shotgun pellets. The site of the entry wound in perforating injury had prognostic significance. The outcome was generally poor in OGI and good in CGI.

Mortality and Incidence Rate of SARS-CoV-2 (COVID-19) Infection in Patients Admitted and Operated for Hip Fracture during SARS-CoV-2 pandemic in a London Hospital.

Objective We are doing a study on patients admitted with hip fractures to determine the impact of COVID-19 on a vulnerable patients group in the United Kingdom. This will help us in making informed decisions about restarting elective surgical services and expanding trauma surgical services. The objectives of the study are: 1) to find the incidence of COVID-19 in patients admitted with hip fractures; 2) To find the 30-day mortality in patients operated with hip fractures; 3) To find the 30-day mortality of patients with hip fracture and COVID 19; and 4) to compare this data with the mortality in hip fractures in previous years. Methods This is a single-center, observational, retrospective, cohort study involving 65 patients who were admitted in our trust with hip fractures. Besides epidemiological data, patient records were followed-up for 14 days to look for COVID positive polymerase chain reaction (PCR) swabs, and the patient records were followed-up for 30 days to look for mortality. Results A total of 64% of the patients had no significant comorbidity. The incidence of hospital-acquired COVID-19 infections in our trust was 9%. Overall, the 30-day mortality was of 15%. Mortality was much higher in COVID positive patients (40%) and in patients with "very high risk" (63%) operated during this period. Conclusion It should be safe to start elective surgery in patients with low, moderate and high risk without an appreciable rise in mortality. We will need more data to understand the impact of COVID-19 on very high risk patients.

A Comprehensive Survey of COVID-19 Detection Using Medical Images.

The outbreak of the Coronavirus disease 2019 (COVID-19) caused the death of a large number of people and declared as a pandemic by the World Health Organization. Millions of people are infected by this virus and are still getting infected every day. As the cost and required time of conventional Reverse Transcription Polymerase Chain Reaction (RT-PCR) tests to detect COVID-19 is uneconomical and excessive, researchers are trying to use medical images such as X-ray and Computed Tomography (CT) images to detect this disease with the help of Artificial Intelligence (AI)-based systems, to assist in automating the scanning procedure. In this paper, we reviewed some of these newly emerging AI-based models that can detect COVID-19 from X-ray or CT of lung images. We collected information about available research resources and inspected a total of 80 papers till June 20, 2020. We explored and analyzed data sets, preprocessing techniques, segmentation methods, feature extraction, classification, and experimental results which can be helpful for finding future research directions in the domain of automatic diagnosis of COVID-19 disease using AI-based frameworks. It is also reflected that there is a scarcity of annotated medical images/data sets of COVID-19 affected people, which requires enhancing, segmentation in preprocessing, and domain adaptation in transfer learning for a model, producing an optimal result in model performance. This survey can be the starting point for a novice/beginner level researcher to work on COVID-19 classification.

Automated COVID-19 Detection from Chest X-Ray Images: A High-Resolution Network (HRNet) Approach.

The pandemic, originated by novel coronavirus 2019 (COVID-19), continuing its devastating effect on the health, well-being, and economy of the global population. A critical step to restrain this pandemic is the early detection of COVID-19 in the human body to constraint the exposure and control the spread of the virus. Chest X-Rays are one of the non-invasive tools to detect this disease as the manual PCR diagnosis process is quite tedious and time-consuming. Our intensive background studies show that, the works till now are not efficient to produce an unbiased detection result. In this work, we proposed an automated COVID-19 classification method, utilizing available COVID and non-COVID X-Ray datasets, along with High-Resolution Network (HRNet) for feature extraction embedding with the UNet for segmentation purposes. To evaluate the proposed method, several baseline experiments have been performed employing numerous deep learning architectures. With extensive experiment, we got a significant result of 99.26% accuracy, 98.53% sensitivity, and 98.82% specificity with HRNet which surpasses the performances of the existing models. Finally, we conclude that our proposed methodology ensures unbiased high accuracy, which increases the probability of incorporating X-Ray images into the diagnosis of the disease.

Perforating ocular trauma due to shotgun pellet - Clinical profile and visual outcome.

Purpose: The aim of this study was to determine visual and anatomical outcome of perforating injuries due to shotgun pellet. Methods: This was a prospective observational study carried out between July 2016 and Jan 2019 at a tertiary care referral center in Srinagar, Jammu and Kashmir. A total of 172 eyes with perforating injuries of 170 patients were included in the study and were followed up for 6 months with best-corrected visual acuity, slit-lamp examination for status of anterior chamber and lens, fundus examination for status of retina and media, intraocular pressure measurements, and OCT (optical coherence tomography) and FFA (fundus fluoresceine angiography) in selected cases. The relative improvement of visual acuity after treatment was interpreted by applying paired two-tailed t tests. Prognostic significance of other variables was calculated using Chi-square and Chi-square for linear trend tests, for two dependent outcome variables of good outcome and poor outcome. Results: WHO category 4 visual impairment was found in 66 (38.4%) eyes, whereas category 0 was found in 24 (14%) of eyes. Retina was found to be attached 99 (57.6%) of study eyes. Conclusion: Perforating injury is a severe form of ocular trauma with grave consequences in terms of functional and anatomical outcome.

Modulation instability induced by cross-phase modulation of transient stimulated Raman scattering and self-phase modulation in calcite.

Pairs of sidebands about the transient stimulated Raman scattering (SRS) 1086cm-1 vibration mode peak are observed for calcite under 517 nm 390 fs pulse excitation. These pairs of side frequency lobes arise from modulation instability (MI) from the interaction of cross-phase modulation (XPM) from self-phase modulation (SPM) and SRS. The pairs of secondary frequencies are attributed to the daughter 1086cm-1 decay product modes from the multiphonon of 3, 4, and 5 decays. The main sideband peak from 1086cm-1 phonon at 546cm-1 suggests the operation of the Orbach effect.

Degradation mechanism of Saccharomyces cerevisiae ß-D-glucan by ionic liquid and dynamic high pressure microfluidization.

The insolubility of Saccharomyces cerevisiae ß-D-glucan in most common solvents seriously restricts its applications and recovery. In this work, ionic liquids (ILs) were used for dissolution and modification under high pressure microfluidization (HPM). ILs 1-ethyl-3-methylimidazolium acetate (EmimAc) showed good ß-D-glucan dissolving capacities, which can facilitate its structural modifications to recycle under environmentally friendly conditions. However, the synergistic effect of ionic liquid and high pressure microfluidization on physiochemical properties and structure of S. cerevisiae ß-D-glucan were unclearly. The objectives of this study were: 1) to study the physiochemical properties of ß-D-glucan after treating by ILs and HPM; 2) to compare the essential structure and conformation of ß-D-glucan after treating by ILs and HPM; 3) to provide theoretical basis for precise regulation and green manufacturing of soluble S. cerevisiae ß-D-glucan.

Association of Gonial Angle on Panoramic Radiograph with the Facial Divergence on Lateral Cephalogram.

OBJECTIVE: To find the mean gonial angle values among different facial divergent cases. STUDY DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: Karachi Medical and Dental College from October 2018 to December 2019. METHODOLOGY: Panoramic radiographs (OPG) and lateral cephalograms of 91 patients, 33 males and 58 females, were obtained. Sella-Nasion-Mandibular Plane (SNMP) angle was measured on lateral cephalogram and gonial angles were measured on panoramic radiograph. Subjects were divided into three groups as per SNMP angle as hypodivergent, normodivergent and hyperdivergent. A p-value of less than 0.05 was considered statistically significant. RESULTS: The mean value of the gonial angle in OPG among all the patients was 125.05° with a standard deviation 7.24°. The average gonial angle in males was 124.10° ±5.67° and in females was 125.59° ±7.99°. Out of 91 patients, 14 were hypodivergent, 28 were normodivergent and 49 were hyperdivergent. The mean values of gonial angle among these three groups were 119.77° ±6.05°, 123.66° ±5.50° and 127.36° ±7.52°. One-way ANOVA demonstrated highly significant differences in the values of gonial angles among three facial divergences (p=0.001). Post-Hoc Tukey analysis showed that there was a significant difference between gonial angle of hyperdivergent and hypodivergent cases (p=0.001). CONCLUSION: Gonial angle on panoramic radiographs (OPG) may provide useful knowledge about the facial divergence of the orthodontic patients. Key Words: Gonial angle, Facial divergence, Lateral cephalogram, Panoramic radiograph, Orthodontic diagnosis.

Explanation of the competition between O- and E-wave induced stimulated Raman and supercontinuum in calcite under ultrafast laser excitation.

Key optical properties of calcite were measured to unravel the difference between stimulated Raman scattering (SRS) and self-phase modulation (SPM) for the supercontinuum (SC) for ordinary (O) wave and extraordinary (E) wave. These properties are group velocity dispersion, walk-off, spontaneous Raman spectra and cross section, optical 1086cm-1 phonon linewidth, nonlinear susceptibility (χ3), steady-state and transient SRS, and SC caused from SPM. These are investigated for O-waves and E-waves from a 2.7 cm thick calcite crystal. Using 390 fs pulses (∼0.8µJ pulse energy) at 517 nm, the O-wave produced a stronger sharp SRS peak at 1086cm-1 and a weaker SC spectrum in the visible range than the E-wave. The salient difference found between the O- and E-waves for SRS and SPM in calcite is attributed to the larger Raman cross section and the size of nonlinear susceptibility (χ3) for O-waves as compared to E-waves.

Results of a Standard versus an Accelerated Ponseti Protocol for Clubfoot: A Prospective Randomized Study.

BACKGROUND: The aim of this study was to compare the results of the standard once-weekly Ponseti casting technique to an accelerated twice-weekly regimen in our population cohort. METHODS: A prospective randomized controlled study was conducted with a total of 100 consecutive patients (158 feet) being enrolled for the study. Fifty patients were randomized to each group and followed up for at least one year. RESULTS: Initial mean Pirani score was 4.67 ± 0.73 in the standard group and 4.35 ± 0.76 in the accelerated group, and the score decreased to 0.34 ± 0.38 and 0.35 ± 0.31, respectively. Initial mean Dimeglio score was 11.75 ± 2.75 in the standard group and 10.51 ± 2.57 in the accelerated group, and the score decreased to 0.79 ± 0.77 and 0.79 ± 0.71, respectively, immediately after casting. The average number of casts required to correct all the deformities was 6.3 ± 1.2 in the standard group and 6.1 ± 1.4 in the accelerated group (p = 0.45). Average time spent in cast was 58.2 ± 8.3 days in the standard group and 39.5 ± 5.2 days in the accelerated group (p < 0.001). Percutaneous Achilles tendon tenotomy was done in 86.42% in the standard group and in 84.41% in the accelerated group (p = 0.72). Final results were assessed by using a modified functional rating scoring system: 55.55% clubfeet had excellent results and 44.45% had good results in the standard group, whereas 66.23% clubfeet had excellent results and 33.77% had good results in the accelerated group. None amongst the two groups had fair or poor results. CONCLUSIONS: These results suggest that the accelerated Ponseti technique significantly reduces the correction time without affecting the final results and that it is as safe and effective as the traditional Ponseti technique.

Modeling and computational analysis of 3D radiative stagnation point flow of Darcy-Forchheimer subject to suction/injection.

BACKGROUND: This manuscript elaborates the three-dimensional radiated Darcy-Forchheimer viscous liquid flow subject to permeable stretched surface. The stretched surface is nonlinear and saturated via Darcy-Forchheimer medium. Energy expression is derived through implementation of first of thermodynamics and discussed subject to convective condition and nonlinear heat flux. Mixed convection is also considered. METHOD: The governing systems of nonlinear equations are tackled numerically by Shooting method. RESULTS: Graphical results are depicted and examined with different values of non-dimensional parameters for velocity and energy equations respectively. Drag force and Nusselt number are computationally computed and analyzed through Tables. CONCLUSIONS: It is concluded from the derived outcomes that both component of velocity decay against higher values of local inertia coefficient and inverse Darcy number variables. For suction case both velocities increases while opposite trend is observed for injection case. Temperature profile has an increasing impact for higher values of Radiation, and Biot number while opposite result is seen for injection. Drag force or skin friction declines via larger injection variable. Nusselt number increases for radiation variable.

Theoretical and mathematical analysis of entropy generation in fluid flow subject to aluminum and ethylene glycol nanoparticles.

BACKGROUND: Here we have conducted a magnetohydrodynamic (MHD) flow of viscous material with alumina water and ethylene glycol over a stretched surface. The flow is discussed with and without effective Prandtl number. MHD liquid is considered. Electric field is absent. Effect of uniform magnetic field is taken in the vertical direction to the surface. Influence of thermal radiation as well as Joule heating are taken into account for both aluminum oxide-water and aluminum oxide-Ethylene glycol nanofluids. Velocity slip and melting heat effects are considered. METHODS: The nonlinear flow expressions are numerically solved via ND-solve technique (built-in-Shooting). RESULTS: The physical impacts of flow variables like mixed convection parameter, magnetic parameter, Reynold number, Eckert number, melting parameter and heat source/sink parameter are graphically discussed. Moreover, entropy generation (irreversibility) and Bejan number are discussed graphically through various flow variables. Physical quantities like skin friction coefficient and Sherwood and Nusselt numbers are numerically calculated and discussed through Tables. CONCLUSIONS: Impact of magnetic and slip parameters on the velocity field show decreasing behavior for both effective and without effective Prandtl number. Temperature field increases for both effective and without effective Prandtl number for higher values of magnetic and radiative parameters. Entropy number is an increasing function of Reynolds number while Bejan number shows opposite impact against Reynolds number. Moreover, heat transfer rate upsurges versus larger melting and radiative parameter.

Dissolution, regeneration and characterization of curdlan in the ionic liquid 1-ethyl-3-methylimidazolium acetate.

In this work, a novel green solvent based on the ionic liquid (IL) 1-ethyl-3-methylimidazolium acetate (EmimAc) with a superior dissolving ability to biomacromolecules was utilized to boost solubility of water-insoluble curdlan. Scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), circular dichroism (CD), and nuclear magnetic resonance (NMR) were used to characterize the structural changes of curdlan before and after regeneration. Thermal decomposition property of curdlan was also investigated using thermal gravimetric analysis (TGA). The results indicated after EmimAc treatment, the water-solubility of regenerated curdlan (RC) achieved 74.41 ±â€¯0.63%. In addition, the hydrogen bonds in curdlan and its native triple helix structure were partially broken. In the meantime, new hydrogen bonds between EmimAc and curdlan formed. Moreover, the disruption of curdlan's original structure made it decreased thermostability and easier to dissolve in water. Therefore, this research can provide a feasible and effective approach for improving solubility of water-insoluble curdlan to enlarge its food and biomedical applications.

Optimization of cell culture and cell disruption processes to enhance the production of thermophilic cellulase FnCel5A in E.coli using response surface methodology.

FnCel5A from Fervidobacterium nodosum is one of the most thermostable endoglucanases that have phenomenal characteristics, such as high activity, pH stability, and multi-specificity towards various substrates. However, large-scale thermophilic enzyme production is still a challenge. Herein, we focus on an optimization approach based on response surface methodology to improve the production of this enzyme. First, a Box-Behnken design was used to examine physiochemical parameters such as induction temperatures, isopropylß-D-1-thiogalactopyranoside concentrations and induction times on the heterogeneous expression of FnCel5A gene in E. coli. The best culture was collected after adding 0.56 mM IPTG and incubating it for 29.5 h at 24°C. The highest enzymatic activity observed was 3.31 IU/mL. Second, an economical "thermolysis" cell lysis method for the liberation of the enzymes was also optimized using Box-Behnken design. The optimal levels of the variables were temperature 77°C, pH 7.71, and incubation time of 20 min, which gave about 74.3% higher activity than the well-established bead-milling cell disruption method. The maximum productivity of FnCel5A achieved (5772 IU/L) illustrated that its production increased significantly after combining both optimal models. This strategy can be scaled-up readily for overproduction of FnCel5A from recombinant E.coli to facilitate its usage in biomass energy production.

Peanut Allergy: Characteristics and Approaches for Mitigation.

Peanut allergy has garnered significant attention because of the high sensitization rate, increase in allergy, and severity of the reaction. Sufficiently reliable therapies and efficient mitigating techniques to combat peanut allergy are still lacking. Current management relies on avoiding peanuts and nuts and seeds with homologous proteins, although adverse events mostly occur with accidental ingestion. There is a need for hypoallergenic peanut products to protect sensitized individuals and perhaps serve as immunotherapeutic products. Alongside traditional practices of thermal and chemical treatment, novel processing approaches such as high-pressure processing, pulsed ultraviolet light, high-intensity ultrasound, irradiation, and pulsed electric field have been performed toward reducing the immunoreactivity of peanut. Covalent and noncovalent chemical modifications to proteins also have the tendency to alter peanut allergenicity. Enzymatic hydrolysis seems to be the most advantageous technique in diminishing the allergenic potential of peanut. Furthermore, the combined processing approach (hurdle technologies) such as enzymatic hydrolysis followed by, or in conjunction with, roasting, high pressure and heat, ultrasound with enzymatic treatment, or germination have shown a significant reduction of peanut immunoreactivity and may emerge as useful techniques in reducing the allergenicity of peanut and other foods. This study represents our current knowledge about the alterations in allergenic properties of peanut via different processing mechanisms as well as evaluating its future potential, geographical based data on increasing sensitization, clinical relevance, eliciting dose, and current management of peanut allergy. Furthermore, the molecular characteristics and clinical relevance of peanut allergens have been discussed.

Hypothalamic and pituitary dysfunction is common in tubercular meningitis: A prospective study from a tertiary care center in Northern India.

INTRODUCTION: Current literature is poor with respect to well conducted prospective studies of hypothalamic pituitary axis (HPA) dysfunction in tubercular meningitis (TBM). As hormonal deficiencies are associated with poor clinical outcome in various neurological and non-neurological disorders, we prospectively evaluated the hypothalamic pituitary axis (HPA) dysfunction in TBM. PATIENTS AND METHODS: Present study included newly diagnosed drug naive TBM patients (n = 63) at a tertiary care centre in Northern India. All patients underwent detailed clinical, radiological evaluation (Gadolinium enhanced magnetic resonance imaging of brain) and HPA hormonal profiles (electrochemiluminescence assay) both at initial presentation and at six month follow up. All the data was recorded on a predesigned proforma. RESULTS: 77.8% patients had definite and 22.2% had highly probable TBM. 84.2% of patients had pituitary hormonal abnormalities at presentation. These included hyperprolactinemia (49.2%), secondary adrenal deficiency (42.9%), secondary hypogonadism (38.1%) and central hypothyroidism (9.5%). At follow up, 42.1% patients had HPA abnormalities [hyperprolactinemia (13.2%), secondary hypogonadism (15.8%), secondary adrenal deficiency (10.5%) and central hypothyroidism (10.5%)]. On multivariate logistic regression analysis, secondary hypocortisolism (Odd ratio: 4.042; 95% CI = 1.074-15.22; P = .039) was associated with poor outcome in TBM. CONCLUSION: Abnormalities of HPA are common in TBM. Patients with TBM should be evaluated for dysfunction of HPA and treated accordingly.