A synonymous single nucleotide polymorphism (g.36417726C > A) in the Lama2 gene influencing fat deposition is associated with post-partum anestrus interval in Murrah buffalo.

Postpartum absence of estrus exhibition known as postpartum anestrus interval (PPAI) for more than 90 days after calving is a concerning issue for dairy buffalo farmers' economy. The PPAI duration is influenced by both management practices and animal genetics. Investigating genetic markers associated with PPAI is crucial for incorporating them into marker-assisted selection programs. Towards this goal, our study focused on exploring potential genetic markers from early postpartum adipose tissue gene networks. We successfully identified 24 Single Nucleotide Polymorphisms (SNPs) within 9 candidate genes. In our initial analysis involving 100 buffaloes, we detected a significant association (P = 0.02267) between a specific synonymous SNP within the Lama2 gene (g.36417726C > A) and PPAI. This finding was subsequently validated (P = 0.02937) in a larger cohort of 415 buffaloes, where the SNP explained 1.36 % of the genetic variance. Intriguingly, buffaloes with the CC genotype of this SNP exhibited a PPAI that was 12.71 ± 3.21 days longer compared to buffaloes with AA and CA genotypes. To gain insight into the functional relevance of this SNP, a computational analysis was performed which indicated that the C allele of the SNP (g.36417726C > A) increased the stability of LAMA2 mRNA compared to the A allele. This computational prediction was corroborated by observing a significant increase (P = 0.01798) in Lama2 gene expression (greater than 8-fold) and higher fat percentage (P < 0.05) in adipose tissue of CC genotypes (48.78 ± 1.87 %) compared to AA genotypes (33.59 ± 4.5 %). Furthermore, we noted a significant (P < 0.05) upregulation of C/ebpß, Pparγ, Fasn, C/ebpα, and Pnpla2 genes, along with the downregulation of Bmp2 and Ptch1 in CC genotypes as opposed to AA genotypes. This observation suggests the involvement of the Pparγ-mediated pathway in both adipogenesis and lipolysis within CC genotypes. In summary, our comprehensive analysis involving association and functional validation underscores the potential of the SNP (g.36417726C > A) within the Lama2 gene as a promising genetic marker against extended PPAI in Murrah buffalo.

A single nucleotide polymorphism of the thyrotropin releasing hormone degrading ectoenzyme (TRHDE) gene is associated with post-partum anestrus in Murrah buffalo.

Thyrotropin releasing hormone degrading enzyme (TRHDE) gene is implicated in Thyrotropin releasing hormone (TRH) mediated prolactin secretion. It has been shown that the prolactin secretion alters the Gonadotropin-releasinghormone(GnRH) mediated estrous cycle. Therefore, TRHDE may also regulate postpartum anestrus. Earlier studies reported the role of non-synonymous single nucleotide polymorphism (SNPs) in various pathophysiological conditions by altering the structure and function of the proteins. Hence, in the present study, we identified SNPs in the putative promoter, first exon, middle exon and 3'-UTR containing the last exon of TRHDE gene and determined their association with postpartum anestrus (PPA) in Murrah buffaloes. We found one non synonymous SNP (G > C at 118095875 bp on chromosome 4) in the first exon of TRHDE and performed its association analysis in a population sample of 50 extreme PPA (residual PPAI: 123.06 ± 12.98 days) and 50 normal (residual PPAI: -80.46 ± 3.19 days) buffaloes. The residual PPAI value was the observed PPAI adjusted for the effect of 38 non-genetic factors. The analysis showed a significant (P < 0.004167) association of this SNP with PPA in buffaloes. Molecular dynamics simulations (MDS) also supported that the C allele altering Glutamine to Histidine at the amino acid 148 of TRHDE could enhance the stability and rigidity of TRHDE protein, which may lower its activity, increase TRH and prolactin, and reduce GnRH in PPA buffaloes. The MDS analysis further strengthens the association of the SNP (G > C) in the TRHDE gene with PPA condition in Murrah buffaloes. However, further investigation is needed to prove the MDS observations.

Meprin A1 subunit beta gene polymorphism is associated with the length of post-partum anestrus interval in Murrah buffaloes.

Postpartum anestrus interval (PPAI) is the interval between parturition and the first postpartum estrus exhibition in animals. Appearance of both normal and PPA buffaloes under the same farm conditions indicates the role of possible genetic predisposition to PPA. To identify the genetic and non-genetic factors associated with PPA in buffaloes, we collected data on PPAI and other 38 non-genetic variables from 575 Murrah buffaloes in the field conditions and identified the PPA associated non-genetic factors in our previous study. To explore the genetic factors associated with the unexplained variation in PPAI residuals, the present study identified 41 single nucleotide polymorphisms (SNPs) in 13 candidate genes using Sanger sequencing. Exploration of their association with the PPAI residuals of 50 extreme PPA and 50 normal buffaloes identified the significant (P < 0.01) association of the SNP (g.37219977A>G) in the 3'-UTR region of the Meprin A 1 subunit beta (Mep1b) gene with PPAI, which was further validated (P = 0.058) in a large population sample (n = 417). Bioinformatics analysis of the 3'-UTR region has identified three miRNA, bta-miR-2420, bta-miR-2325b and bta-miR-453 that could regulate Igf-1 in the plasma of animals with different genotypes (GG, AG and AA). The higher Igf-1 levels in the GG genotypes than that of AA and AG genotypes of this SNP (g.37219977A>G) further suggest the association of Mep1b gene with PPA condition in Murrah buffaloes. As a result of this study, we propose that buffaloes with protective alleles at this SNP be selected to improve the herd's reproductive efficiency.

Regional anesthesia in the coronavirus disease (COVID-19) pandemic: Clinical guidelines by AORA, India.

Anesthesiologists are amongst the front line warriors in this COVID-19 pandemic. We need to change our preferences and practices to reduce the spread to healthcare workers and patients in the hospital. General anesthesia involves aerosol-generating procedures while ventilating and intubating the patients. Regional anesthesia maintains respiratory functions, circumvents airway instrumentation and helps to limit viral transmission. This makes a strong case to patronize regional anaesthesia practises whenever possible. Due to various limitations of diagnostic tests available, all patients can be treated as COVID-19 positive and necessary precautions are suggested to limit the transmission. The importance of a practise advisory is to clear the mist around the dos and don'ts to ensure clarity of thoughts leading to improved safety of both patient and health care professional. We propose clinical guidelines for regional anaesthesia practices in COVID-19 positive patient posted for surgery. Furthermore, current recommendations on confirming the COVID-19 negative status is referred. These features are subject to change further with time.

Body condition score, parity, shelter cleanliness and male proximity: Highly associated non-genetic factors with post-partum anestrus in Murrah buffalo in field conditions.

Postpartum anestrus (PPA) is a major reproductive problem in buffalo. Although both genetic and non-genetic factors influence the incidence of PPA, identifying associated non-genetic factors would be helpful for effective management of this problem. No systematic study, however, has been conducted to identify the association of non-genetic factors with PPA in buffalo, especially in field conditions. Data for 39 variables affecting postpartum anestrus interval (PPAI), health, nutrition, management and environmental status of the animals were collected on 575 buffalo from 15 villages. Data were analyzed using a general linear model considering PPAI as a dependent variable and the remaining 38 non-genetic parameters as independent variables. The results from the analysis indicated body condition score (BCS) variables, such as pelvic girdle score (P <  0.0001) and girth (P <  0.05), parity (P < 0.0001), shelter cleanliness (P <  0.001), male proximity (P <  0.005), amount and frequency of concentrate feeding during the early postpartum period (P <  0.05), general feeding frequency in a day (P <  0.05) and the treatments with oxytocin at the time of milking to facilitate milk release from the udder (P <  0.05) were associated with PPAI in Murrah buffalo. Plotting the PPAI residuals indicated the possibility of other unexplained factors, including genetics, that could also affect the differences in values for this variables in Murrah buffalo. In conclusion, a greater understanding of associated non-genetic factors with PPAI would help farmers in conducting proper managemental practices for early induction of reproductive cycles following parturition in Murrah buffalo.

High serum free fatty acids and low leptin levels: Plausible metabolic indicators of negative energy balance in early lactating Murrah buffaloes.

Lactation is a highly demanding event in mammals, including buffaloes. It modulates the partitioning of nutrients, energy utilization, and food intake of the mother to meet her own and infant's energy needs. Failure to satisfy these energy needs leads to Negative Energy Balance (NEB). Currently, the only available indirect NEB indicator is Body Condition Score (BCS). However, direct dependency of the BCS on the peak depletion of body fat causes its inefficient use in a dairy farm. Thus, to establish objective NEB indicators in buffaloes, the serum levels of biochemical (serum ß-hydroxybutyrate [BHBA] and free fatty acids [FFAs]), and endocrine (Growth Hormone [GH], insulin-like growth factor1 [IGF1], Insulin, and leptin) parameters were estimated in buffaloes. Our results revealed that serum FFA levels were significantly (p < 0.05) higher in high milk yielders (HMY) than low milk yielders (LMY) and heifers (H) during the 3rd and the 4th weeks of postpartum. The serum FFA levels were also significantly (p < 0.001) higher in the postpartum buffaloes with BCS < 3 in the field conditions. Further, serum leptin levels were significantly (p < 0.05) lower in HMY than LMY during the 3rd week of postpartum. However, the BHBA, GH, IGF1, and insulin levels were not significantly different between lactating buffaloes and H. These observations indicated that the NEB condition is probably restricted to the first month of early lactation in buffaloes. In conclusion, the simultaneous higher FFA and lower leptin levels could act as direct plausible metabolic indicators of NEB in buffaloes.

Evaluation of therapeutic potential of nanosilver particles synthesised using aloin in experimental murine mastitis model.

Nanobiotechnology is an emerging biological branch of nanotechnology. Application of nanoparticles with specific size and shape in biology has already shown unforeseen and interesting results. A study was conducted to evaluate the therapeutic potential of phytogenically derived aloin mediated nanosilver particles (AAgNPs), prepared by reduction of silver nitrate with aloin, in Staphylococcus aureus induced murine mastitis. A total of 40 female mice were divided into five groups of eight animals each. Group I served as lactating control, groups II-V were inoculated with 20 µl of 24 h broth culture of S. aureus containing 4.0 × 105 cfu/quarter under ketamine anaesthesia. After 6 h post inoculation, groups III and IV received 20 µl of aloin nanosilver (AAgNPs) through intramammary and intraperitoneal routes, respectively. Group V received antibiotic cefepime at 1 mg/kg body weight through the intra-peritoneal route. After 18 h post-treatment, serum C reactive protein, weights of mammary glands, mammary gland bacterial load, thiobarbituric acid reactive substances content, reduced glutathione content, superoxide dismutase activity and catalase activity and histopathology were determined. The compound showed a minimum inhibitory concentration of 21.8 ng/ml against S. aureus. Significant reduction (98%) in poly-morpho nuclear cell infiltration was observed with AAgNPs than antibiotic (50%).

Low-permeability Gore Excluder device versus the original in abdominal aortic aneurysm size regression.

We sought to compare the efficacy of a low-permeability version of the Gore Excluder™ device with that of the original device. We used volumetric analysis and maximum transverse diameter measurements to examine abdominal aortic aneurysm size regression after endovascular aneurysm repair.From November 2002 through April 2007, 101 patients (82% men; mean age, 71.5 ± 8.9 yr) underwent endovascular aneurysm repair with the Excluder stent-graft: 34 with the original device, and 67 with the low-permeability device. Only patients without endoleak and with preprocedural and 1- and 2-year follow-up computed tomographic scans were included. Eight patients with type II endoleak and 2 with type I endoleak were excluded. Maximum abdominal aortic aneurysm diameter and volume were measured before endovascular aneurysm repair and annually thereafter. Postprocessing, multiplanar computed tomography, and 3-dimensional reconstructions were compared with baseline measurements. Diameter and volume changes that were greater than 5 mm or that exceeded 10% were considered significant.At 12 months, the mean maximum transverse diameter had decreased by -0.16 ± 12.1 mm in recipients of the original device and by -4.8 ± 5.9 mm in recipients of the low-permeability device (P = NS). In addition, mean reduction in volume had changed by -17 ± 16 mL in original-device recipients and by -36.1 ± 37.9 mL in low-permeability device recipients (P < 0.01).One-year follow-up revealed that the low-permeability stent-graft resulted in a greater decrease in abdominal aortic aneurysm volume than did the original stent-graft.

Eggerthella lenta bacteremia in a Crohn's disease patient after ileocecal resection.

Eggerthella lenta is an anaerobic, nonspore-forming Gram-positive rod and is a common gut commensal. Bacteremia from this organism is rare but when present is always clinically significant. Gastrointestinal disease and malignancy are the most common causes for bacteremia from this organism. Eggerthella species have been isolated in feces from patients with inflammatory bowel disease, but bacteremia has not been reported to the best of our knowledge. Here we report the case of a young African-American female with Crohn's disease who developed Eggerthella lenta bacteremia after ileocaecal resection.

Risk of adverse events after coronary artery bypass graft and subsequent noncardiac surgery.

AIMS: Coronary artery bypass grafts (CABGs) are increasingly performed in elderly patients. Risk factors and outcomes are poorly described for those undergoing noncardiac surgery within 1 year after CABG. Our objectives were to assess the risk and predictors of major adverse events associated with noncardiac surgery within 1 year after CABG. METHODS: In a retrospective review of medical records at Mayo Clinic (Rochester, MN, USA), over a period of 5 years, we identified patients who underwent noncardiac procedures within 1 year post-CABG. All events that occurred within 30 days after noncardiac surgery and deaths within 1 year after noncardiac surgery were considered to be related to CABG. RESULTS: We identified 211 patients; of these, 21 patients had 24 adverse events. Within 1 year, 11 died, and within the first 30 days, three myocardial infarctions, six acute congestive heart failure episodes, three cerebrovascular accidents and one deep vein thrombosis episode had occurred. Predictors of an adverse event included emergency operation (odds ratio: 6.8), ejection fraction less than 45% (p < 0.001) and elevated right ventricular systolic pressure by 40 mmHg or more (p = 0.03). After the noncardiac procedure, patients requiring dialysis (p = 0.02), ventilatory support (p = 0.03) and longer hospital stay (p = 0.03) had greater rates of adverse outcomes. CONCLUSION: Post-CABG, preoperative ejection fraction less than 45%, right ventricular systolic pressure of 40 mmHg or more, as well as emergent noncardiac surgery, were predictors of adverse outcomes after the noncardiac procedure. Longer postoperative hospital stay, dialysis, as well as ventilatory support, were predictors of adverse outcomes after CABG.

Epicardial fat: an additional measurement for subclinical atherosclerosis and cardiovascular risk stratification?

BACKGROUND: The value of epicardial adipose tissue (EAT) thickness as determined by echocardiography in cardiovascular risk assessment is not well understood. The aim of this study was to determine the associations between EAT thickness and Framingham risk score, carotid intima media thickness, carotid artery plaque, and computed tomographic coronary calcium score in a primary prevention population. METHODS: Patients presenting for cardiovascular preventive care (n = 356) who underwent echocardiography as well as carotid artery ultrasound and/or coronary calcium scoring were included. RESULTS: EAT thickness was weakly correlated with Framingham risk score. The prevalence of carotid plaque was significantly greater in those with EAT thickness ≥ 5.0 mm who either had low Framingham risk scores or had body mass indexes ≥ 25 kg/m(2), compared with those with EAT thickness <5.0 mm. No significant association between EAT thickness and carotid intima-media thickness or coronary calcium score existed. CONCLUSION: EAT thickness ≥ 5.0 mm may identify an individual with a higher likelihood of having detectable carotid atherosclerosis.

The metabolic syndrome and associated risk factors in an urban industrial male population in South India.

BACKGROUND: The metabolic syndrome is characterized by clustering of risk factors, which predisposes subjects to increased risk of diabetes and cardiovascular disease. Objectives of this study were to estimate prevalence of the metabolic syndrome and determine the association of risk factors with the metabolic syndrome in an urban industrial male population in Chennai, India. METHODS: We conducted a cross-sectional survey for male employees working in an industrial unit. The survey included questionnaire for risk factors, anthropometric and blood pressure measurements. Blood samples were collected for the fasting plasma glucose, serum cholesterol, high-density lipoprotein cholesterol and triglycerides. The metabolic syndrome was defined using International Diabetes Federation (IDF) and American Heart Association (AHA)/National Heart Lung and Blood Institute (NHLBI) criteria. RESULTS: The total numbers of male subjects included in the study were 1077. The prevalence of the metabolic syndrome was 41.3% and 51.4% using IDF and AHA/NHLBI criteria respectively. Risk factors were age above 35 years, family history of diabetes and body mass index (BMI) above 23.9 kg/m2. The consumption of more than three servings of fruits and vegetables was protective. CONCLUSION: The prevalence of the metabolic syndrome was very high in select industrial population in south India. Higher BMI and low intake of fruits and vegetables are modifiable by life style modification. Work site screening for the metabolic syndrome would facilitate the early detection and treatment.

Unicuspid aortic valve in adults: a systematic review.

BACKGROUND AND AIM OF THE STUDY: The natural history of the unicuspid aortic valve (UAV) is poorly described in the literature. In order to study the association between UAV with any other cardiac or extra cardiac abnormalities, an evidence-based systematic review was carried out. METHODS: A computerized search was carried out of the medical literature published between 1st January 1966 and 1st September 2008 of the following databases: MEDLINE; EMBASE; Web of Science; and the Cochrane Database. RESULTS: A total of 231 cases of adult UAV was identified in 38 articles. The mean patient age was 42 years, and the most common presenting symptoms reported (in 52 cases) included dyspnea (44%; n=23), angina (21%; n=11), and dizziness or syncope (8%; n=4). The most common lesion in UAV was isolated aortic stenosis (AS) (41%; n=95) and AS with or without aortic regurgitation (28%; n=64). The preoperative diagnosis of UAV is rare, and 139 cases (60%) of UAV were reported at autopsy or by examination of surgically excised valves. Aortic valve replacement was performed in 166 cases (82%). Concomitant aortic surgery was performed in 47 of the UAV cases (23%), either for a dilated or aneurysmal aorta. CONCLUSION: UAV shares many of the features of bicuspid aortic valve, including valvular dysfunction, aortic dilatation, aortic dissection, and dystrophic calcification, although these conditions develop at an earlier age and progress at a faster pace in UAV. Further investigations are warranted regarding the possibility of a familial incidence, associated histopathological changes in the aorta, preoperative diagnostic tools, ideal follow up and surgical intervention.

Evaluation of left ventricular rotation in obese subjects by velocity vector imaging.

AIMS: Obesity is a well-known risk factor in the development of cardiovascular disease. We hypothesize that early left ventricular (LV) dysfunction secondary to obesity could be signalled by abnormal LV rotation. METHODS AND RESULTS: This prospective study examined 60 subjects divided into two groups: obese group with body mass index (BMI) >or=30 and control group with BMI <25. The peak rotation, twist, and torsion of the left ventricle were studied in obese and control subjects, using velocity vector imaging. Age and gender were comparable between the two groups. Obese subjects had higher BMI, waist circumference, fasting glucose, triglycerides, systolic and diastolic blood pressure, low-density lipoprotein cholesterol, and lower high-density lipoprotein cholesterol (P < 0.05). In obese subjects, LV mass and LV mass index were increased, and the ratio of mitral early and late diastolic filling velocity was decreased (P < 0.05). In obese subjects, the peak twist and torsion of the left ventricle displayed a lower trend, and the peak rotation of the left ventricle apex decreased significantly (3.81 +/- 2.09 degrees vs. 5.77 +/- 3.27 degrees , P < 0.001). CONCLUSION: Obesity was associated with changes in LV rotation. Velocity vector imaging is a feasible and reproducible echocardiographic technique for the detection of early subclinical LV dysfunction.

Unicuspid aortic valve in children: a systematic review spanning four decades.

BACKGROUND AND AIM OF THE STUDY: To date, the natural history of the unicuspid aortic valve (UAV) has been poorly described in the literature. To study the association between UAV with associated cardiac and extracardiac abnormalities, a systematic review was conducted. METHODS: A computerized search was conducted of the medical literature published between 1st January 1966 and 1st September 2008, using the databases MEDLINE, EMBASE, Web of Science and Cochrane database. RESULTS: Nine articles with 60 pediatric cases (age <15 years) were identified. The mean age at diagnosis was 14 months, the most common presentation of UAV was congestive heart failure due to congenital aortic stenosis, and the most common lesion was isolated aortic stenosis, reported in 19 cases (32%). Associated anomalies included 22 cases (37%) of aortic coarctation, seven (12%) with ventricular septal defect (VSD), three (5%) with patent ductus arteriosus (PDA), and three (5%) with aortic aneurysm. The preoperative diagnosis of UAV was rare, and 33 cases (55%) of pediatric UAV were reported at autopsy or at pathological examination of the surgically excised valves. A total of 26 cases (43%) was treated with either balloon valvoplasty or surgical valvotomy or commissurotomy. CONCLUSION: UAV shares many of the features of bicuspid aortic valve, including valvular dysfunction, aortic dilatation, aortic dissection, and dystrophic calcification. The importance of an early diagnosis of UAV lies in its risk of sudden cardiac death and association with other congenital anomalies, such as PDA, VSD, anomalous coronary arteries, and coarctation of the aorta. Further investigations of UAV are warranted in the pediatric age group with regards to familial incidence, associated aortic histopathological changes, the ideal follow up to monitor complications, and surgical intervention.

A comparison of anthropometric indices for predicting hypertension and type 2 diabetes in a male industrial population of Chennai, South India.

OBJECTIVES: To assess the association of four obesity-related indices--body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-stature ratio (WSR)--with hypertension and type 2 diabetes among a male industrial population in south India. DESIGN, SETTING, AND PARTICIPANTS: A cross sectional study of 2148 men aged 18-69 years in two purposely selected industrial units in Chennai, India, in 2003-2005. MAIN OUTCOME MEASURES: The examination included blood pressure and anthropometric measurements (height, weight, hip circumference, and WC) to calculate BMI, WHR, and WSR. Fasting blood samples were taken to assess plasma glucose. RESULTS: Prevalence of overweight was 43.4%; prevalences of central obesity using WC > or = 90.0 cm and WHR > 0.90 were 50.0% and 70%, respectively. The prevalences of hypertension and type 2 diabetes were 26.5% and 16.3%, respectively. There was a significant increase in the prevalence of type 2 diabetes and hypertension across the quintiles for the four anthropometric indices. In logistic regression analysis, BMI and WC showed a significant graded increase in the odds ratio for hypertension after adjusting for age. In case of type 2 diabetes, only WHR showed significant increase in odds ratio across quintiles after adjusting for age and BMI. CONCLUSIONS: WHR was the best predictor for type 2 diabetes in the study sample. BMI and WC were good predictors for hypertension. We recommend that WHR should be routinely used in this clinical setting in addition to BMI to detect persons at high risk in these industrial units. Prospective studies are needed to provide evidence of the predictive power of anthropometric indices for Asian Indians.