Newborn Aides: An Innovative Approach in Sick Newborn Care at a District-level Special Care Unit

A Sick Newborn Care Unit (SNCU), established in a district hospital in India, substantially reduced the neonatal mortality rate in the district; it, however, suffered from a dearth of trained nurses. Local girls with 10-12 years of school education underwent structured and hands-on training for six months, followed by a six-month internship at the SNCU and were assigned to it as stipendiary ‘Newborn Aides’. Based on the results of formal examinations, internal on-the-job assessment and interview of doctors, nurses, and parents and their technical skills and motivation were rated very high. Although the incremental cost of training is small, the cost of sustaining them, i.e. stipend and replacing attrition, needs to be addressed. Trained Newborn Aides may substantially alleviate human-resource constraint for SNCUs and Sick Newborn Stabilization units in smaller peripheral hospitals for care of sick newborns at an affordable cost

Izdvajanje, molekularna obilježja i otpornost na antibiotike enterotoksigenih (ETEC) i nekrotoksigenih sojeva E. coli izdvojenih iz zdravih azijskih vodenih bivola.

The present study was undertaken to detect the prevalence, virulence gene profile and antibiotic resistance of Enterotoxigenic Escherichia coli (ETEC) and Necrotoxigenic E. coli (NTEC) in healthy water buffalo in West Bengal. Out of the 363 E. coli isolates from 165 faecal samples, 18 (4.95%) and 7 (1.9%) isolates were found to possess genes for ETEC (LT or STa or STb) and NTEC (cnf1 or cnf2), respectively in PCR. Among the 18 ETEC isolates, 13 (72.22%), 12 (66.67%), and 1 (5.56%) isolates were found to harbour STa, LT, and STb genes respectively. However, among the 7 NTEC isolates, 3 (42.85%) and 4 (57.14%) were detected to possess cnf1 and cnf2 genes, respectively. Further, among the five isolates possessing the EAST 1 gene, four were detected with the STa gene and one (1) with the LT gene. However, the majority of the F41 strains possessed ST genes, and F5 strains harboured both LT and ST. In addition, one out of three cnf1 NTEC isolates was detected to harbour the papC gene and all the four cnf2 NTEC isolates contained the cdt gene. The ETEC isolates belonged to 11 different serogroups (O11, O53, O71, O84, O88, O103, O112, O120, O128, O153, and O158), while, four NTEC isolates belonged to the OUT serogroup and the remaining 3 were disseminated among the O2, O4, and O6 serogroups. The RAPD of the ETEC isolates produced different electrophoretic profifi les. The antibiotic resistance of ETEC and NTEC isolates was observed most frequently to amikacin (56%), kanamycin (44%), gentamicin (40%), neomycin (36%). The study thus revealed water buffalo as a reservoir of multi drug resistant ETEC/NTEC for the first time in India.Istraživanje je provedeno s ciljem da se ustanovi prevalencija, geni za virulenciju i otpornost na antibiotike enterotoksigenih (ETEC) i nekrotoksigenih (NTEC) sojeva bakterije Escherichia coli izdvojene iz zdravih vodenih bivola iz Zapadnog Bengala. Od 363 izolata E. coli iz 165 uzoraka fecesa, 18 (4,95%) je posjedovalo neki od gena za ETEC (LT ili STa ili STb), a sedam (1,9%) izolata imalo je gene za NTEC (cnf1 ili cnf2) dokazane PCR-om. Od 18 izolata ETEC, 13 (72,22%) je imalo gen STa, 12 (66,67%) gen LT i jedan (5,56%) gen STb. Međutim, od sedam NTEC izolata, tri (42,85%) su imala gen cnfl , a četiri (57,14%) gen cnf2. Nadalje, od pet izolata koji su posjedovali gen EAST 1, četiri su imala gen Sta, a jedan gen LT. Većina sojeva F41 posjedovala je gen ST, a sojevi F5 i LT i ST gen. Nadalje, jedan od triju cnf1 NTEC izolata imao je i gen papC, a sva četiri izolata cnf2 NTEC sadržavala su gen cdt. Izolati ETEC pripadali su u 11 različitih seroloških skupina (O11, O53, O71, O84, O88, O103, O112, O120, O128, O153 i O158). Četiri izolata NTEC pripadala su serološkoj skupini OUT, a preostala tri skupinama O2, O4 i O6. RAPD izolata ETEC davao je različite elektroforetske profile. Izolati ETEC i NTEC najčešće su bili otporni na amikacin (56%), kanamicin (44%), gentamicin (40%) i neomicin (36%). Ovim istraživanjem prviput je u Indiji ustanovljeno da su vodeni bivoli rezervoar multiplo rezistentnih sojeva ETEC/NTEC

Prevalencija i otpornost na lijekove šiga-toksigenih (STEC), enteropatogenih (EPEC) i enterotoksigenih (ETEC) izolata bakterije Escherichia coli u slobodno držanih jakova s proljevom i bez proljeva u pokrajini West Kameng, Arunachal Pradesh, Indija.

Food producing animals are the major reservoirs of Shiga-toxin producing (STEC) and enteropathogenic Escherichia coli (EPEC). The yak (Poephagus grunniens) is a unique multipurpose bovid, reared by highlanders in the Himalayan region. A total of 67 STEC, 5 EPEC and 22 ETEC strains were isolated from 256 rectal swabs of free ranging yaks from the West Kameng district of Arunachal Pradesh, India. Among the STEC isolates, shiga toxin producing genes stx2 was predominant, followed by stx1. Of all the stx variants, stx1c, stx2d, stx2c, stx2e and stx2f were detected in 23, 11, 2 and 1 isolates, respectively. Further, genes such as eaeA, ehxA, saa, iha and toxB were detected in 16, 35, 28, 10 and 2 isolates, respectively. One of the EPEC isolates possessed a bfpA gene and was categorized as typical EPEC. Among the ETEC isolates, genes such as LT, STa, STb, F41 and K99 were detected in 14, 5, 13, 2 and 2 isolates, respectively. The majority of the STEC, EPEC and ETEC isolates exhibited multi-drug resistance. The study revealed the presence of multi-drug resistant diarrhoea genic E. coli in free ranging yaks from the West Kameng district of Arunachal Pradesh. Moreover, the presence of STEC/EPEC can be a potential public health risk for tribal highlanders residing in close proximity of the reservoir yaks.Životinje koje služe za proizvodnju hrane mogu biti rezervoar šiga-toksigenih (STEC) i enteropatogenih (EPEC) sojeva bakterije Escherichia coli. Jak (Poephagus grunniens) je jedinstveni multipari bovid kojeg uzgajaju gorštaci na Himalaji. Ukupno je bilo izdvojeno 67 STEC sojeva, 5 EPEC sojeva i 22 ETEC soja iz 256 rektalnih obrisaka slobodno držanih jakova na području West Kameng, Arunachal Pradesh, Indija. Među izolatima STEC prevladavao je gen stx2 za prizvodnju šiga-toksina, a slijedio ga je gen stx1. Od svih varijanata gena stx, stx1c bio je dokazan u 23 izolata, stx2d u 11 izolata, stx2c u dva izolata, a stx2e i stx2f u jednog izolata. Nadalje gen eaeA dokazan je u 16 izolata, gen ehxA u 35, gen saa u 28, gen iha u 10 te gen toxBu dva izolata. Jedan od izolata EPEC posjedovao je gen bfpA i svrstan je u tipične EPEC izolate. Gen LT dokazan je u 14 ETEC izolata, gen Sta u pet, gen STb u 13, gen F41 u dva i K99 također u dva izolata. Većina izolata STEC, EPEC i ETEC pokazivala je otpornost na više lijekova. Istraživanje je pokazalo da postoji višestruka otpornost bakterije E. coli izdvojene iz slobodno držanih jakova s proljevom na području West Kameng, Arunachal Pradesh. Povrh toga, prisutnost STEC/EPEC može predstavljati rizik za javno zdravstvo za gorštačka plemena koja dolaze u bliski dodir s jakovima

Prevalencija i otpornost na lijekove šiga-toksigenih (STEC), enteropatogenih (EPEC) i enterotoksigenih (ETEC) izolata bakterije Escherichia coli u slobodno držanih jakova s proljevom i bez proljeva u pokrajini West Kameng, Arunachal Pradesh, Indija.

Food producing animals are the major reservoirs of Shiga-toxin producing (STEC) and enteropathogenic Escherichia coli (EPEC). The yak (Poephagus grunniens) is a unique multipurpose bovid, reared by highlanders in the Himalayan region. A total of 67 STEC, 5 EPEC and 22 ETEC strains were isolated from 256 rectal swabs of free ranging yaks from the West Kameng district of Arunachal Pradesh, India. Among the STEC isolates, shiga toxin producing genes stx2 was predominant, followed by stx1. Of all the stx variants, stx1c, stx2d, stx2c, stx2e and stx2f were detected in 23, 11, 2 and 1 isolates, respectively. Further, genes such as eaeA, ehxA, saa, iha and toxB were detected in 16, 35, 28, 10 and 2 isolates, respectively. One of the EPEC isolates possessed a bfpA gene and was categorized as typical EPEC. Among the ETEC isolates, genes such as LT, STa, STb, F41 and K99 were detected in 14, 5, 13, 2 and 2 isolates, respectively. The majority of the STEC, EPEC and ETEC isolates exhibited multi-drug resistance. The study revealed the presence of multi-drug resistant diarrhoea genic E. coli in free ranging yaks from the West Kameng district of Arunachal Pradesh. Moreover, the presence of STEC/EPEC can be a potential public health risk for tribal highlanders residing in close proximity of the reservoir yaks.Životinje koje služe za proizvodnju hrane mogu biti rezervoar šiga-toksigenih (STEC) i enteropatogenih (EPEC) sojeva bakterije Escherichia coli. Jak (Poephagus grunniens) je jedinstveni multipari bovid kojeg uzgajaju gorštaci na Himalaji. Ukupno je bilo izdvojeno 67 STEC sojeva, 5 EPEC sojeva i 22 ETEC soja iz 256 rektalnih obrisaka slobodno držanih jakova na području West Kameng, Arunachal Pradesh, Indija. Među izolatima STEC prevladavao je gen stx2 za prizvodnju šiga-toksina, a slijedio ga je gen stx1. Od svih varijanata gena stx, stx1c bio je dokazan u 23 izolata, stx2d u 11 izolata, stx2c u dva izolata, a stx2e i stx2f u jednog izolata. Nadalje gen eaeA dokazan je u 16 izolata, gen ehxA u 35, gen saa u 28, gen iha u 10 te gen toxBu dva izolata. Jedan od izolata EPEC posjedovao je gen bfpA i svrstan je u tipične EPEC izolate. Gen LT dokazan je u 14 ETEC izolata, gen Sta u pet, gen STb u 13, gen F41 u dva i K99 također u dva izolata. Većina izolata STEC, EPEC i ETEC pokazivala je otpornost na više lijekova. Istraživanje je pokazalo da postoji višestruka otpornost bakterije E. coli izdvojene iz slobodno držanih jakova s proljevom na području West Kameng, Arunachal Pradesh. Povrh toga, prisutnost STEC/EPEC može predstavljati rizik za javno zdravstvo za gorštačka plemena koja dolaze u bliski dodir s jakovima

Newborn Aides: An Innovative Approach in Sick Newborn Care at a District-level Special Care Unit

A Sick Newborn Care Unit (SNCU), established in a district hospital in India, substantially reduced the neonatal mortality rate in the district; it, however, suffered from a dearth of trained nurses. Local girls with 10-12 years of school education underwent structured and hands-on training for six months, followed by a six-month internship at the SNCU and were assigned to it as stipendiary \u2018Newborn Aides'. Based on the results of formal examinations, internal on-the-job assessment and interview of doctors, nurses, and parents and their technical skills and motivation were rated very high. Although the incremental cost of training is small, the cost of sustaining them, i.e. stipend and replacing attrition, needs to be addressed. Trained Newborn Aides may substantially alleviate human-resource constraint for SNCUs and Sick Newborn Stabilization units in smaller peripheral hospitals for care of sick newborns at an affordable cost

Isotope thermometery in nuclear multifragmentation

A systematic study of the effect of fragment$-$fragment interaction, quantum statistics, $\gamma$-feeding and collective flow is made in the extraction of the nuclear temperature from the double ratio of the isotopic yields in the statistical model of one-step (Prompt) multifragmentation. Temperature is also extracted from the isotope yield ratios generated in the sequential binary-decay model. Comparison of the thermodynamic temperature with the extracted temperatures for different isotope ratios show some anomaly in both models which is discussed in the context of experimentally measured caloric curves.Comment: uuencoded gzipped file containing 20 pages of text in REVTEX format and 12 figures (Postscript files). Physical Review C (in press

Characterization of magnesium requirement of human 5'-tyrosyl DNA phosphodiesterase mediated reaction

<p>Abstract</p> <p>Background</p> <p>Topo-poisons can produce an enzyme-DNA complex linked by a 3'- or 5'-phosphotyrosyl covalent bond. 3'-phosphotyrosyl bonds can be repaired by tyrosyl DNA phosphodiesterase-1 (TDP1), an enzyme known for years, but a complementary human enzyme 5'-tyrosyl DNA phosphodiesterase (hTDP2) that cleaves 5'-phosphotyrosyl bonds has been reported only recently. Although hTDP2 possesses both 3'- and 5'- tyrosyl DNA phosphodiesterase activity, the role of Mg²⁺in its activity was not studied in sufficient details.</p> <p>Results</p> <p>In this study we showed that purified hTDP2 does not exhibit any 5'-phosphotyrosyl phosphodiesterase activity in the absence of Mg²⁺/Mn²⁺, and that neither Zn²⁺or nor Ca²⁺can activate hTDP2. Mg²⁺also controls 3'-phosphotyrosyl activity of TDP2. In MCF-7 cell extracts and de-yolked zebrafish embryo extracts, Mg²⁺controlled 5'-phosphotyrosyl activity. This study also showed that there is an optimal Mg²⁺concentration above which it is inhibitory for hTDP2 activity.</p> <p>Conclusion</p> <p>These results altogether reveal the optimal Mg²⁺requirement in hTDP2 mediated reaction.</p

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

INFRARED SPECTROSCOPIC DEMONSTRATION OF COOPERATIVE STRENGTHENING OF AN INTRAMOLECULAR O H--O HYDROGEN BOND BY A WEAK C H--O COUNTERPART

Author Institution: Physical Chemistry Department, Indian Association for the Cultivation of Science, Jadavpur, Kolkata 700032Cooperativity is an important attribute of interconnected hydrogen bonds, and the classic examples are the size and shape dependent stability of small water clusters. The effect involving C H--O hydrogen bonds has been theoretically predicted and inferred also by analyzing crystallographic data. However, direct demonstration by infrared spectroscopy, in terms of spectral shifts, is scarce. We report here such effect probing the spectral shifts of various stretching fundamentals associated with an intramolecular O H--O=C linkage of the tautomer of 1,2-cyclohexanedione. Two types of interconnected C H--O bonds, intra- and intermolecular, with the above linkage are generated. In the first case, we have used 3-methyl 1,2-cyclohexane dione and spectral measurements reveal that the cooperative stabilization occurs with displaying a blue-shifting of the C H stretching fundamental of the hydrogen-bonded methyl C H group. For the intermolecular case, a 1:1 complex between 1,2-cyclohexanedione and chloroform has been used, and the complexation results further red-shifting of the O H stretching fundamental and a concomitant blue-shifting of the C=O stretching fundamental. The details of the spectral effects are corroborated by predictions of electronic structure calculations

Modified decompression technique in the management of odontogenic cystic lesions: An retrospective study

Introduction: Odontogenic cystic lesions requiring conservative management were treated with a novel technique of modified decompression and assessed. Aims and Objective: This study aimed to evaluate the resolution of the lesion, recurrence, and complications in patients treated with the novel modified decompression technique. Materials and Methods: The retrospective study included patients treated with the novel modified decompression technique between 2004 and 2022. The cystic lesions were packed with chlorhexidine acetate gauze dressing (Bactigras), and patients were prescribed a combination of Calcium, Vitamin C, and Vitamin D. Pack was changed periodically until a reduction of at least 80% in the volume of the lesion was achieved. Period of decompression, volume at each follow-up, and lesion size were recorded. In addition, inter-group significance co-relating the size and diagnosis of the lesions with the rate and duration of healing were derived by ANOVA test. Results: OKC, unicystic ameloblastoma, and dentigerous cysts were included, and the follow-up period ranged from one year to eighteen years. 25 cases (83.33%) showed full resolution, whereas five cases (16.17%) showed more than 80% resolution. The period of decompression and the rate of decompression was found to correlate with both the diagnosis and the size of the lesion. Conclusions: The modified decompression technique is superior to traditional decompression with a high rate of resolution of cystic lesions and no recurrence over a long follow-up period