An observational study to correlate arterial lactate level and peripheral perfusion index in context of tissue perfusion in sepsis

Background: In view of goal directed therapies, the predictive value of the course of peripheral perfusion parameters over time has not been studied. Moreover serial assessment of peripheral perfusion index (PI) can be more predictive for mortality when compared to a single assessment of peripheral perfusion. Successfully normalized PI (≥1.4) during treatment might be an indication to stop the resuscitation, whereas pursuing normalized PI (≥1.4) might not result in better outcomes compared with mild-to moderate PI impairment after a normalized arterial lactate level. Complementing arterial lactate assessment with PI during resuscitation can better identify the endpoint of resuscitation and patients at higher risk of adverse outcomes. By simple clinical assessment of peripheral perfusion immediately during and after resuscitation, clinicians will be able to discriminate patients at high risk for developing severe complications even in the rural setups. Methods: This prospective study was conducted on 100 patients admitted at Dr. Kiran C. Patel Medical College and Research Institute, over a period of 12months (Janury 2022 to December 2022). Patients of sepsis were selected on the basis of criteria for tissue hypoperfusion and classification of sepsis. Results: On statistical analysis, PI was found to have significant correlation with arterial lactate levels (P<0.001) in PI <1.4 sub-measurement and not in PI >1.4. SOFA score & metabolic parameters were also found to have statistical significance. Conclusions: We inferred that peripheral perfusion index monitoring could provide useful information to determine the possibility of hyperlactatemia in critically ill patients thus providing a noninvasive source of tissue-bed perfusion monitoring even in the absence of facilities and infrastructure to measure the lactate levels thereby providing a gross insight in the perfusion haemodynamics of the patients of sepsis even in the primary healthcare setups too

Biofilm Formation by Uropathogens and Its Impact on Antimicrobial Susceptibility Pattern

Background: Out of all Hospital-Associated Infections (HAIs),Urinary Tract Infection (UTI) is the second most common infection that accounts for approximately 34%, and 80% are associated with indwelling catheters and hence with biofilm formation, which invites multi-drug resistant microorganisms. The present study was designed to study in-vitro biofilm forming uropathogens and their antimicrobial susceptibility in a tertiary care hospital in north India. Method:The present cross-sectional study consisted of 200 urine specimens collected over one year from patients with symptoms of urinary tract infection. Following their isolation and identification, all the isolates were subjected to screening for biofilm formation by Congo Red Agar (CRA) and the Tube Adherence (TA) methods. Subsequently, the Kirby Bauer-disk diffusion method performed the antimicrobial susceptibility test. Results: Out of the total samples (n = 200), a total of 46 (23%) were positive by the CRA method, while 33 (16.5%) were positive by the TA method. Twenty-one (21%) isolates came positive by both methods. Biofilm formation was seen more commonly in females (82%). Biofilm-forming uropathogens develop significantly higher resistance to antimicrobial drugs than non-producers. Conclusion: The correlation was significant between biofilm production and multidrug resistance. Also, it was concluded that the CRA method could be employed to detect biofilm formation in resource-limited countries

Content Based Image retrieval System

Abstract : This article describes about how technology is enhancing day by day, therefore the focus should be on new technology and new concepts which are getting implemented keeping all these things in mind the paper describes about technique for retrieving images on the basis of automaticallyderived features such as color, edge, shape -a technology now generally referred to as Content-Based Image Retrieval (CBIR). The function of our system is that a query image will be passed to cbir, also by browsing the image database folder and by selecting the image retrieval algorithm according like cedd,fcth,cld,ehd the cbir retrieves the similar images. This"Content-based" means that the search will analyze the actual contents of the image. The term 'content' in this context might refer colors, shapes, textures, or any other information that can be derived from the image itself.cbir is advantageous than purely text based image search

First report of collar rot caused by Pseudomonas aeruginosa on calla lily (Zantedeschia elliottiana)

Collar rot of calla lily cultivated in Himachal Pradesh, India, was recorded during 2011–2013, and the pathogen causing the disease was identified as Pseudomonas aeruginosa. The disease occurred on roots, rhizomes and stems of host plants, causing severe rotting and breakage, and was predominant during the rainy season (June-August) each year. . This is the first record of Pseudomonas aeruginosa affecting calla lily worldwide

An early gene of the flavonoid pathway, flavanone 3-hydroxylase, exhibits a positive relationship with the concentration of catechins in tea (Camellia sinensis)

Tea (Camellia sinensis (L.) O. Kuntze) leaves are a major source of flavonoids that mainly belong to the flavan 3-ols or catechins. Apart from being, responsible for test duality. these compounds have medicinal properties. Flavanone 3-hydroxylase (F3H) is an abundant enzyme in tea leaves that catalyzes the stereospecific hydroxylation of (2S)-naringenin to form (2R.3R)-dihdrokaempferol. We report full-length cDNA sequence of F3H from tea (CsF3H Accessionno. AY641730). CsE3H comprised 1365 by with an open reading frame of 1107 it (from 43 to 1149) encoding a polypeptide of 368 amino, acids. Expression of CsF3H in an expression vector in Escherichia coli yielded a frictional protein with a specific activity of 32 nmol min(-1) mg protein(-1). There was a positive correlation between the concentration of catechins and CsF3H expression in leaves of different developmental stages. CsF3H expression was clown-regulated in response to drought, abscisic acid and gibberellic acid treatment, but up-regulated in response to wounding. The concentration of catechins paralleled the expression data. Exposure of tea shoots to 50-100 mu M catechins led to down-regulation of CSF3H expression suggesting substrate mediated feedback regulation of the gene. The strong correlation between the concentration of catechins and CsF3H expression indicates a critical role of F3H in catechin biosynthesis

Host Biomarkers Reflect Prognosis in Patients Presenting With Moderate Coronavirus Disease 2019: A Prospective Cohort Study

Efficient resource allocation is essential for effective pandemic response. We measured host biomarkers in 420 patients presenting with moderate coronavirus disease 2019 and found that different biomarkers predict distinct clinical outcomes. Interleukin (IL)-1ra, IL-6, IL-10, and IL-8 exhibit dose-response relationships with subsequent disease progression and could potentially be useful for multiple use-cases

Study protocol for economic evaluation of probiotic intervention for prevention of neonatal sepsis in 0-2-month old low-birth weight infants in India: the ProSPoNS trial

Introduction: The ProSPoNS trial is a multicentre, double-blind, placebo-controlled trial to evaluate the role of probiotics in prevention of neonatal sepsis. The present protocol describes the data and methodology for the cost utility of the probiotic intervention alongside the controlled trial. Methods and analysis: A societal perspective will be adopted in the economic evaluation. Direct medical and non-medical costs associated with neonatal sepsis and its treatment would be ascertained in both the intervention and the control arm. Intervention costs will be facilitated through primary data collection and programme budgetary records. Treatment cost for neonatal sepsis and associated conditions will be accessed from Indian national costing database estimating healthcare system costs. A cost–utility design will be employed with outcome as incremental cost per disability-adjusted life year averted. Considering a time-horizon of 6 months, trial estimates will be extrapolated to model the cost and consequences among high-risk neonatal population in India. A discount rate of 3% will be used. Impact of uncertainties present in analysis will be addressed through both deterministic and probabilistic sensitivity analysis. Ethics and dissemination: Has been obtained from EC of the six participating sites (MGIMS Wardha, KEM Pune, JIPMER Puducherry, AIPH, Bhubaneswar, LHMC New Delhi, SMC Meerut) as well as from the ERC of LSTM, UK. A peer-reviewed article will be published after completion of the study. Findings will be disseminated to the community of the study sites, with academic bodies and policymakers. Registration: The protocol has been approved by the regulatory authority (Central Drugs Standards Control Organisation; CDSCO) in India (CT-NOC No. CT/NOC/17/2019 dated 1 March 2019). The ProSPoNS trial is registered at the Clinical Trial Registry of India (CTRI). Registered on 16 May 2019. Trial registration number: CTRI/2019/05/019197; Clinical Trial Registry

Common variants in CLDN2 and MORC4 genes confer disease susceptibility in patients with chronic pancreatitis

A recent Genome-wide Association Study (GWAS) identified association with variants in X-linked CLDN2 and MORC4 and PRSS1-PRSS2 loci with Chronic Pancreatitis (CP) in North American patients of European ancestry. We selected 9 variants from the reported GWAS and replicated the association with CP in Indian patients by genotyping 1807 unrelated Indians of Indo-European ethnicity, including 519 patients with CP and 1288 controls. The etiology of CP was idiopathic in 83.62% and alcoholic in 16.38% of 519 patients. Our study confirmed a significant association of 2 variants in CLDN2 gene (rs4409525—OR 1.71, P = 1.38 x 10-09; rs12008279—OR 1.56, P = 1.53 x 10-04) and 2 variants in MORC4 gene (rs12688220—OR 1.72, P = 9.20 x 10-09; rs6622126—OR 1.75, P = 4.04x10-05) in Indian patients with CP. We also found significant association at PRSS1-PRSS2 locus (OR 0.60; P = 9.92 x 10-06) and SAMD12-TNFRSF11B (OR 0.49, 95% CI [0.31–0.78], P = 0.0027). A variant in the gene MORC4 (rs12688220) showed significant interaction with alcohol (OR for homozygous and heterozygous risk allele -14.62 and 1.51 respectively, P = 0.0068) suggesting gene-environment interaction. A combined analysis of the genes CLDN2 and MORC4 based on an effective risk allele score revealed a higher percentage of individuals homozygous for the risk allele in CP cases with 5.09 fold enhanced risk in individuals with 7 or more effective risk alleles compared with individuals with 3 or less risk alleles (P = 1.88 x 10-14). Genetic variants in CLDN2 and MORC4 genes were associated with CP in Indian patients

Novel Blood Pressure Locus and Gene Discovery Using Genome-Wide Association Study and Expression Data Sets From Blood and the Kidney.

Elevated blood pressure is a major risk factor for cardiovascular disease and has a substantial genetic contribution. Genetic variation influencing blood pressure has the potential to identify new pharmacological targets for the treatment of hypertension. To discover additional novel blood pressure loci, we used 1000 Genomes Project-based imputation in 150 134 European ancestry individuals and sought significant evidence for independent replication in a further 228 245 individuals. We report 6 new signals of association in or near HSPB7, TNXB, LRP12, LOC283335, SEPT9, and AKT2, and provide new replication evidence for a further 2 signals in EBF2 and NFKBIA Combining large whole-blood gene expression resources totaling 12 607 individuals, we investigated all novel and previously reported signals and identified 48 genes with evidence for involvement in blood pressure regulation that are significant in multiple resources. Three novel kidney-specific signals were also detected. These robustly implicated genes may provide new leads for therapeutic innovation

Global estimates on the number of people blind or visually impaired by cataract: a meta-analysis from 2000 to 2020

Background: To estimate global and regional trends from 2000 to 2020 of the number of persons visually impaired by cataract and their proportion of the total number of vision-impaired individuals. Methods: A systematic review and meta-analysis of published population studies and gray literature from 2000 to 2020 was carried out to estimate global and regional trends. We developed prevalence estimates based on modeled distance visual impairment and blindness due to cataract, producing location-, year-, age-, and sex-specific estimates of moderate to severe vision impairment (MSVI presenting visual acuity &lt;6/18, ≥3/60) and blindness (presenting visual acuity &lt;3/60). Estimates are age-standardized using the GBD standard population. Results: In 2020, among overall (all ages) 43.3 million blind and 295 million with MSVI, 17.0 million (39.6%) people were blind and 83.5 million (28.3%) had MSVI due to cataract blind 60% female, MSVI 59% female. From 1990 to 2020, the count of persons blind (MSVI) due to cataract increased by 29.7%(93.1%) whereas the age-standardized global prevalence of cataract-related blindness improved by −27.5% and MSVI increased by 7.2%. The contribution of cataract to the age-standardized prevalence of blindness exceeded the global figure only in South Asia (62.9%) and Southeast Asia and Oceania (47.9%). Conclusions: The number of people blind and with MSVI due to cataract has risen over the past 30 years, despite a decrease in the age-standardized prevalence of cataract. This indicates that cataract treatment programs have been beneficial, but population growth and aging have outpaced their impact. Growing numbers of cataract blind indicate that more, better-directed, resources are needed to increase global capacity for cataract surgery.</p