Functional Outcome of Pediatric Subtrochanteric Fractures Treated With a Titanium Elastic Nailing System (TENS) Versus Plating.

Introduction Uncertainty exists regarding the ideal course of therapy for subtrochanteric fractures in children of intermediate age. These fractures are challenging to treat, with scarce literature-based evidence to support a definitive implant. The ideal course of treatment should consider the patient's weight, age, femoral canal size, associated injuries, fracture stability, and surgeon's experience. A subtrochanteric femoral fracture in a child between the age of 5-12 is difficult to treat. For these patients, there is debate concerning the optimal internal fixation, hence this study was conducted to try and determine the superior mode of treatment for these fractures. The objective of this study is to compare functional outcomes of subtrochanteric fractures in the paediatric age group operated on with titanium elastic nail and plate fixation and the complications associated with both treatment modalities. Materials and methods This is a retrospective observational study of 40 cases that were admitted and operated on in the hospital of the current study from May 2007 to November 2021. Twenty patients underwent titanium elastic nailing system (TENS) nailing and the other 20 patients underwent plating for subtrochanteric fractures. The surgeries were conducted at our institute and patients were followed up at one-, three-, and six-month intervals. The final functional results were calculated with the help of the Flynn scoring system.  Results Out of 40 patients involved in the present study, 17 were female while 23 were male. Twenty patients received treatment with titanium elastic nails, and the remaining twenty received plating. The majority of the patients were males around 9.6 years of age on average in the plating group and 8.9 years in the nailing group. In comparison to 75% of participants in the plating group, 40% of patients who received nailing showed excellent results. Results were satisfactory for five patients who received titanium elastic nails and one who received plating. The only poor outcomes were noticed in six people (30%) in TENS and three people (15%) in the plating group who went through unplanned surgery for complications. In comparison to the plating group, the overall rate of complication was much greater in the TENS group. Conclusion We would like to conclude our study that, in accordance with Flynn's score, both elastic nailing and plating stabilization can produce positive functional outcomes. Both groups have a similar percentage of excellent and good results. We also conclude that the overall complication rate is slightly higher for patients treated with TENS when compared to plating for subtrochanteric fractures.

Evaluation of the Functional Outcome of Both Bone Forearm Fractures in the Pediatric Population With the Titanium Elastic Nailing System in a Tertiary Care Center.

Background Forearm fractures are one of the most common injuries in the pediatric population. Diaphyseal fractures of the forearm, in particular, are among the most common injuries treated in the pediatric population. The incidence of both bone forearm fractures has increased in the past decade. Methodology This is a hospital-based retrospective study conducted from June 2020 to December 2022 at R. L. Jalappa Hospital and Research Centre in the orthopedics department after obtaining clearance from the institutional ethics committee. Once inclusion and exclusion criteria are met, participants with both bone forearm fractures were treated with the Titanium Elastic Nailing System (TENS). Data were entered and analyzed using IBM Corp. Released 2011, IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp, Armonk, NY, USA). Results Thirty patients were included in the study, with a mean age of 8.80 years. The majority were boys constituting 67% and girls constituting 33%. A road traffic accident was the mechanism of injury in the majority of patients (40%). The distal one-third forearm was the most common site fractured (63%). The mean flexion (active) at the elbow improved from 110°at at four weeks to 142° at 24 weeks. A restriction of about 23° in elbow extension at four weeks normalized to 0° at 24 weeks. The range of palmar flexion improved from 44° at four weeks to 68° at 24 weeks. The range of wrist dorsiflexion improved significantly over time from 46° at four weeks to 86° at 24 weeks. Complications such as delayed union and skin irritation were noted in two participants (6%). Conclusions Both bone forearm fractures treated with TENS have shown good results in terms of bony union and functional outcomes with the least complications.

Potential diagnostic application of the baculovirus-expressed recombinant truncated nucleocapsid protein of peste des petits ruminants virus in ELISA.

The study describes the expression of recombinant truncated nucleocapsid protein (NP) of peste des petits ruminants (PPR) virus in the baculovirus system (PPRV-rBNP) and its potential application as a diagnostic antigen in ELISA for diagnosis of PPR in sheep and goats. The PPRV N-terminal immunogenic region (1-266 aa) of the NP coding sequence was amplified and cloned into the pFastBac HT A vector. The PPRV-rBNP with a molecular weight of ∼30 kDa was expressed in an insect cell system using generated recombinant baculovirus through Bac-to-Bac® Baculovirus Expression System. The crude PPRV-rBNP or Ni-NTA affinity-purified NP was characterized by SDS-PAGE and immunoblot using standard PPRV-specific sera. The PPRV-rBNP reacted well with PPRV anti-N specific monoclonal and polyclonal antibodies and PPRV-specific antiserum, suggesting that the expressed PPRV-rBNP is in its native form. The crude PPRV-rBNP as a diagnostic antigen was evaluated either as a coating antigen or standard positive control antigen in the Avidin-Biotin ELISA using the known standard panel reagents. The results showed that the expressed PPRV-rBNP can be an alternative diagnostic antigen to E. coli expressed recombinant PPRV-NPN and the utility of PPRV-rBNP avoids the need to use live PPRV antigen in the diagnostic ELISA. Hence, this allows scope in the future for large-scale field application of the recombinant antigen-based assays for diagnosis/surveillance and monitoring of PPR at the eradication as well as post-eradication phases in endemic countries or PPR non-endemic countries.

Functional Outcome of Distal Humerus Fractures Treated With Open Reduction and Internal Fixation With Bicolumnar Plating in a Tertiary Care Setting.

Introduction Fractures of the distal humerus in the adult comprise approximately one-third of all humeral fractures. Over the past 20 years, nonoperative treatment for these fractures has been substituted by anatomic reduction and internal fixation based on the Association for Osteosynthesis (AO)/Association for the Study of Internal Fixation (ASIF) philosophy of plate fixation which resulted in early mobilization and superior performance. Pre-contoured, anatomically designed locking plates are anticipated to offer sufficient stability, permit early elbow range of motion, and safeguard the soft tissue. In comparison to any other joint, the elbow's good anatomical alignment, perfect stability, and early mobilization principles are of utmost significance. Methodology A hospital-based consecutive case series of distal humerus fracture patients managed surgically with bicolumnar plating at R.L. Jalappa Hospital Centre, from June 2021 to June 2022 was chosen. Patients were clinically assessed by measuring the range of motion of the elbow with a goniometer. A six-week post-operative review was the first one. Routine checkups were scheduled every four weeks up until there was evidence of fracture consolidation radiologically. Clinically Mayo Elbow Performance score (MEPS) was analyzed at the end of six-month follow-up and tabulated. Institutional Ethical committee permission was taken prior to the study. Results In the study, 47% of cases had an Excellent MEPS followed by 33% of patients having a good MEPS and 13% having a Fair MEPS rating. Only 7% of patients had poor MEPS. Among the patients, 33.3% had 90 MEPS followed by 16.6% cases had 85 MEPS. Only 2 patients had 55 MEPS in the study. The fracture pattern configuration based on AO classification in our study was C2>C1>C3>A2.3=A3.3. Conclusion Due to an increase in road traffic accidents, complicated distal humeral fractures are becoming more common among younger people. In terms of stability and arc of motion, excellent to good functional outcomes were attained in around 80% of the study group. Because of the extremely stable build system produced by parallel plating, there have been no reported instances of implant failure or non-union.

Comparative diagnostic efficacy of Avidin-Biotin recombinant nucleoprotein competitive ELISA for serosurveillance and monitoring of peste des petits ruminants in sheep and goats.

In this study extensive evaluation of Avidin-Biotin recombinant nucleoprotein competitive ELISA (ABrC-ELISA) was carried out by mass screening of a large number of sera to make use of this assay for serosurveillance and seromonitoring of peste des petits ruminants (PPR) in sheep and goats to evaluate its diagnostic efficacy value and strengthen findings associated with the assay. The recombinant PPR virus (PPRV) nucleoprotein was over-expressed in E. coli, Ni-NTA affinity-purified, and characterized and used as coating diagnostic antigen in ABrC-ELISA, and evaluated using the field sera from animals. On evaluation of the diagnostic performance or efficacy of this assay using the pre-vaccinated and post-vaccinated sera of sheep and goats (n = 1437), the ABrC-ELISA showed a relative diagnostic sensitivity of 87.2% (95% CI: 84.1-90%) and diagnostic specificity of 92.0% (95% CI: 90-93.7%), against well-established existing indigenous H protein-specific PPR competitive ELISA kit with an accuracy of 90.1% (95% CI: 88.5-91.7%) and good or substantial agreement of Cohen's Kappa value of 0.79 ± 0.017 SE (95% CI: 0.76 to 0.82). These findings suggest that the ABrC-ELISA is a potential additional diagnostic tool of a rapid, sensitive, and specific assay for the detection of the PPRV nucleoprotein antibodies in sera of sheep and goats. This PPR Ab Chek kit can be used extensively under field conditions for serosurveillance, and seromonitoring of PPR in sheep and goats at the eradication /post-eradication phase in disease-controlled countries or PPR non-enzootic countries.

Assessment of post-vaccination immune response to peste des petits ruminants virus in small ruminants in the central and western regions of India.

The cross-sectional serosurvey for post-vaccination assessment of peste des petits ruminants (PPR) virus (PPRV) antibodies in sheep and goats was carried out in different states in the central and western regions of India after the implementation of vaccination under the PPR control programme. The serum samples (n = 4687) were collected from sheep (n = 1539) and goats (n = 3148) from August 2017 to March 2018 at various epidemiological units (n = 301) of the studied regions using a stratified random sampling method and PPR competitive ELISA kit was employed to detect PPRV antibodies. The results revealed 34, 21, 52, 74, 68, and 65% of prevalence of PPRV antibodies in small ruminants in Madhya Pradesh, Goa, Chhattisgarh, Maharashtra, Gujarat, and Rajasthan states, respectively, with a difference in seropositivity in sheep and goats across the states in sheep (p < 0.01) and goats (p < 0.01). Further, this serosurvey revealed that 60% of the epi-units (n = 185) had > 50% prevalence of post vaccination PPRV antibodies across states due to variations in vaccination rates and patterns. The vaccination coverage and the reported outbreaks varied between the states in the studied regions. Due to continuous vaccination under the control program, the reported PPR outbreaks have progressively declined in most of the studied states, and the PPR risk areas are confined to a few districts and sporadically, outbreaks are reported indicating the effectiveness of vaccination. These findings provide valuable information on potential PPRV episystems, and will assist with activities regarding intensive surveillance, vaccination, biosecurity, and modification of policy decisions towards designing and implementing control and eradication measures. Further, the present situation necessitates continuous mass vaccination and active surveillance programs to make these regions free from PPR in consonance with the PPR Global Control and Eradication Strategy under the PPR Global Eradication Program. Supplementary Information: The online version contains supplementary material available at 10.1007/s13337-022-00796-6.

Utility of serum and salivary lactate dehydrogenase and uric acid levels as a diagnostic profile in oral squamous cell carcinoma patients.

Background: Lactate dehydrogenase (LDH), an intra-cellular enzyme present in all cells of the body, catalyses the final step of anaerobic glycolysis. This intra-cellular enzyme is released into the extra-cellular space after tissue disintegration, which is evident in oral squamous cell carcinoma (OSCC). However, investigations comparing Lactate dehydrogenase (LDH) levels in OSCC and healthy controls have shown conflicting findings in both serum and saliva samples. Further, Uric acid's anti-oxidant activity has been demonstrated in several diseases. Several cancers have been linked to increased uric acid levels. However, uric acid levels in oral squamous cell cancer have varied. There exists limitted research comparing serum and salivary uric acid with OSCC. Thus, the present investigation was conducted to evaluate the combined diagnostic abilities of serum and salivary LDH and uric acid in OSCC. Aim and Objective: To compare and correlate LDH and uric acid levels in serum and salivary samples of OSCC patients and healthy individuals. Material and Methods: LDH levels and uric acid levels were measured using an enzymatic method in serum and salivary samples of OSCC cases (n = 18) and healthy individuals (n = 18). Results: This study indicated statistically significant elevated levels of LDH in serum and saliva samples of OSCC patients when compared to healthy individuals. Furthermore, serum and salivary uric acid were higher in OSCC patients than in controls. This increased levels of uric acid was significant only in serum but not in saliva samples. However, salivary uric acid was found to be co-relating with serum uric acid. In addition to this, the receiver operating characteristic (ROC) curve when plotted to assess combined diagnostic abilities of all the investigations to predict oscc, indicating the diagnostic ability to be 77%. Conclusion: This study found an increase in uric acid levels in OSCC patients, which contradicts previous existing litratures. Salivary uric acid and LDH levels may be effective indicators for OSCC screening. However, because of the limited sample size, these findings should be viewed with caution.

A Study of Estimated Glomerular Filtration Rate in Patients Undergoing Diagnostic or Interventional Coronary Contrast Procedures.

Introduction: Angiographic procedures are underused in patients with chronic kidney disease (CKD), who present with acute coronary syndromes, due to risk of contrast-induced acute kidney injury (CI-AKI). In this study, we assessed the change in estimated glomerular filtration rate (eGFR) over 3 months following coronary procedures in CKD patients. Methods: This observational study was done from July 2017 to January 2019 in patients undergoing elective coronary procedures with an eGFR <60 mL/min/1.73 m2. CKD-EPI equation was used to calculate eGFR pre and post coronary procedure at 24, 48, and 72 hours as well as 30, 90 days. AKI was diagnosed and patients were given prophylaxis for CI-AKI as per KDIGO recommendation (intravenous normal saline and oral N-acetyl cysteine). Results: Patients studied were 282 (225 males, 57 females) of which 68.1% were diabetics. Mean eGFR was 42.91 ± 10.51 mL/min/1.73 m2 and mean hemoglobin was 12.08 ± 1.51 gm/dL. Coronary angiogram (CAG) was done in 174; percutaneous transluminal coronary angioplasty (PTCA) was done in 108. Mean contrast volume in CAG was 55.17 ± 34.45 mL and in PTCA was 156.94±±47.99 mL. CI-AKI was seen in 66 (23.4%) patients. The incidence of CI-AKI increased with severity of underlying CKD. The variability of eGFR at 1 and 3 months after coronary procedures showed no significant change from baseline, even in the patients who developed CI-AKI. Conclusions: CI-AKI is self-limiting and has no major detrimental effects on eGFR at 1 and 3 months after contrast exposure.

Null genotypes of Glutathione S-transferase M1 and T1 and risk of oral cancer: A meta-analysis.

Background: Glutathione S-transferase M1 (GSTM1) and Glutathione S-transferase T1 (GSTT1) null genotypes have been considered risk factors for many cancers. Numerous studies have been conducted to evaluate the association of null genotype of GSTM1 and GSTT1 with increased susceptibility to oral cancers, and these have produced inconsistent and inconclusive results. In the present study, the possible association of oral cancer(OC) with GSTM1 and GSTT1 null genotypes was explored by a meta analysis. Materials and Methods: A meta-analysis was conducted on published original studies retrieved from the literature using a bibliographic search from two electronic databases: MEDLINE (National library of medicine, USA) and EMBASE. The pooled odds ratio and presence of publication bias in those studies were evaluated. Results: A total of 49 studies concerning oral cancer (OC) were identified for GSTM1 null genotype. Similarly, 36 studies were identified for GSTT1 null genotype. The pooled OR was 1.551(95% confidence interval [CI]: 1.355-1.774) for the GSTM1 null genotype, while for GSTT1 null genotype, the pooled OR was 1.377 (95% CI: 1.155-1.642). No evidence of publication bias was detected among the included studies. Conclusion: The results suggest that the Glutathione S-transferase M1 and Glutathione S-transferase T1 null genotypes significantly enhances the risk of developing oral cancer by a substantial percentage.

Prevalence of Toxoplasma gondii, Leptospira spp., and Coxiella burnetii-associated antibodies in dairy cattle with reproductive disorders.

Background and Aim: In cattle dairy farms, abortions and other reproductive problems due to major infectious diseases are overlooked, and identifying their causative agents is very challenging without a confirmatory diagnosis. Further, a prevalence study in animals will provide important hints of pathogen reservoirs and provide necessary direction to disease burden with appropriate control and biosecurity measures at the farm level. This study aimed to estimate the prevalence of Toxoplasma gondii antibodies in dairy cattle associated with reproductive problems along with coexisting antibodies against abortifacient zoonotic (Coxiella burnetii and Leptospira spp.) pathogens. Materials and Methods: Cattle sera (n = 246) from dairy farms (n = 35) situated in different locations in India were screened for anti-T. gondii and C. burnetii antibodies with enzyme-linked immunoassay and Leptospira spp. antibodies with microscopic agglutination test. Results: The overall prevalence of 11.4% (95% confidence intervals [CIs]: 7.99%-15.96%) antibodies in cattle associated with reproductive problems (p < 0.021) with farm-level seropositivity of 43% was observed. Further, on analysis of screened sera, 49.8% (95% CI: 42.6%-55%) and 77.6% (95% CI: 72%-82.4%) of samples were found to be positive for C. burnetii and Leptospira spp. antibodies, respectively. Moreover, the seropositivity of 91.9% (226/246) for at least one of the screened zoonotic pathogens was observed, indicating antibodies against either of these organisms in association with reproductive disorders (p < 0.005). The percentage of cattle found to have T. gondii antibodies was only 1.8%, whereas 11.5% and 41.6% of cattle were found to have C. burnetii and Leptospira spp. antibodies, respectively. Nevertheless, the predominantly mixed infections observed were of Leptospira and C. burnetii (34.5%), followed by all three infections (4.9%); toxoplasmosis and leptospirosis (3.5%); and toxoplasmosis and Q fever (2.2%). Conclusion: The serological detection of antibodies against these pathogens in cattle may have significant implications for the livestock industry and public health, suggesting the need for continuous surveillance and monitoring of these infections to prevent their spread.

Towards eradication of peste des petits ruminants: post-vaccination evaluation in sheep and goats in Southern Peninsular India.

The cross-sectional seroprevalence study of the peste des petits ruminants (PPR) in sheep and goats was carried out in the Southern Peninsular region of India to ascertain the prevalence of PPR virus (PPRV) antibodies at the epidemiological units (epi-units) level in the small ruminant population. The serum samples were collected from various epi-units (villages) in the different states and union territory (UT) in Southern Peninsular region using a stratified random sampling methodology from August 2017 to March 2018. A total of 6643 serum samples [sheep (n = 2785) and goats (n = 3858)] were collected from 360 epi-units and were screened by PPR competitive ELISA kit for the detection of PPRV antibodies. The results revealed that the seroprevalence of PPR in small ruminants in Telangana, Andhra Pradesh, Karnataka, Tamil Nadu, and Kerala states, and Puducherry UT was 87.0%, 66.4%, 64.3%, 47.8%, 11.4%, and 50.4%, respectively in the studied region. Further, the results of the chi-squared test revealed that the PPRV antibodies across different states and UT in the region were associated (sheep-χ2 = 218.8, p < 0.01; goats-χ2 = 827.1, p < 0.01), as all the states and UT adopted the PPR vaccination programme. The study also implies that the small ruminants in some of the epi-units (n = 102) had < 30% seroprevalence, which necessitates comprehensive intensive vaccination and active surveillance programmes to make this region as PPR free zone.

Expression of Recombinant Leptospiral Surface Lipoprotein-Lsa27 in E. coli and Its Evaluation for Serodiagnosis of Bovine Leptospirosis by Latex Agglutination Test.

The expressed recombinant leptospiral surface adhesion lipoprotein (Lsa27) of pathogenic Leptospira in E. coli was evaluated for the detection of Leptospira antibodies in cattle sera by latex agglutination test (LAT). The Lsa27 lacking signal peptide coding gene sequences from L. interrogans serovar Pomona was amplified (~ 660 bp) by PCR and the amplicon was cloned into pETiteN-HisKan vector. The expressed recombinant Lsa27 histidine-tagged fusion protein (rLsa27) was Ni-NTA affinity purified under denaturation followed by renaturation methods. The purified rLsa27 was characterized by SDS-PAGE and immunoblot, which confirmed the leptospiral protein with a MW of ~ 25 kDa. Further, the prepared sensitized latex beads coated with rLsa27 were evaluated as a diagnostic antigen for detection of pathogenic Leptospira antibodies by using known microscopic agglutination test (MAT) positive (n = 74) and negative (n = 62) sera for Leptospira antibodies in LAT, which revealed the relative diagnostic sensitivity of 91.89% and specificity of 87.10% against the gold standard serological test, MAT. Furthermore, on evaluation of developed rLsa27 LAT using serum samples from cattle associated with the history of abortions and reproductive disorder (n = 309), the relative sensitivity of 96.15%, and specificity of 89.11% were observed. Therefore, this rapid field test using the rLsa27 is first of its kind and it could be used as a screening test for the detection of Leptospira antibodies or it can be complemented by other diagnostics for the diagnosis /surveillance of bovine leptospirosis.

Seroprevalence of peste des petits ruminants in sheep and goats in Eastern India.

The seroprevalence study of peste des petits ruminants (PPR) in small ruminants in Bihar and Odisha states in the Eastern region of India was carried out. A total of 1836 serum samples were collected from sheep (n = 648) and goats (n = 1188) from various epidemiological units (n = 112) in these states by a two-stage sampling plan during April 2017-March 2018. These samples were tested for the detection of virus antibodies by PPR competitive ELISA kit. The results revealed that the seroprevalence of PPR in sheep and goats in Bihar and Odisha states was 30.91% and 54.20%, respectively. Further, the chi-square analysis showed that the association exists between the presence of PPR virus antibodies in the goats (χ2 = 93.28, p < 0.01) and between the states (χ2 = 82.61, p < 0.01). This cross-sectional serosurvey also infers that the sheep and goats in most of the epi-units (n = 87) had < 70% of PPR virus antibodies prevalence. This warrants the intensive continuous mass vaccination program for a few more years to achieve the desired level of population immunity (epidemiological units protection level) and active surveillance to make these states free from PPR in the Eastern region of India.

Naproxen Induced Acute Interstitial Nephritis with Renal Cortical Necrosis.

Drug induced acute interstitial nephritis is an idiosyncratic reaction following a drug exposure. The commonest drugs implicated are nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics and proton pump inhibitors. Renal cortical necrosis is a rare cause of acute kidney injury caused by severe and sustained vasoconstriction of small renal vessels. There is a change in the epidemiology of acute kidney injury especially in developing countries where drug induced acute kidney injury is becoming increasingly common. Naproxen is known to cause renal failure by renal papillary necrosis, tubular damage and acute interstitial nephritis. We present a case of Naproxen induced acute interstitial nephritis with acute cortical necrosis. To the best of our knowledge this is the first documented case of Naproxen induced renal cortical necrosis.

Robotic assisted kidney transplantation in grafts with multiple vessels: single center experience.

INTRODUCTION: The aim of this study was to assess the feasibility of robotic assisted kidney transplantation in graft with multiple vessels. MATERIALS AND METHODS: Eighteen patients underwent RAKT with grafts with multiple vessels (GMVs) from living donor performed by a single surgeon in single institution. The retrospective data obtained were compared to patients who underwent robotic assisted kidney transplant (RAKT) with single vessel and also open kidney transplant with GMVs. RESULTS: There were no significant differences in graft function outcome and perioperative parameters in all three groups. In comparison with OKT in GMVs we found that RAKT with GMVs had less pain score on post op 4th day. There was also a significant difference in mean analgesic requirement and incision length. CONCLUSION: With increasing experience, grafts with challenging vascular anatomy can be taken up for RAKT and GMVs should not be considered as a contraindication for RAKT.

Seroprevalence and distribution of serogroup-specific pathogenic Leptospira antibodies in cattle and buffaloes in the state of Andhra Pradesh, India.

AIM: In this study, the prevalence and the distribution status of Leptospira serogroup-specific antibodies among cattle and buffaloes in enzootic districts of Andhra Pradesh, a South Indian state was carried out. MATERIALS AND METHODS: A total of 426 serum samples were randomly sampled from various villages from Prakasam, Kurnool, Guntur, Chittoor, Srikakulam, Visakhapatnam, and Godavari districts of Andhra Pradesh between 2016 and 2017. Serum samples from cattle (n=106) and buffaloes (n=320) having a history of pyrexia, and reproductive problems such as agalactia, infertility, abortions, and stillbirth. The serum samples were screened for Leptospira-specific antibodies by microscopic agglutination test using a reference panel of 18 live cultures of pathogenic Leptospira serovars. RESULTS: The overall seropositivity of 68.08% (290/426) was observed with 70.8% (75/106) in cattle and 67.18% (215/320) in buffaloes. The frequency distribution of predominant serogroup-specific Leptospira antibodies in the sampled areas was determined against the employed serovars as follows: Icterohaemorrhagiae - 21.38%, Hebdomadis - 18.97%, Australis - 18.62%, Pomona - 17.24%, Sejroe - 15.86%, Tarassovi - 15.86%, Autumnalis - 15.52%, Panama - 14.83%, Shermani - 12.07%, Javanica - 11.38%, Hurstbridge - 11.03%, and Pyrogenes - 10.69%. CONCLUSION: It was evident that bovines had a role in maintaining several predominant Leptospira serovars with the change in the trend over a period. The results from this study would also help in strategizing and mitigating the disease burden in cattle and buffaloes of the enzootic area.

Co-aggregation of bacterial flora isolated from the human skin surface.

Human hands play a prominent role in the intra and interpersonal transmission of microbes that constantly connect one's microbiome to other individuals and the environment. Along with beneficial bacteria, an individual may harbor pathogenic organisms which may get transferred to others. Thus, understanding the transmission mechanism and interaction among microbiota is crucial in preventing infection. In the present study, the ability of skin microbes, isolated from different individuals, to physically interact (coaggregate) intergenically was assessed. The bacterial flora from the hands (palm area) of similar age group students was isolated. The predominant isolates were selected and identified using 16s rRNA gene sequencing. Further, these isolates were subjected to visual coaggregation assay. A total of 27 bacteria were isolated from the human skin (palm area-fingers) of 10 individuals. These isolates belong to seven bacterial genera and 10 different species. Among 123 combinational visual coaggregation positive reactions; 53.66% showed a reaction score of +1, while 32.52%, 11.38% and 2.44% showed a score of +2, +3, and +4 respectively. Among 27 isolates, Staphylococcus haemolyticus had highest coaggregation partners of 17 followed by Acinetobacter spp. and Pseudomonas spp. with 15 partners each. The present study is the first report demonstrating the coaggregation potential of microbiota harboring the skin surface of the human hand. The study indicates that few microbes have high potential to influence coaggregation among distinct genera isolated from the skin. However, further studies are needed to understand the ability of these bacteria to coaggregate, their influence in interpersonal transmission and shaping of microbial ecology of the host skin.

Extracellular matrix in invasion and metastasis of oral squamous cell carcinoma.

Oral squamous cell carcinoma is a common cancer in developing countries with highly invasive and metastasis credentials. The Lymphnode metastasis in oral squamous cell carcinoma is regarded as the factor that decides on disease survival of patients. Steps have been made towards research in the field of Oral squamous cell carcinoma for better understanding of the molecular events involved in invasion and metastasis. Recently, the role of Extracellular matrix (ECM) of oral squamous cell carcinoma in invasion and metastasis has gained interest, as ECM is known to actively contribute in events that regulate transcriptional controls and cell signalling mechanisms involved in invasion and metastasis. Understanding such contributing role of ECM may pave way for newer methodologies in early detection, prevention and therapeutic strategies for oral squamous cell carcinoma.

Ileal Tuberculosis Causing Hypercalcemia and Renal Failure.

Hypercalcemia rarely causes acute pancreatitis due to secretory block in the pancreas and damage by accumulated proteases. Hypercalcemia, though described in granulomatous disorders, is uncommon in tuberculosis. Acute kidney injury is known to occur with acute pancreatitis, secondary to sepsis and septic shock; however, acute pancreatitis resulting in acute cortical necrosis is very rare. We report a 22-year-old woman, who presented with pain abdomen and vomiting. She was found to have features of acute pancreatitis, both biochemically and radiologically. She had hypercalcemia on presentation and this was attributed to be the cause for pancreatitis as other causes were ruled out. 1, 25-dihydroxyvitamin D level was high with normal parathyroid hormone level. Whole-body positron emission tomography-computed tomography showed increased fluorodeoxyglucose uptake in the terminal ileum and histology from that area showed noncaseating granuloma with acid-fast bacilli in the tissue. She was treated with antituberculosis therapy; hypercalcemia improved over a period of time and pancreatitis resolved. She developed anuric renal failure, and kidney biopsy showed patchy acute cortical necrosis. She is dialysis dependent at the end of 6 months. To the best of our knowledge, this is the first case report of a patient with ileal tuberculosis presenting with hypercalcemia and acute pancreatitis. This case is reported due to the rarity of extrapulmonary tuberculosis presenting with symptomatic hypercalcemia, acute pancreatitis, and acute renal cortical necrosis.