Studies on a novel SrZr2 CaLa2 O8 :Eu3+ phosphor for lighting applications emitting direct white light.

Direct white light emitting phosphors play a significant role in the display industry due to their ability to improve the quality, efficiency, and versatility of lighting sources used in most of the displays. The currently investigated phosphor SrZr2 CaLa2 O8 :Eu3+ was prepared by a conventional solid-state reaction method. It has been observed that the stoichiometric ratio of all precursors plays an important role in determining the characteristics of the final phosphor. From X-ray diffraction (XRD) analysis, the phosphor was observed to have a hexagonal phase and a crystal size of ~28 nm. Scanning electron microscopy (SEM) observations revealed a cluster of rod-like structures with an average diameter of ~0.2 µm. The excitation peak maximum observed at 280 nm is due to charge transfer between Eu3+ -O2- ions. The energy transitions 7 F0 → 5 L6 and 7 F0 → 5 D2 are responsible for the appearance of other excitation peaks at ultraviolet (UV) (395 nm), blue (~467 nm), green (~540 nm), orange (~590 nm), and red (~627 nm) attributed to 5 D0 → 7 FJ (J = 0-4) transitions of europium ion (Eu3+ ). The Commercial International de I'Eclairage (CIE) chromaticity coordinates were estimated to be (0.37, 0.0.33) and (0.67, 0.33) for the emissions corresponding to 395 and 590 nm, respectively. The characteristic emissions of Eu3+ ions allow this novel phosphor to be used to generate direct white light in light-emitting diodes (LEDs), which is otherwise difficult to achieve in single-component systems.

Study of Colistin Resistant Gram Negative Organism in Hospitalized Patients: A Retrospective Study.

Background: Intensive care units have become hotspots for antimicrobial resistance, particularly concerning colistin resistance, posing a threat of untreatable infections. Aim: This study aims to analyze the epidemiological and clinical aspects of patients carrying colistin-resistant organisms. It focuses on identifying risk factors, the microbiological profile, susceptibility patterns, and treatment outcomes. Materials and methods: Isolates with colistin MIC >2 µg/mL, identified via BD PHOENIX, were subjected to colistin broth disc elution testing (as per CLSI guidelines) in our Microbiology Department between January and December 2022. Results: Among the 30 patients, colistin-resistant gram-negative isolates were found predominantly in blood cultures (50%), followed by ET/TT cultures (23.3%), urine cultures (10%), and other sites (16.7%). Klebsiella pneumoniae was the most common organism (80%), showing the highest sensitivity to Ceftazidime-avibactam + Aztreonam (CAZ-AVI + ATM) (76.7%). Of these patients, 66.7% recovered and were discharged, while 33.3% succumbed during hospitalization despite treatment. Conclusion: The study underscores a notable presence of colistin-resistant gram-negative isolates, predominantly in blood cultures, with K. pneumoniae being predominant. The combination of CAZ-AVI + ATM exhibited the highest sensitivity. However, the mortality rate of 33.3% despite sensitive antibiotic treatment highlights the urgency for ongoing vigilance and research to combat colistin-resistant infections and improve patient outcomes. How to cite this article: Diwane D, Rajhans PA, Jog SA, Dalvi M. Study of Colistin Resistant Gram Negative Organism in Hospitalized Patients: A Retrospective Study. Indian J Crit Care Med 2024;28(3):286-289.

Improving blast resistance of maintainer line DRR 9B by transferring broad spectrum resistance gene Pi2 by marker assisted selection in rice.

Hybrid rice technology offers great promise to further enhance rice production and productivity for global food security. Improving hybrid rice parental lines is the first step in developing heterotic rice hybrids. To improve resistance against blast disease, a maintainer line DRR 9B was fortified with a major broad-spectrum blast resistance gene Pi2 through marker-assisted selection. The rice blast caused by Magnaporthe oryzae is a major disease and can cause severe yield losses upto 100%. The NILs of Samba Mahsuri namely BA-23-11-89-12-168 possessing Pi2 was utilized as a donor parent. The PCR-based molecular marker tightly linked to Pi2 gene was used for the foreground selection at BC1F1 generation. The molecular marker tightly linked to the major fertility restorer gene Rf4 was used for negative selection (i.e., selection of plants possessing non fertility restoring alleles) at BC1F1 generation to identify maintainer lines. The positive plants with Rf4 gene were added to the restorer pool for restorer line development. At each stage, MAS for Pi2 coupled with stringent phenotypic selection for agro-morphological and grain quality traits were exercised. At BC1F3 generation, one hundred families were screened against blast disease at uniform blast nursery (UBN) and selected resistant lines were advanced to next generations. In the BC1F5 generation plants were subjected to agro-morphological evaluation for yield and yield-contributing traits. The selected plants at BC1F5 generation were crossed with DRR 9A to assess the maintainer ability of blast resistance lines and for further CMS line conversion for hybrid rice breeding for developing blast resistance rice hybrids.

Preclinical Immunogenicity and Efficacy of Optimized O25b O-Antigen Glycoconjugates To Prevent MDR ST131 E. coli Infections.

Multivalent O-antigen polysaccharide glycoconjugate vaccines are under development to prevent invasive infections caused by pathogenic Enterobacteriaceae. Sequence type 131 (ST131) Escherichia coli of serotype O25b has emerged as the predominant lineage causing invasive multidrug-resistant extraintestinal pathogenic E. coli (ExPEC) infections. We observed the prevalence of E. coli O25b ST131 among a contemporary collection of isolates from U.S. bloodstream infections from 2013 to 2016 (n = 444) and global urinary tract infections from 2014 to 2017 (n = 102) to be 25% and 24%, respectively. To maximize immunogenicity of the serotype O25b O antigen, we investigated glycoconjugate properties, including CRM197 carrier protein cross-linking (single-end versus cross-linked "lattice") and conjugation chemistry (reductive amination chemistry in dimethyl sulfoxide [RAC/DMSO] versus ((2-((2-oxoethyl)thio)ethyl)carbamate [eTEC] linker). Using opsonophagocytic assays (OPAs) to measure serum functional antibody responses to vaccination, we observed that higher-molecular-mass O25b long-chain lattice conjugates showed improved immunogenicity in mice compared with long- or short-chain O antigens conjugated via single-end attachment. The lattice conjugates protected mice from lethal challenge with acapsular O25b ST131 strains as well as against hypervirulent O25b isolates expressing K5 or K100 capsular polysaccharides. A single 1-µg dose of long-chain O25b lattice conjugate constructed with both chemistries also elicited robust serum IgG and OPA responses in cynomolgus macaques. Our findings show that key properties of the O-antigen carrier protein conjugate such as saccharide epitope density and degree of intermolecular cross-linking can significantly enhance functional immunogenicity.

Impact of Purkinje Cell Simple Spike Synchrony on Signal Transmission from Flocculus.

Purkinje cells (PCs) in the cerebellar flocculus carry rate-coded information that ultimately drives eye movement. Floccular PCs lying nearby each other exhibit partial synchrony of their simple spikes (SS). Elsewhere in the cerebellum, PC SS synchrony has been demonstrated to influence activity of the PCs' synaptic targets, and some suggest it constitutes another vector for information transfer. We investigated in the cerebellar flocculus the extent to which the rate code and PC synchrony interact. One motivation for the study was to explain the cerebellar deficits in ataxic mice like tottering; we speculated that PC synchrony has a positive effect on rate code transmission that is lost in the mutants. Working in transgenic mice whose PCs express channelrhodopsin, we exploited a property of optogenetics to control PC synchrony: pulsed photostimulation engenders stimulus-locked spiking, whereas continuous photostimulation engenders spiking whose timing is unconstrained. We photoactivated flocculus PCs using pulsed stimuli with sinusoidally varying timing vs. continuous stimuli with sinusoidally varying intensity. Recordings of PC pairs confirmed that pulsed stimuli engendered greater PC synchrony. We quantified the efficiency of transmission of the evoked PC firing rate modulation from the amplitudes of firing rate modulation and eye movement. Rate code transmission was slightly poorer in the conditions that generated greater PC synchrony, arguing against our motivating speculation regarding the origin of ataxia in tottering. Floccular optogenetic stimulation prominently augmented a 250-300 Hz local field potential oscillation, and we demonstrate relationships between the oscillation power and the evoked PC synchrony.

The Dominance of Candida auris: A Single-center Experience of 79 Episodes of Candidemia from Western India.

Introduction: Invasive candidiasis is a serious infection seen in hospitalized or immunocompromised patients. Mortality rates for candidemia can be as high as 30-60%. Candida auris is an emerging species of Candida and is increasingly becoming a global public health problem. Methods: This was a retrospective observational study, in which we analyzed 79 episodes of candidemia. Blood cultures were done using the Bactec™ FX blood culturing instrument (Becton, Dickinson and Company Sparks, Maryland, USA). Species identification was done using VITEK® 2 YST panels (bioMérieux Inc., Durham, North Carolina, USA). Antifungal susceptibility testing was performed using VITEK® 2 AST-YSO8 panels (bioMérieux Inc., Durham, North Carolina, USA). Results: Among the 79 episodes, the most common species was found to be C. auris (43.03% of all the episodes). Candida tropicalis was found to be the second most common species in patients admitted to our hospital with candidemia. All the isolates of C. auris were resistant to fluconazole, while 32.35 % of the isolates were also resistant to amphotericin B. Crude mortality in patients with C. auris candidemia was higher than the crude mortality for the other species. Conclusion: This is the first study from India where C. auris was seen as the most predominant species among patients admitted with candidemia. This is a serious issue given the high rates of fluconazole resistance, mortality, and cost of therapy associated with C. auris bloodstream infections. Urgent attention needs to be diverted to infection control practices and antimicrobial stewardship programs. How to cite this article: Prayag PS, Patwardhan S, Panchakshari S, Rajhans PA, Prayag A. The Dominance of Candida auris: A Single-center Experience of 79 Episodes of Candidemia from Western India. Indian J Crit Care Med 2022;26(5):560-563.

Hereditary ovarian tumour syndromes: current update on genetics and imaging.

Hereditary ovarian tumour syndromes are a diverse group of hereditary syndromes characterised by the development of specific histotypes of ovarian neoplasms. While BRCA syndromes are exclusively associated with high-grade serous carcinomas, patients with Lynch syndrome show a preponderance of endometrioid subtype of ovarian and endometrial carcinomas. Distinct non-epithelial phenotypes, such as sex cord stromal tumours with annular tubules, Sertoli-Leydig cell tumours, and small cell carcinoma of the hypercalcaemic type occur in patients with Peutz-Jeghers, DICER1, and rhabdoid tumour predisposition syndromes, respectively. Gorlin-Goltz syndrome is characterised by the development of bilateral, multiple ovarian fibromas in 14-24% of patients. Ovarian steroid cell tumours and broad ligament papillary cystadenomas are characteristically found in women with von Hippel-Lindau syndrome. Recent studies have allowed the characterisation of tumour genetics and associated oncological pathways that contribute to tumourigenesis. Implications of the diagnosis of these syndromes on screening, management, and prognosis are discussed.

COVID-19 Combat Fatigue among the Healthcare Workers: The Time for Retrospection and Action.

The present pandemic caused by the novel coronavirus has battered the healthcare infrastructure all around the globe. The doctors, nurses, and healthcare staff-the COVID warriors-have plunged themselves in line of fire to keep the population safe and alive. Around 87,000 healthcare workers (HCWs) have been infected and 573 have died till August in India alone. With no sight of pandemic ebbing anytime soon and patient load in hospitals refusing to come down, combat fatigue has set in these HCWs. The very people whose life mission is caring for others are on the verge of collective collapse physically and emotionally. There is an urgent need to retrospect the problems faced by the HCWs in the previous months, recognize, and preventive measures initiated at the earliest to prevent further loss and burnout among these battle-hardened frontline soldiers. How to cite this article: Rajhans PA, Godavarthy P. COVID-19 Combat Fatigue among the Healthcare Workers: The Time for Retrospection and Action. Indian J Crit Care Med 2021;25(1):3-5.

Intravenous Methylene Blue as a Rescue Therapy in the Management of Refractory Hypoxia in COVID-19 ARDS Patients: A Case Series.

Objectives: To describe the clinical outcomes of hypoxic coronavirus disease 2019 (COVID-19) patients treated with intravenous methylene blue (MB) in a tertiary care hospital. Materials and methods: We conducted a case series of 50 patients with hypoxic COVID-19 treated with intravenous MB admitted to our hospital between June 01 and September 10, 2020. Intravenous MB was administered as rescue therapy in dosage of 1 mg/kg body weight, with a maximum of five doses, to patients with high oxygen requirements (SpO2/FiO2 <200) apart from the standard of care after obtaining G6PD levels. Data were abstracted from multiple electronic data sources or patient charts to provide information on patient characteristics, clinical and laboratory variables and outcomes. Results: The median age of the patients was 53.3 (range 25-74 years) and most patients (74%) were men. About 68% of patients had pre-existing comorbidity. Median SpO2/FiO2 ratio progressively improved from 132.5 (predose) to 284 before the terminal event (death or discharge), ventilator-free days, and decrease in the proinflammatory biochemical parameter was significantly higher after the second dose of MB. A total of six patients out of 50 required invasive mechanical ventilation (IMV). Thirty patients were discharged with a recovery rate of 60%, while 20 patients succumbed to the illness. There was no major side effect or adverse event reported in any of the patients. Conclusion: MB due to its polypharmacological action against SARS-CoV-2, an inexpensive and widely available drug with minimal side effects, has a significant potential in the treatment of COVID-19. How to cite this article: Mahale N, Godavarthy P, Marreddy S, Gokhale SD, Funde P, Rajhans PA, et al. Intravenous Methylene Blue as a Rescue Therapy in the Management of Refractory Hypoxia in COVID-19 ARDS Patients: A Case Series. Indian J Crit Care Med 2021;25(8):934-938.

Risk of Distal Embolization From tPA (Tissue-Type Plasminogen Activator) Administration Prior to Endovascular Stroke Treatment.

BACKGROUND AND PURPOSE: In large artery occlusion stroke, both intravenous (IV) tPA (tissue-type plasminogen activator) and endovascular stroke treatment (EST) are standard-of-care. It is unknown how often tPA causes distal embolization, in which a procedurally accessible large artery occlusion is converted to a more distal and potentially inaccessible occlusion. METHODS: We analyzed data from a decentralized stroke telemedicine program in an integrated healthcare delivery system covering 21 hospitals, with 2 high-volume EST centers. We captured all cases sent for EST and examined the relationship between IV tPA administration and the rate of distal embolization, the rate of target recanalization (modified Treatment in Cerebral Infarction scale 2b/3), clinical improvement before EST, and short-term and long-term clinical outcomes. RESULTS: Distal embolization before EST was quite common (63/314 [20.1%]) and occurred more often after IV tPA before EST (57/229 [24.9%]) than among those not receiving IV tPA (6/85 [7.1%]; P<0.001). Distal embolization was associated with an inability to attempt EST: after distal embolization, 26/63 (41.3%) could not have attempted EST because of the new clot location, while in cases without distal embolization, only 8/249 (3.2%) were unable to have attempted EST (P<0.001). Among patients who received IV tPA, 13/242 (5.4%) had sufficient symptom improvement that a catheter angiogram was not performed; 6/342 (2.5%) had improvement to within 2 points of their baseline NIHSS. At catheter angiogram, 2/229 (0.9%) of patients who had received tPA had complete recanalization without distal embolization. Both IV tPA and EST recanalization were associated with improved long-term outcome. CONCLUSIONS: IV tPA administration before EST for large artery occlusion is associated with distal embolization, which in turn may reduce the chance that EST can be attempted and recanalization achieved. At the same time, some IV tPA-treated patients show symptomatic improvement and complete recanalization. Because IV tPA is associated with both distal embolization and improved long-term clinical outcome, there is a need for prospective clinical trials testing the net benefit or harm of IV tPA before EST.

Antimicrobial peptide polymers: no escape to ESKAPE pathogens-a review.

Antimicrobial resistance (AMR) is one of the significant clinical challenges and also an emerging area of concern arising from nosocomial infections of ESKAPE pathogens, which has been on the rise in both the developed and developing countries alike. These pathogens/superbugs can undergo rapid mutagenesis, which helps them to generate resistance against antimicrobials in addition to the patient's non-adherence to the antibiotic regimen. Sticking to the idea of a 'one-size-fits-all' approach has led to the inappropriate administration of antibiotics resulting in augmentation of antimicrobial resistance. Antimicrobial peptides (AMPs) are the natural host defense peptides that have gained attention in the field of AMR, and recently, synthetic AMPs are well studied to overcome the drawbacks of natural counterparts. This review deals with the novel techniques utilizing the bacteriolytic activity of natural AMPs. The effective localization of these peptides onto the negatively charged bacterial surface by using nanocarriers and structurally nanoengineered antimicrobial peptide polymers (SNAPPs) owing to its smaller size and better antimicrobial activity is also described here.

A Novel Hexavalent Capsular Polysaccharide Conjugate Vaccine (GBS6) for the Prevention of Neonatal Group B Streptococcal Infections by Maternal Immunization.

BACKGROUND: Group B streptococcus (GBS) causes serious diseases in newborn infants, often resulting in lifelong neurologic impairments or death. Prophylactic vaccination of pregnant women prior to delivery could provide comprehensive protection, as early onset and late-onset disease and maternal complications potentially could be addressed. METHODS: Capsular polysaccharide conjugate vaccine GBS6 was designed using surveillance data yielded by whole-genome sequencing of a global collection of recently recovered GBS isolates responsible for invasive neonatal GBS disease. Capsular polysaccharides were isolated, oxidized using sodium periodate, and conjugated to CRM197 by reductive amination in dimethyl sulfoxide. Immune responses in mice and rhesus macaques were measured in a multiplex Luminex immunoglobulin G (IgG) assay and opsonophagocytic activity assays. RESULTS: The optimized conjugates were immunogenic, alone and in combination, in mice and rhesus macaques, inducing IgG antibodies that mediated opsonophagocytic killing. Active immunization of murine dams with GBS6 prior to mating resulted in serotype-specific protection of pups from a lethal challenge with GBS. Protection following passive administration of serotype-specific IgG monoclonal antibodies to dams demonstrated conclusively that anticapsular polysaccharide IgG alone is sufficient for protection. CONCLUSIONS: The findings support the ongoing clinical evaluation of maternal GBS6 vaccination as a potential alternative method to prevent GBS disease in infants.

Absence of the Musculocutaneous Nerve and Associated Compensation by the Median Nerve.

The musculocutaneous and median nerves frequently show variations from their normal course. The purpose of this paper is to report a rare variation, in which the right musculocutaneous nerve was absent. Consequently, the median nerve supplied motor innervation to the flexor compartment of the arm and sensory innervation to the lateral aspect of the forearm. The primary targets of this paper are orthopedic surgeons, anesthesiologists and radiologists. In cases of injuries to the upper limb, knowledge of these variations can assist them in avoiding misdiagnoses.

Recurrence after hospitalization for acute coronary syndrome among HIV-infected and HIV-uninfected individuals.

OBJECTIVES: We evaluated the association of HIV infection and immunodeficiency with acute coronary syndrome (ACS) recurrence, and with all-cause mortality as a secondary outcome, after hospitalization for ACS among HIV-infected and HIV-uninfected individuals. METHODS: We conducted a retrospective cohort study within Kaiser Permanente Northern California of HIV-infected and HIV-uninfected adults discharged after ACS hospitalization [types: ST-elevation myocardial infarction (STEMI), non-STEMI, or unstable angina] during 1996-2010. We compared the outcomes of ACS recurrence and all-cause mortality within 3 years, both overall by HIV status and stratified by recent CD4 count, with HIV-uninfected individuals as the reference group. Hazard ratios (HRs) were obtained from Cox regression models with adjustment for age, sex, race/ethnicity, year, ACS type, smoking, and cardiovascular risk factors. RESULTS: Among 226 HIV-infected and 86 321 HIV-uninfected individuals with ACS, HIV-infected individuals had a similar risk of ACS recurrence compared with HIV-uninfected individuals [HR 1.08; 95% confidence interval (CI) 0.76-1.54]. HIV infection was independently associated with all-cause mortality after ACS hospitalization overall (HR 2.52; 95% CI 1.81-3.52). In CD4-stratified models, post-ACS mortality was higher for HIV-infected individuals with CD4 counts of 201-499 cells/µL (HR 2.64; 95% CI 1.66-4.20) and < 200 cells/µL (HR 5.41; 95% CI 3.14-9.34), but not those with CD4 counts ≥ 500 cells/µL (HR 0.67; 95% CI 0.22-2.08), compared with HIV-uninfected individuals (P trend < 0.001). CONCLUSIONS: HIV infection and immunodeficiency were not associated with recurrence of ACS after hospitalization. All-cause mortality was higher among HIV-infected compared with HIV-uninfected individuals, but there was no excess mortality risk among HIV-infected individuals with high CD4 counts.

In silico prediction of short hairpin RNA and in vitro silencing of activin receptor type IIB in chicken embryo fibroblasts by RNA interference.

Gene silencing by RNA interference is extensively used reverse genetic approach to analyse the implications of any gene in mammalian systems. The silencing of the Activin type IIB receptor belonging to transforming growth factor beta superfamily has demonstrated increase in muscle growth in many species. We designed five short hairpin RNA constructs targeting coding region of chicken ACTRIIB. All the shRNAs were transfected into chicken embryo fibroblast cells and evaluated their silencing efficiency by real time PCR and western blotting. Initially the computational analysis of target region and shRNA constructs was undertaken to predict sequence based features (secondary structures, GC% and H-b index) and thermodynamic features (ΔGoverall, ΔGduplex, ΔGbreak-target, ΔGintra-oligomer, ΔGinter-oligomer and ΔΔGends). We determined that all these predicted features were associated with shRNA efficacy. The invitro analysis of shRNA constructs exhibited significant (P < 0.05) reduction in the levels of ACTRIIB at mRNA and protein level. The knock down efficiency of shRNAs varied significantly (P < 0.001) from 83% (shRNA 1) to 43% (shRNA 5). All the shRNAs up regulated the myogenic pathway associated genes (MyoD and MyoG) significantly (P < 0.05). There was significant (P < 0.05) up-regulation of IFNA, IFNB and MHCII transcripts. The ACTRIIB expression was inversely associated with the expression of myogenic pathway and immune response genes. The anti ACTRIIB shRNA construct 1 and 3 exhibited maximum knock down efficiency with minimal interferon response, and can be used for generating ACTRIIB knockdown chicken with higher muscle mass.

Irradiation-Induced Compositional Effects on Human Bone After Extracorporeal Therapy for Bone Sarcoma.

The present study investigates Raman scattering of human bone irradiated with 50 Gy single dose during therapeutic treatment of Ewing and Osteosarcoma. Bone quality was evaluated via mineral-to-matrix ratio, degree of crystallinity, change in amount of calcium, and carbonate substitution. Alteration in collagen and its cross-links was quantified through second-derivative deconvolution of Amide I peak. A dose of 50 Gy radiation leads to almost 50% loss of mineral content, while maintaining mineral crystallinity, and small changes in carbonate substitution. Deconvolution of Amide I suggested modifications in collagen structure via increase in amount of enzymatic trivalent cross-linking (p < 0.05). Overall irradiation led to detrimental effect on bone quality via changes in its composition, consequently reducing its elastic modulus with increased plasticity. The study thus quantifies effect of single-dose 50 Gy radiation on human bone, which in turn is necessary for designing improved radiation dosage during ECRT and for better understanding post-operative care.

Isolation and analysis of the molecular epidemiology and zoonotic significance of Mycobacterium tuberculosis in domestic and wildlife ruminants from three states in India.

The majority of tuberculosis cases in ruminants are caused by Mycobacterium bovis (MB). However, in this study, the authors reported the isolation of Mycobacterium tuberculosis (MT) from bovine milk, nasal swabs and post-mortem tissue samples (n = 841) collected from cattle and buffaloes in the states of Telangana, Maharashtra and Gujarat in India in the period from 2010 to 2015. The isolates (n = 7) were confirmed as Mycobacterium due to their growth characteristics and colony morphology in a commercial liquid medium Mycobacterial Growth Indicator Tube (MGIT)™ employing the BD BACTEC™ MGIT™ 960 system and the Löwenstein-Jensen (LJ) medium supplemented with glycerol but not with sodium pyruvate, and BD-DIFCO™ Middlebrook 7H10 agar containing oleic albumin dextrose catalase (OADC). These isolates were initially identified as members of the M. tuberculosis complex (MTC) using a commercial nested polymerase chain reaction (PCR) kit based on the IS6110 MTC specific nucleotide sequence. The isolates were confirmed as MT using three commercial line probe assay kits, were further genotyped, and the spoligotypes identified were of East African Indian (EAI) 3_IND, EAI5, Central-Asian (CAS) 1_DELHI, U and T1 lineages. Two MT isolates from one antelope (Antilope cervipara) andone gazelle (Gazella bennettii) from Gujarat, which were identified previously, were spoligotyped during this study and identified as belonging to EAI3_IND and EAI5 lineages, respectively. The epidemiological significance and zoonotic implications of regional presence and documentation of the same or two differents poligotypes in different species within the family Bovidae as well as humans is discussed.

La majorité des cas de tuberculose chez les ruminants sont dus à Mycobacterium bovis. Néanmoins, les auteurs rapportent les résultats d'une étude réalisée de 2010 à 2015 en Inde (états de Telangana, Maharashtra et Gujarat), au cours de laquelle Mycobacterium tuberculosis a été isolé à partir de lait de vache ainsi que d'écouvillons nasaux et de prélèvements tissulaires postmortem (n = 841) collectés sur des bovins et des buffles. L'appartenance des isolats au genre Mycobacterium a été confirmée par l'observation des caractéristiques de croissance des colonies et de leur morphologie dans un milieu de culture liquide du commerce (Mycobacterial Growth Indicator Tube [MGIT]™ : tube avec indicateur de croissance mycobactérienne) en utilisant l'automate BD BACTEC™MGIT™ 960 et un milieu de Lowenstein-Jensen additionné de glycérol mais sanspyruvate de sodium, ainsi qu'une gélose BD-DIFCO™ Middlebrook enrichie en acide oléique, albumine, dextrose et catalase (OADC). Dans un premier temps, les isolats ont été identifiés comme étant des membres du complexe M. tuberculosisau moyen d'une amplification en chaîne par polymérase nichée ciblant la séquence nucléotidique spécifique IS6110 du complexe M. tuberculosis. Trois kits commerciaux d'analyse de souches ont permis d'identifier les isolats comme étant M. tuberculosis ; il a ensuite été procédé à l'analyse des génotypes des souches de spoligotypes, lesquelles appartenaient aux lignées East African Indian (EAI) 3_IND,EAI5, Central-Asian (CAS) 1_DELHI, U et T1. Les spoligotypes de deux isolats de M. tuberculosis obtenus précédemment, provenant respectivement d'une antilope(Antilope cervipara) et d'une gazelle (Gazella bennettii) de l'état de Gujarat ont été analysés lors de la présente étude et identifiés comme étant respectivement de lignée EAI3_IND et EAI5. Les auteurs analysent l'importance épidémiologique et la portée zoonotique de la présence rapportée dans la région du même spoligotype ou de deux spoligotypes différents chez des espèces différentes de la famille des Bovidés ainsi que chez l'homme.

La mayoría de los casos de tuberculosis que afectan a los rumiantes son causados por Mycobacterium bovis (MB). En este estudio, sin embargo, los autores dan cuenta del aislamiento de Mycobacterium tuberculosis (MT) en muestras de leche, frotis nasales y tejidos obtenidos post-mortem (n = 841) de ganado vacuno y búfalos de los estados de Telangana, Maharashtra y Gujarat (India) entre 2010 y 2015. Se confirmó que los microorganismos aislados(n = 7) eran micobacterias por sus características de crecimiento y la morfología de las colonias cultivadas en medio líquido comercial Mycobacterial Growth Indicator Tube (MGIT)™ empleando el sistema BD BACTEC™ MGIT™ 960 y el medio Löwenstein-Jensen (LJ) suplementado con glicerol, pero no con piruvato sódico, y agar BD-DIFCO™ Middlebrook 7H10 con ácido oleico, albúmina, dextrosa y catalasa (OADC). Mediante una PCR (reacción en cadena de la polimerasa) anidada comercial basada en la secuencia nucleotídica IS6110 específica del complejo, se empezó por determinar que esos microorganismos pertenecían al complejo M. tuberculosis (MTC). Tras confirmar que se trataba de M. tuberculosis empleando tres ensayos comerciales con sondas en línea, se procedió a caracterizar su genotipo, lo que sirvió para identificar espoligotipos correspondientes a los siguientes linajes: East African Indian (EAI) 3_IND, EAI5, Central-Asian (CAS) 1_DELHI, U y T1. Durante el estudio se caracterizaron asimismo los espoligotipos de dos M. tuberculosis aislados previamente a partir de un antílope (Antilope cervipara) y una gacela (Gazella bennettii) de Gujarat, lo que permitió adscribirlos respectivamente a los linajes EAI3_IND y EAI5. Los autores exponen la importancia desde el punto de vista epidemiológico que tiene la presencia comprobada en la región del mismo espoligotipo o de dos espoligotipos diferentes en distintas especies de la familia Bovidae, así como en el ser humano, y las consecuencias que de ahí se siguen por lo que respecta a posibles zoonosis.

Outcome Analysis of Neonates following Laparotomy for Acute Abdomen: A Prospective Study.

Background Low and middle-income countries (LMIC) bear the majority of the global pediatric surgical burden. Despite increasing volume of pediatric surgeries being performed in LMIC, outcomes of these surgeries in low and middle-income countries remain unknown due to lack of robust data. Objective The objective of our study was to collect data on and evaluate neonatal surgical outcomes at a tertiary level center in India. Method The surgical outcomes data of all neonates undergoing laparotomy between February 15, 2015 and October 14, 2015, at Sir Ganga Ram Hospital, New Delhi, India was collected prospectively. Descriptive statistics were used to determine the rates of various postoperative outcomes. Result A total of 37 neonatal surgeries were performed during the study period. The mean age of the neonates on the day of surgery was 7 days (range: 1-30 days). Most of the neonates (72.9%, n=27) were males. About 40% (n=15) of the neonates were preterm and 15 (40.5%) of them were small for gestational age. In our study, 10 neonates (28.6%) needed ventilation for 48 hours or less after surgery and 5 neonates (13.5%) were kept Nil per Oral (NPO) postoperatively for more than 10 days. Out of 37 neonates, 4 (10.80%) developed a surgical site infection and 8 neonates (21.6%) had postoperative sepsis. The in-hospital mortality rate among neonates undergoing laparotomy during the study period was 8.1 deaths per 100 neonates. Conclusion Co-ordination of care among pediatric surgeons, neonatologists, nursing and anesthesia team is required for optimal surgical outcome.

Debunking Occam's razor: Diagnosing multiple genetic diseases in families by whole-exome sequencing.

BACKGROUND: Recent clinical whole exome sequencing (WES) cohorts have identified unanticipated multiple genetic diagnoses in single patients. However, the frequency of multiple genetic diagnoses in families is largely unknown. AIMS: We set out to identify the rate of multiple genetic diagnoses in probands and their families referred for analysis in two national research programs in Canada. MATERIALS & METHODS: We retrospectively analyzed WES results for 802 undiagnosed probands referred over the past 5 years in either the FORGE or Care4Rare Canada WES initiatives. RESULTS: Of the 802 probands, 226 (28.2%) were diagnosed based on mutations in known disease genes. Eight (3.5%) had two or more genetic diagnoses explaining their clinical phenotype, a rate in keeping with the large published studies (average 4.3%; 1.4 - 7.2%). Seven of the 8 probands had family members with one or more of the molecularly diagnosed diseases. Consanguinity and multisystem disease appeared to increase the likelihood of multiple genetic diagnoses in a family. CONCLUSION: Our findings highlight the importance of comprehensive clinical phenotyping of family members to ultimately provide accurate genetic counseling.

Recent advancements and new perspectives in animal models for Neurocysticercosis immunopathogenesis.

Neurocysticercosis (NCC), one of the most common parasitic diseases of the central nervous system, is caused by Taenia solium. This parasite involves two hosts, intermediate hosts (pig and human) and a definitive host (human) and has various stages in its complex life cycle (eggs, oncosphere, cysticerci and adult tapeworm). Hence, developing an animal model for T. solium that mimics its natural course of infection is quite challenging. We have reviewed here the animal models frequently used to study immunopathogenesis of cysticercosis and also discussed their usefulness for NCC studies. We found that researchers have used mice, rats, guinea pigs, dogs, cats and pigs as models for this disease with varying degrees of success. Mice and rats models have been utilized extensively for immunopathogenesis studies due to their relative ease of handling and abundance of commercially available reagents to study these small animal models. These models have provided some very exciting results for in-depth understanding of the disease. Of late, the experimentally/naturally infected swine model is turning out to be the best animal model as the disease progression closely resembles human infection in pigs. However, handling large experimental animals has its own challenges and limitations.