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Abstract Background Total serum protein (TSP) within the first few days of life in the neonatal calf has predictive value for subsequent growth and production in calves before and after weaning. Introduction The objective of this study was to evaluate the effect of TSP concentration 24‐h after birth (24‐h) on the performance and health of Holstein dairy calves. Methods A total of 152 female calves were enrolled in this study. Blood samples were collected at 24‐h, and TSP concentration was measured with a refractometer. Calves based on TSP concentration at 24‐h were allocated into three groups: 1 – TSP ≤6.5 g/dL, 2 – TSP between 6.6 and 6.9 g/dL and 3 – TSP ≥7 g/dL. The weighing was done at birth and at days 30 and 60. Starter feed intake was recorded from day 3 to weaning, and body structures were measured at birth and weaning day. Results Calves with TSP >6.5 g/dL had greater body weight at days 30 and 60 than calves with TSP ≤6.5 g/dL. Average daily gain during 1–30 and 1–60 days of life increased as TSP increased. Furthermore, starter feed intake during the first 60 days of life was greater in calves with TSP ≥7 g/dL than calves with TSP 6.5 g/dL calves had greater heart girth, hip width and body length than ≤6.5 g/dL calves. Moreover, odds ratio for pneumonia decreased as TSP increased, whereas diarrhoea was unaffected. Conclusion The TSP at 24‐h is an important contributing factor for the variation in growth performance and health of preweaning calves, and strategies to improve calf immunity and increase TSP lead to better animal health during preweaning period. Implications These results indicated that TSP ≥6.5 g/dL possibly was associated with greater performance, and this concentration could be considered a baseline for future analyses.

Purpose: The emergence of highly mutated and transmissible BA variants has caused an unprecedented surge in COVID-19 infections worldwide. Thorough analysis of its genome structure and phylogenomic evolutionary details will serve as scientific reference for future research., Method: Here, we have analyzed the BA variants from India using whole-genome sequencing, spike protein mutation study, spatio-temporal surveillance, phylogenomic assessment and epitope mapping., Results: The predominance of BA.2/BA.2-like was observed in India during COVID-19 third wave. Genome analysis and mutation study highlighted the existence of 2128 amino acid changes within BA as compared to NC_045512.2. Presence of 23 unknown mutation sites (spanning region 61-831) were observed among the Indian BA variants as compared to the global BA strains. Unassigned probable Omicron showed the highest number of mutations (370) followed by BA.1 (104), BA.2.3 (56), and BA.2 (27). Presence of mutations 'Q493R ​+ ​Q498R ​+ ​N501Y', and 'K417 ​N ​+ ​E484A ​+ ​N501Y' remained exclusive to BA.2 as well as unassigned probable Omicron. The time-tree and phylogenomic network assessed the evolutionary relationship of the BA variants. Existence of 424 segregating sites and 113 parsimony informative sites within BA genomes were observed through haplotype network analysis. Epitope mapping depicted the presence of unique antigenic sites within the receptor binding domain of the BA variants that could be exploited for robust vaccine development., Conclusion: These findings provide important scientific insights about the nature, diversity, and evolution of Indian BA variants. The study further divulges in the avenues of therapeutic upgradation for better management and eventual eradication of COVID-19., Competing Interests: Declaration of competing interest All the authors declare that no competing interests exist., (Copyright © 2022 Indian Association of Medical Microbiologists. Published by Elsevier B.V. All rights reserved.)

Identification of the genomic diversity and the phylodynamic profiles of prevalent variants is critical to understand the evolution and spread of SARS-CoV-2 variants. We performed whole-genome sequencing of 54 SARS-CoV-2 variants collected from COVID-19 patients in Kolkata, West Bengal during August-October 2020. Phylogeographic and phylodynamic analyses were performed using these 54 and other sequences from India and abroad that are available in the GISAID database. We estimated the clade dynamics of the Indian variants and compared the clade-specific mutations and the co-mutation patterns across states and union territories of India over the time course. Frequent mutations and co-mutations observed within the major clades across time periods do not show much overlap, indicating the emergence of newer mutations in the viral population prevailing in the country. Furthermore, we explored the possible association of specific mutations and co-mutations with the infection outcomes manifested in Indian patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Biswas, Mallick, Maity, Bhowmik, Mitra, Saha, Roy, Chakrabarti, Paul and Chakrabarti.)

Background: Philadelphia chromosome, a hallmark of chronic myeloid leukemia (CML), plays a key role in disease pathogenesis. It reflects a balanced reciprocal translocation between long arms of chromosomes 9 and 22 involving BCR and ABL1 genes, respectively. An accurate and reliable detection of BCR-ABL fusion gene is necessary for the diagnosis and monitoring of CML. Previously, many technologies, most of which are laborious and time consuming, have been developed to detect BCR-ABL chimeric gene or chromosome., Methods: A new flow cytometric immunobead assay was used for detection of BCR-ABL fusion proteins and applicability, sensitivity, reliability, efficacy and rapidity of this method was evaluated., Results: From February 2009 to January 2014, a total 648 CML patients were investigated for the status of BCR-ABL1 protein. Among them, 83 patients were enrolled for comparative study of BCR-ABL1 positivity by three routinely used procedures like karyotyping, and quantitative real time PCR (RT-PCR) as well as immunobead flow cytometry assay. BCR-ABL protein analysis was found consistent, more sensitive (17% greater sensitivity) and reliable than the conventional cytogenetics, as flow cytometry showed 95% concordance rate to RT-PCR., Conclusion: BCR-ABL fusion protein assay using a new flow cytometric immunobead might be useful in the diagnosis and monitoring CML patients., Competing Interests: Authors' Disclosures of Potential Conflicts of Interest: No potential conflicts of interest relevant to this article were reported.

Methylphophorbide a (MPa) has been isolated from the ethanol extract of the wheat grass plant. Its antioxidative efficacy is evaluated by hydroxyl radical scavenging activities and reducing capacity which are significantly up regulated in comparison with aqueous extract of the plant. The compound shows iron-binding capacity where the Fe(2+) binds with MPa by two types of binding patterns with dissociation constants 157.17 and 27.89. It has antioxidative and cytotoxic effects on HeLa and Hep G2 cells. The cancerous cell survivability decreases with increasing concentration of MPa. These findings have provided evidence for the traditional use of the wheat grass plant in the treatment of cancers, oxidative stress and iron overloaded disorders.

The last 20 years have seen a staggering growth in the practice of off-shoring clinical research to low-and middle-income countries (LICs and MICs), a growth that has been matched by the neoliberal policies adopted by host countries towards attracting trials to their shores. A recurring concern in this context is the charge of exploitation, linked to various aspects of off-shoring. In this paper, I examine Alan Wertheimer's approach and offer an alternative view of understanding exploitation in this context. I will suggest that the justification for the enterprise of research is largely dependent on its integration within a health system from which participants regularly benefit and I argue that an attention to a principle of reciprocity will enable us to better recognize and address exploitation in international research., (© 2012 John Wiley & Sons Ltd.)

Objective: To evaluate the possible role of a novel, minimally invasive approach to the management of abdominal pregnancy., Methods: We hypothesized that sonographically guided feticide without subsequent laparotomy for removal of the fetus and placenta could minimize potential blood loss and would be a reasonable approach in the care of a patient who had a viable 14.5-week abdominal pregnancy with placental implantation directly over the bifurcation of the left common iliac artery. An extensive MEDLINE literature review revealed 1 case of sonographically guided feticide followed 10 days later by uneventful laparotomy for removal of the fetus and placenta. Thus, we used sonographically guided feticide without subsequent laparotomy for removal of the products of conception., Results: The sonographically guided feticide was uneventful, and the patient had no major postprocedure morbidity; a mild ileus was treated conservatively without the need for nasogastric suctioning. No major postprocedure bleeding was encountered. Human chorionic gonadotropin levels dropped precipitously. During the 1.5 years of postprocedure follow-up, the patient reported no major complications. The gestational sac involuted very slowly; amniotic fluid volume appeared normal at 6 months after the procedure but was diminished at the 9-month postprocedure examination., Conclusions: In cases of previable intra-abdominal pregnancy, sonographically guided feticide may lessen the risk of extensive hemorrhage that can be associated with exploratory laparotomy. Sonographically guided feticide without subsequent exploratory laparotomy can result in a gradual resorption of the products of conception and an uncomplicated recovery. This treatment option should be considered in the management of this potentially life-threatening condition.

Cervical ectopic pregnancy is the rarest form of ectopic gestation. Viable cervical ectopic pregnancies of 10 weeks' gestation or more are even rarer. It is unclear whether these advanced cervical ectopic gestations should be managed primarily by surgical evacuation or by more conservative medical management with chemotherapeutic agents. Cases of medical treatment of viable cervical ectopic gestations reported in the literature are reviewed. An additional case of a 10.6 weeks of gestation, viable cervical ectopic pregnancy treated with methotrexate, intrafetal potassium chloride, and intramuscular methotrexate is added to the previously reported literature. Advanced cervical ectopic pregnancies with fetal cardiac activity at 10 or more weeks' gestation may be successfully managed with chemotherapeutic agents. Ultrasound-guided intrafetal injection of feticidal agents may be preferable to maternal systemic chemotherapy alone.

We report the first case of prenatal diagnosis of fatal infantile olivopontocerebellar hypoplasia syndrome, OMIM 225753. Ultrasound findings noted at 28 weeks' gestation included polyhydramnios, a small stomach bubble, a small but morphologically normal cerebellum, dilatation of the fourth ventricle, and long periods of normal fetal movement punctuated by sudden bursts of violent seizure-like activity of the fetal extremities. At birth, the child was noted to be hypertonic, myoclonic, hyper-reflexic, demonstrated poor gastrointestinal motility, and had severe apneic episodes. Magnetic resonance imaging (MRI) demonstrated marked hypoplasia or atrophy of the cerebellum, pons and medulla, mild atrophy of the cerebral cortex, and mild ex vacuo venticulomegaly of the fourth, third and lateral ventricles. This child died from respiratory insufficiency at 14 days of age. The parents of this child had previously lost a child with similar clinical and anatomical findings. Prenatal sonographers should be aware of the existence of this rare syndrome and should look carefully at the size of the cerebellum in cases of polyhydramnios or when in utero 'seizure-like' activity is seen. The importance of establishing this diagnosis lies in the fact that it appears to have a very poor postnatal prognosis and is likely to be inherited as an autosomal recessive disease.

Objective: The efficacy, safety, and antibiotic-related charges for once-daily gentamicin with twice-daily clindamycin were compared with those of thrice-daily dosing of these antibiotics., Study Design: Patients with puerperal endometritis or with chorioamnionitis in labor assessed to be at risk for endometritis were randomized to receive gentamicin 4 mg/kg intravenously every 24 hours with clindamycin 1200 mg intravenously every 12 hours (experimental arm) or gentamicin 1.33 mg/kg intravenously and clindamycin 800 mg intravenously every 8 hours (conventional dosing interval arm). Primary outcomes included cure rates, mean length of treatment, antibiotic-related charges, and nephrotoxicity. Multiple logistic regression analysis was used to control for confounding variables., Results: There were 135 and 137 patients randomized to the experimental and conventional interval arms, respectively. Cures were obtained in 94.1% and 87.6% of patients in the experimental and conventional arms, respectively (p = 0.06). The experimental arm had mean antibiotic charges of $250.79 versus $442.49 in the conventional arm (p < 0.0001). There was no permanent nephrotoxicity in either group., Conclusions: Once-daily gentamicin dosing with twice-daily clindamycin dosing is as efficacious and safe as the thrice-daily dosing of gentamicin and clindamycin for peripartum uterine infection. The experimental regimen results in substantial cost savings. The incidence of nephrotoxicity is low.

Objective: Our purpose was to determine whether transvaginal Doppler auscultation is more sensitive than transabdominal auscultation for the detection of fetal heart rate in the first trimester of pregnancy., Study Design: In a prospective study 141 patients between 6 weeks and 11 weeks 6 days of gestation underwent both transvaginal and transabdominal Doppler evaluation by use of continuous-wave Doppler instruments for detection of fetal heart rate. Transvaginal ultrasonography was used as the gold standard to establish fetal cardiac activity and to help assign gestational age. The two methods of auscultation were compared for accuracy in different gestational age ranges. Sensitivities and specificities were calculated, and associations were investigated with chi 2 analysis. The direction of disagreement between modalities was tested with the McNemar chi 2 test., Results: Transvaginal auscultation outperformed transabdominal auscultation in every gestational age range. Transvaginal Doppler auscultation performed significantly better than transabdominal Doppler auscultation at 8 weeks to 8 weeks 6 days (p < or = 0.004) and 9 weeks to 9 weeks 6 days (p < or = 0.006). In pregnancies with cardiac activity, fetal heart rate can be successfully detected transvaginally in 60.5% of pregnancies at 8 weeks to 8 weeks 6 days and in 87.5% of pregnancies at 9 weeks to 9 weeks 6 days of gestation. This compares with successful transabdominal detection rates of 22.9% and 56% at 8 and 9 weeks, respectively. As gestational age advances both methods became increasingly sensitive for the detection of fetal heart rate. The earliest fetal heart rate detected transvaginally was at 6 weeks 0 days of gestation compared with 7 weeks 0 days transabdominally. The transvaginal Doppler method was also more successful in detecting the fetal heart rate in women with a retroverted uterus (p < or = 0.01)., Conclusion: By use of continuous-wave Doppler instrumentation, transvaginal auscultation is significantly better than transabdominal auscultation in detecting fetal heart rate between 8 weeks to 8 weeks 6 days and 9 weeks to 9 weeks 6 days of gestation. Use of transvaginal auscultation has potential in the evaluation of first-trimester fetal cardiac activity.

Background: There are three syndromes of histiocytosis X: eosinophilic granulomatosis of the lungs, Hand-Schüller-Christian disease, and Letterer-Siwe disease. Although there have been five case reports of Hand-Schüller-Christian disease in pregnancy, we found none describing pregnancy in patients with eosinophilic granulomatosis., Case: We present a report of eosinophilic granulomatosis of the lungs in pregnancy. The patient's pregnancy was complicated by fetal growth retardation (FGR) and oligohydramnios, but resulted in the delivery of a healthy infant. Her pulmonary disease remained stable., Conclusion: Pregnancy does not appear to exacerbate pulmonary eosinophilic granulomatosis. In this patient, pregnancy was complicated by FGR and oligohydramnios. This case report may be valuable in counseling patients with eosinophilic granulomatosis who are currently pregnant or contemplating pregnancy.

Multiple gestations are increasing in frequency secondary to assisted reproductive technologies; therefore, it will become increasingly important to know how to manage a multiple pregnancy in which an in utero fetal death has occurred. This case report describes the spontaneous resolution of maternal hypofibrinogenemia associated with the deaths of two fetuses in a triplet gestation. A 29-year-old woman with a triplet gestation had in utero death of two monoamniotic fetuses between 15 and 17 weeks' gestation. Maternal plasma fibrinogen levels were obtained weekly and were initially in the normal range for pregnancy. At 31 weeks' gestation, the fibrinogen level decreased to 239 mg/dl and reached a nadir of 150 mg/dl 11 days later. Although the patient received no treatment, her fibrinogen level increased to 307 mg/dl over the next 4 days and then remained above 260 mg/dl for the rest of her pregnancy. At 35 weeks' gestation, a healthy 2090 gm female was delivered. The infant is alive and well and developing normally. When there is an in utero death of one fetus of a multiple gestation in the second or early third trimester, some authors advocate heparinization to reverse maternal coagulopathy; others describe spontaneous resolution of hypofibrinogenemia. The role of heparin in treating hypofibrinogenemia remains unclear. Hypofibrinogenemia may resolve spontaneously without exposing the patient to the potentially serious risks associated with heparin therapy.

A normocalcemic animal model of vitamin D (vit. D)-deficiency has been successfully developed by feeding a high calcium (Ca2+) diet to vit. D.-deficient rats. The modulating role of Ca2+ on the hepatic antioxidant defence system and lipid peroxidation has been evaluated in this model. Partial restoration of liver function was noted in these rats following extra Ca2+ feeding. Serum alkaline phosphatase and alanine aminotransferase reverted to a normal level. The reduced levels of hepatic SOD and glutathione peroxidase in vit. D.-deficient rats, were also increased after extra Ca2+ supplementation. Even elevated lipid peroxidation due to vit. D.-deficiency was reduced after feeding the extra Ca(2+)-supplemented diet. However, catalase activity remained at the control level throughout the study. The results provide important evidence that normocalcemia is essential for maintaining the hepatic antioxidant defence and controlling lipid peroxidation in the in vivo milieu.

This report describes 40 consecutive emergency cerclages on dilated and effaced cervices prior to 26 weeks' gestation. These "emergency" cerclages were associated with a mean extension of gestational age of 12 weeks (range, 3 days to 20.5 weeks). Thirty-one of 40 pregnancies were carried to 28 weeks' gestation and 23 were carried to 34 weeks' gestation or greater. Twelve of 19 women with amniotic membranes bulging into the vagina carried pregnancies to 28 weeks' gestation, with seven of these 19 women carrying the gestation to 34 weeks' or beyond. There was no maternal morbidity. Thirty-four of 41 infants survived (83%). Two pregnancies delivered within 8 days of the procedure. Emergency cerclages should be considered as a management option in women with painless dilation of the cervix and previable gestation.