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Characterization of crop-growing environments in relation to crop's genotypic performance is crucial to harness positive genotype-by-environment interactions (GEI) in systematic breeding programs. Given that, the study aimed to delineate the impact of diverse environments on crop phenology and yield traits of dwarf-statured field pea, pinpointing location(s) favoring higher yield and distinctiveness within breeding lines. We tested twelve field pea breeding lines across twenty locations in India, covering Central Zone (CZ), North Western Plain Zone (NWPZ), North Eastern Plain Zone (NEPZ), and Northern Hill Zone (NHZ). Across these locations, maximum and minimum temperatures during flowering (TMAXF, TMINF) and reproductive period (TMAXRP, TMINRP) ranged 18.9-28.3, 3.3-18.0, 15.0-30.8, and 7.9-22.1oC, respectively. Meanwhile, notable variations in phenological and agronomic traits (coefficient of variation) were observed: flowering (31%), days to maturity (21%), reproductive period (18%), grain yield (48%), and 100-seed weight (18%). Combined ANOVA demonstrated an oversized impact of environment (81%) on yield, while genotype and GEI effects were 2% and 14%, respectively. The variables TMINF, TMINRP, and cumulative growing degree-day showed positive correlations with yield, while extended vegetative and maturity durations negatively influenced yield (p < 0.05). Additionally, linear mixed-models and PCA results explained that instability in crop phenology had significant influence on field pea yield. Seed weight was markedly varied within the locations (9.9-20.8 g) and both higher and lower seed weights were associated with lower yields (Optimal = 17.1 g). HA-GGE biplot-based on environment focus-scaling demonstrated three mega-environments and specific locations viz. Kota (CZ), SK Nagar (CZ), Raipur (CZ), Sehore (CZ), and Pantnagar (NWPZ) as the ideal testing-environments with high efficiency in selecting new genotypes with wider adaptability. The study findings highlight distinct impact of environments on crop phenology and agronomic traits of field pea (dwarf-type), hold substantial value in designing efficient field pea (dwarf-type) breeding program at mega-environment scale.
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Carbon dioxide (CO2) conversion into value-added chemicals/fuels by utilizing solar energy is a sustainable way to mitigate our dependence on fossil fuels and stimulate a carbon-neutral economy. However, the efficient and affordable conversion of CO2 is still an ongoing challenge. Here, we report an interfacially synthesized visible-light-active Ni(II)-integrated covalent organic frameworks (TaTpBpy-Ni COFs) film as a photocatalyst for efficient CO2 conversion into carboxylic acid under ambient conditions. Notably, the TaTpBpy-Ni COFs film showed excellent photocatalytic activity for the carboxylation of various arylamines with CO2 to the corresponding arylcarboxylic acid via C-N bond activation under solar-light irradiation. Moreover, this carboxylation protocol exhibits mild reaction conditions and good functional group tolerance without the necessity of using stoichiometric metallic reductants. This work shows a benchmark example of not only the interfacially synthesized COFs film used as a photocatalyst for solar-light energy utilization but also the selective solar chemical production system of arylcarboxylic acid directly from CO2.
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Computational spectrometry is an emerging field that uses photodetection in conjunction with numerical algorithms for spectroscopic measurements. Compact single photodetectors made from layered materials are particularly attractive since they eliminate the need for bulky mechanical and optical components used in traditional spectrometers and can easily be engineered as heterostructures to optimize device performance. However, such photodetectors are typically nonlinear devices, which adds complexity to extracting optical spectra from their response. Here, we train an artificial neural network to recover the full nonlinear spectral photoresponse of a single GeSe-InSe p-n heterojunction device. The device has a spectral range of 400 to 1100 nm, a small footprint of ~25 × 25 square micrometers, and a mean reconstruction error of 2 × 10-4 for the power spectrum at 0.35 nanometers. Using our device, we demonstrate a solution to metamerism, an apparent matching of colors with different power spectral distributions, which is a fundamental problem in optical imaging.
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Our cohort study aimed to compare serum C-reactive protein (CRP) and procalcitonin (PCT) levels in children with community-acquired pneumonia defined by WHO. The former differentiated between pneumonia and severe pneumonia while the latter was better for the outcome of pneumonia.
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Biomarcadores , Proteína C-Reactiva , Infecciones Comunitarias Adquiridas , Neumonía , Polipéptido alfa Relacionado con Calcitonina , Índice de Severidad de la Enfermedad , Humanos , Polipéptido alfa Relacionado con Calcitonina/sangre , Proteína C-Reactiva/análisis , Infecciones Comunitarias Adquiridas/sangre , Infecciones Comunitarias Adquiridas/diagnóstico , Biomarcadores/sangre , Masculino , Femenino , Preescolar , Neumonía/sangre , Neumonía/diagnóstico , Niño , Lactante , Estudios de Cohortes , Valor Predictivo de las PruebasRESUMEN
Pulmonary mucormycosis is a rare but highly lethal fungal infection, usually affecting immunocompromised patients. Pulmonary mucormycosis was also a critical problem that complicated the later part of the clinical course of COVID-19 in India. Early diagnosis of the disease, combined with aggressive treatment, is crucial for patient survival. Fibreoptic bronchoscopy is a useful procedure for diagnosis of pulmonary mucormycosis, but image-guided percutaneous biopsy efficiently samples lesions abutting the chest wall. Biopsy is more yielding than cultures and imaging guided biopsy is required for lesions that cannot be microbiologically confirmed by fibreoptic bronchoscopy. We present a case series of four patients of pulmonary mucormycosis in whom ultrasound guided biopsy clinched the diagnosis. All the four patients were poor surgical candidates and underwent medical management with antifungal agents, and had successful clinical recovery and radiological resolution. Our case series illustrates the utility of ultrasound guided percutaneous biopsy as a diagnostic tool for sampling cavitatory disease due to pulmonary mucormycosis, when fibreoptic bronchoscopy failed to yield a diagnosis and the beneficial role antifungal agents as salvage therapy in poor surgical candidates.
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Mucormicosis , Humanos , Antifúngicos/uso terapéutico , Biopsia , Broncoscopía , Biopsia Guiada por Imagen , Mucormicosis/diagnóstico por imagen , Mucormicosis/tratamiento farmacológico , Ultrasonografía IntervencionalRESUMEN
OBJECTIVE: To study the prevalence of abnormal renal functions among children living with HIV (CLHIV) receiving tenofovir disoproxil fumarate (TDF) containing antiretroviral therapy (ART). METHODS: A prospective, observational study was conducted among CLHIV aged 10 years to 21 years attending the pediatric HIV clinic. We included CLHIV weighing ≥ 30 kg who had been receiving TDF-containing regimens for at least 6 months, with estimated glomerular filtration rate (eGFR) > 60 ml/min/m2 at enrolment and for whom baseline laboratory parameters were available before starting ART. Clinical and laboratory parameters like serum creatinine, serum phosphate, urinary protein and glucose estimation, CD4 count and viral load were noted from records. The mean change in serum creatinine, estimated glomerular filtration rate (eGFR), creatinine clearance, serum phosphate, and presence of urinary glucose and protein by dipstick were assessed at 3- and 12-months follow-up. RESULTS: We enrolled 70 patients with mean (SD) age 14.99 (2.45) years who had been receiving TDF-based ART for a mean (SD) duration of 14.60 (12.80) months. At 3-months and 12-months follow-up, 32.85% and 41.42% patients, respectively, had eGFR below 90 mL/min/1.73m2, while 4.2% and 2.8% patients, respectively, had eGFR between 50-60 mL/min/1.73m2. One patient had creatinine clearance below 50 mL/min/1.73m2. Four patients had hypophosphatemia at the first and last follow-up respectively, and five patients had proteinuria. There was no statistically significant change in CD4 counts, serum potassium, or serum uric acid during study duration. CONCLUSION: TDF-containing ART regimen is associated with decreased eGFR, creatinine clearance and proteinuria.
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Fármacos Anti-VIH , Infecciones por VIH , Niño , Humanos , Adolescente , Tenofovir/efectos adversos , Creatinina/farmacología , Creatinina/uso terapéutico , Fármacos Anti-VIH/efectos adversos , Estudios Prospectivos , Ácido Úrico/farmacología , Ácido Úrico/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Proteinuria , Tasa de Filtración Glomerular , Fosfatos/uso terapéutico , Glucosa/farmacología , Glucosa/uso terapéuticoRESUMEN
BACKGROUND: Immediate start of antiretroviral treatment (ART) among non-hospitalized outpatient children living with HIV may improve or worsen clinical outcomes due to immune reconstitution. OBJECTIVE: Role of immediate versus post-stabilization start of antiretroviral treatment in children and youths living with HIV on CD4 count and viral load suppression. METHODS: This was a single blinded, randomized controlled trial conducted on outpatients attending a tertiary care hospital associated HIV clinic in North India. We enrolled ART-naive children and youths living with HIV aged 18 months to 21 years in a 1:1 ratio. Block randomization was done using computerized software. Children and youths living with HIV were either started with ART on diagnosis immediately within 24 h (Group A) or post stabilization at 2 weeks (Group B) as per National AIDS Control Organization (NACO) India guidelines. Both groups were comparable for baseline characteristics. RESULTS: There was no significant difference seen in CD4 counts between two groups at 6 months follow up. CD4 count increased significantly in immediate group but not in post-stabilization group at 6 months. No significant changes/differences was seen in WHO clinical staging or anthropometry; one patient developed tuberculosis in both groups. Viral load at 6 months in both the groups did not differ significantly. CONCLUSION: Immediate ART in children and youths living with HIV results in significant increase in CD4 count at 6 months follow up exemplifying immunological response to ART.
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Fármacos Anti-VIH , Infecciones por VIH , Niño , Humanos , Adolescente , Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Recuento de Linfocito CD4 , Terapia Antirretroviral Altamente Activa/métodos , Antirretrovirales/uso terapéutico , Carga Viral , IndiaRESUMEN
Cases of drowning at home of unsupervised infants and toddlers in buckets have been reported elsewhere but little research on this largely preventable death in India exists. We performed a descriptive analysis on the basis of Google search of published news report in leading Indian newspapers or news channels. Data were collected employing a pre-determined tool. Between April 2016 and March 2022, we found 18 such cases. The large majority were between 12 and 18 months of age (12/18). This little recognized source of unintentional injury is eminently avoidable, necessitating both public and parental attention and awareness.
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Lesiones Accidentales , Ahogamiento , Humanos , Lactante , Preescolar , Ahogamiento/epidemiología , India/epidemiologíaRESUMEN
Background: The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public health care providers in the fight against tuberculosis using international health care standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. Methods: We conducted key informant interviews with 20 participants, 14 of whom were from private clinics, polyclinics, and hospitals where the PPM approach was used, two from government hospitals, and four from policymakers. All data were audio-recorded, transcribed, and translated into English. The transcripts of the interviews were manually organized, and themes were generated and categorized into 1. TB case detection, 2. patient-related barriers, and 3. health-system-related barriers. Results: A total of 20 respondents participated in the study. Barriers to PPM were identified into following three themes: (1) Obstacles related to TB case detection, (2) Obstacles related to patients, and (3) Obstacles related to health-care system. PPM implementation was challenged by following sub-themes that included staff turnover, low private sector participation in workshops, a lack of trainings, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. Conclusion: Government stakeholders can significantly benefit by applying a proactive role working with the private in monitoring and supervision. The joint efforts with private sector can then enable all stakeholders to follow the government policy, practice and protocols in case finding, holding and other preventive approaches. Future research are essential in exploring how PPM could be optimized.
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Manejo de Caso , Tuberculosis , Humanos , Estudios de Factibilidad , Nepal , Asociación entre el Sector Público-Privado , Tuberculosis/diagnóstico , Tuberculosis/prevención & controlRESUMEN
BACKGROUND: Overweight is a global public health problem with increasing trend especially in middle to lower socioeconomic country like Nepal. The nutritional status of adolescents being shaped by socio-cultural, environmental, and economic factors has also been impacted by their food habits and level of physical activity. The current nutritional shift and rapid urbanization had emerged overweight as an additional burden for consistently prevalent undernutrition issues. So, the study aimed to identify the prevalence of and risk factors for overweight among school adolescents. METHODS: A cross-sectional analytical study was carried out among random sample of 279 adolescents from nine schools of a Sub-metropolitan city of Nepal. The anthropometric measurement of the height and the weight were taken as per the standard. The odds ratio with a 95% CI was calculated and a p-value of ≤0.05 was considered as cut off for statistical significance by fitting into the final multivariable logistic regression. RESULTS: The overall prevalence of overweight was obtained as 9.31% (95% CI: 6.40-13.3). The early aged adolescents were more overweight than compared to middle-aged adolescents (AOR: 0.27, CI: 0.028-2.67) and late adolescents (AOR: 0.66, CI: 0.068-6.44) respectively. Similarly, adolescents residing in rural areas had 0.35 (AOR = 0.33, CI: 0.030-3.71) odds of being overweight compared to their counterparts. Adolescents with sedentary behavior were about 4 times (AOR = 3.51, CI: 0.79-15.54) more likely of being overweight than their counterparts. CONCLUSION: Overweight among adolescents residing in urban areas has emerged as an alarming issue due to their unhealthy lifestyle habits. It is therefore pertinent to emphasize adolescents to maintain healthy weight status through health food habits and physical activity.
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Sobrepeso , Adolescente , Humanos , Persona de Mediana Edad , Anciano , Nepal/epidemiología , Estudios Transversales , Sobrepeso/epidemiología , Prevalencia , Factores de RiesgoRESUMEN
BACKGROUND: Left Ventricular Diastolic Dysfunction is considered a critical link between hypertension and heart failure, particularly in individuals with heart failure and preserved ejection fraction. The aim of this study is to assess the prevalence and factors associated with clinical parameters of left ventricular diastolic dysfunction in patients with essential hypertension. METHODS: A hospital-based cross-sectional study was done among 68 newly diagnosed and known hypertensive patients visiting out patientdepartmentat Bir hospital. Patients who meet the inclusion criteria were chosen alternatively by referring OPD register. Patients with hypertension had undergone echocardiography to see whether left ventricular diastolic dysfunction was present and was compared to other clinical parameters like age, sex, body mass index, and dyslipidemia using the student t-test/chi-square test. RESULTS: The prevalence of left ventricular diastolic dysfunction in essential hypertensive patients was 33.8%. About 25% patients had grade 1; 7.4% and 1.5% of patients had grade 2 and grade 3 diastolic dysfunction respectively. Patients who had a duration of hypertension of more than five years were more than nine times (OR 9.14; 2.89-28.87) more likely to have Left ventricular diastolic dysfunction. Age and Body Mass Index were found statistically significant with diastolic dysfunction (P<0.05). CONCLUSIONS: Left ventricular diastolic dysfunction was found prevalent in hypertensive patients. Age, Body mass index, Dyslipidemia and Duration of hypertension were found to be statistically significant with diastolic dysfunction Keywords: Diastolic dysfunction; hypertension; Nepal; prevalence.
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Insuficiencia Cardíaca , Hipertensión , Disfunción Ventricular Izquierda , Humanos , Prevalencia , Estudios Transversales , Nepal/epidemiología , Disfunción Ventricular Izquierda/epidemiología , Disfunción Ventricular Izquierda/diagnóstico , Hipertensión Esencial/complicaciones , Hipertensión Esencial/epidemiología , Hipertensión/epidemiología , Insuficiencia Cardíaca/epidemiologíaRESUMEN
BACKGROUND: Mal-positioning of cervical screws risks neurovascular injury so, it is necessary to understand cervical pedicle morphology for pedicle screw fixation in the region. The risks of pedicle screw insertion in the cervical spine can be mitigated by a three-dimensional appreciation of pedicle anatomy. The study aims to determine the morphology of the sub axial cervical spine pedicles in Nepalese Population based on computerized tomography. METHODS: A cross-sectional study using computerized tomography scans of the spine was made among the randomly selected 87 patients who had visited National Trauma center, Kathmandu, Nepal with vertebral fracture other than cervical vertebrae. Patient was examined as per Advanced Trauma Life support protocol and neurological assessment. Measurement was done from the third cervical vertebra down to the seventh cervical vertebra in computer with standard software in the department of radiology from where all the computerized tomography scan reporting are done. RESULTS: The mean pedicle length ranged from 4.41 mm at C3 to 4.96 mm at C7 where mean pedicle height ranged from 4.64 at C3 to 5.12 at C7. Pedicle length, pedicle height and pedicle width were observed to be statistically significant with gender. The pedicle axial length of C3 and C7 vertebra were found significant with gender. All parameters were found to be greater in male compared to female. CONCLUSIONS: The study revealed that pedicle length, pedicle height, pedicle width, pedicle axial length increased from third to seventh cervical however, transverse angulation increased up to fifth vertebra and decreased to seventh vertebra.
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Tornillos Óseos , Tomografía Computarizada por Rayos X , Humanos , Masculino , Femenino , Nepal , Estudios Transversales , Tomografía Computarizada por Rayos X/métodos , Vértebras Cervicales/diagnóstico por imagen , Vértebras Cervicales/cirugía , Vértebras Cervicales/anatomía & histologíaRESUMEN
Burgeoning morbidity and mortality due to COVID-19 pandemic including the peaks in outbreaks due to different variants have attracted global attention. Although the development and rolling out of vaccines have been impressive, low- and middle-income countries suffer from a double burden: (1) lack of adequate vaccines; and (2) low vaccine uptake (vaccine hesitancy). The main objective of this study was to explore perceptions around COVID-19 and vaccine hesitancy among urban and rural population in Western Nepal. A qualitative study was conducted in six urban wards of Pokhara municipality and four rural municipalities in Kaski district of Nepal. A semi-structured interview guide was used to interview participants who were selected purposively to explore the perceived burden of COVID-19 pandemic, roles, and contributions of vaccine. Nineteen interviews were conducted by telephone following a government recommendation to avoid face-to-face meetings. Audio-recorded interviews were thematically analysed after transcription and translation into English. COVID-19 is a major (public) health concern and affects people at an individual, societal and national level. People dreaded its health hazards and consequences and seemed to be compliant with public health measures such as maintaining social distance, wearing masks and maintaining hygiene. Vaccine was considered to be a major intervention to fight the pandemic, nonetheless, the rationale and benefits of vaccines were blemished by the perceived lack of the vaccine's effectiveness, duration of protection, and its potential side-events. Expedited development of vaccine was embraced with suspicion that vaccine may have incurred compromise in quality. Science and rationale behind vaccine were smeared by misinformation and clearly counteracting the misinformation were deemed critical. Providing information about vaccines through government entities (who are trusted) and respected individuals may engender trust and uptake of vaccine. Fighting off misinformation of COVID-19 is critical to curb the course of pandemic. Increased attention towards monitoring and investing in legitimacy of information and offering information through trusted sources can help improve the vaccine coverage.
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Introduction: Detecting low viral load has been a challenge in this pandemic, which has led to its escalated transmission. Complement activation has been implicated in pathogenesis of Covid-19 infection. Thus, evaluation of complement activation in suspected Covid-19 infection may help to detect infection and limit false negative cases thus limiting transmission of infection. We speculate that measuring C4b, produced from an activated complement system due to the presence of Covid-19 may help in its detection, even when the viral titers are low. Methods: Plasma C4b levels of symptomatic RT-PCR positive patients (cases, n = 40); symptomatic RT-PCR negative patients (n = 35) and asymptomatic RT-PCR negative controls (n = 40) were evaluated. Plasma C5b-9, IL-6, D-dimer and C1-Inhibitor (C1-INH) were also measured in cases and controls. ELISA kits were used for all measurements. Statistical analyses were carried out using Stata, version 12 (Stata Corp., Texas, USA). Results: C4b levels were found to be significantly increased in RT-PCR positive patients as compared to asymptomatic RT-PCR negative controls. RT-PCR negative but symptomatic patients still showed increased C4b levels. The significantly higher levels of C4b in cases with a cut-off value of ≥ 116 ng/ml with optimum sensitivity and specificity of 80% and 52% respectively is indicative of its possible use as an adjunct marker. Increased levels of D-dimer, IL6, along with decreased levels of C1-INH were found in cases compared to controls. Whereas, C5b-9 levels were not significantly raised in cases. Conclusions: The results of our study suggests that plasma C4b may help to detect infection in false negative cases of RT-PCR that escape detection owing to low viral load. However, to confirm it a large-scale study is needed. Supplementary Information: The online version contains supplementary material available at 10.1007/s12291-022-01033-z.
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Background: To conduct a meta-analysis with the aim of comparing the outcomes of antiviral prophylaxis and preemptive therapy for the prevention of cytomegalovirus (CMV) infection in liver transplant (LT) recipients. Methods: We searched databases for qualified studies up until March 2022. Finally, a meta-analysis was carried out using a fixed-effect or random-effect model based on the heterogeneity. Results: With a total of 1834 LT patients, the pooled incidence of CMV infection and CMV disease in the overall LT recipients using antiviral prophylaxis and preemptive therapy were 24.7% vs. 40.4% and 6.4% vs. 9.4%, respectively. Our meta-analysis exhibited a significant reduction in the incidence of CMV infection due to antiviral prophylaxis when compared to preemptive therapy in the high-risk group (OR: 6.67, 95% CI: 1.73, 25.66; p = 0.006). In contrast, there was a significant reduction in the incidence of late-onset of CMV disease in preemptive therapy compared to antiviral prophylaxis in the high-risk group (OR: 0.29, 95% CI: 0.12, 0.74; p = 0.009). However, the incidence of CMV disease, allograft rejection, graft loss, drug related adverse effects, opportunistic infections and mortality did not differ significantly between both the interventions (all p> 0.05). Conclusions: We found the use of antiviral prophylaxis, compared with preemptive therapy, is superior in controlling CMV infection and prolonging the time to CMV disease in LT recipients without an increased risk of opportunistic infections, allograft rejection, graft loss, drug related adverse effects, development of drug resistance, and mortality.
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Infecciones por Citomegalovirus , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Trasplante de Hígado , Infecciones Oportunistas , Humanos , Citomegalovirus , Trasplante de Hígado/efectos adversos , Infecciones por Citomegalovirus/prevención & control , Antivirales/uso terapéuticoRESUMEN
Background: The emergence of Enterococcus as an important nosocomial pathogen is mainly attributed to its inherent resistance to commonly used antibiotics and now in recent times, it has acquired resistance to other available therapeutic options as well. Materials and Methods: Enterococcus isolates from clinical samples received in the department of microbiology over a period of 1 year were included in the study. Isolates were identified and species determined by standard methods. Antibiotic susceptibility test was done by Kirby Bauer disc diffusion test. Epsilometer test was done to determine the minimum inhibitory concentration for vancomycin. Results: A total of 145 Enterococcus isolates were obtained; 73 (50.3%) isolates were identified as Enterococcus faecalis, 69 (47.5%) Enterococcus faecium, 2 (1.3%) Enterococcus durans and 1 (0.68%) as Enterococcus gallinarum. Most of the isolates were from urine samples (125, 86.2%); followed by pus (16, 11.03%). Vancomycin resistance was seen in 14 (9.6%) isolates while linezolid resistance was seen in 8 (5.5%) isolates. Conclusion: E. faecalis is the most common clinical species isolated from clinical samples and the emergence of linezolid-resistant enterococci from the hospital is a matter of concern as till now it is considered to be the last resort for treatment in patients infected with vancomycin-resistant enterococci.
Résumé Contexte: L'émergence d'Enterococcus en tant qu'agent pathogène nosocomial important est principalement attribuée à sa résistance inhérente aux antibiotiques couramment utilisés et, ces derniers temps, il a également acquis une résistance à d'autres options thérapeutiques disponibles. Matériels et Méthodes: des isolats d'entérocoques provenant d'échantillons cliniques reçus au service de microbiologie sur une période d'un an ont été inclus dans l'étude. Les isolats ont été identifiés et les espèces déterminées par des méthodes standard. Le test de sensibilité aux antibiotiques a été effectué par le test de diffusion sur disque de Kirby Bauer. Un test Epsilomètre a été effectué pour déterminer la concentration minimale inhibitrice de la vancomycine. Résultats: Au total, 145 isolats d'Enterococcus ont été obtenus ; 73 (50,3 %) isolats ont été identifiés comme Enterococcus faecalis, 69 (47,5 %) Enterococcus faecium, 2 (1,3 %) Enterococcus durans et 1 (0,68 %) comme Enterococcus gallinarum. La plupart des isolats provenaient d'échantillons d'urine (125 ; 86,2 % ); suivi de pus (16 ; 11,03 %). La résistance à la vancomycine a été observée dans 14 (9,6 %) isolats, tandis que la résistance au linézolide a été observée dans 8 (5,5 %) isolats. Conclusion: E. faecalis est l'espèce clinique la plus courante isolée à partir d'échantillons cliniques et l'émergence d'entérocoques résistants au linézolide à partir de l'hôpital est préoccupante car jusqu'à présent, elle est considérée comme le dernier recours pour le traitement des patients infectés par la vancomycine. entérocoques résistants. Mots-clés: Enterococcus faecalis, Enterococcus, entérocoques résistants au linézolide, entérocoques résistants à la vancomycine.
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Enterococcus faecium , Infecciones por Bacterias Grampositivas , Enterococos Resistentes a la Vancomicina , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Enterococcus faecalis , Infecciones por Bacterias Grampositivas/tratamiento farmacológico , Infecciones por Bacterias Grampositivas/epidemiología , Infecciones por Bacterias Grampositivas/microbiología , Humanos , Linezolid/farmacología , Linezolid/uso terapéutico , Pruebas de Sensibilidad Microbiana , Centros de Atención Terciaria , Vancomicina/farmacología , Vancomicina/uso terapéuticoRESUMEN
BACKGROUND: There is inconclusive evidence on the role of nebulized magnesium sulphate (MgSO4) in the management of acute asthma in paediatric population. OBJECTIVES: Whether the use of nebulized salbutamol with or without MgSO4 in the management of acute asthma results in clinically significant improvement in lung function in Indian children? The primary outcome measure was to assess improvements in peak expiratory flow rate (PEFR), heart rate, respiratory rate and SpO2. METHODS: This was a single centre; prospective double-blind randomized control trial conducted in paediatric intensive care unit of a tertiary care centre. Ninety children of 6-14 years with acute exacerbations of bronchial asthma were enrolled to receive either inhaled magnesium sulphate (95 mg) with salbutamol (5 mg) or inhaled salbutamol (5 mg) alone. All patients got three nebulizations done during the first hour at 20 min intervals, two nebulizations during the second hour at 30 min intervals, hourly for the next 2 h and then at 24 and 48 h. RESULTS: Eighty-five patients were finally analysed as per protocol analysis. The trial showed that PEFR increased gradually in both groups over the study duration, but it was statistically not significant. Heart rate decreased significantly in both groups over the study duration. Respiratory rate decreased significantly between the groups at 24 and 48 h only. SpO2 improved too in both groups but was not significant statistically. CONCLUSION: The addition of nebulized MgSO4 to salbutamol does not seem to result in improvement in lung function in the management of acute asthma in Indian children.
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Albuterol , Asma , Enfermedad Aguda , Administración por Inhalación , Albuterol/uso terapéutico , Asma/tratamiento farmacológico , Broncodilatadores/uso terapéutico , Niño , Método Doble Ciego , Humanos , India , Sulfato de Magnesio/uso terapéutico , Estudios ProspectivosRESUMEN
BACKGROUND: HIV infection is still a serious public health issue globally. Suboptimal vitamin D status is highly prevalent in HIV-infected children and adolescents throughout the world. OBJECTIVES: To evaluate the outcome of vitamin D supplementation on CD4 count in HIV-infected children and adolescents with suboptimal vitamin D status. METHODS: Vitamin D level of HIV-infected children and adolescents were measured at enrolment. Suboptimal vitamin D level was defined as 25(OH)D < 30 ng/ml. Vitamin D insufficiency and deficiency were defined as 21-29 and <20 ng/ml, respectively. Children with suboptimal vitamin D levels were supplemented with vitamin D. RESULTS: This was a single-centre, non-randomized comparative study enrolling 50 eligible participants. There were 20 patients who were vitamin D sufficient, 7 were vitamin D insufficient and 23 were found to be vitamin D deficient at enrolment. However, after supplementation, the status of sufficient remained same and 7 insufficient become sufficient, whereas in 23 deficient, 18 (78.3%) become sufficient and 5 (21.7%) become insufficient and this change was found statistically significant among the groups (χ2 = 6.52, p = 0.038). There was a significant improvement of CD4 count from baseline to 4 months in deficient group on vitamin D supplementation (p value < 0.001; 1.2-fold rise). No significant change was seen in vitamin D insufficient (p value = 0.791) and sufficient groups (p value = 0.168). CONCLUSION: Vitamin D should be supplemented in HIV-infected children on ART with low CD4 counts.
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Infecciones por VIH , Deficiencia de Vitamina D , Adolescente , Recuento de Linfocito CD4 , Niño , Colecalciferol , Suplementos Dietéticos , Infecciones por VIH/tratamiento farmacológico , Humanos , India/epidemiología , Vitamina D , Deficiencia de Vitamina D/tratamiento farmacológico , Deficiencia de Vitamina D/epidemiología , VitaminasRESUMEN
Covalent perylene frameworks (CPFs) with melamine linkages have newly received rising interest for a variety of applications because of nitrogen-rich content and high stability. Herein, we account a new simple strategy to in situ attain nitrogen-rich covalent perylene frameworks (NRCPFs) as highly active photo platforms for in situ bond formation between aryldiazonium salts and heteroarenes (C-H bond arylation) through the controlled photoredox route.
RESUMEN
OBJECTIVE: Undernutrition is one of the leading causes of morbidity and mortality among under-five children, particularly in low-and-middle-income countries. Since women, including mothers, are the primary caregivers of their children, their empowerment status can inherently influence children's nutritional status. Empowerment is, mainly, an intrinsic agency developed as an affective domain trajectory or attitude that guides the skill or behavior. This study aimed to assess the association between women's empowerment and nutritional status of their children. METHODS: A cross-sectional study was carried out among 300 mothers having children aged 6-59 month in rural municipalities of Kaski district in Nepal. Face to face interview and various anthropometric measurements were used to collect data. Chi-square test was performed to assess the association between women's empowerment and children's nutritional status, and multivariable logistic regression was used to assess the strength of association. RESULTS: Of 300 mothers having 6-59 months' children, nearly half (49%) were highly empowered while around 38% children were in poor nutritional status. More than one-fourth (26.7%) children were stunted, 7% were wasted, 17.7% were underweight, and in overall, nearly 38% were in poor nutrition. There was a five-fold increase in odds of wasting, thirty-fold increase in odds of stunting, and twenty-nine-fold increase in odds of underweight among children whose mothers had low empowerment status compared to their counterparts. CONCLUSION: Overall, this study exhibited that maternal empowerment strongly affected children's nutritional status, especially stunting and underweight. Thus, intrinsic factor, mainly education and community membership are suggested to empower them for making their own decisions. Interventions aiming to improve nutritional status of children should include women empowerment incorporating dimensions of material resources. Further empirical evidence is required from trials and cohort studies.