Comparative performance of Cerebral Perfusion Ratio as compared to MCA PI and UA PI in prediction of adverse perinatal outcomes in intra uterine growth restricted fetuses

Background: Intra uterine growth restriction (IUGR) is a common clinical sign seen due to chronic foetal hypoxemia and is considered a major contributor of perinatal morbidity and mortality. The aim of the present study was to determine and compare the sensitivity and specificity of umbilical artery pulsatility index (UA PI), middle cerebral artery (MCA) PI and cerebral perfusion ratio (CPR) in predicting adverse and poor perinatal outcomes in fetuses with IUGR.Methods: The study included 100 pregnant women with post 24 weeks of gestation with clinical history of IUGR.  Doppler examination parameters, including waveforms and measurements, of the umbilical artery, middle cerebral artery were recorded. The Cerebral Perfusion Ratio (CPR) was calculated from MCA PI and UA PI and a final comparison of accuracy of Doppler indices was done with perinatal outcome.Results: The sensitivity of the UA PI was higher (49.3%) than that of the MCA PI (43.6%) and the CPR (37.7%). The specificity of the CPR was higher (87.1%) than that of the MCA PI (83.9%) and the UA PI (74.2%).Conclusions: From the findings of the study, it can be concluded that UA PI is the most sensitive and CPR is the most specific parameter in predicting adverse perinatal outcomes in IUGR fetuses. Thus, in addition to pulsatility indices, CPR should be used as a tool for surveillance and included in the routine reporting formats of obstetric Doppler studies

Gene Expression Profiling of Preovulatory Follicle in the Buffalo Cow: Effects of Increased IGF-I Concentration on Periovulatory Events

The preovulatory follicle in response to gonadotropin surge undergoes dramatic biochemical, and morphological changes orchestrated by expression changes in hundreds of genes. Employing well characterized bovine preovulatory follicle model, granulosa cells (GCs) and follicle wall were collected from the preovulatory follicle before, 1, 10 and 22 h post peak LH surge. Microarray analysis performed on GCs revealed that 450 and 111 genes were differentially expressed at 1 and 22 h post peak LH surge, respectively. For validation, qPCR and immunocytochemistry analyses were carried out for some of the differentially expressed genes. Expression analysis of many of these genes showed distinct expression patterns in GCs and the follicle wall. To study molecular functions and genetic networks, microarray data was analyzed using Ingenuity Pathway Analysis which revealed majority of the differentially expressed genes to cluster within processes like steroidogenesis, cell survival and cell differentiation. In the ovarian follicle, IGF-I is established to be an important regulator of the above mentioned molecular functions. Thus, further experiments were conducted to verify the effects of increased intrafollicular IGF-I levels on the expression of genes associated with the above mentioned processes. For this purpose, buffalo cows were administered with exogenous bGH to transiently increase circulating and intrafollicular concentrations of IGF-I. The results indicated that increased intrafollicular concentrations of IGF-I caused changes in expression of genes associated with steroidogenesis (StAR, SRF) and apoptosis (BCL-2, FKHR, PAWR). These results taken together suggest that onset of gonadotropin surge triggers activation of various biological pathways and that the effects of growth factors and peptides on gonadotropin actions could be examined during preovulatory follicle development

CBC parameters and morphological alterations in peripheral blood cells in COVID-19 patients: Their significance and correlation with clinical course

Background:SARS-CoV2  infection  induces inflammatory responses and acute lung injury in human beings.CBC and its derivatives are important investigative tools in its prognosis. However very few studies highlight the importance of Peripheral blood cell morphology in this disease.Aim:To Analyze significance of the CBC,  derived parameters and peripheral blood cells morphology in Covid-19 patients,and to study their correlation with its Clinical Status of the patients at admission and at subsequent assessment during hospital stay. Material and methods: A Single center retrospective study of laboratory-confirmed 26 COVID-19 patients admitted at SSPH & PGTI, from April to July 2020., CBC, its derived parameters and Romanowsky stained peripheral blood  smears were analysed at two points of time during clinical course. Data was tabulated and analyzed using SPSS22 software.Results:On admission, 42.3% cases were mildly symptomatic and 19.2% were moderate to severely symptomatic requiring oxygen/ventilatory support. No significant statistical findings noted in CBC and its derived parameters at the  time of admission . Follow-up, revealed a significant change in WBC and platelet count. (p=0.002). 7 cases showed persistent changes in CBC parameters and blood cell morphology and 3 out of 7 had moderate to severe clinical course. Bizarre atypical mononuclear cells , 2-3 times the size of RBC with dense homogenous chromatin, nuclear  membrane irregularity and deep blue cytoplasm(?covicytes) were the most significant morphological finding. Conclusion: It is evident from our studies that a relevant number of cases having moderate to severe symptoms showed persistence of morphological changes and alteration in CBC parameters

Comparison of NLR,LMR,PLR, RDW, and Platelet count in hematological malignancies at baseline and at intervals of 2 months in patients undergoing chemotherapy

Blood cancer has become quite common in all age groups, worldwide. The cancer ranges from acute life threatening leukemias to indolent chronic leukemias, Lymphoma spillovers causing morbidity and mortality to slow-growing indolent lymphomas. Since blood is present everywhere in the body hence the spread of hematological malignancies is massive. Chemotherapy is expensive and a must to treat blood cancers. However, the ancillary workups like flowcytometry etc in prognosticating and diagnosing blood cancers become quite cumbersome and heavy on the pocket for an average Indian. Therefore, the authors planned the study aimed at analyzing- -Trend in NLR,LMR, PLR RDW, Platelet count at baseline -Trend in NLR,LMR, PLR RDW, Platelet count 2 months post-chemotherapy -Comparison between 2 parameters for any significant change The study was carried out on 11 cases as a prospective case-based study of 11 cases where pre and post-values of chemotherapy cases of newly diagnosed blood cancer cases were available with the author. The baseline CBC and post-induction 1 st CBC were used to record the variables under study and latest SPSS software was used to come to a conclusion through the results. The findings stated that there was a decline in NLR, PLR and platelet count at follow-up as compared to baseline and an increase in LMR and RDW at follow-up as compared to baseline, however, the difference was significant statistically only for PLR (p=0.028) and near significant (p=0.059) for platelet count. Hence in view of significant findings seen only in 11 cases a larger cohort may be used to correlate these findings with follow up of such cases

Axillary Schwannoma: Diagnosed on Fine Needle Aspiration Cytology

Schwannomas affect mainly head, neck and flexor aspect of the limbs. Axillary Schwannoma is extremely uncommon, that is neurogenic tumors arising from brachial plexus are rare. We report one such rare case of a solitary axillary Schwannoma which was diagnosed on fine needle aspiration cytology (FNAC) and subsequently confirmed by histopathological examination. Clinically it was diagnosed as axillary lymphadenopathy and FNAC was advised to rule out granulomatous lymphadenitis

Proinflammatory Innate Cytokines and Distinct Metabolomic Signatures Shape the T Cell Response in Active COVID-19

The underlying factors contributing to the evolution of SARS-CoV-2-specific T cell responses during COVID-19 infection remain unidentified. To address this, we characterized innate and adaptive immune responses with metabolomic profiling longitudinally at three different time points (0–3, 7–9, and 14–16 days post-COVID-19 positivity) from young, mildly symptomatic, active COVID-19 patients infected during the first wave in mid-2020. We observed that anti-RBD IgG and viral neutralization are significantly reduced against the delta variant, compared to the ancestral strain. In contrast, compared to the ancestral strain, T cell responses remain preserved against the delta and omicron variants. We determined innate immune responses during the early stage of active infection, in response to TLR 3/7/8-mediated activation in PBMCs and serum metabolomic profiling. Correlation analysis indicated PBMCs-derived proinflammatory cytokines, IL-18, IL-1β, and IL-23, and the abundance of plasma metabolites involved in arginine biosynthesis were predictive of a robust SARS-CoV-2-specific Th1 response at a later stage (two weeks after PCR positivity). These observations may contribute to designing effective vaccines and adjuvants that promote innate immune responses and metabolites to induce a long-lasting anti-SARS-CoV-2-specific T cell response

Emerging Complexity and the Need for Advanced Drug Delivery in Targeting Candida Species

BACKGROUND: Candida species are the important etiologic agents for candidiasis, the most prevalent cause of opportunistic fungal infections. Candida invasion results in mucosal to systemic infections through immune dysfunction and helps in further invasion and proliferation at several sites in the host. The host defence system utilizes a wide array of the cells, proteins and chemical signals that are distributed in blood and tissues which further constitute the innate and adaptive immune system. The lack of antifungal agents and their limited therapeutic effects have led to high mortality and morbidity related to such infections. METHODS: The necessary information collated on this review has been gathered from various literature published from 1995 to 2019. RESULTS: This article sheds light on novel drug delivery approaches to target the immunological axis for several Candida species (C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, C. krusei, C. rugose, C. hemulonii, etc.). CONCLUSION: It is clear that the novel drug delivery approaches include vaccines, adoptive transfer of primed immune cells, recombinant cytokines, therapeutic antibodies, and nanoparticles, which have immunomodulatory effects. Such advancements in targeting various underpinning mechanisms using the concept of novel drug delivery will provide a new dimension to the fungal infection clinic particularly due to Candida species with improved patient compliance and lesser side effects. This advancement in knowledge can also be extended to target various other similar microbial species and infections.</p