Recent trends in the immunopathogenesis of tuberculosis

Tuberculosis kills about 500,000 Indians every year, ie, one person every minute. For every patient who dies of the disease, there are at least two individuals who develop disability. Further, the advent of infection by the human immunodeficiency virus and drug resistant forms of Mycobacterium tuberculosis have made the management and control of tuberculosis more difficult. Although the genome of M. tuberculosis has been sequenced, diagnosis of the infectious sputum positive case is straightforward, simple and inexpensive and effective short course chemotherapy is available, morbidity and mortality due to the disease have not appreciably decreased. Among the several reasons cited for this failure are the inadequacy of the BCG vaccine in preventing post primary tuberculosis and the relatively long duration (six months) of chemotherapy which encourages irregularity and incomplete treatment. Furthermore, two more aspects which deserve consideration are a) lack of appropriate tests to identify the individual who is likely to develop clinical illness and b) disability caused by the disease process. This presentation will limit itself to two major areas of the immunopathology of the disease. These are a) host immune mechanisms underlying the varied clinical and pathological manifestations and b) events that lead to tissue damage and disability

Enhancement of agronomic traits and yield of rice var. ADT 43 grown in typic ustifluvent soil through silicon fertilization

Rice is a rich accumulator of silicon and its supply is essential for the growth and economic yield of rice. Hence, a field experiment was conducted in sandy clay loam soil belonging to Padugai series (Typic ustifluvent) at farmers holding in Kuttalam block, Mayiladuthurai district, Tamil Nadu to assess the role of silicon in improving agronomic characters and yield of rice ADT 43, Oryza sativa. The treatments included  T1 -  Recommended dose of fertilizer (RDF), T2 - RDF + Potassium silicate (FS) - 0.25%, T3- RDF + FS - 0.50%, T4 - RDF +FS - 1.00%, T5­ -RDF + FS - 0.25%, T6 - RDF + FS - 0.50%,  T7­ - RDF + FS - 1.00%,  T8 - RDF + SA - 50 kg ha-1, T9 - RDF + SA - 100 kg ha-1 and T10 - RDF + SA- 150 kg ha-1. From T2 to T4, the foliar spray was done at tillering stage and from T5 to T7, the foliar spray was done at tillering and panicle initiation stage.  The silicon was applied through FS with the rice crop. The soil application of silicon relatively recorded higher growth and yield compared to foliar application. Besides improving different agronomic characters of the rice, the soil application of 50 kg Si ha-1 registered the highest grain yield (6183.3 kg ha-1) and straw yield (6740 kg ha-1) and was comparable with a single foliar spray of 1% Si.  Growth and rice yield increased with Si concentration of 0.25% to 1%.  Thus, the soil application of silicon @50 kg ha-1 through potassium silicate is advocated to realize maximum rice yield

Fetus papyraceous: a case report of preterm premature rupture of membrane with adherent placenta

Fetus papyraceous is a rare condition and is associated with obstetric complications. Antenatal diagnosis of this condition aids in follow-up care of co twin(s) as well as to predict future obstetric complications. In this report, we describe a case of fetus papyraceous identified after the manual removal of adherent placenta

A rare case of a ruptured ovarian pregnancy

Ovarian pregnancy is a rare type of extrauterine pregnancy accounting for 1 to 3% of all extrauterine pregnancies. We report a rare case of a ruptured ovarian pregnancy. A 22 year old, gravida 2 para 1 living 1 was admitted with amenorrhea of 4 weeks and 6 days with chief complaints of severe acute lower abdomen pain. Urine pregnancy test was positive. Ultrasonogram pelvis revealed left sided ruptured adnexal mass with moderated hemoperitoneum. Laparotomy was performed and a diagnosis of ruptured ovarian pregnancy was made. Biopsy of the mass was taken which confirmed the diagnosis. Although ovarian pregnancy is rare, in any case of a ruptured ectopic pregnancy where the tubes are found to be normal on laparotomy, an ovarian pregnancy must be ruled out. Early detection and prompt diagnosis can preserve the future fertility of the woman

Traditional Remedies for Wound Healing: A Review

Wounds are a natural part of everyday life that can be successfully treated with the knowledge of Ayurveda. Ayurveda is the study of science that is based on herbal remedies. A wound must progress through vrana shodhana (wound purification) and vrana roopana (wound healing) and pass through the four stages of wound healing; dushta vrana (septic wound), shudh vrana (clean wound), roohyamana vrana (healing wound), and roodha vrana (healed wound). Through this, Ayurveda has revealed knowledge for treating conditions that can’t be treating by the modern medicine. Ghee-based herbal formulations claimed to promote wound healing in traditional practices. This article aims to provide probable scientific explanations for using medicated ghrita (ghee) as wound healing formulation in Ayurvedic system of medicine and its clinical importance. Keywords: Ayurveda, Wound, Ghrita, Wound healing

Success of an International Learning Health Care System in Hematopoietic Cell Transplantation: The American Society of Blood and Marrow Transplantation Clinical Case Forum

The ASBMT Clinical Case Forum (CCF) was launched in 2014 as an online secure tool to enhance interaction and communication among hematopoietic cell transplantation (HCT) professionals worldwide through the discussion of challenging clinical care issues. After 14 months, we reviewed clinical and demographical data on cases posted in the CCF from 1/29/2014 to 3/18/2015. A total of 137 cases were posted during the study period. Ninety-two cases (67%) were allogeneic HCT, 29 (21%) autologous HCT and in 16 (12%) the type of transplant (auto vs. allo) was still under consideration. The diseases most frequently discussed included non-Hodgkin lymphoma (NHL; n = 30, 22%), acute myeloid leukemia (AML; n = 23, 17%) and multiple myeloma (MM; n = 20, 15%). When compared with the US transplant activity reported by the US Department of Health and Human Services, NHL and acute lymphoblastic leukemia cases were overrepresented in the CCF while myeloma was underrepresented (P < 0.001). A total of 259 topics were addressed in the CCF with a median of two topics/case (range 1-6). Particularly common topics included whether transplant was indicated (n = 57, 41%), conditioning regimen choice (n = 44, 32%), and post-HCT complications after day 100 (n = 43, 31%). The ASBMT CCF is a successful tool for collaborative discussion of complex cases in the HCT community worldwide and may allow identification of areas of controversy or unmet need from clinical, educational and research perspectives

Analysis of Stability and G × E Interaction of Rice Genotypes across Saline and Alkaline Environments in India

Genotype × environment (G × E) interaction effects are of special interest for identifying the most suitable genotypes with respect to target environments, representative locations and other specific stresses. Twenty-two advanced breeding lines contributed by the national partners of the Salinity Tolerance Breeding Network (STBN) along with four checks were evaluated across 12 different salt affected sites comprising five coastal saline and seven alkaline environments in India. The study was conducted to assess the G × E interaction and stability of advanced breeding lines for yield and yield components using additive main effects and multiplicative interaction (AMMI) model. In the AMMI1 biplot, there were two mega-environments (ME) includes ME-A as CARI, KARAIKAL, TRICHY and NDUAT with winning genotype CSR 2K 262; and ME-B as KARSO, LUCKN, KARSA, GOA, CRRI, DRR, BIHAR and PANVE with winning genotypes CSR 36. Genotypes CSR 2K 262, CSR 27, NDRK 11-4, NDRK 11-3, NDRK 11-2, CSR 2K 255 and PNL 1-1-1-6-7-1 were identified as specifically adapted to favorable locations. The stability and adaptability of AMMI indicated that the best yielding genotypes were CSR 2K 262 for both coastal saline and alkaline environments and CSR 36 for alkaline environment. CARI and PANVEL were found as the most discernible environments for genotypic performance because of the greatest GE interaction. The genotype CSR 36 is specifically adapted to coastal saline environments GOA, KARSO, DRR, CRRI and BIHAR and while genotype CSR 2K 262 adapted to alkaline environments LUCKN, NDUAT, TRICH and KARAI. Use of most adapted lines could be used directly as varieties. Using them as donors for wide or specific adaptability with selection in the target environment offers the best opportunity for widening the genetic base of coastal salinity and alkalinity stress tolerance and development of adapted genotypes. Highly stable genotypes can improve the rice productivity in salt-affected areas and ensure livelihood of the resource poor farming communities

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

Cytokine and Chemokine Concentrations as Biomarkers of Feline Mycobacteriosis

Abstract Mycobacteriosis is an emerging zoonotic disease of domestic cats and timely, accurate diagnosis is currently challenging. To identify differential cytokine/chemokine concentrations in serum/plasma of cats, which could be diagnostic biomarkers of infection we analysed plasma/serum from 116 mycobacteria-infected cats, 16 healthy controls and six cats hospitalised for unrelated reasons was analysed using the Milliplex MAP Feline Cytokine Magnetic Bead multiplex assay. Three cytokines; sFAS, IL-13 and IL-4 were reduced while seven; GM-CSF, IL-2, PDGF-BB, IL-8, KC, RANTES and TNF-α were elevated in mycobacteria-infected cats compared to healthy controls. However, IL-8 and KC concentrations were not significantly different from cats hospitalised for other reasons. Elevations in TNF-α and PDGF-BB may have potential to identify M. bovis and M. microti infected cats specifically while GM-CSF, IL-2 and FLT3L were increased in MTBC infected cats. This study demonstrates potential use of feline tuberculosis as a spontaneously occurring model of this significant human disease. Cytokine profiling has clear diagnostic potential for mycobacteriosis of cats and could be used discriminate tuberculous from non-tuberculous disease to rapidly inform on zoonotic risk. Future work should focus on the in-field utility of these findings to establish diagnostic sensitivity and specificity of these markers

Studies on the Management of Soil Fertility and Sustainable Productivity in Bhendi [Abelmoschus esculentus (L.) Moench]

A field experiment on COBh Hybrid Bhendi 4 was conducted in the Department of Horticulture, Pandit Jawaharlal Nehru College of Agriculture and Research Institute, Karaikal, U.T. of Puducherry, during summer 2022 with the objective of comparing the effects of organics and bioenhancers on soil fertility restoration and sustained vegetable production. The experiment was laid out in a Randomized Block Design with two replications involving two factors (fertilisers and bioenhancers) forming eighteen treatment combination in a factorial way (FRBD). The study material comprised of vermicompost and goat manure (organics) as well as panchagavya and jivamirtham (bioenhancers), besides recommended FYM and N, P, K fertilisers in various combinations. Maximum plant height (118.62 cm), number of primary branches (5.02) at final harvest, maximum fruit length (15.49 cm) and fruit girth (6.89 cm), fruit weight (21.71 g), number of fruits plant-1 (51.70), highest yield (891.60 g plant-1 and 16.47 t ha-1) and maximum dry matter production (5.74 t ha-1) were recorded in the treatment receiving RDF with 3 per cent panchagavya as foliar spray on 30, 45, 60 and 75 DAS