Use of Bacillus probiotics for immune responses and intestinal microflora of white leg shrimp Litopenaeus vannamei (Boone, 1931) post larvae

The effect of dietary containing of Bacillus subtilis and Bacillus licheniformis in three groups including commercial, commercial-indigenous and indigenous was investigated on the immune parameters (glucose, albumin, total protein, lysozyme, cortisol, immunoglobulin M (IgM)) and the intestinal flora of white leg shrimp (Litopenaeus vannamei) post larvae. The shrimp were fed for 60 days with four different diets: control (without probiotics), diet T1 supplemented with 1.5×106 CFU g-1 commercial probiotic, diet T2 with 1.5×106 CFU g-1 commercial-indigenous probiotic, diet T3 with 1.5×106 CFU g-1 indigenous probiotic. At the end of experimental period, the levels of biochemical parameters (glucose, total protein, lysozyme, cortisol, IgM) of shrimp fed probiotic diets were significantly higher than in those shrimps fed the control diet for 60 days. However, albumin concentrations showed no significant difference between the experimental treatments and the control, but increased by 1.19, 1.15 and 1.14 after 60 days of feeding with diets T1, T2 and T3, respectively. Likewise, population density of Bacillus bacteria counted in digestive tract of shrimps treated with probiotic were significantly higher than the control group. Results of this study indicated that the addition of probiotic bacilli can improve immune parameters and modulates intestinal microbiota of shrimp (L. vannamei) post larvae

Life threatening acute kidney injury in a patient of rheumatoid arthritis, is it drug or disease related?

Even low-dose MTX therapy for treatment of rheumatic diseases is claimed to cause impairment in renal function. We report an insidious and progressive deterioration of renal function of patient with RA on low-dose MTX in a 41-year-old woman. We suggest that patients on low-dose MTX therapy should be periodically monitored for creatinine levels

Influence of hyperhomocysteinemia on the cellular redox state - Impact on homocysteine-induced endothelial dysfunction

Hyperhomocysteinemia is an independent risk factor for the development of atherosclerosis. An increasing body of evidence has implicated oxidative stress as being contributory to homocysteines deleterious effects on the vasculature. Elevated levels of homocysteine may lead to increased generation of superoxide by a biochemical mechanism involving nitric oxide synthase, and, to a lesser extent, by an increase in the chemical oxidation of homocysteine and other aminothiols in the circulation. The resultant increase in superoxide levels is further amplified by homocysteinedependent alterations in the function of cellular antioxidant enzymes such as cellular glutathione peroxidase or extracellular superoxide dismutase. One direct clinical consequence of elevated vascular superoxide levels is the inactivation of the vasorelaxant messenger nitric oxide, leading to endothelial dysfunction. Scavenging of superoxide anion by either superoxide dismutase or 4,5-dihydroxybenzene 1,3-disulfonate (Tiron) reverses endothelial dysfunction in hyperhomocysteinemic animal models and in isolated aortic rings incubated with homocysteine. Similarly, homocysteineinduced endothelial dysfunction is also reversed by increasing the concentration of the endogenous antioxidant glutathione or overexpressing cellular glutathione peroxidase in animal models of mild hyperhomocysteinemia. Taken together, these findings strongly suggest that the adverse vascular effects of homocysteine are at least partly mediated by oxidative inactivation of nitric oxide

Tissue-engineered tracheal replacement in a child: a 4-year follow-up study

In 2010, a tissue-engineered trachea was transplanted into a 10-year-old child using a decellularized deceased donor trachea repopulated with the recipient's respiratory epithelium and mesenchymal stromal cells. We report the child's clinical progress, tracheal epithelialization and costs over the 4 years. A chronology of events was derived from clinical notes and costs determined using reference costs per procedure. Serial tracheoscopy images, lung function tests and anti-HLA blood samples were compared. Epithelial morphology and T cell, Ki67 and cleaved caspase 3 activity were examined. Computational fluid dynamic simulations determined flow, velocity and airway pressure drops. After the first year following transplantation, the number of interventions fell and the child is currently clinically well and continues in education. Endoscopy demonstrated a complete mucosal lining at 15 months, despite retention of a stent. Histocytology indicates a differentiated respiratory layer and no abnormal immune activity. Computational fluid dynamic analysis demonstrated increased velocity and pressure drops around a distal tracheal narrowing. Cross-sectional area analysis showed restriction of growth within an area of in-stent stenosis. This report demonstrates the long-term viability of a decellularized tissue-engineered trachea within a child. Further research is needed to develop bioengineered pediatric tracheal replacements with lower morbidity, better biomechanics and lower costs

A cross sectional study of various types of acute poisoning; pharmacological management and their outcome in a tertiary care hospital

Background: Acute poisoning is a common and life-threatening crisis, leading to serious complications and death of patients. Poisoning may be due to self-consumption, accidental exposure of chemical compounds, medications and poisonous animal bites/stings. Aim of current study was to investigate the pattern of drug utilization, poisoning agents and outcome in patients with acute poisoning treated at a tertiary care teaching hospital, Vadodara, Gujarat. Methods: This prospective cross-sectional study was done on patients of acute poisoning admitted in emergency department, SSG Hospital during August 2021-March 2022. Results: 400 patients were enrolled during the study, from which 262 (65.50%) were male and 138 (34.50%) were female. Mean age of patients was 30.30 ± 13.79 years. The commonest mode of poisoning observed was Suicidal (66.25%). The most common cause of poisoning was due to Pesticides (33.25%), followed by venomous animal exposures (30.75%). Death was recorded in 53 (13.25%) patients with highest number seen in suicidal poisoning (14.34%) compared to accidental poisonings (11.19%). Mainly, multivitamins (19.03%), Antimicrobials (16.65%), Proton Pump Inhibitors (15.85%) and Antiemetics (11.10%) were prescribed. Antidotes used were Atropine (4.81%), Pralidoxime (4.46%) and Anti-snake venom (2.80%). Median number of drugs per patient was 8; range: 2-25. Conclusions: Pattern and magnitude of poisoning are multidimensional and demand multi-sectoral approach for facing this problem. Due to high incidence of snakebites, hospital stockpiles should be regularly checked for availability of antivenom. There is a need for stringent pesticide regulation laws, counselling and training programs to reduce incidence of poisonings and deaths due to it

Dynamic auroral storms on Saturn as observed by the Hubble Space Telescope

We present observations of significant dynamics within two UV auroral storms observed on Saturn using the Hubble Space Telescope in April/May 2013. Specifically, we discuss bursts of auroral emission observed at the poleward boundary of a solar wind-induced auroral storm, propagating at ∼330% rigid corotation from near ∼01 h LT toward ∼08 h LT. We suggest that these are indicative of ongoing, bursty reconnection of lobe flux in the magnetotail, providing strong evidence that Saturn’s auroral storms are caused by large-scale flux closure. We also discuss the later evolution of a similar storm and show that the emission maps to the trailing region of an energetic neutral atom enhancement. We thus identify the auroral form with the upward field-aligned continuity currents flowing into the associated partial ring current

SHANK3 variant as a cause of nonsyndromal autism in an 11-year-old boy and a review of published literature

Autism spectrum disorder (ASD) encompasses a spectrum of pervasive neuropsychiatric disorders characterized by deficits in social interaction, communication, unusual and repetitive behaviours. The aetiology of ASD is believed to involve complex interactions between genetic and environmental factors; it can be further classified as syndromic or nonsyndromic, according to whether it is the primary diagnosis or secondary to an existing condition where both common and rare genetic variants contribute to the development of ASD or are clearly causal. The prevalence of ASD in children is increasing with higher rates of diagnosis and an estimated one in 100 affected in the UK. Given that heritability is a major contributing factor, we aim to discuss research findings to-date in the context of a high-risk autism candidate gene, SHANK3 (SH3 and multiple ankyrin repeat domain 3), with its loss resulting in synaptic function disruption. We present a 10-year-old patient with a pathogenic de novo heterozygous c.1231delC, p.Arg411Val frameshift variant in SHANK3. He presented with severe autism, attention deficit hyperactivity disorder and pathological demand avoidance, on a background of developmental impairment and language regression. The number of genes associated with autism is ever increasing. It is a heterogeneous group of disorders with no single gene conferring pathogenesis in the majority of cases. Genetic abnormalities can be detected in ~15% of ASD and these range from copy number variants in 16p11.2 and 15q13.2q13.3 to several well-known genetic disorders including tuberous sclerosis and fragile X syndrome. Further, high confidence autism genes include but are not limited to NRXN, NLGN3, NLGN4, SHANK2 and SHANK3

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

COVID-19 in cancer patients on systemic anti-cancer therapies: outcomes from the CAPITOL (COVID-19 Cancer PatIenT Outcomes in North London) cohort study

Background: Patients with cancer are hypothesised to be at increased risk of contracting COVID-19, leading to changes in treatment pathways in those treated with systemic anti-cancer treatments (SACT). This study investigated the outcomes of patients receiving SACT to assess whether they were at greater risk of contracting COVID-19 or having more severe outcomes. / Methods: Data was collected from all patients receiving SACT in two cancer centres as part of CAPITOL (COVID-19 Cancer PatIenT Outcomes in North London). The primary outcome was the effect of clinical characteristics on the incidence and severity of COVID-19 infection in patients on SACT. We used univariable and multivariable models to analyse outcomes, adjusting for age, gender and comorbidities. / Results: A total of 2871 patients receiving SACT from 2 March to 31 May 2020 were analysed; 68 (2.4%) were diagnosed with COVID-19. Cancer patients receiving SACT were more likely to die if they contracted COVID-19 than those who did not [adjusted (adj.) odds ratio (OR) 9.84; 95% confidence interval (CI) 5.73–16.9]. Receiving chemotherapy increased the risk of developing COVID-19 (adj. OR 2.99; 95% CI = 1.72–5.21), with high dose chemotherapy significantly increasing risk (adj. OR 2.36, 95% CI 1.35–6.48), as did the presence of comorbidities (adj. OR 2.29; 95% CI 1.19–4.38), and having a respiratory or intrathoracic neoplasm (adj. OR 2.12; 95% CI 1.04–4.36). Receiving targeted treatment had a protective effect (adj. OR 0.53; 95% CI 0.30–0.95). Treatment intent (curative versus palliative), hormonal- or immunotherapy and solid versus haematological cancers had no significant effect on risk. / Conclusion: Patients on SACT are more likely to die if they contract COVID-19. Those on chemotherapy, particularly high dose chemotherapy, are more likely to contract COVID-19, while targeted treatment appears to be protective

Prevalence and risk factor's analysis of bovine brucellosis in peri-urban areas under intensive system of production in Gujarat, India

Aim: A study on surveillance of bovine brucellosis in dairy herds of peri-urban areas under intensive system of production was carried out by milk-ELISA. Various risk factors were identified having significant association with occurrence of bovine brucellosis in dairy herds of peri-urban areas. Materials and Methods: Five randomly selected peri-uban areas of six cities of Gujarat were included in the present study. Five randomly selected dairy herds under intensive system of production from each selected peri-urban area were included for further investigation. In total, 199 bulk and 582 individual milk samples were screened by milk-ELISA. Forty three different risk factors were identified and grouped into four major categories as general characteristics of farms, introduction of infection to farms, management systems of farms and exposure of disease. Further, their distribution and association with prevalence of bovine brucellosis was studied. Results: The overall herd and animal prevalence in peri-urban areas was 33.70 and 11.90%, respectively. Out of 11 risk factors on general characteristics of dairy farms, only five (herd size, type of animals, type of breed, age of owner and knowledge gained by owners) showed significant (p<0.05) association with occurrence of bovine brucellosis. None of risk factors on introduction of infection to farms (n=6) and management systems of farms (n=11) was found significantly associated with occurrence of brucellosis. Among risk factors on exposure of disease (n=15), history of abortion, retention of placenta, still birth and metritis/endometritis showed significant (p<0.05) association with prevalence of bovine brucellosis. Conclusion: It was concluded that prevalence of bovine brucellosis in dairy herds under intensive system of production in peri-urban areas of Gujarat was comparatively higher than reported overall prevalence of brucellosis. Risk factors like larger herd in close confinement without adequate sheds, type of animal, type of breed and knowledge/awareness of dairyman, unrestricted animal market, replacement without prior testing, reproductive disorders with absence of their testing are the important risk factors under the intensive production system of peri-urban areas of Gujarat, India