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An understanding of genetic information and relationships among traits is required for an improvement programme to be successful. Therefore, this study aims to estimate certain (co)variance components for bodyweights Mecheri sheep collected at various ages. The data consisted of 2 768 records that were produced by the progeny of 110 sires and 748 dams maintained in the tropical climatic conditions of Tamil Nadu, India, between 2010 and 2020. Computations of the genetic parameters were made using Bayesian methods with Gibbs sampling. The direct heritability estimates for weight at birth (BWT), weaning (WWT), 6 months (6WT), 9 months (9WT) and one year old (12WT) were 0.155, 0.262, 0.069, 0.111 and 0.067, respectively. The maternal heritabilities obtained for the pre- and post-weaning traits were low, with the mean values for BWT, WWT, 6WT, 9WT and 12WT being 0.067, 0.030, 0.036, 0.040 and 0.039, respectively. The estimates of additive genetic correlations between bodyweights at the various ages were positive and of variable magnitude ranging from 0.198 (BWT-12WT) to 0.970 (6WT-9WT). The heritability of WWT was higher than the weights at other ages, and indicated the presence of significant genetic variation in this trait. There were also high correlations between WWT and post-weaning weights. Thus, WWT, recorded early in life, could be used as a selection criterion for improving the growth traits. [ABSTRACT FROM AUTHOR]

Scedosporium aurianticum infection developed in 2 recipients of kidney transplants in India, acquired from the same deceased near-drowning donor. Given the substantial risk for death associated with Scedosporium infection among solid-organ transplant recipients, safety protocols for organ transplantation from nearly drowned donors should be thoroughly revaluated and refined.

Pediatric critical care is highly sophisticated and precise and is possible only in specialized areas such as pediatric intensive care units (PICUs) or high dependency units equipped with round-the-clock monitoring facilities, skilled and trained staff, and treatment equipment. The need for critical care beds was sharply felt during the COVID-19 pandemic and the Government of India launched the COVID-19 emergency response and health system preparedness package: phase II (ECRP-II) with a hub and spoke model to strengthen pediatric critical care delivery at district level under the skilled supervision of state-level PICUs of the identified center of excellence (CoE). The CoEs will have well-equipped PICUs providing tele-ICU service, mentoring, and technical hand-holding to the district pediatric unit. This model was envisioned to be extended to critically ill children with nonCOVID illnesses after the pandemic abates. For achieving the proposed objectives under the ECRP-II scheme, this guideline aims to provide a practical framework for setting up comprehensive pediatric care units at district hospitals and medical colleges (spoke) well connected with a CoE (hub) for teleconsultation, knowledge exchange, referral, and back referral between hub and spokes.

Objectives: The International Liaison Committee on Resuscitation, in collaboration with drowning researchers from around the world, aimed to review the evidence addressing seven key resuscitation interventions: 1) immediate versus delayed resuscitation; (2) compression first versus ventilation first strategy; (3) compression-only CPR versus standard CPR (compressions and ventilations); (4) ventilation with and without equipment; (5) oxygen administration prior to hospital arrival; (6) automated external defibrillation first versus cardiopulmonary resuscitation first strategy; (7) public access defibrillation programmes. Methods: The review included studies relating to adults and children who had sustained a cardiac arrest following drowning with control groups and reported patient outcomes. Searches were run from database inception through to April 2023. The following databases were searched Ovid MEDLINE, Pre-Medline, Embase, Cochrane Central Register of Controlled Trials. Risk of bias was assessed using the ROBINS-I tool and the certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. The findings are reported as a narrative synthesis. Results: Three studies were included for two of the seven interventions (2,451 patients). No randomised controlled trials were identified. A retrospective observational study reported in-water resuscitation with rescue breaths improved patient outcomes compared to delayed resuscitation on land (n = 46 patients, very low certainty of evidence). The two observational studies (n = 2,405 patients), comparing compression-only with standard resuscitation, reported no difference for most outcomes. A statistically higher rate of survival to hospital discharge was reported for the standard resuscitation group in one of these studies (29.7% versus 18.1%, adjusted odds ratio 1.54 (95% confidence interval 1.01–2.36) (very low certainty of evidence). Conclusion: The key finding of this systematic review is the paucity of evidence, with control groups, to inform treatment guidelines for resuscitation in drowning.

Background: This study was planned to study the existing status of neonatal transport in North India after the introduction of National Ambulance Service (NAS). We evaluated the quality of referral, admission status, and outcome of referred neonates. Materials and Methods: We enrolled neonates admitted between March 2016 and October 2016, excluding neonates referred from the outpatient department. Information was collected from referral slips, interviewing accompanying persons and observation. Results: Sixty-one percent were referred from government hospitals with “sick newborn care units” contributing to maximum. The main mode of transport was ambulance in 80% and referral notes were available in the majority but incomplete in majority. Sepsis (39%), jaundice (16%), and birth asphyxia (13%) were the most common diagnoses. Half of the neonates were hemodynamically unstable. Twenty-seven percent had poor circulation, 15% were hypoxic, 9% hypoglycemic, and 8% hypothermic. Twenty-two percent either died or “left against medical advice” with a high probability of death. Conclusion: NAS is utilized for transporting neonates. However, there are quality gaps which need attention to develop it into efficient referral system.

Childhood pneumonia is a very common cause of morbidity and mortality in children, especially in developing countries. A small proportion of these are due to recurrent pneumonias. This is defined as the occurrence of more than one episode of pneumonia within a single year, or greater than 3 episodes within any duration; with radiographically documented clearing between episodes. A diligent, step-wise clinical approach and judicious laboratory investigations are required to establish clinical diagnosis. In this article, we describe the approach used to establish etiology in a case of recurrent pneumonia.

Abstract Background Acute kidney injury (AKI) due to Diabetic Ketoacidosis (DKA) is rather common. Novel biomarkers to diagnose AKI are being increasingly used in different settings. The use of urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) in predicting persistent AKI in pediatric DKA cases is still not thoroughly investigated. Methods This was a secondary analysis of Saline versus Plasma-Lyte in Ketoacidosis (SPinK) trial data; 66 children (> 1 month-12 years) with DKA, defined by the International Society for Pediatric and Adolescent Diabetes (ISPAD), were analyzed. Children with cerebral edema, chronic kidney disease and those who received pre-referral fluids and/or insulin were excluded. uNGAL and urine NGAL-creatinine ratio (uNCR) at 0 and 24 h were measured in all. Persistent AKI was defined as a composite outcome of continuance of AKI defined by the Kidney Disease Improving Global Outcomes (KDIGO) stage 2 or 3 beyond 48 h from AKI onset, progression of AKI from either KDIGO stage 0 or 1 to a worse stage, need of renal replacement therapy or death. Main outcomes Thirty-five (53%) children had AKI at admission; 32 (91.4%) resolved within 48 h. uNGAL was significantly higher in the AKI group at admission [79.8 ± 27.2 vs 54.6 ± 22.0, p = 0.0002] and at 24 h [61.4 ± 28.3 vs 20.2 ± 14.5, p = 0.0003]. Similar trend was observed with uNCR at admission [6.7 ± 3.7 vs 4.1 ± 2.6, p = 0.002] and at 24 h [6.3 ± 2.5 vs 1.2 ± 1.0, p = 0.01]. Furthermore, uNGAL at admission showed a moderate positive linear correlation with serum creatinine. Additionally, elevated uNGAL at 0 and 24 h correlated with corresponding KDIGO stages. Admission uNGAL >88 ng/ml and uNCR of >11.3 ng/mg had a sensitivity of 66% and 67%, specificity of 76% and 95%, and Area under the receiver operating characteristic curve (AUC) of 0.78 and 0.89 respectively for predicting persistent AKI at 48 h. Conclusions Majority of AKI resolved with fluid therapy. While uNGAL and uNCR both correlated with serum creatinine and AKI stages, serial uNCR was a better predictor of persistent AKI than uNGAL alone. However, feasibility of routine uNGAL measurement to predict persistent AKI in DKA needs further elucidation. Trial registration This was a secondary analysis of the data of SPinK trial [CTRI/2018/05/014042 ( ctri.nic.in )].

Women with colorectal cancer (CRC) have survival advantages over men, yet the underlying mechanisms are unclear. T cell infiltration within the CRC tumor microenvironment (TME) correlates strongly with survival. We hypothesized that women with CRC have increased T cell infiltration and differential gene expression in the TME compared to men. Tissue microarrays comprising primary tumor, tumor infiltrated lymph nodes, and uninvolved colon were created from CRC patients. Proportions of CD4 positive (CD4+) and CD8 positive (CD8+) T cells were identified using immunohistochemistry. TME immune- and cancer-related genetic expression from primary and metastatic CRC tumor were also evaluated via the NanoStringIO360 panel and The Cancer Genome Atlas Project database. CD4+ was higher in tumor samples from women compared to men (22.04% vs. 10.26%, p=0.002) and also in lymph node samples (39.54% vs. 8.56%, p=0.001). CD8+ was increased in uninvolved colon from women compared to men (59.40% vs. 43.61%, p=0.015), and in stage I/II tumors compared to III/IV in all patients (37.01% vs. 23.91%, p=0.009). Top CD8+ tertile patients survived longer compared to the bottom (43.9 months vs. 25.3 months, p=0.007). Differential gene expression was observed in pathways related to Treg function, T cell activity, and T cell exhaustion, amongst several others, in women compared to men. Thus, significant sexual dimorphism exists in the TME that could contribute to survival advantages observed in female patients with CRC.

Abstract Background Chest radiograph (CXR) prescribing pattern and practice vary widely among pediatric intensive care units (PICU). ‘On demand’ approach is increasingly recommended as against daily ‘routine’ CXRs; however, the real-world practice is largely unknown. Methods This was a prospective observational study performed in children younger than 12 years admitted to PICU of a tertiary care teaching hospital in India. Data were collected on all consecutive CXRs performed between December 2016 and April 2017. The primary outcome was to assess the factors that were associated with higher chest radiograph prescriptions in PICU. Secondary outcomes were to study the indications, association with mechanical ventilation, image quality and avoidable radiation exposure. Results Of 303 children admitted during the study period, 159 underwent a total of 524 CXRs in PICU. Median (IQR) age of the study cohort was 2 (0.6–5) years. More than two thirds [n = 115, 72.3%] were mechanically ventilated. Most CXRs (n = 449, 85.7%) were performed on mechanically ventilated patients, amounting to a median (IQR) of 3 (2–5) radiographs per ventilated patient. With increasing duration of ventilation, the number of CXRs proportionately increased in the first two weeks of mechanical ventilation. In non-ventilated children, about two thirds (68%) underwent only one CXR. Majority of the prescriptions were on demand (n = 461, 88%). Most common indications were peri-procedure prescriptions (37%) followed by evaluation for respiratory disease status (24%). About 40% CXRs resulted in interventions; adjustment in ventilator settings (13.5%) was the most frequent intervention. In 26% (n = 138) of radiographs, image quality required improvement. One or more additional body part exposure other than chest and upper abdomen were noted 336 (64%) images. Children with > 3 CXR had higher PRISM III score, more often mechanically ventilated, had higher number of indwelling devices [mean (SD) 2.6 (1.2) vs. 1.7 (1.0)] and stayed longer in PICU [median (IQR) 11(7.5–18.5) vs. 6 (3–9)]. Conclusion On demand prescription was the prevalent practice in our PICU. Most non-ventilated children underwent only one CXR while duration of PICU stay and the number of devices determined the number of CXRs in mechanically ventilated children. Quality improvement strategies should concentrate on the process of acquisition of images and limiting the radiation exposure to unwanted body parts.

An experiment was carried out to study the effect of feeding of cultivated fodders on the growth performance of Mecheri lambs under intensive system. Twenty four 3 months old Mecheri lambs were selected and divided randomly into three groups Viz., (T1, T2 and T3) and the animals were fed with CO(CN)4, CO(BN)5 and COFS29 fodders respectively. The study revealed that the highest body weight (P<0.05) was observed in T2 group at the end of the experimental period followed by T1 group and T3 group. T2 group recorded significantly (P<0.01) higher cumulative DMI and the lower value was recorded in T3 group. T2 group had better feed conversion ratio than other groups. Slaughter studies revealed that, carcass characteristics were not differed significantly among the three groups. [ABSTRACT FROM AUTHOR]

The proposed domino logic is developed with the combination of Current Comparison Domino (CCD) logic and Conditional High Speed Keeper (CHSK) domino logic. In order to improve the performance metrics like power, delay and noise immunity, the redesign of CHSK is proposed with the CCD. The performance improvement is based on the parasitic capacitance, which reduces on the dynamic node for robust and rapid process of the circuit. The proposed domino logic is designed with keeper and without keeper to measure the performance metrics of the circuit. The outcomes of the proposed domino logic are better when compared to the existing domino logic circuits. The simulation of the proposed CHSK based on the CCD logic circuit is carried out in Cadence Virtuoso tool. [ABSTRACT FROM AUTHOR]

An experiment was conducted to evaluate the carcass characteristics of Salem Black kids under intensive and semi-intensive systems of management. Sixteen weaned kids were selected at random and they were placed in two treatments comprising of eight kids in each group. The dressing percentage of intensive and semi-intensively reared kids differed highly significantly(P< 0.01). The primal cuts percentage did not differ significantly for leg, loin, rack, breast and fore shank and the neck and shoulder. The loin eye area was highly significant (P<0.01) between intensive and semiintensively reared kids. The kidney and omental fat was significantly (P<0.05 and P<0.01 ) higher in intensive system when compared compare to semi-intensive system of rearing. [ABSTRACT FROM AUTHOR]

Abstract Background The European Society of Pediatric and Neonatal Intensive Care (ESPNIC) developed and validated a definition of pediatric refractory septic shock (RSS), based on two septic shock scores (SSS). Both bedside SSS (bSSS) and computed SSS (cSSS) were found to be strongly associated with mortality. We aimed at assessing the accuracy of the RSS definition on a prospective cohort from India. Methods Post hoc analysis of a cohort issued from a double-blind randomized trial that compared first-line vasoactive drugs in children with septic shock. Sequential bSSS and cSSS from 60 children (single-center study, 53% mortality) were analyzed. The prognostic value of the ESPNIC RSS definition was tested for 28-day all-cause mortality. Results In this septic shock cohort, RSS was diagnosed in 35 patients (58.3%) during the first 24 h. Death occurred in 30 RSS patients (85.7% mortality) and in 2 non-RSS patients (8% mortality), OR = 60.9 [95% CI: 10.5–676.2], p

Abstract Background Globally, Pediatric Intensive Care Unit (PICU) admissions are amongst the most expensive. In low middle-income countries, out of pocket expenditure (OOP) constitutes a major portion of the total expenditure. This makes it important to gain insights into the cost of pediatric intensive care. We undertook this study to calculate the health system cost and out of pocket expenditure incurred per patient during PICU stay. Methods Prospective study conducted in a state of the art tertiary level PICU of a teaching and referral hospital. Bottom-up micro costing methods were used to assess the health system cost. Annual data regarding hospital resources used for PICU care was collected from January to December 2018. Data regarding OOP was collected from 299 patients admitted from July 2017 to December 2018. The latter period was divided into four intervals, each of four and a half months duration and data was collected for 1 month in each interval. Per patient and per bed day costs for treatment were estimated both from health system and patient’s perspective. Results The median (inter-quartile range, IQR) length of PICU stay was 5(3–8) days. Mean ± SD Pediatric Risk of Mortality Score (PRISM III) score of the study cohort was 22.23 ± 7.3. Of the total patients, 55.9% (167) were ventilated. Mean cost per patient treated was US$ 2078(₹ 144,566). Of this, health system cost and OOP expenditure per patient were US$ 1731 (₹ 120,425) and 352 (₹ 24,535) respectively. OOP expenditure of a ventilated child was twice that of a non- ventilated child. Conclusions The fixed cost of PICU care was 3.8 times more than variable costs. Major portion of cost was borne by the hospital. Severe illness, longer ICU stay and ventilation were associated with increased costs. This study can be used to set the reimbursement package rates under Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). Tertiary level intensive care in a public sector teaching hospital in India is far less expensive than developed countries.

Abstract Background Hyperferritinemia is increasingly associated with mortality in sepsis. Studies estimating the prevalence of hyperferritinemia in pediatric scrub typhus are limited. Methods This was a secondary analysis of a prospective observational study (FERRIS) from a tertiary care teaching hospital in North India where 72 children with confirmed scrub typhus, 4 (5.5%) PCR positive, 55 (76.4%)-IgM ELISA positive, and 13 (18.1%)-both PCR and ELISA positive, were analyzed. Serum ferritin was measured in 62 children to identify the prevalence of hyperferritinemia and determine its association with mortality. Results Hyperferritinemia (> 500 μg/L) was seen in 72.6% [n = 45] children; 26 (41.9%) were mild (500–2000 μg/L), 13 (21%) were moderate (2000–10,000 μg/L), and 6 (9.7%) were severe (> 10,000 μg/L). Early presentation to hospital (≤ 7 days of febrile illness) had more survivors than late presentation (> 7 days). Non-survivors had significantly higher PRISM III, PELOD-2, hyperlactatemia, hypoalbuminemia, organ dysfunction, need for mechanical ventilation, and need of RRT. Ferritin had poor sensitivity and specificity in predicting survival with AUC of 0.56. Organ dysfunction and risk scores as PRISM III, PELOD 2, and VIS at admission were better predictors with AUC (95% CI) of 0.72 (0.56, 0.89), 0.77 (0.63, 0.92), and 0.90 (0.78, 1.0) respectively. Conclusions Hyperferritinemia is common in scrub typhus but it did not predict survival. Organ dysfunction and risk scores were better predictors of mortality than ferritin.

Context: Cancer is the leading cause of death in the human population, ensuing from the accumulation of damage to genetic materials and affecting various parts of the organs. This review is focused on the cell signaling cross-talk mechanism of colorectal cancer (CRC) and its regulations. Genomic instability acts as the major driving force for CRC. The major CRC cascade mechanisms such as Wnt, Ras, TOPK, p53, and ubiquitin pathways were discussed. These interlinked signals cross-talk with one another in various regulatory mechanisms and play a unique role in CRC. Evidence Acquisition: The major cross-talking signals of CRC are the most significant part of this review. Wnt is a resource and center of axis for cross-talk and interlinked signaling mechanism. Wnt/β-catenin signaling was regulated by frizzled receptor, co-factors, Ras, TOPK, and many other mechanisms; related literature of CRC were collected through a literature survey and categorized using the keywords. The pathways with high specificity interlinked with Wnt were identified and used as the major targets for this review. Results and Conclusion: The interlinked signaling pathways and gene networks were explained with their specificity role in CRC. We highlighted the major regulatory signaling and interlinked pathways of CRC, as new multi targets approach. Furthermore, we discussed the potent targeted genes, bio-markers for a better prognosis, and therapies for CRC patients. Through highlighting the gene cross-talking signaling cascade; we have provided the source for gene network interaction and targeted therapy. This study paves the way for multi-targeting of interlinked pathways and suggesting these would be perfect for suppressing of CRC. The signaling pathways discussed in this review are not only focused on CRC but also the new potent targets and bio-markers for different types of cancers. Targeting multiple interlinked pathways could be useful for developing new potential bio-markers for treatment and diagnosis purposes.

Abstract Background Provision of timely care to critically ill children is essential for good outcome. Referral from smaller peripheral hospitals to higher centers for intensive care is common. However, lack of an organized referral and feedback system compromises optimal care. We studied the quality of referral letters coming to our Emergency Department (ED) with respect to their demography, association with severity of illness and mortality before and after referral education. Methods Our study was completed in three phases in the Pediatric ED; Pre-intervention, Intervention and Post intervention phases. Quality of referral letter was matched with a quality checklist proforma and graded as ‘good’, ‘fair’ and ‘poor’ if it scored > 7, 5–7 and

Thymoquinone, a therapeutic phytochemical derived from Nigella sativa, has been shown to have a potent anticancer activity. However, it has been identified that the tumor microenvironment (TME) can attenuate the anticancer effects of thymoquinone (TQ) in ovarian cancer. Lysophosphatidic acid (LPA), a lipid growth factor present in high concentration in the TME of ovarian cancer, has been shown to regulate multiple oncogenic pathways in ovarian cancer. Taking account of the crucial role of LPA in the genesis and progression of ovarian cancer, the present study is focused on assessing the efficacy of TQ in inhibiting LPA-stimulated oncogenic pathways in ovarian cancer cells. Our results indicate that TQ is unable to attenuate LPA-stimulated proliferation or metabolic reprogramming in ovarian cancer cells. However, TQ potently inhibits the basal as well as LPA-stimulated migratory responses of the ovarian cancer cells. Furthermore, TQ abrogates the invasive migration of ovarian cancer cells induced by Gαi2, through which LPA stimulates cell migration. TQ also attenuates the activation of JNK, Src, and FAK, the downstream signaling nodes of LPA-LPAR-Gαi2 signaling pathway. In addition to establishing the differential effects of TQ in ovarian cancer cells, our results unravel the antitherapeutic role of LPA in the ovarian cancer TME could override the inhibitory effects of TQ on cell proliferation and metabolic reprogramming of ovarian cancer cells. More importantly, the concomitant finding that TQ could still sustain its inhibitory effect on LPA-stimulated invasive cell migration, points to its potential use as a response-specific therapeutic agent in ovarian cancer.

BackgroundProspective data on hand hygiene compliance in pediatric emergency department (PED) settings is limited. We studied the impact of quality improvement measures on the overall and health care personnel wise hand hygiene compliance rates in a busy PED.MethodsThe baseline hand hygiene compliance rates were audited from May–July 2018. The quality improvement interventions included various structural changes to the environment, administrative changes, education and training. During the interventions, auditing was continued for 2 months (August – September 2018). Statistical Process control charts were created.ResultsWe observed a significant increase in overall compliance rates from 31.8 to 53.9% (p < 0.001). These improvements were observed in the children (29.6 to 46.4%, p < 0.001) as well as neonatal area (35.7% to 59.7, p < 0.001) of PED as well as amongst various health care personnel and in four out of the five moments of hand hygiene.ConclusionHand hygiene compliance improved significantly in a busy PED of a lower middle-income country following quality improvement interventions. Such improvement was observed amongst all categories of health care personnel and different types of hand hygiene opportunities. This study demonstrates the feasibility and efficacy of simple quality improvement interventions in a challenging hospital environment.

Clinical management of gynecological cancer begins by optimal debulking with first-line platinum-based chemotherapy. However, in ~80% patients, ovarian cancer will recur and is lethal. Prognostic gene signature panel identifying platinum-resistance enables better patient stratification for precision therapy. Retrospectively collected serum from 11 “poor” (24 months PFI) prognosis patients, were evaluated using circulating cell-free DNA (cfDNA). DNA from both groups showed 50 to 10 000 bp fragments. Pairwise analysis of sequenced cfDNA from patients showed that gene dosages were higher for 29 genes and lower for 64 genes in poor than favorable prognosis patients. Gene ontology analysis of higher dose genes predominantly grouped into cytoskeletal proteins, while lower dose genes, as hydrolases and receptors. Higher dosage genes searched for cancer-relatedness in Reactome database indicated 15 genes were referenced with cancer. Among them 3 genes, TGFBR2, ZMIZ2, and NRG2, were interacting with more than 4 cancer-associated genes. Protein expression analysis of tumor samples indicated that TGFBR2 was downregulated and ZMIZ2 was upregulated in poor prognosis patients. Our results indicate that the cfDNA gene dosage combined with protein expression in tumor samples can serve as gene signature panel for prognosis determination amongst ovarian cancer patients.

Peritoneal cancers present significant clinical challenges with poor prognosis. Understanding the role of cancer cell metabolism and cancer-promoting metabolites in peritoneal cancers can provide new insights into the mechanisms that drive tumor progression and can identify novel therapeutic targets and biomarkers for early detection, prognosis, and treatment response. Cancer cells dynamically reprogram their metabolism to facilitate tumor growth and overcome metabolic stress, with cancer-promoting metabolites such as kynurenines, lactate, and sphingosine-1-phosphate promoting cell proliferation, angiogenesis, and immune evasion. Targeting cancer-promoting metabolites could also lead to the development of effective combinatorial and adjuvant therapies involving metabolic inhibitors for the treatment of peritoneal cancers. With the observed metabolomic heterogeneity in cancer patients, defining peritoneal cancer metabolome and cancer-promoting metabolites holds great promise for improving outcomes for patients with peritoneal tumors and advancing the field of precision cancer medicine. This review provides an overview of the metabolic signatures of peritoneal cancer cells, explores the role of cancer-promoting metabolites as potential therapeutic targets, and discusses the implications for advancing precision cancer medicine in peritoneal cancers.

COVID-19 is more virulent and challenging to human life. In India, the Ministry of AYUSH recommended some strategies through Siddha, homeopathy, and other methods to effectively manage COVID-19 (Guidelines for AYUSH Clinical Studies in COVID-19, 2020). Kabasura Kudineer and homeopathy medicines are in use for the prevention and treatment of COVID-19 infection; however, the mechanism of action is less explored. This study aims to understand the antagonist activity of natural compounds found in Kabasura Kudineer and homeopathy medicines against the SARS-CoV-2 using computational methods. Potential compounds were screened against NSP-12, NSP-13, NSP-14, NSP-15, main protease, and spike proteins. Structure-based virtual screening results shows that, out of 14,682 Kabasura Kudineer compounds, the 250395, 129677029, 44259583, 44259584, and 88583189 compounds and, out of 3,112 homeopathy compounds, the 3802778, 320361, 5315832, 14590080, and 74029795 compounds have good scoring function against the SARS-CoV-2 structural and nonstructural proteins. As a result of docking, homeopathy compounds have a docking score ranging from −5.636 to 13.631 kcal/mol, while Kabasura Kudineer compounds have a docking score varying from −8.290 to −13.759 kcal/mol. It has been found that the selected compounds bind well to the active site of SARS-CoV-2 proteins and form hydrogen bonds. The molecular dynamics simulation study shows that the selected compounds have maintained stable conformation in the simulation period and interact with the target. This study supports the antagonist activity of natural compounds from Kabasura Kudineer and homeopathy against SARS-CoV-2’s structural and nonstructural proteins.

An attempt was made to investigate the broiler performance raised on used litter subjected to windrow composting and disinfectant spray by using Gluteraldehyde -- (Kohrsolin-Th) at 50% concentration. The windrow size of 4 feet length, 2.5 feet width and 1 feet 3 inches height was found to be suitable in this experiment. The average pile temperature reached 46.93 ± 2.29 °C during the primary stage and 51.75 ± 1.48 °C during the secondary stage. [ABSTRACT FROM AUTHOR]

An experiment was conducted to study the effects of concentrate and urea molasses mineral block (UMMB) supplementation on sheep under intensive system of rearing. Eight weaned Mecheri ram lambs were reared under concentrate (T1) and UMMB (T2) supplementation for 150 days. There was no significant difference between the groups in final body weight at the end of growth trial. Cumulative DMI was significantly higher (P < 0.01) in T1 group than T2 but, the supplementation of UMMB increased the intake of other fodders. Cumulative body weight gain was significantly higher (P < 0.05) in T1 group in 5 months of the feeding experiment. Cumulative FCR was significantly higher (P < 0.05) in T1 group in 0 to 60 and 0 to 90 days period and there after the difference was not significant. Cumulative per cent feed efficiency was better in T1 group at 0 to 90 days and 0 to 150 days of the experiment. It was concluded that UMMB could be used as a versatile non protein nitrogenous supplement to replace concentrate feed for intensively reared Mecheri sheep. [ABSTRACT FROM AUTHOR]

Abstract Background Acute kidney injury (AKI) is an important complication encountered during the course of diabetic ketoacidosis (DKA). Plasma-Lyte with lower chloride concentration than saline has been shown to be associated with reduced incidence of AKI in adults with septic shock. No study has compared this in DKA. Methods This double-blind, parallel-arm, investigator-initiated, randomized controlled trial compared 0.9% saline with Plasma-Lyte-A as initial fluid in pediatric DKA. The study was done in a tertiary care, teaching, and referral hospital in India in children (> 1 month–12 years) with DKA as defined by ISPAD. Children with cerebral edema or known chronic kidney/liver disease or who had received pre-referral fluids and/or insulin were excluded. Sixty-six children were randomized to receive either Plasma-Lyte (n = 34) or 0.9% saline (n = 32). Main outcomes Primary outcome was incidence of new or progressive AKI, defined as a composite outcome of change in creatinine (defined by KDIGO), estimated creatinine clearance (defined by p-RIFLE), and NGAL levels. The secondary outcomes were resolution of AKI, time to resolution of DKA (pH > 7.3, bicarbonate> 15 mEq/L & normal sensorium), change in chloride, pH and bicarbonate levels, proportion of in-hospital all-cause mortality, need for renal replacement therapy (RRT), and length of ICU and hospital stay. Results Baseline characteristics were similar in both groups. The incidence of new or progressive AKI was similar in both [Plasma-Lyte 13 (38.2%) versus 0.9% saline 15 (46.9%); adjusted OR 1.22; 95% CI 0.43–3.43, p = 0.70]. The median (IQR) time to resolution of DKA in Plasma-Lyte-A and 0.9% saline were 14.5 (12 to 20) and 16 (8 to 20) h respectively. Time to resolution of AKI was similar in both [Plasma-Lyte 22.1 versus 0.9% saline 18.8 h (adjusted HR 1.72; 95% CI 0.83–3.57; p = 0.14)]. Length of hospital stay was also similar in both [Plasma-Lyte 9 (8 to 12) versus 0.9% saline 10 (8.25 to 11) days; p = 0.39]. Conclusions The incidence of new or progressive AKI and resolution of AKI were similar in both groups. Plasma-Lyte-A was similar to 0.9% Saline in time to resolution of DKA, need for RRT, mortality, and lengths of PICU and hospital stay. Trial registration Clinical trial registry of India, CTRI/2018/05/014042 ( ctri.nic.in ) (Retrospectively registered).

The present study was carried out to analyse the pig husbandry practices in semi-arid region of Tamil Nadu. The study revealed that, 95.00 per cent of farmers reared the pigs in shed covered with asbestos sheet (53.83 per cent) followed by thatches (34.64 per cent) on concrete flooring (92.28 per cent). The majority of the farmers (76.92 per cent) maintaining Large White Yorkshire pigs and followed natural service using boars. The farmers followed stall feeding and 50 % of the farmers fed swill feeding along with poultry offal waste with small quantity of own mix concentrate feed. Majority of the farmers (50 %) vaccinated their pigs against both swine fever and FMD and 19.23 per cent of the farmers did not give any vaccination. 61.54 % farmers followed deworming using allopathic medicine. Similarly, only 65 per cent of the farmers protected their piglets against piglet anemia with iron injection and 32.5 % of them used ectoparasitic drugs in their farms. The farmers followed weaning at 2 months of age and castration of male piglets at 2 to 3 weeks of age. Pigs were marketed at 8 to 9 months of age when they attained the body weight of 90 to 100 kg at the rate of Rs.90 to 95 per kg live weight. [ABSTRACT FROM AUTHOR]

The influence of non-genetic factors namely breed, sex, age, season and cause of death on the mortality of rabbits were studied utilizing a total of 835 mortality records over a period of 20 years. The study revealed that there is a significant difference (P<0.05) in number of pre-weaning mortalities between seasons, with more mortality in summer and least in winter season. The preweaning mortality observed in Soviet Chinchilla in summer, south-west monsoon, north-west monsoon and winter seasons were 29.53, 28.37, 27.60 and 14.48 per cent, respectively and the values observed in White Giant were 32.80, 27.12, 32.49 and 7.57 per cent, respectively. The postweaning mortality did not differ significantly between breeds, sexes and seasons. The cause of death did not influence the number of mortality between four seasons of the year. However, pneumonia and enteritis resulted in more mortalities than other causes. [ABSTRACT FROM AUTHOR]

A study was undertaken to assess the blood biochemical parameters of off season Mecheri male lambs, under concentrate and urea molasses mineral block (UMMB) supplementation. In the growth trial, 24 lambs in three groups of eight lambs each were reared under grazing for a period of 180 days; T1 - Grazing alone, T2- Grazing + concentrate supplementation, T3 - Grazing + UMMB supplementation. Blood samples were collected at 30, 60, 90, 120, 150 and 180 days of experiment. Serum protein increased (P < 0.05) in supplemented groups whereas, serum albumin increased significantly (P < 0.05) only in concentrate supplemented group (T2). Serum calcium (P < 0.01) and phosphorus (P < 0.05) values were higher in supplemented groups Concentrate supplemented group had higher (P < 0.05) serum cholesterol than unsupplemented group. UMMB supplemented group had significantly (P < 0.01) higher BUN values than the unsupplemented group. It was concluded that blood biochemical parameters of off season Mecheri lambs were influenced by supplementation. [ABSTRACT FROM AUTHOR]

The ongoing pandemic of coronavirus disease 2019 (COVID-19) poses several challenges to clinicians. Timely diagnosis and hospitalization, risk stratification, effective utilization of intensive care services, selection of appropriate therapies, monitoring and timely discharge are essential to save the maximum number of lives. Clinical assessment is indispensable, but laboratory markers, or biomarkers, can provide additional, objective information which can significantly impact these components of patient care. COVID-19 is not a localized respiratory infection but a multisystem disease caused by a diffuse systemic process involving a complex interplay of the immunological, inflammatory and coagulative cascades. The understanding of what the virus does to the body and how the body reacts to it has uncovered a gamut of potential biomarkers. This review discusses the different classes of biomarkers – immunological, inflammatory, coagulation, hematological, cardiac, biochemical and miscellaneous – in terms of their pathophysiological basis followed by the current evidence. Differences between children and adults are highlighted. The role of biomarkers in the diagnosis and management of Multisystem Inflammatory Syndrome in Children (MIS-C) is reviewed. The correlation of biomarkers with clinical and radiological features and the viral load, temporal evolution and the effect of treatment remain to be studied in detail. Which biomarker needs to be evaluated when and in whom, and how best this information can contribute to patient care are questions which currently lack convincing answers. With the evidence currently available broad guidelines on the rational use of available biomarkers are presented. Integrating clinical and laboratory data, monitoring trends rather than a single value, correlating with the natural course of the disease and tailoring guidelines to the individual patient and healthcare setting are essential.

Experiment was carried out at Instructional Livestock Farm complex, Veterinary college and Research Institute, Namakkal, Tamil Nadu during 2015-2016 and with the aim to study the feeding behaviour of sheep fed with cultivated hybrid napier and multicut fodder sorghum at different stage of cuttings under intensive system. Intensity of eagerness towards the green fodders and bouts length, duration and frequency were studied. The intensity of eagerness towards the fodder was highest in CO(BN)5 group followed by CO(CN)4 and COFS29 at 60th and 75th days of cuttings. The number of bites per min was highest in CO(BN)5 group whereas the bout time (min) and frequency of bite was highest in CO(CN)4 group and lowest in COFS29 group. [ABSTRACT FROM AUTHOR]