Effect of teriparatide in fracture healing of intertrochanteric fracture: a prospective study

Background: Intertrochanteric fracture is a relatively common and serious medical issue in geriatric trauma result in serious health problems and decrease health related quality of life. Faster time-to-union is important for early return to daily activities and reduction of complications. Teriparatide has been shown to accelerate fracture-healing. The purpose of the present prospective, randomized, controlled study was to evaluate the effect of teriparatide on the course of intertrochanteric fracture-healing.Methods: Forty patients of intertrochanteric fractures who underwent surgical intervention between June 2016 and May 2017 were enrolled in this prospective study and followed for minimum of six months. Group A included patients who received only calcium supplementation; patients in Group B received teriparatide along with calcium supplementation postoperatively.Results: The mean time to fracture healing was between 8-12 weeks for the treatment group, compared with 12-16 weeks for the control group. There was also significant effectiveness with regards to Parker and Palmer mobility score at 6 months.Conclusions: Postoperative use of teriparatide for 6 months appears to be an effective adjunct therapy in the treatment of patients with intertrochanteric fractures. However, because of the limited power of the study a large-scale cohort study is still required for determining the efficacy of teriparatide

Looking For Niches In All The Right Places: Designing An MBA Program For The Next Decade

In an over-built, mature industry as is graduate management education it is increasingly important that schools find the right niche at which to target their MBA programs.  However, the literature is largely silent as to how a school might go about the process of finding the right niche for its MBA.  Using gap analysis and data from Occupational Outlook Handbook, we develop a process for identifying future employment trends as a means of identifying promising niches toward which to orient an MBA program.  This is an important exercise for those who design MBA programs, especially in light of the AACSB/International’s current focus upon continuous improvement among its member institutions.  Even if accreditation standards did not require it, the rapidly changing business climate makes continually upgrading MBA programs a necessity

Application of pediatric risk of mortality-III score to predict outcome in critically sick children admitted in a tertiary care pediatric unit in a developing country

Objective: The aim of this study is to assess the utilization of the pediatric risk of mortality-(PRISM)-III score to predict mortality in critically sick children and determination of mortality risk factors in a tertiary care pediatric unit. Materials and Methods: In this cross-sectional descriptive study, 100 children admitted during an 18-month period were enrolled in the study. PRISM-III score and mortality risk were calculated. Follow-up was noted as death or survival. Results: Of 100 patients, 27 died and 73 survived. The 47% of the patients were males. The PRISM-III score was 0-9 in 75%, 10-19 in 15% and 20-29 in 8%, ≥30 in 2% of patients. PRISM-III score showed an increase of mortality from 8% in 0-9 score patients to 100% in ≥20 score. PRISM-III score was significantly associated with study variables such as duration of hospital stay, mental status (Glasgow Coma scale <8), and blood pH <7.28 (p<0001). Conclusion: PRISM-III score showed good predictive value (94.5%) and adequate discriminatory capacity (area under receiver operating characteristics curve 90.8%), and thus constitutes a useful tool for the assessment of prognosis for pediatric patients

RNAi-Mediated Downregulation of Inositol Pentakisphosphate Kinase (IPK1) in Wheat Grains Decreases Phytic Acid Levels and Increases Fe and Zn Accumulation

Enhancement of micronutrient bioavailability is crucial to address the malnutrition in the developing countries. Various approaches employed to address the micronutrient bioavailability are showing promising signs, especially in cereal crops. Phytic acid (PA) is considered as a major antinutrient due to its ability to chelate important micronutrients and thereby restricting their bioavailability. Therefore, manipulating PA biosynthesis pathway has largely been explored to overcome the pleiotropic effect in different crop species. Recently, we reported that functional wheat inositol pentakisphosphate kinase (TaIPK1) is involved in PA biosynthesis, however, the functional roles of the IPK1 gene in wheat remains elusive. In this study, RNAi-mediated gene silencing was performed for IPK1 transcripts in hexaploid wheat. Four non-segregating RNAi lines of wheat were selected for detailed study (S3-D-6-1; S6-K-3-3; S6-K-6-10 and S16-D-9-5). Homozygous transgenic RNAi lines at T4 seeds with a decreased transcript of TaIPK1 showed 28–56% reduction of the PA. Silencing of IPK1 also resulted in increased free phosphate in mature grains. Although, no phenotypic changes in the spike was observed but, lowering of grain PA resulted in the reduced number of seeds per spikelet. The lowering of grain PA was also accompanied by a significant increase in iron (Fe) and zinc (Zn) content, thereby enhancing their molar ratios (Zn:PA and Fe:PA). Overall, this work suggests that IPK1 is a promising candidate for employing genome editing tools to address the mineral accumulation in wheat grains

Effect of timing of cord clamping on iron stores of infants born to anemic mothers

Objective: To study the effect of timing of cord clamping on the iron stores of infants born to anemic (hemoglobin [Hb] 7-10 g/dl)mothers, and if late clamping leads to polycythemia. Design: Randomized comparative trial. Setting: Tertiary care hospital in ametropolitan city. Participants: Term, healthy, and vaginally delivered neonates without any congenital malformations or birth asphyxia,born to booked anemic (Hb 7-10 g/dl) mothers having no medical or pregnancy-related complications were included in the study.Interventions: The pregnant mothers were randomized into three groups, and their umbilical cords were clamped at 1, 2, and 3 min.Neonatal hematocrit was estimated by the capillary method at 24 h of life, and infant’s (Hb) and ferritin were obtained at 3 monthsof life. Main Outcome Measures: Hematocrit at 24 h of life and serum iron and ferritin levels at 3 months of age. Results: Theoutcome variables significantly associated (p<0.05) with hematocrit were cord clamping time, maternal Hb and cord Hb, and ferritin.That associated with infant’s Hb were cord clamping time and cord Hb and ferritin. Whereas, only cord clamp time was significantlyassociated with infant’s ferritin. None of the neonates had polycythemia, and Hb and ferritin were found to be the highest in those whosecord was clamped at 3 min. Conclusion: In resource-constrained countries, where iron deficiency anemia is a major public healthproblem, delaying the umbilical cord clamping by up to 3 min will reduce the incidence of infantile anemia. It will serve as an additionalcost-effective intervention in anemia control program without any adverse effect of polycythemia

Clinico-epidemiological profile and predictors of in-hospital outcome of acute poisoning cases in children of Northern India

Background: Childhood poisoning is a common but preventable problem worldwide with incidence varying from 0.3% to 7.6%. Demography, socioeconomic status, education, local belief and customs, occupation, religious, and cultural influences determine the cause of poisoning. Aim: This study was conducted to understand the recent changes increasing urbanization and rapid socioeconomic development in India during the past decade and to find out the change in pediatric due to poisoning profile. Materials and Methods: This study was conducted in a pediatric ward of a tertiary care hospital in North India during the period of January 2016–December 2016. A total of 174 children admitted with acute poisoning in the hospital during the study tenure were enrolled for the study. Clinical and demographic data were recorded in a predesigned proforma and results were compared with the previous studies from the region. Results: Mean age at presentation was 3.7 years, wherein males outnumbered females. Accidental mode (97%) was the most common mode of poisoning while ingestion (99%) was the most common route of exposure. The common agents incriminated in decreasing order of frequency were corrosives (24.71%), pyrethroids (12.64%), and kerosene (9.77%). Majority of patients belongs to lower middle class (57%) and urban areas (61%). Most children present with mild symptoms, of them vomiting was the most common (65%) and 12.6% developed complications. Mean duration of hospital stay was 2.5±1.91 days with a mortality of 2.16%. Conclusion: There is changing pattern in acute poisoning in children with decline in incidence of kerosene and pesticide poisoning while increase in corrosives and parathyroid poisoning. Low Glasgow Coma Scale and time lapse between poisoning and presentation to the hospital can be a predictor of high mortality

Minimal hepatic encephalopathy: consensus statement of a working party of the Indian National Association for study of the liver

Hepatic encephalopathy (HE) is a major complication that develops in some form and at some stage in a majority of patients with liver cirrhosis. Overt HE occurs in approximately 30-45% of cirrhotic patients. Minimal HE (MHE), the mildest form of HE, is characterized by subtle motor and cognitive deficits and impairs health-related quality of life. The Indian National Association for Study of the Liver (INASL) set up a Working Party on MHE in 2008 with a mandate to develop consensus guidelines on various aspects of MHE relevant to clinical practice. Questions related to the definition of MHE, its prevalence, diagnosis, clinical characteristics, pathogenesis, natural history and treatment were addressed by the members of the Working Party

Risk of COVID-19 death for people with a pre-existing cancer diagnosis prior to COVID-19-vaccination : A systematic review and meta-analysis

Research Funding National Health and Medical Research Council. Grant Number: APP1194679 World Health Organization Article Funding Open access publishing facilitated by The University of Sydney, as part of the Wiley - The University of Sydney agreement via the Council of Australian University Librarians.Peer reviewedPublisher PD

Motivations for Capital Controls and Their Effectiveness

We assess the motivations for changing capital controls and their effectiveness in India, a country with extensive and long-standing controls. We focus on the controls on foreign borrowing that can, in principle, be motivated by macroprudential concerns. We construct a fine-grained data set on capital control actions on foreign borrowing in India. Using event study methodology, we assess the factors that influence these capital control actions, the main factor being the exchange rate. Capital controls are tightened after appreciation, and eased after depreciation, of the exchange rate. Macroprudential concerns, measured by variables that capture systemic risk buildups, do not seem to be a factor shaping the use of capital controls. To assess the impact of controls, we use both event study and propensity score matching methodologies. Event study methodology suggests no impact of capital controls on most variables evaluated, but reveals limited evidence that capital controls relieve currency pressures in the short term. However, even this limited evidence disappears once selection bias is controlled for