Search

Russell Viper Venom (RVV) is widely used as a diagnostic test for antiphospholipid syndrome (APS). But the history of how this venom came to be discovered is well known. Dr Patrick Russell is responsible for the identification of the venom during his work on snake bites in India while Dr Robert Macfarlane used it to staunch bleeding in persons with haemophilia. The ability to directly activate factor X led RVV to the laboratory diagnosis of APS. More recently, it has come back to clinical world with a potential for an engineered factor X activator from RVV to be used in the treatment of haemophilia. [ABSTRACT FROM AUTHOR]

Dysphagia Handicap Index (DHI) is a clinically effective, concise, and user-friendly tool for assessing the functional impact of dysphagia in clinical populations. The present study aims to trans-adapt the DHI in the Telugu language and assesses its psychometric properties. The present study was conducted in two phases. The first phase includes translating and adapting the DHI tool into Telugu (T-DHI). The second phase includes an analysis of the psychometric properties of the trans-adapted Telugu version of the DHI. The DHI was translated into the Telugu language using the forward–backward translation method. The psychometric analysis was done on 100 participants. All the participants underwent a detailed clinical swallow examination after filling the T-DHI. The overall internal consistency and Guttmann split-half reliability for the Telugu version of the DHI were good. The correlation between the T-DHI subscales and the self-perceived severity of dysphagia was found to be high. The comparison of the T-DHI scores of the control and experimental groups revealed a significant difference. The T-DHI is a reliable and valid tool to assess the quality of life of the Telugu-speaking dysphagia population. [ABSTRACT FROM AUTHOR]

This review is devoted to underpinning the contributions of Indian researchers towards asymmetric organocatalysis. More specifically, a comprehensive compilation of reactions mediated by a wide range of non-covalent catalysis is illustrated. A detailed overview of vividly catalogued asymmetric organic transformations promoted by hydrogen bonding and Brønsted acid catalysis, alongside an assortment of catalysts is provided. Although asymmetric organocatalysis has etched itself in history, we aim to showcase the scientific metamorphosis of Indian research from baby steps to large strides within this field. 1 Introduction 2 Non-Covalent Catalysis and Its Various Activation Modes 3 Hydrogen-Bonding Catalysis 3.1 Urea- and Thiourea-Derived Organocatalysts 3.1.1 Thiourea-Derived Organocatalysts 3.1.2 Urea-Derived Organocatalysts 3.2 Squaramide-Derived Organocatalysts 3.2.1 Michael Reactions 3.2.2 C-Alkylation Reactions 3.2.3 Mannich Reactions 3.2.4 [3+2] Cycloaddition Reactions 3.3 Cinchona-Alkaloid-Derived Organocatalysts 3.3.1 Michael Reactions 3.3.2 Aldol Reactions 3.3.3 Friedel–Crafts Reactions 3.3.4 Vinylogous Alkylation of 4-Methylcoumarins 3.3.5 C-Sulfenylation Reactions 3.3.6 Peroxyhemiacetalisation of Isochromans 3.3.7 Diels–Alder Reactions 3.3.8 Cycloaddition Reactions 3.3.9 Morita–Baylis–Hilman Reactions 4 Brønsted Acid Derived Organocatalysts 4.1 Chiral Phosphoric Acid Catalysis 4.1.1 Diels–Alder Reactions 4.1.2 Addition of Ketimines 4.1.3 Annulation of Acyclic Enecarbamates 5 Conclusion [ABSTRACT FROM AUTHOR]

Information about the 8th Biennial Congress of theWorld Society for Reconstructive Microsurgery that was held at the Grand Hyatt in Mumbai, India in march 2015. Topics include pride, opportunity, trust, and leadership. It featured the attendees of the symposium including Ian Taylor, Samir Kumta and Rajendra Nehete.

Objective  Neonates perceive pain which also has adverse long-term consequences. Newborns experience several painful procedures a day. Various methods of analgesia may be used but are underutilized. The SMART aim of this project was to increase the use of procedural analgesia from 11.5 to 75% in 6 months by using quality improvement principles. Study Design  After a baseline audit, a root cause analysis was done. Based on this, a series of interventions were done as Plan-Do-Study-Act (PDSA) cycles. These included posters on analgesia, display of the pain protocol, orders for analgesia, a written test, small power point presentations on the importance of analgesia, and reminders on the trays used for procedures. At the end of each PDSA cycle, an audit was done to determine the proportion of times analgesia was used. Process indicators were also used when possible. Analysis was done by using the Chi-square test and the paired t -test. Results  At baseline 11% of procedures were done after giving analgesia. This significantly improved to 40% at the end of the first PDSA, and 81% after third PDSA. This was sustained at 75% over the next 2 months. Conclusion  Procedural analgesia can improve and be sustained by using simple interventions. Key Points Procedural pain in neonates can be decreased by the use of analgesia. However, most units do not utilize analgesia appropriately. This QI showed that simple interventions can optimize use of procedural analgesia. [ABSTRACT FROM AUTHOR]

Background SLC25A19 gene mutations cause Amish congenital lethal microcephaly and bilateral striatal necrosis with polyneuropathy. We are reporting two cases of bilateral striatal necrosis with polyneuropathy due to SLC25A19 gene mutations. Methods A 36-month-old boy and a 5-year-old girl, unrelated, presented with recurrent episodes of flaccid paralysis and encephalopathy following nonspecific febrile illness. Examination showed dystonia and absent deep tendon reflexes. Results Nerve conduction studies showed an axonal polyneuropathy. Magnetic resonance imaging (MRI) of the brain in both cases showed signal changes in the basal ganglia. Next-generation sequencing revealed a novel homozygous missense variation c.910G>A (p.Glu304Lys) in the SLC25A19 gene in the boy and a homozygous mutation c.869T > A (p. Leu290Gln) in the SLC25A19 gene in the girl. Mutations were validated by Sanger sequencing, and carrier statuses of parents of both children were confirmed. Both children improved with thiamine supplementation. Conclusion If any child presents with recurrent encephalopathy with flaccid paralysis, dystonia, and neuropathy, a diagnosis of bilateral striatal necrosis with polyneuropathy due to SLC25A19 mutations should be considered and thiamine should be initiated. [ABSTRACT FROM AUTHOR]

Objective  Few data are available on cesarean delivery and operative vaginal delivery trends in low- and middle-income countries. Our objective was to analyze a prospective population-based registry including eight sites in seven low- and middle-income countries to observe trends in operative vaginal delivery versus cesarean delivery rates over time, across sites. Study Design  A prospective population-based study, including home and facility births among women enrolled from 2010 to 2016, was performed in communities in Argentina, Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia. Women were enrolled during pregnancy and delivery outcome data were collected. Results  We analyzed 354,287 women; 4,119 (1.2%) underwent an operative vaginal delivery and 45,032 (11.2%) delivered by cesarean. Across all sites with data for 7 years, rates of operative vaginal delivery decreased from 1.6 to 0.3%, while cesarean delivery increased from 6.4 to 14.4%. Similar trends were seen when individual country data were analyzed. Operative vaginal delivery rates decreased in both hospitals and clinics, except in the hospital setting at one of the Indian sites. Conclusion  In low- and middle-income countries, operative vaginal delivery is becoming less utilized while cesarean delivery is becoming an increasingly common mode of delivery. [ABSTRACT FROM AUTHOR]

Objective To determine population-based neonatal mortality rates in low- and middle income countries and to examine gestational age, birth weight, and timing of death to assess the potentially preventable neonatal deaths.Methods A prospective observational study was conducted in communities in five low-income countries (Kenya, Zambia, Guatemala, India, and Pakistan) and one middle-income country (Argentina). Over a 2-year period, all pregnant women in the study communities were enrolled by trained study staff and their infants followed to 28 days of age.Results Between October 2009 and March 2011, 153,728 babies were delivered and followed through day 28. Neonatal death rates ranged from 41 per 1000 births in Pakistan to 8 per 1000 in Argentina; 54% of the neonatal deaths were >37 weeks and 46% weighed 2500 g or more. Half the deaths occurred within 24 hours of delivery.Conclusion In our population-based low- and middle-income country registries, the majority of neonatal deaths occurred in babies >37 weeks' gestation and almost half weighed at least 2500 g. Most deaths occurred shortly after birth.With access to better medical care and hospitalization, especially in the intrapartum and early neonatal period, many of these neonatal deaths might be prevented. [ABSTRACT FROM AUTHOR]

Regular participation in an external quality assessment scheme (EQAS) is critical for ensuring acceptable laboratory performance. However, participation in such programs is uncommon for laboratories performing tests of hemostasis in developing countries. There are several reasons, including lack of awareness of its significance, absence of locally administered and easily accessible programs, and costs associated with some of the international schemes. To address this problem, we initiated an EQAS for hemostasis in India in the year 2000. This initially was limited to ~25 laboratories associated with the chapters of the Hemophilia Federation (India), with samples and analysis of results supported by United Kingdom National External Quality Assessment Scheme. This was converted to a national program in 2003, in association with the Indian Society of Haematology and Transfusion Medicine. Local manufacture of survey samples began in 2004, along with analysis of results. Currently, more than 100 laboratories are registered in the program. They receive samples three times a year for the following tests: prothrombin time, activated partial thromboplastin time, and factor assays. Some surveys also include samples for fibrinogen and von Willebrand factor assays. In recent surveys, 60 to 95% of laboratories had their clotting times and 57 to 77% of laboratories had their factor assays within consensus. The program has helped identify causes of unacceptable performance. The challenges ahead are to increase participation, improve reporting of results, and provide individualized support to laboratories to improve performance when necessary. [ABSTRACT FROM AUTHOR]