A case of left sided gastroschisis with pulmonary hypoplasia

Gastroschisis is a congenital paraumbilical anterior abdominal wall defect resulting in herniation of abdominal wall contents. Incidence of gastroschisis is ~5 per 10,000 live births. Usually, it is right sided and left sided gastroschisis is rare. Gastroschisis in itself has a good prognosis, but the prognosis may vary with the severity of associated conditions. This article reports a case of left sided gastroschisis associated with pulmonary hypoplasia

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Comparative Transcriptome Analysis to Reveal Differentially Expressed Cytochrome P450 in Response to Imidacloprid in the Aphid Lion, <i>Chrysoperla zastrowi sillemi</i> (Esben-Petersen)

The aphid lion, Chrysoperla zastrowi sillemi (Neuroptera: Chrysopidae) is a highly effective beneficial predator of many agricultural pests and has developed resistance to several insecticides. Understanding the molecular mechanism of insecticide resistance in the predators is crucial for its effective application in IPM programs. Therefore, transcriptomes of imidacloprid-resistant and susceptible strains have been assessed using RNA-seq. Cytochrome P450 is one of the important gene families involved in xenobiotic metabolism. Hence, our study focused on the CYP gene family where mining, nomenclature, and phylogenetic analysis revealed a total of 95 unique CYP genes with considerable expansion in CYP3 and CYP4 clans. Further, differential gene expression (DGE) analysis revealed ten CYP genes from CYP3 and CYP4 clans to be differentially expressed, out of which nine genes (CYP4419A1, CYP4XK1, CYP4416A10, CYP4416A-fragment8, CYP6YL1, CYP6YH6, CYP9GK-fragment16, CYP9GN2, CYP9GK6) were downregulated and one (CYP9GK3) was upregulated in the resistant strain as compared to the susceptible strain. Expression validation by quantitative real-time PCR (qRT-PCR) is consistent with the DGE results. The expansion and differential expression of CYP genes may be an indicator of the capacity of the predator to detoxify a particular group of insecticides

Three new Ceratocystis spp. in the Ceratocystis moniliformis complex from wounds on Acacia mangium and A. crassicarpa

The genus Ceratocystis includes many important tree pathogens and agents of sap stain. These fungi have a global distribution and commonly infect wounds on trees. During a survey of wound-infecting pathogens in the genus Ceratocystis on plantation-grown Acacia mangium trees in Indonesia, several isolates resembling Ceratocystis moniliformis sensu lato (s.l.) were obtained. The aim of this study was to identify these isolates and to test their pathogenicity on commercially grown Acacia spp. in the country. Use was made of morphology and comparisons of DNA sequence data for the ITS, β-tubulin, and transcription elongation factor 1-α gene regions to identify the isolates. Three previously undescribed species in the C. moniliformis s.l. species complex were identified and are described here as C. inquinans sp. nov., C. sumatrana sp. nov., and C. microbasis sp. nov. Pathogenicity trials on Acacia mangium and A. crassicarpa in the greenhouse and in the field indicated that all three species have the potential to infect A. mangium and A. crassicarpa, although they are not considered important pathogens.National Research Foundation (NRF), members of the Tree Protection Co-operative Programme (TPCP), THRIP initiative of the Department of Trade and Industry; Department of Science and Technology (DST)/NRF Centre of Excellence in Tree Health Biotechnology (CTHB