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.

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.

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.

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.

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.

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.

Tumor-suppressive p53 Signaling Empowers Metastatic Inhibitor KLF17-dependent Transcription to Overcome Tumorigenesis in Non-small Cell Lung Cancer.

Metastasis, which is controlled by concerted action of multiple genes, is a complex process and is an important cause of cancer death. Krüppel-like factor 17 (KLF17) is a negative regulator of metastasis and epithelial-mesenchymal transition (EMT) during cancer progression. However, the underlying molecular mechanism and biological relevance of KLF17 in cancer cells are poorly understood. Here, we show that tumor suppressor protein p53 plays an integral role to induce KLF17 expression in non-small cell lung cancer (NSCLC). p53 is recruited to the KLF17 promoter and results in the formation of p53-DNA complex. p53 enhances binding of p300 and favors histone acetylation on the KLF17 promoter. Mechanistically, p53 physically interacts with KLF17 and thereby enhances the anti-metastatic function of KLF17. p53 empowers KLF17-mediated EMT genes transcription via enhancing physical association of KLF17 with target gene promoters. Nutlin-3 recruits KLF17 to EMT target gene promoters and results in the formation of KLF17-DNA complex via a p53-dependent pathway. p53 depletion abrogates DNA binding affinity of KLF17 to EMT target gene promoters. KLF17 is critical for p53 cellular activities in NSCLC. Importantly, KLF17 enhances p53 transcription to generate a novel positive feedback loop. KLF17 depletion accelerates lung cancer cell growth in response to chemotherapy. Mechanistically, we found that KLF17 increases the expression of tumor suppressor genes p53, p21, and pRB. Functionally, KLF17 required p53 to suppress cancer cell invasion and migration in NSCLC. In conclusion, our study highlights a novel insight into the anti-EMT effect of KLF17 via a p53-dependent pathway in NSCLC, and KLF17 may be a new therapeutic target in NSCLC with p53 status.

Open access upper gastrointestinal endoscopy: a 2-year experience from 2001 to 2003.

BACKGROUND: The role of open access endoscopy in detecting serious diseases like malignancy and peptic ulcers is debated. We participated in an open access endoscopy service and this study details our experience. METHODS: The Cancer Society of Kashmir provided an open access upper gastrointestinal (GI) endoscopy service in Kashmir between 2001 and 2003. The records of patients who underwent endoscopy were analyzed. RESULTS: A total of 1,000 endoscopies were performed over a two-year period (average >40 endoscopies per month). Two-thirds of endoscopies were normal. Gastric (n = 30) and esophageal (n = 42) tumors were seen in 7.2 % of patients. The other common abnormality detected was peptic ulcer. No complications were reported during or immediately after the procedure. CONCLUSION: Open access upper GI endoscopy is a viable service option that can become more widely available.

Unusual case of methicillin resistant staphylococcus aureus and acanthamoeba keratitis in a non-contact lens wearer from Kashmir, India.

Acanthamoeba species can cause a chronic, progressive, ulcerative keratitis of the eye, which is not responsive to the usual antimicrobial treatment and is frequently mistaken for stromal herpes keratitis. Acanthamoeba keratitis continues to be a burgeoning and unsolved problem. Although soft contact lens wear is reported as the major risk factor in other parts of the world, reports from India suggest that acanthamoeba keratitis is more common among non-contact lens wearers. An unusual case of coinfection with Acanthamoeba and methicillin resistant staphylococcus aureus (MRSA) as causes of corneal keratitis in a contact lens wearer from Kashmir, India, is reported. Recent findings have shown that MRSA uses amoebae to spread, sidestepping hospital and other protection measures. Cysts of the isolated Acanthamoeba tolerated an incubation temperature of 40°C, indicating a pathogenic species. This case highlights the importance of culture methods in the diagnosis of corneal infection and the choice of treatment regimen.