study on effects of repeated salbutamol nebulizations on serum potassium levels and QTc on electrocardiogram in children with acute wheeze

Objective: Acute wheeze is a common problem in young children with respiratory disorders. This study emphasizes on whether there are any significant changes in serum potassium levels and QTc interval during repeated salbutamol nebulizations. Methods: A cross-sectional observational study was conducted at a tertiary care teaching hospital. The study group comprised of 41 children in the age group of 6 months–12 years. Pediatric asthma score and vital parameters (heart rate, respiratory rate, and SpO2) were recorded at the onset and end of salbutamol nebulizations. Baseline serum potassium levels were taken at the onset and then at the end. An electrocardiogram (ECG) was taken at 1 h and another at 3 h, for those who continued to require repeated nebulizations until then. Results: The mean fall in serum potassium levels after repeated salbutamol nebulizations was 0.3±0.4 (p<0.05). The mean fall after 3, 4, 5, and 6 salbutamol nebulizations was 0.06, 0.44, 0.66, and 0.43 mEq/L, respectively. There were no significant changes in ECG patterns in these children. The mean QTc at 1 h of repeated salbutamol nebulizations was 0.41±0.02 (s) and that after 3 h (for children requiring repeated nebulizations until then) was 0.43±0.01 (s). The mean rise in QTc at 3 h was 0.004 s, which was not statistically significant (p=0.137). Conclusion: We conclude that serum potassium levels should be monitored in children receiving repeated salbutamol nebulizations for acute wheeze

Prevalence of subclinical Vitamin K deficiency in early infancy in exclusively breast-fed term infants

Background: Late Vitamin K deficiency bleeding, is a disease of exclusively breast-fed infants attributable to poor content of Vitamin K in breast milk. We aimed to estimate the prevalence of subclinical Vitamin K deficiency, at 3 months of age in exclusively breast-fed term infants who were administered routine Vitamin K 1 mg intramuscular at birth. Methods: This prospective observational study was conducted between June 2018 and June 2020 in a Tertiary Care Teaching Hospital in Western India. Consecutive inborn infants, having received Injection Vitamin K at birth and on exclusive breast feeds attending immunization at 3 months of age were included. Half milliliter of venous blood was withdrawn for the estimation of Proteins Induced by Vitamin K Absence or Antagonist-II (PIVKA-II). Subclinical Vitamin K deficiency was defined as PIVKA-II level of more than 2 ng/mL. Results: The mean age of infants was 3.2 ± 0.2 months and the PIVKA II levels ranged from 0.19 to 10.07 ng/ml. Subclinical Vitamin K deficiency was present in 62 (32.63%) out of 190 infants. Conclusion: Significantly raised PIVKA II levels (>2 ng/mL) were detectable in 32.6% of infants after 3 months of age who had received 1 mg of Vitamin K at birth

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Not AvailableEven though cultivated rice is highly sensitive to salinity, significant variability exists in the primary and secondary gene-pool of rice with respect to traits of salinity tolerance. Breeding salinity tolerance rice varieties is imperative due to climate change and increasing rice demand for global population. A meta-analysis of plethora of genomic data and published literature available on various genes/factors associated with response to rice salinity and tolerance can be used to enlist selected candidates genes affecting salinity. Such genes can be utilized to identify potential candidate salinity resistance genes from donor rice genotypes and facilitate their transfer to high yielding varieties of rice through marker-assisted breeding. This approach has tremendous advantage over transgenic approach as no bio-safety or regulatory issues are involved in exploiting the variability. Meta-analyses were performed on three datasets viz., rice microarray data of 166 series comprising of 2586 samples, 1228 published research literature in the last one and half decades and RNA-Seq data of 454 and Illumina from Sequence Retrieval Archive (SRA) at NCBI. Among microarray dataset, six salinity related series were finally selected and multi experiment analysis revealed 2289 differentially expressed genes belonging to 44 gene families. Out of these, 13 families viz., AP2-EREBP, AUX/IAA, bZIP, C2H2, bHLH, C3H, HB, HSF, MYB, MYB-related, NAC, Tify and WRKY were selected. Applying various parameters on the published literature data, 13 genes were selected, of which five were common to the different microarray datasets. From RNA-Seq data, total of 751 differentially expressed genes were obtained from 21 gene families, out of which 11 genes were common with those obtained from microarray data and five genes, viz., AP2-EREBP/DREB, MYB, HSF, bZIP and NAC were common to all the three data sets. Based on the results obtained, a total of 31 metaanalyzed genes have been selected and recommended for use in genetic improvement programs aimed at salinity resistance in rice.The meta-analysis of microarray, RNA-Seq and published literature has been successfully used to select 31 best salinity tolerance associated genes which can be exploited by candidate gene approach for targeted introgression through marker assisted breeding. This approach has multi-fold advantages, as it obviates statutory and ecological issues. Such endeavors are more warranted for combating the key abiotic stresses like salinity, whose effects are increasing due to a changing climateNot Availabl

How do psychiatrists in India construct their professional identity? A critical literature review

Psychiatric practice in India is marked by an increasing gulf between largely urban-based mental health professionals and a majority rural population. Based on the premise that any engagement is a mutually constructed humane process, an understanding of the culture of psychiatry including social process of local knowledge acquisition by trainee psychiatrists is critical. This paper reviews existing literature on training of psychiatrists in India, the cultural construction of their professional identities and autobiographical refections. The results reveal a scarcity of research on how identities, knowledge, and values are constructed, contested, resisted, sustained, and operationalized through practice. This paper hypothesizes that psychiatric training and practice in India continues to operate chiefy in an instrumental fashion and bears a circular relationship between cultural, hierarchical training structures and patient–carer concerns. The absence of interpretative social science training generates a professional identity that predominantly focuses on the patient and his/her social world as the site of pathology. Infrequent and often superfuous critical cultural refexivity gained through routine clinical practice further alienates professionals from patients, caregivers, and their own social landscapes. This results in a peculiar brand of theory and practice that is skewed toward a narrow understanding of what constitutes suffering. The authors argue that such omissions could be addressed through nuanced ethnographies on the professional development of psychiatrists during postgraduate training, including the political economies of their social institutions and local cultural landscapes. Further research will also help enhance culturally sensitive epistemology and shape locally responsive mental health training programs. This is critical for majority rural Indians who place their trust in State biomedical care