Time to think beyond sickle cell screening and haemoglobin electrophoresis: a case report and review of literature of sickle cell D-Punjab falsely labelled as sickle cell SS from central India

Sickle cell haemoglobin D disease (D-Punjab) is a rare variant of sickle cell disease (SCD) reported from central India. Exact incidence of pulmonary thrombosis in patients with HbSD is unknown. Pulmonary thrombosis is known complication of SCD but rare in case of HbSD pattern. We reported a case of 34-year-old male patient with HbSD (D-Punjab) with acute chest syndrome (ACS). CT pulmonary angiogram revealed near complete thrombosis of right middle lobe segmental and subsegmental branches with pulmonary infarct. Our patient responded to anticoagulant therapy. This case report is a reminder that HPLC should be done in all patients with sickle cell disease along with solubility test and hemoglobin electrophoresis to detect exact incidence of hemoglobin D disease in central India

A rare nexus: G6PD deficiency's uncommon affiliation with rapidly progressive renal failure through the prism of pigment nephropathy

Acute kidney injury (AKI) with evidence of hemolysis is associated with tropical infections. However, pigment-induced AKI can happen with relatively uncommon genetic causes of hemolytic anemia, i.e., glucose 6-phosphate deficiency (G6PD). We share our experience of one such patients whose clinical presentation was rapidly progressive glomerulonephritis. On evaluation, she had a history of usage of some drugs and with G6PD estimation revealing deficient status even during the episode while other tests such as Coomb's test and bone marrow biopsy was normal. The kidney biopsy revealed diffuse tubular injury with presence of several coarse granular/pigmented casts in tubular lamina. She was managed with hemodialysis and showed complete recovery. Thus, in tropical countries G6PD deficiency although is not common, should be considered among patients who presented as rapidly progressive renal failure (RPRF) and having history of precipitating factors for G6PD deficiency and a detailed hemolytic work-up needs to be carried out as an important cause of preventable recurrent AKI in tropical countries

Assessment of clinical epidemiology, treatment patterns, and survival outcomes in epithelial ovarian cancer: a retrospective analysis from a tertiary cancer centre in North India

Background: Ovarian cancer stands as the daunting third most prevalent cancer among females. The aim of this study is to assess the clinical epidemiology, treatment patterns (including end-of-life care), and survival outcomes among patients diagnosed with epithelial ovarian cancer. Methods: This retrospective analysis encompassed all patients diagnosed with epithelial ovarian cancer and enrolled at the tertiary cancer center, IGMC Shimla in Himachal Pradesh. The study included patients registered between January 2014 and December 2018, spanning all age groups. Results: During the aforementioned period, ovarian cancer accounted for 18.7% of gynaecological cancers among females out of which epithelial ovarian cancer accounted for 14.8% of the cases. The median age of patients diagnosed with epithelial ovarian cancer (EOC) was 54.5 years. Most patients hailed from Shimla, followed by Mandi and Kullu districts, among the twelve districts in the state of Himachal Pradesh. The majority of patients were diagnosed at advanced stages FIGO III and IV, comprising a total of 77.1%. Chief complaints included abdominal pain, followed by abdominal distention, heaviness, or bloating. The median duration of follow-up was 27 months (with a standard deviation of ±9.175). The median overall survival (OS) for stage I, II, III, and IV was 92.59 months, 87 months, 82.17 months, and 52.5 months, respectively, and these differences were statistically significant. Conclusions: Ovarian cancer patients are often diagnosed in advanced stages III and IV, primarily due to late diagnosis and the presence of vague symptoms. Achieving optimal cytoreduction significantly improves overall survival. Therefore, it's crucial to raise awareness among general physicians in rural healthcare settings and the public about the symptoms of ovarian cancer to facilitate early detection. Additionally, there's a notable deficiency in end-of-life discussions and palliative care management, which should be accessible to every patient

IMPORTANCE OF NANOCARRIERS AND PROBIOTICS IN THE TREATMENT OF ULCERATIVE COLITIS

Ulcerative colitis (UC) is an inflammatory chronic disease primarily affecting the colonic mucosa; the extent and severity of colon involvement are variable. Ulcerative colitis is identified by mucus diarrhea, tenesmus, bowel distension, and anemia. 5-aminosalicylic acid drugs, steroids, and immune suppressants are used for the therapy of ulcerative colitis. The mainchallenges in the management of thediseaseare drug-related side-effects and local targeting. To overcome these challengesprobiotics and micro and Nanoparticulate systemauspiciousapproaches to overcome drug-related adverse side effects and local targeting.Upon ingestion, the probiotics can result in beneficial health effects. Probiotics and micro and nanoparticulate approaches for suitable targeting and overcome the drug-associated side effect. Probiotics are mainly used as gut modulators but are also nowadays explored for their use in ulcerative colitis.The current therapeutic goals are to achieve clinical remission along with mucosal healing, avoidance of complications such as side effects of the drug and to improve the quality of life. The use of probiotics to increase the health of the intestine and used to block or manage intestinal disorders. They may prevent the induction of inflammatory reactions. Probiotics must be inspected for efficacy in the prevention and management of a wide spectrum of gastrointestinal diseases, like antibiotic-associated diarrhea.Micro and Nanoparticulate drug delivery system has been achieving huge importance for targeting of the drug to colon locally at a controlled and sustained rate

Quantifying the impact of fermented liquid bio formulations, biofertilizers and organic amendments on horticultural and soil nutrient traits of garden pea ( Pisum sativum L.)

Purpose: Modern agriculture heavily relies on the use of synthetic fertilisers, which are expensive and associated with significant environmental risks. Hence, it is necessary to focus on developing integrated farming practices that encompass cost-effective synthetic fertilisers. Method: The present experimentation was carried out to assess the effect of various treatments comprised of fermented liquid bio formulations, biofertilizers, & organic amendments on the horticultural, biochemical, & soil nutrient attributes of garden pea varieties. A Factorial Randomized Block Design was laid out for treatments in three replications.  Results: The results of the investigation exhibited a significantly positive influence of the treatments and their interaction with pea varieties for most of the studied traits. Among varieties, treatments, and their interactions, variety GS-10 and PB-89 treatment modules, viz., Jeevmurta 20% + Phosphorus solubilizing bacteria 100% + Farmyard manure, and their interaction were found to be best for improving the various horticultural and soil traits i.e. shelling percentage, protein content, effective nodules per plant, available nitrogen and phosphorus content. However, the application of Jeevamurta 20 % + Rhizobium 100 % + Farm yard manure on pea variety GS-10, resulted a positive increment in yielding traits namely, plant height, number of pods per plant, single pod weight, total pod yield, pod yield per plant and pod yield per plot. Conclusion: The combination of variety “GS-10” with Jeevamurta 20%, Rhizobium 100%, and FYM, showed the positive increment in productivity of the garden pea, also found to be effective to control the incidence of rust and powdery mildew. Highlights ·       Peas have the capability to fix atmospheric nitrogen in the soil, which ultimately benefits the growth and development ·       Modern agriculture heavily relies on the use of synthetic fertilizers, which are expensive and associated with significant environmental risks ·       It is necessary to focus on developing integrated farming practices that encompass cost-effective and sustainable alternatives to synthetic fertilizers. ·       Application of Jeevmurta 20% +Rhizobium 100% coupled with FYM were found to be the best for improvising the growth, yield, quality, and nutrient status of the soil

Photosensitized INA-Labelled protein 1 (PhIL1) is novel component of the inner membrane complex and is required for Plasmodium parasite development.

Plasmodium parasites, the causative agents of malaria, possess a distinctive membranous structure of flattened alveolar vesicles supported by a proteinaceous network, and referred to as the inner membrane complex (IMC). The IMC has a role in actomyosin-mediated motility and host cell invasion. Here, we examine the location, protein interactome and function of PhIL1, an IMC-associated protein on the motile and invasive stages of both human and rodent parasites. We show that PhIL1 is located in the IMC in all three invasive (merozoite, ookinete-, and sporozoite) stages of development, as well as in the male gametocyte and locates both at the apical and basal ends of ookinete and sporozoite stages. Proteins interacting with PhIL1 were identified, showing that PhIL1 was bound to only some proteins present in the glideosome motor complex (GAP50, GAPM1-3) of both P. falciparum and P. berghei. Analysis of PhIL1 function using gene targeting approaches indicated that the protein is required for both asexual and sexual stages of development. In conclusion, we show that PhIL1 is required for development of all zoite stages of Plasmodium and it is part of a novel protein complex with an overall composition overlapping with but different to that of the glideosome

Randomized Clinical Trial of High-Dose Rifampicin With or Without Levofloxacin Versus Standard of Care for Pediatric Tuberculous Meningitis: The TBM-KIDS Trial

Background. Pediatric tuberculous meningitis (TBM) commonly causes death or disability. In adults, high-dose rifampicin may reduce mortality. The role of fluoroquinolones remains unclear. There have been no antimicrobial treatment trials for pediatric TBM. Methods. TBM-KIDS was a phase 2 open-label randomized trial among children with TBM in India and Malawi. Participants received isoniazid and pyrazinamide plus: (i) high-dose rifampicin (30 mg/kg) and ethambutol (R30HZE, arm 1); (ii) high-dose rifampicin and levofloxacin (R30HZL, arm 2); or (iii) standard-dose rifampicin and ethambutol (R15HZE, arm 3) for 8 weeks, followed by 10 months of standard treatment. Functional and neurocognitive outcomes were measured longitudinally using Modified Rankin Scale (MRS) and Mullen Scales of Early Learning (MSEL). Results. Of 2487 children prescreened, 79 were screened and 37 enrolled. Median age was 72 months; 49%, 43%, and 8% had stage I, II, and III disease, respectively. Grade 3 or higher adverse events occurred in 58%, 55%, and 36% of children in arms 1, 2, and 3, with 1 death (arm 1) and 6 early treatment discontinuations (4 in arm 1, 1 each in arms 2 and 3). By week 8, all children recovered to MRS score of 0 or 1. Average MSEL scores were significantly better in arm 1 than arm 3 in fine motor, receptive language, and expressive language domains (P < .01). Conclusions. In a pediatric TBM trial, functional outcomes were excellent overall. The trend toward higher frequency of adverse events but better neurocognitive outcomes in children receiving high-dose rifampicin requires confirmation in a larger trial. Clinical Trials Registration. NCT02958709

Organic matter distribution pattern in Arabian Sea: Palynofacies analysis from the surface sediments off Karwar coast (west coast of India)

399-406Central Arabian Sea region, situated off the Karwar coast, is characterized by intense mid depth (~120-1200 m) oxygen minima zone and shows preservation and accumulation of relatively high organic matter content. Palynofacies analysis was carried out with a view to understand the organic matter production, preservation and degradation in the surface sediments of Arabian Sea from 15 m-2750 m depth off Karwar [14.47-14.40 N -70.77-74.25 E transect]. Palynofacies analysis, which involves qualitative and quantitative estimation of terrestrial and marine organic matter is a useful tool to decipher and assess paleoenvironmental changes in various water depth zones from shelf-slope region off the Karwar coast. There is a marked change in the palynofacies characteristics of the organic matter recovered from various depth zones. High SW monsoonal activity over Karwar coast results in increased runoff and nutrient loading in the coastal waters. This enhances primary productivity in the inner shelf region. Organic walled dinoflagellate cysts as important constituent of primary productivity, predominate under such conditions, being converted into Amorphous organic matter (AOM) as a result of degradation under low oxygen environment. Hence, in the present study high AOM is used as proxy for the low oxygen content at sediment-water interface. It also provides evidence of high primary productivity in the photic zone. Study further reveals that terrestrially derived charcoal and woody plant tissue resistant to degradation, are transported to continental slope regions at greater depths. Occurrence of a large proportion of well preserved labile organic matter (exoskeleton fragments of planktonic crustaceans) and AOM in the mid-outer slope surface sediments indicate enhanced primary productivity and high rate of burial efficiency making these areas, characteristic of low oxygen. The study shows that the Karwar coast margin is highly productive as a result of runoff related nutrient loading and is the primary cause for oxygen minima conditions