Lactate dehydrogenase levels in preeclampsia and its correlation with maternal and perinatal outcome

Background: Hypertensive disorder of pregnancy occurs in approximately 6-8% of all pregnancies. The most serious consequences for the mother and the baby are the result of preeclampsia and eclampsia. Lactate Dehydrogenase (LDH) is an intracellular enzyme. Recently LDH has been suggested as potential marker to predict severity of pre-eclampsia. The objective of the present study was to compare the serum lactate dehydrogenase levels in women with preeclampsia and normal pregnant women and to correlate lactate dehydrogenase levels with maternal and perinatal outcome in preeclampsia.Methods: An observational prospective study was conducted on 200 antenatal women attending the labour room emergency. Women with singleton pregnancy and cephalic presentation, from 28 weeks onwards were enrolled in the study. Out of 200, 100 were normal pregnant women and 100 were preeclamptic women. Serum LDH levels were measured in all women and maternal and perinatal outcome was assessed in terms of LDH levels.Results: Higher levels of LDH was observed in pregnant women with preeclampsia (627.38±230.04 IU/l) as compared to normal pregnant women (224.43±116.61 IU/l). The maternal complications were found to be maximum in women with LDH > 800 IU/l.  Abruption was the most common complication. The perinatal mortality and neonatal deaths were found to have significant correlation with high LDH levels.Conclusions: Maternal and perinatal complications were associated with higher LDH levels in preeclampsia patients. Serum LDH levels can be offered to all patients of preeclampsia and can be used to predict the prognosis of preeclampsia

Multivariate analysis of histopathological features as prognostic factors in fifty cases of thyroid neoplasm: a retrospective study done at tertiary care centre

Background: Number of prognostic factors for thyroid carcinoma have been identified including age, gender and tumor characteristics, such as histology and stage. The importance of these factors as independent predictors of survival for patients with differentiated thyroid carcinoma has been extensively studied but remains uncertain. Methods: A retrospective analysis of 50 thyroid carcinomas was made to assess prognostic factors including histological variants from September 2019 to February 2022 at our centre. The surgical and histopathological data were studied. Results: 72% patients had papillary thyroid cancer. Multivariate analysis was done and factors showing prognostic significance were tumour size, extrathyroid extension, extranodal extension, lymphovascular, perineural invasion, histological type, necrosis, focality, capsular invasion were found to have poor prognosis. Conclusions: There are histopathological factors which can modify the course and influence the line of treatment of thyroid neoplasms

Lipase catalyzed esterification of Docosahexaenoic acid (DHA) with immobilized Pseudomonas cepacia and Thermomyces lanuginosus

139-149The selective behaviour of lauryl alcohol to catalyze esterification for the synthesis of tuna free fatty acids (TFFAs) using immobilized Pseudomonas cepacia (PCL) and Thermomyces lanuginosus lipases (TLL) have been investigated. The characterization of both immobilized PCL and TLL and their support immobead-150 is carried out using particle size analyzer, BET method and FT-IR. The suitable reaction conditions have been determined as lauryl alcohol to TFFAs ratio 4:1 (wt/wt), pH 8.0, buffer to TFFAs ratio 1:1 (wt/wt), temperature 50°C and agitation speed 800 rpm. Reusability of both the immobilized lipases for esterification has also been carried out and the activity was stabilized at 60.9% and 47.6% after 5 cycles of repeated use of immobilized PCL and TLL, respectively. Maximum 93.8 wt% Docosahexaenoic acid is recovered in esters with immobilized PCL after 16 h

Hepatitis C Virus (HCV) and its Genetic Diversity in clinical Isolates from Uttarakhand Population

Hepatitis C is major cause of chronic liver disease. It has been recognised as a global health problem because of the progression to cirrhosis and hepatocellular cancer. Quantization and genotyping of HCV RNAs are important to determine the optimal duration of anti-viral therapy and predict likelihood of response. Total 77 samples were tested biochemically, serologically and molecular assay (Roche COBAS TaqMan 48 Real Time PCR). Out of 77 cases 33(42.85%) were with high viral load (>103IU/ ml of HCV RNA) and low viral load (below 103IU/ml) 2 (2.59%) and 42 (54.54%) were target not detected (below 25 IU/ml). Genotype 3 was prevailed with 68.42% out of 35 cases followed by HCV genotype 15.78% in 1, 5.26% in 2 and 6, 2.63% in 1b and 4. In addition, our studies showed that genotype 1, 2, 4 and 6 (mixed genotype was detected in 1 cases with viral load 6.62 × 108IU/ml). Total protein content in serum in all the cases was average except 04 cases that was having low protein content. 02 cases were having low uric acid content that was having high viral load. From all high positive (high viral load) cases which were further diagnosed for their genotyping in which genotype 3 was prevalent following by genotype1, 1b, 2, 4 and  6. Study signifies the gene based diagnosis and its clinical relevance for the proper management of the patients. Keywords: Hepatitis, Chronic, Real Time PCR, Hepatocellular Carcinoma, Serolog

Clinical Characteristics and Outcomes of Drug-Induced Acute Kidney Injury Cases

Introduction Drug-induced acute kidney injury (DI-AKI) is a frequent adverse event. The identification of DI-AKI is challenged by competing etiologies, clinical heterogeneity among patients, and a lack of accurate diagnostic tools. Our research aims to describe the clinical characteristics and predictive variables of DI-AKI. Methods We analyzed data from the DIRECT study (NCT02159209), an international, multi-center, observational cohort study of enriched clinically adjudicated DI-AKI cases. Cases met the primary inclusion criteria if the patient was exposed to at least one nephrotoxic drug for a minimum of 24 hours prior to acute kidney injury (AKI) onset. Cases were clinically adjudicated and inter-rater reliability (IRR) was measured using Krippendorff's alpha. Variables associated with DI-AKI were identified using L1 regularized multivariable logistic regression. Model performance was assessed using the area under the receiver operating characteristic curve (ROC AUC). Results 314 AKI cases met the eligibility criteria for this analysis, and 271 (86%) cases were adjudicated as DI-AKI. The majority of the AKI cases were recruited from the United States (68%). The most frequent causal nephrotoxic drugs were vancomycin (48.7%), non-steroidal anti-inflammatory drugs (18.2%), and piperacillin/tazobactam (17.8%). The IRR for DI-AKI adjudication was 0.309. The multivariable model identified age, vascular capacity, hyperglycemia, infections, pyuria, serum creatinine trends, and contrast media as significant predictors of DI-AKI with good performance, ROC AUC 0.86. Conclusions The identification of DI-AKI is challenging even with comprehensive adjudication by experienced nephrologists. Our analysis identified key clinical characteristics and outcomes of DI-AKI compared to other AKI etiologies

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Smart Farming: Unleashing Power of IoT Solutions in Indian Agricultural System

Internet of Things is growing very popularly for supplying and accessing all the real-world information. For easy and quick access to data, many devices are now being connected to the internet [1]. On the basis of the internet of things, the agricultural system developed and used by farmers for easy and fast access to the devices used by them in the field, like pH-meter, water motor, street lights, and sprinkler. Using internet of things in agricultural activities, a farmer can on and off the water motor anytime he wants. To supply water to the field, the farmer will turn on the motor, which will suck water from well and then it get supplied to the field. When the water level reaches to a normal level the farmer will turn off the motor through a web browser.[2] Also the pH value of the crop plays a very important role while growing plants, a farmer can keep updated by the pH value of the crop by anyplace. This reduces farmer’s manual work of every time checking the pH value at every place of the field differently. The aim of designing street light is for saving energy.[3] This project gives solution for electrical power wastage, in this, a person can ON and OFF the streetlights by seating at any place. Using Automatic farming irrigation allows farmers to supply the right amount of water at the right time to the crops, regardless of the availability the labor to turn the motor on and off. This will help the farmer to save water and time.[4] This system will not only help the farmer in gaining information of his own farm because it will also help him to update with the new devices used in this world for agricultural purposes. The farmer will be able to get access to and supply the information using web technology on his mobile device. [5

Drought stress effect, tolerance, and management in wheat – a review

AbstractWheat is the most important cereal crop in the world. It contributes as a major source of protein and calories in the daily human diet. Drought has become a major abiotic stress that severely affects wheat production globally. Changing rainfall patterns, increased atmospheric CO2 levels, rises in atmospheric temperature and hot and dry winds are the major causes of drought stress. It has morphological, physiological, and biochemical consequences such as reduced yield performance, yield attributing parameters, germination, and seed vigor, early leaf senescence, early maturity, decreased chlorophyll content, decreased Rubisco activity, decreased photosynthesis, and decreased starch accumulation. Drought produces reactive oxygen species that cause oxidative damage to the plants leading to programmed cell death. Wheat plant has developed various tolerance mechanisms such as drought escape, avoidance, and tolerance to protect them from drought. Increasing trichome density and leaf waxiness, root: shoot ratio, stay green, accumulation of proline, production of various enzymes viz; superoxide dismutase (SOD), ascorbate (APX), peroxidase (POD), catalase (CAT), osmotic adjustment, ABA accumulation, and formation of dehydrins leads to drought tolerance. Screening of the various genotypes for the identification of novel trait combinations, genetic engineering, and transgenic approaches (incorporates, transfer, and introduces the desirable gene into the desired plants) and thereby the adaptable varieties can be selected and induced to develop new varieties with desired characteristics would be a major genetic management strategies to overcome drought, increase production, and ensure the food and nutritional security of the world

Patient adverse events and technical failures with the bravo capsule pH system: insights from the MAUDE database

Background: The BRAVO pH monitor system can benefit patients with ongoing GERD symptoms despite treatment and/or atypical symptoms. We aim to investigate the number and type of complications associated with the BRAVO pH capsule. Methods: From April 2016 through February 2021, we analyzed post-marketing surveillance data from the FDA Manufacturer and User Facility Device Experience (MAUDE) database. Results: During the study period, approximately 1,651 reports were identified with 2391 cases associated with a device failure, and 254 reporting a patient-related adverse event. Most device complications were due to aspiration n = 153), followed by reported pain (n = 79), injury (unspecified) (n = 63), and additional radiologic imaging (n = 44). Laceration and bleeding accounted for 29 and 19 cases. Furthermore, three patients suffered perforation. Most device failures were due to loss or failure of the Bravo capsule to bond or adhere to the esophageal mucosa as planned (n = 1269), followed by an activation or positioning failure (n = 972), premature detachment of device (n = 284), and failure of the device to record or transmit data (n = 158). Conclusions: Findings from the MAUDE database highlight the risk of aspiration, hemorrhage/bleeding, perforation, injury, and retention as potential complications of BRAVO capsule placement

Heat Priming of Lentil (Lens culinaris Medik.) Seeds and Foliar Treatment with γ-Aminobutyric Acid (GABA), Confers Protection to Reproductive Function and Yield Traits under High-Temperature Stress Environments

Gradually increasing temperatures at global and local scales are causing heat stress for cool and summer-season food legumes, such as lentil (Lens culinaris Medik.), which is highly susceptible to heat stress, especially during its reproductive stages of development. Hence, suitable strategies are needed to develop heat tolerance in this legume. In the present study, we tested the effectiveness of heat priming (HPr; 6 h at 35 °C) the lentil seeds and a foliar treatment of γ-aminobutyric acid (GABA; 1 mM; applied twice at different times), singly or in combination (HPr+GABA), under heat stress (32/20 °C) in two heat-tolerant (HT; IG2507, IG3263) and two heat-sensitive (HS; IG2821, IG2849) genotypes to mitigate heat stress. The three treatments significantly reduced heat injury to leaves and flowers, particularly when applied in combination, including leaf damage assessed as membrane injury, cellular oxidizing ability, leaf water status, and stomatal conductance. The combined HPr+GABA treatment significantly improved the photosynthetic function, measured as photosynthetic efficiency, chlorophyll concentration, and sucrose synthesis; and significantly reduced the oxidative damage, which was associated with a marked up-regulation in the activities of enzymatic antioxidants. The combined treatment also facilitated the synthesis of osmolytes, such as proline and glycine betaine, by upregulating the expression of their biosynthesizing enzymes (pyrroline-5-carboxylate synthase; betaine aldehyde dehydrogenase) under heat stress. The HPr+GABA treatment caused a considerable enhancement in endogenous levels of GABA in leaves, more so in the two heat-sensitive genotypes. The reproductive function, measured as germination and viability of pollen grains, receptivity of stigma, and viability of ovules, was significantly improved with combined treatment, resulting in enhanced pod number (21–23% in HT and 35–38% in HS genotypes, compared to heat stress alone) and seed yield per plant (22–24% in HT and 37–40% in HS genotypes, in comparison to heat stress alone). The combined treatment (HPr+GABA) was more effective and pronounced in heat-sensitive than heat-tolerant genotypes for all the traits tested. This study offers a potential solution for tackling and protecting heat stress injury in lentil plants