Fungal diversity notes 1387-1511: taxonomic and phylogenetic contributions on genera and species of fungal taxa.

This article is the 13th contribution in the Fungal Diversity Notes series, wherein 125 taxa from four phyla, ten classes, 31 orders, 69 families, 92 genera and three genera incertae sedis are treated, demonstrating worldwide and geographic distribution. Fungal taxa described and illustrated in the present study include three new genera, 69 new species, one new combination, one reference specimen and 51 new records on new hosts and new geographical distributions. Three new genera, Cylindrotorula (Torulaceae), Scolecoleotia (Leotiales genus incertae sedis) and Xenovaginatispora (Lindomycetaceae) are introduced based on distinct phylogenetic lineages and unique morphologies. Newly described species are Aspergillus lannaensis, Cercophora dulciaquae, Cladophialophora aquatica, Coprinellus punjabensis, Cortinarius alutarius, C. mammillatus, C. quercoflocculosus, Coryneum fagi, Cruentomycena uttarakhandina, Cryptocoryneum rosae, Cyathus uniperidiolus, Cylindrotorula indica, Diaporthe chamaeropicola, Didymella azollae, Diplodia alanphillipsii, Dothiora coronicola, Efibula rodriguezarmasiae, Erysiphe salicicola, Fusarium queenslandicum, Geastrum gorgonicum, G. hansagiense, Helicosporium sexualis, Helminthosporium chiangraiensis, Hongkongmyces kokensis, Hydrophilomyces hydraenae, Hygrocybe boertmannii, Hyphoderma australosetigerum, Hyphodontia yunnanensis, Khaleijomyces umikazeana, Laboulbenia divisa, Laboulbenia triarthronis, Laccaria populina, Lactarius pallidozonarius, Lepidosphaeria strobelii, Longipedicellata megafusiformis, Lophiotrema lincangensis, Marasmius benghalensis, M. jinfoshanensis, M. subtropicus, Mariannaea camelliae, Melanographium smilaxii, Microbotryum polycnemoides, Mimeomyces digitatus, Minutisphaera thailandensis, Mortierella solitaria, Mucor harpali, Nigrograna jinghongensis, Odontia huanrenensis, O. parvispina, Paraconiothyrium ajrekarii, Parafuscosporella niloticus, Phaeocytostroma yomensis, Phaeoisaria synnematicus, Phanerochaete hainanensis, Pleopunctum thailandicum, Pleurotheciella dimorphospora, Pseudochaetosphaeronema chiangraiense, Pseudodactylaria albicolonia, Rhexoacrodictys nigrospora, Russula paravioleipes, Scolecoleotia eriocamporesi, Seriascoma honghense, Synandromyces makranczyi, Thyridaria aureobrunnea, Torula lancangjiangensis, Tubeufia longihelicospora, Wicklowia fusiformispora, Xenovaginatispora phichaiensis and Xylaria apiospora. One new combination, Pseudobactrodesmium stilboideus is proposed. A reference specimen of Comoclathris permunda is designated. New host or distribution records are provided for Acrocalymma fici, Aliquandostipite khaoyaiensis, Camarosporidiella laburni, Canalisporium caribense, Chaetoscutula juniperi, Chlorophyllum demangei, C. globosum, C. hortense, Cladophialophora abundans, Dendryphion hydei, Diaporthe foeniculina, D. pseudophoenicicola, D. pyracanthae, Dictyosporium pandanicola, Dyfrolomyces distoseptatus, Ernakulamia tanakae, Eutypa flavovirens, E. lata, Favolus septatus, Fusarium atrovinosum, F. clavum, Helicosporium luteosporum, Hermatomyces nabanheensis, Hermatomyces sphaericoides, Longipedicellata aquatica, Lophiostoma caudata, L. clematidis-vitalbae, Lophiotrema hydei, L. neoarundinaria, Marasmiellus palmivorus, Megacapitula villosa, Micropsalliota globocystis, M. gracilis, Montagnula thailandica, Neohelicosporium irregulare, N. parisporum, Paradictyoarthrinium diffractum, Phaeoisaria aquatica, Poaceascoma taiwanense, Saproamanita manicata, Spegazzinia camelliae, Submersispora variabilis, Thyronectria caudata, T. mackenziei, Tubeufia chiangmaiensis, T. roseohelicospora, Vaginatispora nypae, Wicklowia submersa, Xanthagaricus necopinatus and Xylaria haemorrhoidalis. The data presented herein are based on morphological examination of fresh specimens, coupled with analysis of phylogenetic sequence data to better integrate taxa into appropriate taxonomic ranks and infer their evolutionary relationships.

Comparative evaluation of carcass traits and meat quality in native Aseel chickens and commercial broilers.

A comprehensive study was conducted to analyse the meat quality attributes, composition and carcass traits in Aseel chickens and commercial broilers at market age on the basis of physiological age. A total of 20 Aseel (26 and 56 weeks) and 20 broiler (6 weeks) chickens were divided into two groups on a live weight basis, i.e. large (≥2.5 kg) and small (<2.5 kg) with 10 birds in each subgroup. The pH of meat did not show any significant variation between Aseel and broiler chickens. The meat from heavier birds had significantly higher pH. Shear force value and hydroxyproline contents were significantly higher in Aseel chickens. Aseel birds had significantly higher red (a*) colouration and lower lightness (L*) than broiler chickens. The texture and acceptability of Aseel meat were significantly higher. Scanning electron microscopy revealed that muscle fibres in Aseels were arranged in a more coiled pattern making the muscle tough. A larger amount of connective tissue was also observed between the muscle fibres compared with the broiler chickens. The dressing percentage was significantly higher in larger chickens. Commercial broilers recorded significantly higher meat proportion and lower proportion of bone. The meat:bone ratio was 1.07:1.0 in Aseel and 1.31-1.0 in broiler chicken. Breast muscle content was significantly lower in smaller Aseel chickens. Aseel chicken had stronger and heavier backs and shanks. Abdominal fat percentage was significantly lower in Aseel (0.73-0.78%). The study concluded that the firm texture of Aseel meat was due to the high collagen content and interlocking connective tissue between the muscle fibres. The texture and acceptability of Aseel meat was higher. Aseel cocks had strong legs, lean meat and less abdominal fat, making them a high-value meat bird in addition to their aggressive fighting ability.

Dengue Fever and Takotsubo Cardiomyopathy.

A young male admitted for dengue fever and systemic involvement developed ECG abnormalities on third day, in the form of prolonged QT interval and deep and symmetrical inversion of T wave. Echocardiography revealed akinesia of mid and apical segments and well contracting basal segments, typical of Takotsubo cardiomyopathy or stress cardiomyopathy. These changes were transient and echocardiography findings reverted to normal kinesis of left ventricle without any treatment or without any residual left ventricle dysfunction.

Delineating maternal influence in regulation of variance in major economic traits of White Leghorns: Bayesian insights.

Proper variance partitioning and estimation of genetic parameters at appropriate time interval is crucial for understanding the dynamics of trait variance and genetic correlations and for deciding the future breeding strategy of the population. This study was conducted on the same premise to estimate genetic parameters of major economic traits in a White Leghorn strain IWH using Bayesian approach and to identify the role of maternal effects in the regulation of trait variance. Three different models incorporating the direct additive effect (Model 1), direct additive and maternal genetic effect (Model 2) and direct additive, maternal genetic and maternal permanent environmental effects (Model 3) were tried to estimate the genetic parameters for body weight traits (birth weight, body weight at 16, 20, 40 and 52 weeks), Age at sexual maturity (ASM), egg production traits (egg production up to 24, 28, 40, 52, 64 and 72 weeks) and egg weight traits (egg weight at 28, 40 and 52 weeks). Model 2 and Model 3 with maternal effects were found to be the best having the highest accuracy for almost all the traits. The direct additive genetic heritability was moderate for ASM, moderate to high for body weight traits and egg weight traits and low to moderate for egg production traits. Though the maternal heritability (h2mat) and permanent environmental effect (c2mpe) was low (<0.1) for most of the traits, they formed an important component of trait variance. Traits like egg weight at 28 weeks (0.14±0.06) and egg production at 72 weeks (0.13±0.07) reported comparatively higher values for c2mpe and h2mat respectively. Additive genetic correlation was high and positive between body weight traits, between egg weight traits, between consecutive egg production traits and between body weight and egg weight traits. However, a negative genetic correlation existed between egg production and egg weight traits, egg production and body weight traits, ASM and early egg production traits. Overall, a moderate positive genetic correlation was estimated between ASM and body weight traits and ASM and egg weight traits. Based on our findings, we can deduce that maternal effects constitute an important source of variation for all the major economic traits in White Leghorn and should be necessarily considered in genetic evaluation programs.

Machine Learning to Predict Prostate Artery Embolization Outcomes.

PURPOSE: This study leverages pre-procedural data and machine learning (ML) techniques to predict outcomes at one year following prostate artery embolization (PAE). MATERIALS AND METHODS: This retrospective analysis combines data from the UK-ROPE registry and patients that underwent PAE at our institution between 2012 and 2023. Traditional ML approaches, including linear regression, lasso regression, ridge regression, decision trees and random forests, were used with leave-one-out cross-validation to predict international prostate symptom score (IPSS) at baseline and change at 1 year. Predictors included age, prostate volume, Qmax (maximum urinary flow rate), post-void residual volume, Abrams-Griffiths number (urodynamics score) and baseline IPSS (for change at 1 year). We also independently confirmed our findings using a separate dataset. An interactive digital user interface was developed to facilitate real-time outcome prediction. RESULTS: Complete data were available in 128 patients (66.7 ± 6.9 years). All models predicting IPSS demonstrated reasonable performance, with mean absolute error ranging between 4.9-7.3 for baseline IPSS and 5.2-8.2 for change in IPSS. These numbers represent the differences between the patient-reported and model-predicted IPSS scores. Interestingly, the model error in predicting baseline IPSS (based on objective measures alone) significantly correlated with the change in IPSS at 1-year post-PAE (R2 = 0.2, p < 0.001), forming the basis for our digital user interface. CONCLUSION: This study uses ML methods to predict IPSS improvement at 1 year, integrated into a user-friendly interface for real-time prediction. This tool could be used to counsel patients prior to treatment.

How Common are Depressive-Anxiety States, Body Image Concerns and Low Self-Esteem in Patients of PCOS?

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age with increased incidence of emotional disturbances and other psychopathology. We undertook this research to study the prevalence and severity of depression and anxiety as well as understand body image disturbances and self-esteem of the women of PCOS. We studied the relationship of depressive symptoms with self-esteem and body image disturbances. METHOD: A total of 105 patients diagnosed as PCOS were recruited from gynecology OPD after informed consent and ethics approval. A proforma along with Beck's Depression Inventory, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Body Image Concern Inventory and Rosenberg' s Self-Esteem Scale were administered to patients for further assessment. RESULTS: In total, 54 (51.43%) patients of PCOS had depression on BDI, 12( 11.43%) patients had body image disturbances an d 23 (21.90%) patients had a low self-esteem. A total of 21 patients( 20%) had mild and moderate depression while 5% had severe depression. Majority 53 (50.48%) of our patients had mild anxiety whereas severe to extreme anxiety was seen in about 31% of patients. Body image disturbances were seen in only 12(11.43%) patients and low self-esteem was present in 23 patients. No statistically significant correlation of depression was seen with body image or self-esteem. CONCLUSIONS: The results of this study indicate that there is a high prevalence of depression and anxiety in patients of PCOS than body image concerns and low self-esteem. Prognosis for patients would improve by liaison between gynecologist and psychiatrist.

Bichromatic state-dependent disordered potential for Anderson localization of ultracold atoms.

Abstract: The ability to load ultracold atoms at a well-defined energy in a disordered potential is a crucial tool to study quantum transport, and in particular Anderson localization. In this paper, we present a new method for achieving that goal by rf transfer of atoms in an atomic Bose-Einstein condensate from a disorder-insensitive state to a disorder-sensitive state. It is based on a bichromatic laser speckle pattern, produced by two lasers whose frequencies are chosen so that their light-shifts cancel each other in the first state and add up in the second state. Moreover, the spontaneous scattering rate in the disorder-sensitive state is low enough to allow for long observation times of quantum transport in that state. We theoretically and experimentally study the characteristics of the resulting potential.

Polymorphism in the prolactin promoter and its association with growth traits in chickens.

The pituitary hormone prolactin has a wide variety of functions involving growth, behavioral, and ovarian activities in chickens. The objectives of the present study were to identify polymorphisms in the prolactin promoter and estimate their effects on growth traits in White Leghorn chickens. Among 28 haplotypes found, the h1 haplotype was predominant. Body weight at 16 and 64 weeks and age at sexual maturity were significantly associated with haplotype combinations (P < 0.05). The h1/h1 haplogroup showed the highest body weight at 16 weeks of age, and h1/h7 was the highest at 64 weeks. The lowest age at sexual maturity was found in birds with the h1/h6 haplotype combination, and mRNA expression of prolactin was lowest in h1/h4 birds and highest in h1/h5 birds. The prolactin promoter was highly polymorphic and had significant associations with growth traits in White Leghorn chickens.

Identification of haplotypes in promoter of prolactin gene and their effect on egg production and quality traits in layer chicken.

Expression of prolactin hormone is a crucial event in regulating egg production in chickens for which promoter plays the vital role in expressing the prolactin gene. The objective of the present study was to identify haplotypes in the prolactin promoter and their effects on egg production and egg quality traits in White Leghorn chicken. Single stranded conformation polymorphism followed by sequencing was conducted to explore polymorphism at 561 bp promoter of prolactin gene. The effect of haplotype combinations on egg production and quality traits were estimated following general linear model technique. The expression of prolactin by different haplogroups was quantified by qPCR. Total 28 haplotypes were found in White Leghorn chicken of which h1 haplotype possessed the highest frequency of 0.46 and h8, h14, h16, h25, h26, and h28 haplotypes had the lowest frequency (0.1%). The egg production up to 52 and 64 weeks of age were found to be significantly (p < 0.05) associated with haplotype combinations where the highest 52-w (52 weeks) egg production was found in animals with h1/h22 combination and the lowest production was observed in the birds with h1/h2 haplogroup. The haplotype combinations had the significant effect (p < 0.05) on Haugh Unit, yolk index and albumen weight at 40 weeks of age; Haugh Unit and albumen weight at 52 weeks of age and Haugh unit, yolk weight and yolk percentage at 64 weeks of age. The prolactin expression in h1/h22 birds was found to be the lowest and in h1/h5 birds to be the highest. The prolactin expression showed significant effect on 52-w egg production and albumin weight at 52 weeks age. In conclusion, it may be stated that the prolactin promoter was highly polymorphic and had the significant association with egg production and quality traits in White Leghorn chicken.

Characterization of two Indian native chicken breeds for production, egg and semen quality, and welfare traits.

The present study was conducted to characterize 2 important native chicken breeds from India and compare them on growth, production, egg and semen quality, and welfare traits. The Aseel breed showed (P < 0.001) higher BW at different ages; higher shank, radius, and toe lengths at 40 wk of age; and greater egg weights at 28, 32, and 40 wk of age than did the Kadaknath breed. The Kadaknath breed reached sexual maturity at an early age, and it had higher 40-wk egg production (P < 0.001). Higher egg specific gravity (P < 0.05) and higher albumen (P < 0.001) and shell (P < 0.009) percentages in the Kadaknath were observed, whereas the Aseel breed had a higher yolk index (P < 0.004), higher yolk percentage (P < 0.001), and higher yolk-to-albumen ratio (P < 0.001). Concentration of sperm (P < 0.01), live sperm counts (P < 0.05), and semen appearance scores (P < 0.05) were higher in the Aseel breed than in the Kadaknath breed. The Aseel breed showed a greater incidence of feather-pecking behavior under floor rearing, and this was negligible or mild in the Kadaknath breed. Broodiness under cage rearing was observed (8.42%) in the Aseel breed. With regard to welfare traits, male Aseel birds had a significantly shorter (P < 0.05) duration of tonic immobility (TI) than did male Kadaknath birds. Furthermore, male Aseel birds had a shorter (P < 0.001) duration of TI than did female Aseel birds, whereas female Aseel birds had a longer (P < 0.05) duration of TI than did female and male Kadaknath birds. From this study, it was concluded that the breeds differed on various growth, production, egg and semen quality, and behavioral traits, but not on welfare traits, although female Aseel birds exhibited a greater fear response.

Association of polymorphism in the prolactin promoter and egg quality traits in laying hens.

Single strand conformation polymorphism analysis and DNA sequencing was performed in White Leghorn hens to explore the polymorphisms present in the promoter of the prolactin gene. The effects of different genotypes on egg production and quality traits were determined, and expression of the prolactin gene in different genotypes was quantified by real time-PCR. Five genotypes and four alleles at each of two Fragments of the promoter were found, of which the FG genotype in Fragment 1 and the PQ genotype in Fragment 2 were the most predominant genotypes. The genotypes of Fragment 1 had significant effects (P < 0·05) on Haugh unit, albumen weight, albumen percentage and shell percentage at 40 weeks of age; egg weight and yolk index at 52 weeks of age; and egg weight at 64 weeks of age. Prolactin expression in the genotypes of Fragment 1 differed significantly and GH genotyped birds had the highest level of expression. The genotypes of Fragment 2 did not show any significant differences of expression. It was concluded that the prolactin gene promoter was highly polymorphic, and had significant effects on egg quality traits in White Leghorn hens.

Genetic analysis of juvenile growth and carcass traits in a full diallel mating in selected colored broiler lines.

The juvenile growth and carcass traits were evaluated in a 4 × 4 full diallel crossing involving four colored broiler chicken lines viz., Naked neck (NN), Dwarf, Punjab Broiler-1 (PB-1), and Punjab Broiler-2 to study the performance and crossbreeding parameters. The data on 2,280 chicks were analyzed using least squares techniques to assess the effect of genetic group, and the significant traits were further analyzed for crossbreeding parameters. Genetic group had significant influence on the body weights and carcass traits. The cross of PB-1 × NN recorded significantly (p ≤ 0.05) higher body weight at 6 weeks of age. The data revealed that general combining ability (GCA), specific combining ability (SCA), maternal ability (MA), sex-linked effect (SE), and purebred effects significantly influenced the growth and carcass traits in the broiler crosses. The crossbred PB-1 × NN showed positive heterosis for growth as well as carcass traits. The results suggest that GCA, SCA, SE, and MA are important in the inheritance of the body weights and carcass traits indicating the presence of both additive and nonadditive genetic variation along with reciprocal effects. Therefore, pure line selection along with development of specialized sire and dam lines followed by crossing will improve the growth performance and benefit the poultry farmers. It is concluded that PB-1 as a male line and NN as a female line performed significantly higher, therefore, may be used for improving the performance of colored broilers.

Analysis of (co) variance components and estimation of breeding value of growth and production traits in Dahlem Red chicken using pedigree relationship in an animal model.

Variance and covariance components of growth and production traits were analyzed employing REML animal model to assess the Dahlem Red (PD-3) chicken population for direct additive genetic, maternal effects and to estimate the estimated breeding value (EBV), genetic parameters, genetic trends and rate of inbreeding (ΔF) utilizing seven generation's data. The generation and hatch had significant (P≤0.01) effect on the body weight at 0 day (BW0), 2 (BW2), 4 (BW4) and 6 weeks (BW6) and shank length at six weeks of age (SL6). The average least squares means (LSM) for BW6 and SL6 were 273.93±0.62 g and 53.97±0.05 mm, respectively. All the production traits were significantly (P≤0.01) influenced by generation and hatch. The average LSM for age at sexual maturity (ASM), egg production up to 40 weeks (EP40) and egg mass up to 40 weeks (EM40) were 168.82±0.25 d, 72.60±0.41 eggs and 4.21±0.07 kg, respectively. Model 5 with additive direct, maternal genetic, maternal permanent environmental and residual variance components was the best for BW0, BW2 and BW4 based on the AIC values obtained in WOMBAT. Model 4 was the best model for BW6, SL6, ASM, EP40 and EM40 with additive direct, maternal permanent environmental and residual variance components. Maternal effects were higher during early age, decreased with age, and remained present until 20 weeks of age. The heritability (h2) estimates were low to moderate in magnitude for all the growth traits and ranged from 0.02±0.03 to 0.19±0.03. The maternal heritability was high at hatch (0.35±0.06), decreased gradually until 4th week (0.02±0.01) and ceased afterwards. The heritabilities of EP40 (0.11±0.03) and EM40 (0.12±0.04) were low. The direct additive genetic correlations (ra) between BW2, BW4, BW6 and SL6 were high and positive (P≤ 0.05). The additive genetic and maternal permanent environmental correlation between EP40 and EM40 were high and positive (P≤ 0.05). The EBV of EM40 was significant (P≤ 0.05) with 0.48 kg/generation in PD-3 chicken at the end of the seventh generation. The EBV of EP40 showed an increasing trend with a genetic gain of 1.87 eggs per generation. The average inbreeding coefficient of the population was 0.019 and average ΔF was 0.007 over the last seven generations of selection. The EBV trends for primary and associated traits showed linear trends in the desired direction and negligible inbreeding.

Suppression of octahedral tilts and associated changes in electronic properties at epitaxial oxide heterostructure interfaces.

Epitaxial oxide interfaces with broken translational symmetry have emerged as a central paradigm behind the novel behaviors of oxide superlattices. Here, we use scanning transmission electron microscopy to demonstrate a direct, quantitative unit-cell-by-unit-cell mapping of lattice parameters and oxygen octahedral rotations across the BiFeO3-La0.7 Sr0.3 MnO3 interface to elucidate how the change of crystal symmetry is accommodated. Combined with low-loss electron energy loss spectroscopy imaging, we demonstrate a mesoscopic antiferrodistortive phase transition near the interface in BiFeO3 and elucidate associated changes in electronic properties in a thin layer directly adjacent to the interface.

Two treatment strategies for management of Neurosymptomatic cerebrospinal fluid HIV escape in Pune, India.

Symptomatic cerebrospinal fluid (CSF) viral escape (sCVE) is reported in people with HIV, who are on ritonavir-boosted protease inhibitor (PI/r) containing antiretroviral therapy (ART). Management of sCVE includes performing genotypic HIV-1 resistance testing (GRT) on CSF and plasma HIV and changing ART accordingly. Neither GRT nor newer drugs (Dolutegravir and Darunavir/ritonavir) are routinely available in India. As a result, management of sCVE includes 2 modalities: a) ART intensification by adding drugs that reach therapeutic concentrations in CSF, like Zidovudine, to existing ART or b) Changing to a regimen containing newer boosted PI/r and integrase strand transfer inhibitor (INSTI) as per GRT or expert opinion. In this retrospective study, we report the outcomes of above 2 modalities in treatment of sCVE in Pune, India.Fifty-seven episodes of sCVE in 54 people with HIV taking PI/r-containing ART were identified. Clinical, demographic, laboratory and ART data were recorded. Forty-seven cases had follow-up data available after ART change including measurement of plasma and CSF viral load (VL).Of the 47 cases, 23 received zidovudine intensification (Group A, median VL: plasma- 290, CSF- 5200 copies/mL) and 24 received PI/INSTI intensification (Group B, median VL: plasma- 265, CSF-4750 copies/mL). CSF GRT was performed in 16 participants: 8 had triple class resistance. After ART change, complete resolution of neurologic symptoms occurred in most participants (Group A: 18, Group B: 17). In Group A, follow-up plasma and CSF VL were available for 21 participants, most of whom achieved virologic suppression (VL < 20 copies/mL) in plasma (17) and CSF (15). Four participants were shifted to the PI/INSTI intensification group due to virologic failure (plasma or CSF VL > 200 copies/mL). In Group B, follow-up plasma and CSF VL were available for 23 participants, most of whom also achieved virologic suppression in plasma (21) and CSF (18). Four deaths were noted, 2 of which were in individuals who interrupted ART.This is a unique sCVE cohort that was managed with 1 of 2 approaches based on treatment history and the availability of GRT. At least 75% of participants responded to either approach with virologic suppression and improvement in symptoms.

Acute Pyelonephritis: A Single-center Experience.

Acute pyelonephritis (APN), although a common clinical entity, still not much is known about the clinical profile in the Indian scenario. We prospectively collected clinical, biochemical, and radiological data of patients hospitalized with a diagnosis of APN from March 2014 to June 2016. A total of 296 cases were included in the study. Mean age was 53.85 ± 9.78 years. Male to females ratio was 1.93:1. Among the risk factors recognized for complicated pyelonephritis (PN), diabetes mellitus (DM) (54.4%) was the most common factor followed by renal calculi (14.4%), benign prostatic hyperplasia (6.7%), immunocompromised state (3.3%), stricture urethra and meatal stenosis (3.3%), and neurogenic bladder (2%). Urinary culture was negative in 153 (51.7%) and positive in 143 patient (48.3%). Most common organism isolated was Escherichia coli (29.7%), followed by Klebsiella pneumoniae (5.4%), pseudomonas (5.4%), Enterococcus (4.4%), and Proteus in 10 (3.4%). Serum creatinine of more than 1.5 mg/dl at admission was seen in 96.3% patients; 40% of them had underlying chronic kidney disease with DM being the most common. Multiorgan dysfunction either at admission or during the course in hospital stay was seen in 31.8% patients. Twelve (2%) had emphysematous PN. Six patients had Class II, 4 had Class III, 1 with Class I, and another with Class IV. A total of 18 deaths were noted (6.1%). Hemoglobin <10 g/dl, serum creatinine at admission >1.5 mg/dl, HbA1c% >10%, and immunosuppression had statistically significant association with the development of multiorgan dysfunction on univariate analysis, but on multivariate analysis, only hemoglobin, HbA1c%, and immunosuppression reached statistical significance. Even with attributable risk of mortality, only hemoglobin, HbA1c%, and immunosuppression reached statistical significance on multivariate analysis. HbA1c% adds to the predictive parameters to recognize at-risk patients to intensify the treatment and avoid complications.

Discordant CSF/plasma HIV-1 RNA in individuals on virologically suppressive antiretroviral therapy in Western India.

Aim of this study was to estimate the prevalence of cerebrospinal fluid (CSF)/Plasma HIV-1 RNA discordance in virologically suppressed individuals presenting with incident neurologic symptoms.In this retrospective cohort study conducted between March 1, 2009, and March 1, 2017, HIV-1 infected adults exposed to atleast 12 months of antiretroviral therapy (ART) and having plasma viral load (VL) <1000 copies/mL (virologically suppressed) were included. Among these, individuals presenting with neurologic symptoms during follow-up were assessed for CSF/Plasma HIV-1 RNA discordance by measuring HIV-1 RNA in collected plasma and CSF samples. CSF/plasma HIV-1 RNA discordance was defined as either detectable CSF HIV-1 RNA (VL > 20 copies/mL) with an undetectable plasma RNA (complete viral suppression, VL ≤20 copies/mL) or CSF HIV-1 RNA ≥ 0.5 log10 higher than plasma RNA when plasma VL was between 20 and 1000 copies/mL (low-level viremia, LLV).Out of 1584 virologically suppressed patients, 71 (4.4%) presented with incident neurologic symptoms. Twenty out of 71 (28.2%) patients were diagnosed with CSF/Plasma HIV-1 discordance. Median plasma and CSF VL in patients with discordance was 120 [interquartile range (IQR): <20 to 332.5] and 4250 (IQR: 2550.0- 9615.0) copies/mL, respectively. All 9 individuals in which CSF HIV-1 genotypic resistance testing was done showed mutations that would compromise efficacy of prescribed ART regimen. Prevalence of CSF/plasma HIV-1 RNA discordance was higher among neurologically symptomatic patients with plasma LLV as compared with those with complete viral suppression (70% vs 11.8%, P < .001). The risk of discordance was also greater in patients who received protease inhibitor (PI) containing ART (P < .001) and those on ART regimens with central nervous system (CNS) penetration effectiveness (CPE) value <6 (P = .006).CSF/plasma HIV-1 RNA discordance indicates replication of HIV-1 that has adapted to the CNS or has developed antiretroviral drug resistance. Larger studies should be performed to study incidence of discordance in India. This will help in managing patients presenting with neurologic symptoms on suppressive ART with appropriate neuroeffective therapy.

Comparative Study of Surgical Management of Fracture Neck of Femur with Cemented Versus Uncemented Bipolar Hemiarthroplasty.

INTRODUCTION: There is evidence for use of cemented hemiarthroplasty resulting in greater anchoring and lesser peri prosthetic fracture. However, this procedure results in more haemodynamic instability and cardiopulmonary complications termed as 'cement reaction' or bone cement implantation syndrome. There has been a heightened interest among surgeons to compare cemented and uncemented hemiarthroplasty for fracture neck of femur. AIM: To compare cemented and uncemented hemiarthroplasty in terms of blood loss during the procedure, post-operative complications, mortality, functional recovery and long term clinical outcome. MATERIALS AND METHODS: In a prospective study spanning 8 years from January 2006 to January 2014 in a tertiary care hospital, 52 cases of fracture of neck were selected. Twenty four patients underwent cemented and 28 patients underwent uncemented hemiarthroplasty. Mean follow up duration was 59.3 months. Harris Hip Score evaluation was done at each follow up. Radiological evaluation was done at each follow up for calcar length and periprosthetic fractures. RESULTS: Mean age of patients was 70 years. Harris Hip scores at 3, 6 and 12 months did not show statistically significant differences. Periprosthetic osteolysis or loosening was not seen in the present study. No complications noted in uncemented hemiarthroplasty. Four patients who had cemented hemiarthroplasty had infections. No mortality occurred during admission and within 12 months after surgery. CONCLUSION: No significant difference was noted between the cemented and uncemented hemiarthroplasty procedures on long term follow up in terms of functionality. No re-operations and no mortality reported. Cemented hemiarthroplasty had more blood loss and minimal post-operative complications.