Changing trends in intrauterine contraceptive device: from interval intrauterine contraceptive device to postpartum intrauterine contraceptive device: a prospective observational study in a tertiary care hospital in eastern Uttar Pradesh

Background: The current outburst of Indian population (1.21 billion as per census 2011) is because of the lack of awareness and acceptance of contraception in the immediate postpartum period. Postpartum intrauterine contraceptive device (PPIUCD) insertion can do wonders and curb this unmet need of family planning if good counselling and proper insertion techniques are followed.Methods: The present study was carried among 526 women in the department of obstetrics and gynaecology of Nehru Hospital in BRD medical college Gorakhpur, India. Intrauterine contraceptive device (IUCD) was inserted in 424 women in PPIUCD group and in 102 women in interval IUCD group after taking proper consent and following the WHO medical eligibility criteria for contraceptive use (MEC). Follow-up was done at 6 weeks and 6 months.Results: The acceptance rate of PPIUCD was 30.34% as compared to 18% in interval IUCD group (p-value <0.05). The chief reason for declining the use of IUCD was fear of excessive pain and bleeding (26.3%). Long term reversible method (32%) was the main reason given for accepting IUCD. There was no perforation or any other major complication at the time of insertion in both the groups. Rate of expulsion was 5.7% in PPIUCD and 2.22% in interval IUCD group p-value (>0.05).Conclusions: PPIUCD is a safe, effective, feasible and reversible method of contraception. It should be made a part of family health care programmes in India

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Identification of Novel Broad-Spectrum Leaf Rust Resistance Sources from Khapli Wheat Landraces

Wheat leaf rust caused by Puccinia triticina Eriks is an important disease that causes yield losses of up to 40% in susceptible varieties. Tetraploid emmer wheat (T. turgidum ssp. Dicoccum), commonly called Khapli wheat in India, is known to have evolved from wild emmer (Triticum turgidum var. dicoccoides), and harbors a good number of leaf rust resistance genes. In the present study, we are reporting on the screening of one hundred and twenty-three dicoccum wheat germplasm accessions against the leaf rust pathotype 77-5. Among these, an average of 45.50% of the germplasms were resistant, 46.74% were susceptible, and 8.53% had mesothetic reactions. Further, selected germplasm lines with accession numbers IC138898, IC47022, IC535116, IC535133, IC535139, IC551396, and IC534144 showed high level of resistance against the eighteen prevalent pathotypes. The infection type varied from “;”, “;N”, “;N1” to “;NC”. PCR-based analysis of the resistant dicoccum lines with SSR marker gwm508 linked to the Lr53 gene, a leaf rust resistance gene effective against all the prevalent pathotypes of leaf rust in India and identified from a T. turgidum var. dicoccoides germplasm, indicated that Lr53 is not present in the selected accessions. Moreover, we have also generated 35K SNP genotyping data of seven lines and the susceptible control, Mandsaur Local, to study their relationships. The GDIRT tool based on homozygous genotypic differences revealed that the seven genotypes are unique to each other and may carry different resistance genes for leaf rust

The <i>Escherichia coli</i> Phosphotyrosine Proteome Relates to Core Pathways and Virulence

<div><p>While phosphotyrosine modification is an established regulatory mechanism in eukaryotes, it is less well characterized in bacteria due to low prevalence. To gain insight into the extent and biological importance of tyrosine phosphorylation in <i>Escherichia coli</i>, we used immunoaffinity-based phosphotyrosine peptide enrichment combined with high resolution mass spectrometry analysis to comprehensively identify tyrosine phosphorylated proteins and accurately map phosphotyrosine sites. We identified a total of 512 unique phosphotyrosine sites on 342 proteins in <i>E. coli</i> K12 and the human pathogen enterohemorrhagic <i>E. coli</i> (EHEC) O157:H7, representing the largest phosphotyrosine proteome reported to date in bacteria. This large number of tyrosine phosphorylation sites allowed us to define five phosphotyrosine site motifs. Tyrosine phosphorylated proteins belong to various functional classes such as metabolism, gene expression and virulence. We demonstrate for the first time that proteins of a type III secretion system (T3SS), required for the attaching and effacing (A/E) lesion phenotype characteristic for intestinal colonization by certain EHEC strains, are tyrosine phosphorylated by bacterial kinases. Yet, A/E lesion and metabolic phenotypes were unaffected by the mutation of the two currently known tyrosine kinases, Etk and Wzc. Substantial residual tyrosine phosphorylation present in an <i>etk wzc</i> double mutant strongly indicated the presence of hitherto unknown tyrosine kinases in <i>E. coli</i>. We assess the functional importance of tyrosine phosphorylation and demonstrate that the phosphorylated tyrosine residue of the regulator SspA positively affects expression and secretion of T3SS proteins and formation of A/E lesions. Altogether, our study reveals that tyrosine phosphorylation in bacteria is more prevalent than previously recognized, and suggests the involvement of phosphotyrosine-mediated signaling in a broad range of cellular functions and virulence.</p></div

Proteomics approach used for phosphotyrosine profiling of <i>E. coli</i>.

<p>EHEC O157:H7 strain TUV93-0 and <i>E. coli</i> K12 strain MG1655 were grown to stationary phase in DMEM. Total protein was trypsin-digested, peptides purified using reversed-phased chromatography and subjected to immunoaffinity (IP)-based phosphotyrosine enrichment. Tyrosine phosphorylated peptides were identified by high resolution LC-MS/MS analysis using LTQ Orbitrap XL and Velos instruments.</p

BY kinases Etk and Wzc are dispensable for the A/E lesion phenotype of EHEC O157:H7.

<p>HeLa cells were co-cultured with wild type EHEC O157:H7, <i>etk</i>, <i>wzc</i> and <i>etk wzc</i> double mutant derivatives for 5 h followed by actin staining of infected cells using FITC-phalloidin to visualize A/E lesion formation. Representative images of FITC-phalloidin stained actin of infected HeLa cells are shown with arrowheads indicating A/E lesions.</p

Tyrosine phosphorylation of SspA Tyr92 affects virulence phenotypes of EHEC O157:H7.

<p>(A) Location of Tyr92 in dimeric SspA (PDB 1YY7 <a href="http://www.plospathogens.org/article/info:doi/10.1371/journal.ppat.1003403#ppat.1003403-Hansen1" target="_blank">[42]</a>). The structure of dimeric SspA is shown as blue ribbon diagrams. The hydrophobic residues Tyr92 and His85 of the functionally important surface-exposed pocket are shown in green and orange, respectively. The hydroxyl group of Tyr92 that is subject to phosphorylation is shown in red. The SspA structure was visualized using PyMOL (Schrödinger LLC). (B) SspA Tyr92 positively affects expression and secretion of T3SS proteins. The abundance of LEE-encoded proteins in whole cell lysates (lanes 1–4) and their abundance in culture supernatants (lanes 5–8) from cultures of wild type EHEC O157:H7 and isogenic <i>sspA</i> mutants were determined by western analyses as described in <a href="http://www.plospathogens.org/article/info:doi/10.1371/journal.ppat.1003403#s4" target="_blank"><i>Material and Methods</i></a>. Strains tested included the <i>sspA</i> mutant containing the vector control pSec10*, the <i>sspA</i> mutant expressing wild type SspA from pSspA and the SspA Y92F mutant from pSspAY92F. EspA, EspB, Tir, SspA and GroEL were detected using polyclonal antisera against the respective proteins. GroEL served as an internal control for the total amount of protein in cell samples, and for the precipitation of proteins in culture supernatants to which 100 ng of GroEL were added. (C) SspA Tyr92 positively affects the A/E phenotype of EHEC O157:H7. A/E lesion formation was assessed using the FAS test as described in <a href="http://www.plospathogens.org/article/info:doi/10.1371/journal.ppat.1003403#s4" target="_blank"><i>Material and Methods</i></a>. HeLa cells were co-cultured for 5 h with wild type EHEC O157:H7, an <i>sspA</i> mutant and the <i>sspA</i> mutant harboring the vector pSec10*, pSspA (SspA) and pSspAY92F (SspAY92F). The actin cytoskeleton of HeLa cells was stained with FITC-phalloidin for visualization of the A/E lesions. Representative images of fluorescence stained actin of infected HeLa cells are shown. Arrows indicate examples of A/E lesions.</p

Definition of <i>E. coli</i> tyrosine phosphorylation site motifs.

<p>(A–E) Probability logos of significantly enriched phosphotyrosine site motifs extracted from 512 unique pTyr sites by aligning peptide sequences comprising 12 residues surrounding the phosphorylated tyrosine residue using Motif-X (<i>p value</i><0.001). Site motif consensus sequences with variable residues indicated as x and the number of unique sites comprising each motif are indicated. (F) Sequence logos of the general residue representation surrounding the phosphorylated tyrosine residue from the 512 unique sites with residues above the midline being overrepresented and those below underrepresented constructed using Phophosite logo generator.</p