Comparative assessment of severity and prognosis of acute pancreatitis through APACHE II and HAPS predictor models

Background: Acute pancreatitis is one of the leading causes of hospitalization amongst all gastrointestinal disorders with high burden of morbidity and mortality. Predicting the progression of AP in terms of course and outcome to determine suitable management strategy and level of care is challenging. A number of predictor models are developed to predict the severity of acute pancreatitis but they vary in their definitions of severity. HAPS have been proposed as a simple scoring tool for assessment of severity and prognosis of acute pancreatitis. Thus, the aim of present study was to investigate the usefulness of HAPS predictor model against APACHE II model.Methods: Current investigation was a hospital based prospective study conducted on 80 proven cases of acute pancreatitis at K. K. hospital, Uttar Pradesh. The serum amylase and lipase levels of all enrolled patients, were tested and measured at admission, and at 48 and 72 hours post admission. The pancreatitis-specific clinical investigations like; HAPS, APACHE II were calculated and assessed statistically in terms of sensitivity, specificity, positive and negative predictive values and accuracy.Results: The findings of present investigation revealed that amongst the two scoring systems, APACHE II was superior predictor model in terms of sensitivity and specificity for various outcomes like severe acute pancreatitis, hospital stay >7 days and in-hospital mortality. However, HAPS exhibited high specificity for all the outcomes.Conclusions: HAPS can be recommended as a useful tool for early evaluation of acute pancreatitis in patients specifically in primary care settings of developing countries like India

Comparison of predictive values of Mannheim peritonitis index, acute physiology and chronic health evaluation-II and Portsmouth-POSSUM scoring systems for prognosis of mortality in patients with perforation peritonitis

Background: Perforation peritonitis has emerged as one of the very common cause of surgical emergencies, particularly in developing countries like India. If left untreated for long due to improper prognosis or late diagnosis, perforation peritonitis may prove potentially fatal with a high mortality and morbidity rate. Scoring systems like APACHE-II (acute physiology and chronic health evaluation), p-POSSUM (Portsmouth-POSSUM) and MPI (Mannheim peritonitis index) may serve as simple, critical, and efficient prognostic tools in predicting the mortality in patients with perforation peritonitis. Thus, the aim of the current investigation was to examine the usefulness and accuracy of these scoring systems for predicting the mortality rate in perforation peritonitis.Methods: Current study was a prospective observational comparative study conducted at department of general surgery, KK Hospital, Lucknow. Detailed clinical and lab investigations of the participating patients were done and their demographic details were documented. Using history, clinical examination and lab values p-POSSUM, APACHE-II and MPI scores were calculated. Scores of each scoring system were statistically analyzed in prognosticating the mortality rate.Results: Mean age of the participating patients was 41.24±19.32 years. Abdominal pain and vomiting were observed as the most common symptoms in majority of patients.  No mortality was observed in patients with ≤20 MPI score, ≤20 APACH-II scores and ≤55 p-POSSUM score. Whereas mortality rate was observed to be 21.53% in patients with >20 MPI score, 82% in >20 APACH-II scores and 78% in >55 p-POSSUM score.Conclusions: APACHE II and p-POSSUM scores had a higher sensitivity and specificity in comparison to MPI for predicting the mortality in perforation peritonitis

Pre-operative predictors of difficult laparoscopic cholecystectomy and its correlation with post-cholecystectomy syndrome and its impact on quality of life in North Indian population

Background: Laparoscopic cholecystectomy (LC) is the most preferable surgical procedure worldwide. LC is not completely risk-free and 2 to 15% of attempted LC procedures have to be converted to open cholecystectomy. The aim of the study was to assess the predictors of difficult LC procedures and for knowing the impact of difficult LC procedures on post-cholecystectomy syndrome and quality of life of patients.Methods: A prospective observational study was conducted on patients who underwent LC. Clinical, demographic, radiological and biochemical parameters along with detailed history of patients were documented. Laparoscopic cholecystectomy was then done on patients using standard technique. Level of difficulty in LC procedure was assessed and graded. Occurrence of post-cholecystectomy syndrome was investigated and quality of patient’s life was assessed using SF-36 inventory.Results: The difficulty rate in LC procedure was observed to be 17.4%. The clinical predictors of difficult LC procedures were old age and prior history of abdominal surgery. Contracted gall bladder, peripancreatic fluid and thick gallbladder wall were radiological predictors and presence of adhesions, longer duration of surgery and conversion to open procedures were intraoperative predictors of difficult LC procedures. Early PCS was affected by difficult LC procedures; though with passage of time it reduced. Post-operative quality of life was affected more by PCS incidence than the difficult LC procedure.Conclusions: The findings of the study would help in anticipating predictors of difficult LC procedures and in understanding the phenomenology and determinants of PCS along with its relationship with operative difficulty and quality of life of patients

New validated RP-UPLC method for determination of aripiprazole assay in aripiprazole tablets

A simple, economic and time-efficient, isocratic reverse-phase ultra performance liquid chromatographic (RP-UPLC) method has been developed to analyze aripiprazole in tablets. Successful chromatographic elution and quantification of the drug was achieved on a Waters Symmetry C18, 100 mm x 4.6mm, 3.5 μm column, UV detection at 220 nm with a isocratic mobile phase comprising a mixture of component A (pH 2.5, phosphate buffer) and component B (methanol and acetonitrile (1:1, v/v) in the ratio of 45:55 (v/v). The flow rate was 1.0 mL/min. The method was validated for specificity, precision, linearity, accuracy, range, stability in analytical solution, robustness and system suitability. The linearity concentration range was 5.4-67.8 μg/mL with the correlation coefficient of 0.9997. Total elution time was about 6 min which allowed quantification of more than 100 samples per day.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Genetic divergence in fenugreek (Trigonella foenum-graecum L.) germplasm

Thirty six genotypes of fenugreek (Trigonella foenum-graecum  ) were studied at Jobner(Rajasthan) for their genetic divergence following D2 analysis. The study indicated that thegenotypes were grouped into six clusters and there was lack of parallelism between geneticand geographic diversity. Intra cluster distance was highest in cluster I followed by clusterII. Inter cluster distance was maximum between cluster IV and II followed by III and II.Among the 10 characters studied for genetic divergence, fat content contributed the maxi-mum accounting for 70.3% of total divergence, followed by plant height (8.6%). The studyindicated that for obtaining heterotic response as well as better segregants, inter-matingbetween genotypes of diverse clusters may be undertaken in breeding programmes for im-proving yield and quality traits. &nbsp

DNA barcoding of gobiid fishes (Perciformes, Gobioidei)

Gobiids constitute a major proportion of fish population in both tropical and temperate freshwater as well as marine ecosystem. Due to their small size, cryptic ecology and ambiguous morphological characters, gobiids diversity was not documented completely. In this study, DNA barcodes were generated for 11 species of gobiids, collected from the Ashtamudi Lake, India. The mitochondrial COI gene was amplified using universal primers and the resulted 650 bp amplicon was sequenced. The COI barcodes clearly distinguished all the species with high interspecific genetic distance values than intra-specific values based on K2P (Kimura 2 Parameter) model. The average genetic distance (K2P model) within species, genus and family was 1.2%, 22.2% and 25.3%, respectively. In addition to barcode-based species identification system, Nucleotide Diagnostic (ND) characters specific for species were identified. The Neighbor-Joining tree revealed distinct clusters shared by the species of same genera

Genetic variation for seed yield and its components and their association in coriander (Coriandrum sativum L.) germplasm

Evaluation of 360 lines of coriander (Coriandrum sativum) at Jobner (Rajasthan) indicatedhigh variability for seed yield (22.82%), umbels plant-1 (28.65%) and seeds umbel-1 (21.63%)and low variability for days to 50% flowering (12.39%) and umbellets umbel-1 (13.30%). Highbroad sense heritability (91.94%) and genetic advance (56.55%) were obtained for umbelsplant-1 and seeds umbel-1. Correlation and path coefficient analysis indicated that umbelsplant-1 and branches plant-1 were the most important traits as they exerted positive directeffect on seed yield. &nbsp

Necrotizing enterocolitis: Bench to bedside approaches and advancing our understanding of disease pathogenesis

Necrotizing enterocolitis (NEC) is a devastating, multifactorial disease mainly affecting the intestine of premature infants. Recent discoveries have significantly enhanced our understanding of risk factors, as well as, cellular and genetic mechanisms of this complex disease. Despite these advancements, no essential, single risk factor, nor the mechanism by which each risk factor affects NEC has been elucidated. Nonetheless, recent research indicates that maternal factors, antibiotic exposure, feeding, hypoxia, and altered gut microbiota pose a threat to the underdeveloped immunity of preterm infants. Here we review predisposing factors, status of unwarranted immune responses, and microbial pathogenesis in NEC based on currently available scientific evidence. We additionally discuss novel techniques and models used to study NEC and how this research translates from the bench to the bedside into potential treatment strategies

Concurrent Overexpression of OsGS1;1 and OsGS2 Genes in Transgenic Rice (Oryza sativa L.): Impact on Tolerance to Abiotic Stresses

Glutamine synthetase (GS) is a key enzyme involved in the nitrogen metabolism of higher plants. Abiotic stresses have adverse effects on crop production and pose a serious threat to global food security. GS activity and expression is known to be significantly modulated by various abiotic stresses. However, very few transgenic overexpression studies of GS have studied its impact on abiotic stress tolerance. GS is also the target enzyme of the broad spectrum herbicide Glufosinate (active ingredient: phosphinothricin). In this study, we investigated the effect of concurrent overexpression of the rice cytosolic GS1 (OsGS1;1) and chloroplastic GS2 (OsGS2) genes in transgenic rice on its tolerance to abiotic stresses and the herbicide Glufosinate. Our results demonstrate that the co-overexpression of OsGS1;1 and OsGS2 isoforms in transgenic rice plants enhanced its tolerance to osmotic and salinity stress at the seedling stage. The transgenic lines maintained significantly higher fresh weight, chlorophyll content, and relative water content than wild type (wt) and null segregant (ns) controls, under both osmotic and salinity stress. The OsGS1;1/OsGS2 co-overexpressing transgenic plants accumulated higher levels of proline but showed lower electrolyte leakage and had lower malondialdehyde (MDA) content under the stress treatments. The transgenic lines showed considerably enhanced photosynthetic and agronomic performance under drought and salinity stress imposed during the reproductive stage, as compared to wt and ns control plants. The grain filling rates of the transgenic rice plants under reproductive stage drought stress (64.6 ± 4.7%) and salinity stress (58.2 ± 4.5%) were significantly higher than control plants, thereby leading to higher yields under these abiotic stress conditions. Preliminary analysis also revealed that the transgenic lines had improved tolerance to methyl viologen induced photo-oxidative stress. Taken together, our results demonstrate that the concurrent overexpression of OsGS1;1 and OsGS2 isoforms in rice enhanced physiological tolerance and agronomic performance under adverse abiotic stress conditions, apparently acting through multiple mechanistic routes. The transgenic rice plants also showed limited tolerance to the herbicide Glufosinate. The advantages and limitations of glutamine synthetase overexpression in crop plants, along with future strategies to overcome these limitations for utilization in crop improvement have also been discussed briefly

Identification of serum biomarkers for necrotizing enterocolitis using aptamer-based proteomics

Introduction Necrotizing enterocolitis (NEC) is a potentially fatal intestinal disease primarily affecting preterm infants. Early diagnosis of neonates with NEC is crucial to improving outcomes; however, traditional diagnostic tools remain inadequate. Biomarkers represent an opportunity to improve the speed and accuracy of diagnosis, but they are not routinely used in clinical practice. Methods In this study, we utilized an aptamer-based proteomic discovery assay to identify new serum biomarkers of NEC. We compared levels of serum proteins in neonates with and without NEC and identified ten differentially expressed serum proteins between these groups. Results We detected two proteins, C-C motif chemokine ligand 16 (CCL16) and immunoglobulin heavy constant alpha 1 and 2 heterodimer (IGHA1 IGHA2), that were significantly increased during NEC and eight that were significantly decreased. Generation of receiver operating characteristic (ROC) curves revealed that alpha-fetoprotein (AUC = 0.926), glucagon (AUC = 0.860), and IGHA1 IGHA2 (AUC = 0.826) were the proteins that best differentiated patients with and without NEC. Discussion These findings indicate that further investigation into these serum proteins as a biomarker for NEC is warranted. In the future, laboratory tests incorporating these differentially expressed proteins may improve the ability of clinicians to diagnose infants with NEC rapidly and accurately