Role of aspiration cytology in splenic lesions

Background: Splenic fine needle aspiration cytology (FNAC) as a diagnostic procedure has been used since beginning of last century and was first reported in 1916. The objective of the study was to evaluate the diagnostic role of aspiration cytology in splenic lesions.Methods: In our retrospective study Fine needle aspiration cytology (FNAC) of spleen was done in a total 34 cases, out of which 28 cases were aspirated under ultrasonological guidance and 6 cases were aspirated blindly. There were 23 male and 11 female patients and the age range of the patients was from 2 to 69 years with 8 patients from paediatric group. Before commencing the procedure all the necessary precautions and investigations including coagulation profile were done.Results: Out of 34 FNAC cases, 5 were bloody aspirate while 2 cases showed normal splenic aspirate. In 27 cases definite diagnostic opinion was possible. Amongst non-neoplastic group maximum patients (8 cases) were showing features of extra medullary hematopoeisis followed by 4 cases of tuberculosis, then 3 cases each of kala azar and storage disorder and 2 cases showed granulomas. In the neoplastic group, we had 2 cases of non-Hodgkins lymphoma, one case of Hodgkin lympoma with 2 cases of hairy cell leukemia and one case of histiocytosis. No major difference in the cellularity noticed when the aspiration done blindly or under ultrasound guidance No procedural complications were seen in our study.Conclusion: Hence when done with full precautions FNAC spleen is a safe, cheap, rapid and highly diagnostic procedure as a primary investigation.

Pretreated rice straw as an improved fodder for ruminants-An overview

Rice straw, a by-product of the rice production is mainly used as a source of feed for ruminant livestock is the major forage in rice-producing areas in India. The disposal of the rice straw is a serious problem in areas where it is the major agricultural product. It is rich in polysaccharides and has a high lignin and silica content, limiting voluntary intake and reducing degradability by rumen microbes. By rice straw treatment, its quality and digestibility can be improved and enhanced the protein content. Several methods have been used to improve the utilization of rice straw by ruminants or supplemented by other ingredients to increase digestibility and nutrient value before it can be considered a suitable animal feed. In recent years, biological treatments have been investigated for improvement in nutritional value of rice straw. The use of ligninolytic fungi and their extracellular ligninolytic enzymes for treatment of rice straw results in degrading cellulose and hemicelluloses contents which improve its nutritional value. The use of fungi and enzyme treatments is expected to be a practical, cost-effective and environmental-friendly approach for enhancing the nutritive value and digestibility of rice straw. Therefore, the treated rice straw has a good potential as feed for ruminants

Impact of different grades of anaemia severity during pregnancy on maternal and neonatal outcomes: a prospective study

Background: Anaemia in pregnancy is a universal health problem that may cause a number of obstetrical and neonatal complications. This prospective observational study aims to evaluate and compare maternal and neonatal outcomes in different grades of anaemia severity.Methods: A total of 400 pregnant women with anaemia in third trimester were classified into three groups according to haemoglobin (Hb) levels-group I with Hb:10-10.9 g/dl, group II with Hb:7-9.9g/dl and group III with Hb<7 g/dl. Maternal and neonatal outcomes of women with different severity of anaemia were analyzed and compared. Two groups means were compared by Student’s t-independent test and more than two groups means by one way analysis of variance test followed by post-hoc pairwise comparison using Bonferroni test.Results: The prevalence of anaemia in the study population was 35.2%. Mild, moderate and severe anaemia were found in 58% (n=232), 29.0% (n=116) and 13% (n=52) women respectively. A statistically significant difference in maternal outcomes such as Preterm labor (p=0.001), Prelabor premature rupture of membranes (p=0.044), Intrauterine growth restriction (p=0.002) and postpartum hemorrhage (p=0.001) was observed amongst the three groups. Cardiac failure occurred in 26.9% (n=14) and mortality in 13.4% (n=7) women with severe anaemia. Amongst the neonatal morbidities, the rate of low birth weight, preterm birth, respiratory distress syndrome, septicaemia, pneumonitis and jaundice revealed an increasing trend with rising severity of anaemia which was statistically significant.Conclusions: Targeted interventions addressing early detection and appropriate treatment in early pregnancy can prevent and avoid dismal maternal and neonatal consequences

Antibacterial and qualitative phytochemical analysis of Giloy extract for application of herbal finish on cotton fabric

The current study was planned to prepare antibacterial finish for grey cotton fabric using Giloy stem extract for healthcare applications. The selected grey cotton fabric was pretreated prior to application of the extract. For the extraction of the herb, maceration process was employed and the solution prepared was further subjected to soxhlet extraction to congeal the extract. Giloy extract was assessed for its phytochemical and antibacterial properties, to find out the bioactive components responsible for such activity. The application of the extract was carried out on pretreated cotton fabric using exhaust and pad dry cure methods (5 g/L). The treated fabric was assessed for its efficacy against the selected bacterium (Pseudomonas aeruginosa) using AATCC-100 Test method employing Agar well diffusion method. It is discernible from the results of the study that there was good antibacterial activity of Giloy stem extract treated fabric against Pseudomonas aeruginosa which was determined on the basis of zone of inhibition. It was also found that the finish nearly retained upto ten wash cycles and can be used for medical purposes

Chitosan- hypothalamic hormonal analogue nanoconjugates enhanced the reproductive performance in Indian major carp, Labeo rohita

The current study reports the potential of chitosan nanoparticles for the efficient delivery of hypothalamic hormonal analogue in Labeo rohita, aiming to improve reproductive performance. Here salmon gonadotropin-releasing hormone analogue (sGnRH-a) was conjugated with chitosan nanoparticles (ChN-sGnRH-a) to evaluate its efficiency in enhancing the reproductive gene expression, hormones as well as the overall reproductive output in L. rohita. A total of 54 pairs of brooders were selected and divided into six treatments viz; C0: Negative Control (fish injected with bare chitosan nanoparticles), C: Positive Control (fish injected with Gonopro-FH®, a commercially available inducing hormone, at a dose of 0.2 ml/kg body weight of fish), T1: fish injected with ChN-sGnRH-a at a dose of 0.2 ml/kg, T2: T1 + 10 mg/ml domperidone, T3: fish injected with ChN-sGnRH-a at a dose of 0.1 ml/kg, T4: T3 + 10 mg/ml domperidone. In T2 and T4 treatments, serum hormones, Testosterone (T); Estradiol (E2); Vitellogenin (Vtg); and 17α, 20β-dihydroxyprogesterone (17α, 20β-DHP) showed the sustained elevation. The means of reproductive traits like fecundity, fertilization rate, pseudo-gonadosomatic index and spawning rate were significantly (P&lt;0.05) higher in T2 treatment, while no significant difference was found between C and T4 treatment. The mRNA expression level of follicle-stimulating hormone (fshβ), luteinizing hormone (lhβ) and their cognate receptors was significantly better in T2 treatment, while no significant difference was found between T4 and C treatments. Further, the histological analysis of ovaries showed increased post-ovulatory follicles in C, T2 and T4 treatments. The results indicate that ChN-sGnRH-a could help in reducing the recommended dose of sGnRH-a without affecting the reproductive performance in L. rohita females. The sustained releasing mechanism of this formulation may be used as an induced breeding strategy in female L. rohita broodstock

Clinical relevance of molecular testing methods in the diagnosis and guidance of therapy in patients with staphylococcal empyema: a systematic review and meta-analysis

BackgroundEfficient detection tools for determining staphylococcal pleural infection are critical for its eradication. The objective of this meta-analysis was to assess the diagnostic utility of nucleic acid amplification tests (NAAT) in suspected empyema cases to identify staphylococcal strains and avoid unnecessary empiric methicillin-resistant Staphylococcus aureus (MRSA) therapy.MethodsFrom inception to July 24, 2021, relevant records were retrieved from PubMed, Embase, Scopus, Web of Science, and the Cochrane Library. The quality of studies was determined using the QUADAS-2 tool. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and hierarchical summary receiver operating characteristic (HSROC) curve for NAAT’s diagnostic performance were evaluated using an HSROC model.ResultsEight studies comprising 424 samples evaluated NAAT accuracy for Staphylococcus aureus (SA) identification, while four studies comprising 317 samples evaluated methicillin-resistant Staphylococcus aureus (MRSA) identification. The pooled NAAT summary estimates for detection of both SA (sensitivity: 0.35 (95% CI 0.19–0.55), specificity: 0.95 (95% CI 0.92–0.97), PLR: 7.92 (95% CI 4.98–12.59), NLR: 0.44 (95% CI 0.14–1.46), and DOR: 24.0 (95% CI 6.59–87.61) ) and MRSA (sensitivity: 0.45 (95% CI 0.15–0.78), specificity: 0.93 (95% CI 0.89–0.95), PLR: 10.06 (95% CI 1.49–67.69), NLR: 0.69 (95% CI 0.41–1.15), and DOR: 27.18 (95% CI 2.97–248.6) ) were comparable. The I2 statistical scores for MRSA and SA identification sensitivity were 13.7% and 74.9%, respectively, indicating mild to substantial heterogeneity. PCR was frequently used among NAA tests, and its diagnostic accuracy coincided well with the overall summary estimates. A meta-regression and subgroup analysis of country, setting, study design, patient selection, and sample condition could not explain the heterogeneity (meta-regression P = 0.66, P = 0.46, P = 0.98, P = 0.68, and P = 0.79, respectively) in diagnostic effectiveness.ConclusionsOur study suggested that the diagnostic accuracy of NAA tests is currently inadequate to substitute culture as a principal screening test. NAAT could be used in conjunction with microbiological culture due to the advantage of faster results and in situations where culture tests are not doable

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Acute kidney injury in patients treated with immune checkpoint inhibitors

Background: Immune checkpoint inhibitor-associated acute kidney injury (ICPi-AKI) has emerged as an important toxicity among patients with cancer. Methods: We collected data on 429 patients with ICPi-AKI and 429 control patients who received ICPis contemporaneously but who did not develop ICPi-AKI from 30 sites in 10 countries. Multivariable logistic regression was used to identify predictors of ICPi-AKI and its recovery. A multivariable Cox model was used to estimate the effect of ICPi rechallenge versus no rechallenge on survival following ICPi-AKI. Results: ICPi-AKI occurred at a median of 16 weeks (IQR 8-32) following ICPi initiation. Lower baseline estimated glomerular filtration rate, proton pump inhibitor (PPI) use, and extrarenal immune-related adverse events (irAEs) were each associated with a higher risk of ICPi-AKI. Acute tubulointerstitial nephritis was the most common lesion on kidney biopsy (125/151 biopsied patients [82.7%]). Renal recovery occurred in 276 patients (64.3%) at a median of 7 weeks (IQR 3-10) following ICPi-AKI. Treatment with corticosteroids within 14 days following ICPi-AKI diagnosis was associated with higher odds of renal recovery (adjusted OR 2.64; 95% CI 1.58 to 4.41). Among patients treated with corticosteroids, early initiation of corticosteroids (within 3 days of ICPi-AKI) was associated with a higher odds of renal recovery compared with later initiation (more than 3 days following ICPi-AKI) (adjusted OR 2.09; 95% CI 1.16 to 3.79). Of 121 patients rechallenged, 20 (16.5%) developed recurrent ICPi-AKI. There was no difference in survival among patients rechallenged versus those not rechallenged following ICPi-AKI. Conclusions: Patients who developed ICPi-AKI were more likely to have impaired renal function at baseline, use a PPI, and have extrarenal irAEs. Two-thirds of patients had renal recovery following ICPi-AKI. Treatment with corticosteroids was associated with improved renal recovery

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention