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This article seeks to understand the modern-day value of children to middle class Indian parents. It examines parental strategies aimed at raising successful children by providing them with the best education possible. These strategies, involving ‘concerted cultivation’ and gendered ‘educational labour’, are analysed in relation to schooling and preparation for a highly competitive national entrance exam, for admission to an elite engineering college in the country. Describing and analysing the classed and gendered nature of these strategies, the article explores the shifting nature of returns that middle class parents expect from their grown children. As the article shows, gendered burdens and class location of parents are crucial in shaping the value of children. Mothers across class contribute disproportionately to children’s educational training and highly educated mothers are withdrawn from the labour market to immerse themselves in educational labour. Ironically, educated mothers’ own educational inputs remain invisible even to themselves, resulting from an acceptance of culturally constructed norms around the gendered division of labour. Family strategies are oriented towards aspirations of upward social mobility, a return that parents seek to derive from educationally and professionally successful children.

Background: Superficial fungal infections are one of the commonest human infections. Causative agents of such infections may vary from yeasts like Candida species, Trichosporon species to dermatophytes and non-dermatophyte moulds. Fungal culture therefore, holds importance in identification and characterization of a fungal isolate, so that proper diagnosis can be made and correct treatment is instituted. Our objective was to study the etiology of the superficial fungal infections in patients presenting to the dermatology department in a tertiary care hospital in New Delhi. Materials and Methods: A total of 340 skin and hair samples from patients clinically suspected to have superficial fungal infection of skin and hair were microscopically examined and cultured over a period of 2 years. The percentage and frequency distribution of etiological fungal agents was studied. Also the performance of the culture and microscopy as methods of detecting fungal agents was statistically compared using Kappa and proportions of positive and negative agreement as well as McNemar’s Chi-squared value. Corresponding p-values were also calculated for both kappa and Chi-squared values. The analysis has been done using Epitools. Results: Of these, 57.6% were positive for fungal elements by microscopic examination and the overall positivity of fungal infection was 70%. Out of 238 culture positive samples, 72.7% grew dermatophytes and 27.3% grew non-dermatophytes (including 16.8% yeasts and 10.9% non-dermatophyte moulds. Trichophyton mentagrophytes was the commonest (60.7%) dermatophyte isolated, followed by T. rubrum (17.3%), T. violaceum (7.5%), T. tonsurans (7.5%), T. verucosum (2.9%), Microsporum gypseum (1.2%) and M. canis (0.6%). Among the isolated non-dermatophytes, Candida species was the commonest (50.8%) majority of which were C. albicans , other non-dermatophytes included moulds like Fusarium spp. (6.1%), Aspergillus fumigatus (4.6%), A. flavus (3.1%), Alternaria spp. (3.1%), Acremonium spp. (3.1%), A. niger (3.1%) etc. and yeasts like Trichosporon spp. (10.8%). Conclusion: Dermatophytosis still remains the most common type of fungal infection involving skin and its appendages but non-dermatophytes are also slowly emerging as the causative agents for these infections.

The deep interconnections between biology, population politics, and ethics have been strongly brought to the fore by the ongoing COVID-19 pandemic. The virus has highlighted the ways in which governments and state machineries calculate, control, and manage entire populations and demographic groupings, akin to what Foucault refers to as ‘biopolitics’ (Burchell et al. 1991): through measures such as complete or partial lockdowns, contact tracing, clinical trials, and vaccination. These steps immediately raise several important ethical concerns around questions of discrimination, inequality, surveillance, security, privacy, right to healthcare, and social protection. In this special issue, we foreground the discussion of bioethics in relation to demography and population politics by focusing on the two most populous countries in the world, India and China. In the process, we seek to enhance our understanding of the ways in which biology is enmeshed with population politics and the nature of bioethical concerns this generates. In doing this, we are guided by the conceptualisation that population as bioresource is not only ‘bioavailable’ (Cohen 2007) but can be rendered into ‘biocapital’ as Rajan (2006) articulates in his study of clinical trial patients.

After China, India has the most skewed sex ratio at birth. These two Asian countries account for about 90 to 95% of the estimated 1.2 to 1.5 million missing female births annually, worldwide, due to gender-biased (prenatal) sex selection. To understand this extreme discrimination against girls, this article examines the gendered biopolitics embedded in population policies, new sex selection technologies, and in the social reproduction of patriarchal society. The ethical consequences of advanced reproductive technologies, which remove the moral turpitude around gender-based sex selection by reformulating it into a "modern", "scientific" endeavour, facilitating the rise of "missing girls", make this an issue of gender justice, as noted by the World Population Report 2020. This article argues that unpacking gendered biopolitics within the household is crucial to understanding the reproduction of son preference and daughter aversion since it is here that reproduction and parenthood are subjected to biopolitical governance. We discuss how "biosocial" strategies of the household aimed at producing the "desired" and "right" family of more sons at the cost of daughters are operationalized through women's bodies with a view to family mobility. While women and girls continue to bear the burden and costs of social reproduction that lie at the heart of the patriarchal capitalist system of accumulation, a perusal of more recent studies suggests the beginning of an equalizing trend of parental investments, especially in the health and education of daughters who are "allowed" to be born. We suggest that familial enhancement of girls' human capital can help as a means of developing girls' capabilities and agency, enhancing their power in the biopolitics of the family and increasing their "bio-value" in parents' eyes.

Undergraduate students participating in the UCLA Undergraduate Research Consortium for Functional Genomics (URCFG) have conducted a two-phased screen using RNA interference (RNAi) in combination with fluorescent reporter proteins to identify genes important for hematopoiesis in Drosophila. This screen disrupted the function of approximately 3500 genes and identified 137 candidate genes for which loss of function leads to observable changes in the hematopoietic development. Targeting RNAi to maturing, progenitor, and regulatory cell types identified key subsets that either limit or promote blood cell maturation. Bioinformatic analysis reveals gene enrichment in several previously uncharacterized areas, including RNA processing and export and vesicular trafficking. Lastly, the participation of students in this course-based undergraduate research experience (CURE) correlated with increased learning gains across several areas, as well as increased STEM retention, indicating that authentic, student-driven research in the form of a CURE represents an impactful and enriching pedagogical approach.

Contains fulltext : 245825.pdf (Publisher’s version ) (Closed access) BACKGROUND: Phaeochromocytoma or paraganglioma (collectively known as PPGL) in pregnant women can lead to severe complications and death due to associated catecholamine excess. We aimed to identify factors associated with maternal and fetal outcomes in women with PPGL during pregnancy. METHODS: We did a multicentre, retrospective study of patients with PPGL and pregnancy between Jan 1, 1980, and Dec 31, 2019, in the International Pheochromocytoma and Pregnancy Registry and a systematic review of studies published between Jan 1, 2005, and Dec 27, 2019 reporting on at least five cases. The inclusion criteria were pregnancy after 1980 and PPGL before or during pregnancy or within 12 months post partum. Eligible patients from the retrospective study and systematic review were included in the analysis. Outcomes of interest were maternal or fetal death and maternal severe cardiovascular complications of catecholamine excess. Potential variables associated with these outcomes were evaluated by logistic regression. FINDINGS: The systematic review identified seven studies (reporting on 63 pregnancies in 55 patients) that met the eligibility criteria and were of adequate quality. A further 197 pregnancies in 186 patients were identified in the International Pheochromocytoma and Pregnancy Registry. After excluding 11 pregnancies due to potential overlap, the final cohort included 249 pregnancies in 232 patients with PPGL. The diagnosis of PPGL was made before pregnancy in 37 (15%) pregnancies, during pregnancy in 134 (54%), and after delivery in 78 (31%). Of 144 patients evaluated for genetic predisposition for phaeochromocytoma, 95 (66%) were positive. Unrecognised PPGL during pregnancy (odds ratio 27·0; 95% CI 3·5-3473·1), abdominal or pelvic tumour location (11·3; 1·5-1440·5), and catecholamine excess at least ten-times the upper limit of the normal range (4·7; 1·8-13·8) were associated with adverse outcomes. For patients diagnosed during pregnancy, α-adrenergic blockade therapy was associated with fewer adverse outcomes (3·6; 1·1-13·2 for no α-adrenergic blockade vs α-adrenergic blockade), whereas surgery during pregnancy was not associated with better outcomes (0·9; 0·3-3·9 for no surgery vs surgery). INTERPRETATION: Unrecognised and untreated PPGL was associated with a substantially higher risk of either maternal or fetal complications. Appropriate case detection and counselling for premenopausal women at risk for PPGL could prevent adverse pregnancy-related outcomes. FUNDING: US National Institutes of Health.

Purpose To evaluate the usefulness of chemical shift imaging (CSI) in differentiating benign osteoporotic and malignant vertebral marrow lesions. Material and methods Patients undergoing spinal magnetic resonance imaging (MRI) for back pain, which showed altered marrow signal intensity on conventional MRI sequences, were included in the study. Patients with acute traumatic vertebral fractures, infective spondylodiscitis, paravertebral collections, etc. were excluded. The patients underwent CSI. In-phase and opposed-phase images were taken to calculate the signal intensity ratio (SIR) of the abnormal vertebra. The SIR of the mean signal intensity measured on opposed-phase to mean signal intensity measured on in-phase images was measured and recorded. Results The studied population included 30 patients, in whom 58 vertebrae were accessed, which included 38 dorsal, 18 lumbar, 1 sacral, and 1 cervical. Out of 58 vertebrae, 46 (79%) were malignant and 12 (20%) were benign. The mean CSI/SIR of malignant lesions was 0.96 and the mean SIR of benign lesions was 0.76. Conclusions Conventional MRI sequences cannot always differentiate between benign and malignant lesions. So newer sequences like CSI have been developed. CSI SIR can be used as a new tool in differentiating benign osteoporotic and malignant vertebral marrow lesions.

COVID-19 caused by Coronavirus strain “Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2)” has been responsible for the significant threat to the world and its pandemic has become the most important matter of concern in health care systems. The cases of reinfection with virus have been noted in the patients after the discharge. The lack of reporting of COVID-19 virus in asymptomatic cases of reinfection was observed on basis of various studies. Genetically distinct SARS-CoV-2 rules out persistent viral shedding or reactivation. There is not any protocol for the diagnosis of reinfection on the basis of single specimen, therefore it has been advised to test Paired specimens for the diagnosis of reinfection. To minimize the spread of transmission of virus in India, certain necessary steps of prevention has been taken by Indian Council of Medical Research (ICMR) and The Ministry of Health and Family Welfare (MOHFW), India. For the control of the COVID-19, the surge in awareness along with guidelines have been posed as a part of preventive measure in the country. The protocol for diagnosis of reinfection is needed to combat the problem. This is a review article to study the diagnostic approach and diagnostic criteria of reinfection after few cases were studied so far with Indian Scenario. The whole genome sequencing done in these patients provide valuable evidence for reinfection.

Nontypeable Haemophilus influenzae (NTHi) causes respiratory infections that lead to high morbidity and mortality worldwide, encouraging development of effective vaccines. To achieve a protective impact on nasopharyngeal (NP) colonization by NTHi, enhanced immunogenicity beyond that achievable with recombinant-protein antigens is likely to be necessary.

Neurocysticercosis is a leading cause of acquired epilepsy. Calcified granulomas are known to cause seizure recurrence. Researchers have reported that vitamin D deficiency is associated with brain calcification and reduction in calcification occurs with vitamin D receptor agonist calcitriol through upregulation of SLC20A2. Based on these observations, a hypothesis was proposed that the occurrence of calcification could be reduced by optimizing vitamin D levels, resulting in early resolution of neurocysticercosis.A case-control (retrospective and prospective) study on 60 children with solitary intraparenchymal neurocysticercosis, 20 new cases prior to starting cysticidal therapy and other 40 resolved cases was carried out. Among new cases, children deficient in vitamin D were given megadose of vitamin D and vitamin D levels were rechecked after 30 days. Children having normal vitamin D were taken as cases and the deficient ones were taken as controls. Standard treatment for neurocysticercosis was given. Three monthly MRI scans were done. Outcome was evaluated as resolution/persistence of neurocysticercosis at 3, 6, 9 and 12 months.Pearson chi square/Fisher's exact test was used along with Kaplan Meier and log rank test. Of 60 patients, at 6 months 3 cases and 4 controls (The results do not show that adequate vitamin D levels result in early resolution of neurocysticercosis.

Horticulture is backbone of our country and greater population about 60-65% is directly or indirectly hooked in to it. In the export earnings for the country the role of horticultural produce is vital. In Indiaabout 20-40% of total horticulture produce wasted due to lack of post-harvest management of vegetables which resulted in huge financial loss.Most poor horticulture producers cannot meet the expense of modern technologies.Many metabolic changes occur in vegetables after harvesting that are influenced by disruption of supply of nutrients, water and growth regulators from the parent plant to the harvested vegetables. The overall process leads to postharvest deterioration of the produce. However, the losses are often reduced with adoption of postharvest management and use of processing technology of vegetable crops.

PURPOSE: Tibial torsion is important to be factored in during calculations of angular deformities of the lower extremity. Three methods are commonly used, thigh foot angle, measurement of transmalleolar axis with proximal tibia or knee as a reference, and Computerized tomography. The purpose of the current study was to find out the effectiveness of clinical methods and compare CT based method for tibial torsion. METHODS: A total of 68 limbs (34 subjects) were included. Tibial torsion was measured using thigh foot angle, transmalleolar axis in relation to knee forward position (Knee ankle axis) and CT based evaluation using Jend method. RESULTS: Pearson correlation coefficient showed strong correlation between CT values and thigh foot angle (r = 0.848) as well as between CT values and Knee ankle axis (r = 0.889). Scatter plots also showed a linear distribution. CONCLUSION: Both thigh foot angle and Knee ankle axis provide reliable alternative to ionizing CT in measuring tibial torsion.

Nontypeable Haemophilus influenzae (NTHi) causes respiratory infections that lead to high morbidity and mortality worldwide, encouraging development of effective vaccines. To achieve a protective impact on nasopharyngeal (NP) colonization by NTHi, enhanced immunogenicity beyond that achievable with recombinant-protein antigens is likely to be necessary. Adding a lipid moiety to a recombinant protein would enhance immunogenicity through Toll-like receptor 2 signaling of antigen-presenting cells and Th17 cell response in the nasal-associated lymphoid tissue (NALT). We investigated effects of lipidation (L) of recombinant proteins P6 and OMP26 compared to nonlipidated (NL) P6 and OMP26 and as fusion constructs (L-OMP26ϕNL-P6 and L-P6ϕNL-OMP26) in a mouse model. After intraperitoneal or intranasal vaccination, antibody responses were compared and protection from NP colonization and middle ear infection were assessed. L-P6 and L-OMP26 induced approximately 10- to 100-fold-higher IgG antibody levels than NL-P6 and NL-OMP26. Fusion constructs significantly increased IgG antibody to both target proteins, even though only one of the proteins was lipidated. NP colonization and middle ear bullae NTHi density was 1 to 4 logs lower following vaccination with L-P6 and L-OMP26 than with NL-P6 and NL-OMP26. Fusion constructs also resulted in a 1- to 3-log-lower NTHi density following vaccination. NALT cells from mice vaccinated with lipidated protein constructs had higher levels of interleukin-17 (IL-17), IL-22, and CD4(+) T-cell memory. Passive transfer of sera from L-OMP26ϕNL-P6-vaccinated mice to recipient infant mice reduced NP colonization and ear bulla NTHi density. We conclude that L-P6, L-OMP26, and fusion constructs generate enhanced antibody responses and protection from NP colonization and middle ear infection by NTHi in mice.

Rubella is an important infectious, vaccine-preventable etiology of congenital defects. The aim of the study was to develop a prediction nomogram to assess the probability of an infant being at risk for congenital rubella based on demographics and ophthalmological findings. This was a cross-sectional sentinel surveillance study conducted at 5 centers spanning pan-India and involved 1134 infants. The diagnosis of rubella was made using standard guidelines. For the construction of the prediction model, laboratory-confirmed cases were grouped as “at-risk” (AR) infants and the discarded cases into “not at risk” (NAR) infants. Univariate analysis (p value cut-off < 0.05) followed by multivariate binary logistic regression model development was performed. The average (median) age of the suspected CRS infants was 3 (IQR 1–6) months, and the average (mean) age of their mothers was 25.8 ± 4.1 years. Out of the total infants, 81 (7.3%) died, 975 (88%) were alive, and 55 (5.0%) were lost to follow-up. The final model showed that the odds of cataract, retinopathy, glaucoma, microcornea, and age of the infant at presentation were 3.1 (2.2–4.3), 4.9(2.3–10.4), 2.7(1.1–5.9), 2.3(1.1–4.7), and 1.1 (1–1.1), respectively, for the AR infant as compared to NAR infant. AUC of final model was 0.68 (95% CI Delong, 0.64–0.72). Bootstrapping for calibration of the model showed satisfactory results. Nomogram, along with a web version, was developed. The developed nomogram would have a wide community-based utilization and will help in prioritizing attention to high-risk children, thereby avoiding loss to follow-up.

The COVID-19 pandemic has brought a unique set of challenges to assessing and treating paediatric dental patients in the secondary care setting These children often present with high disease burdens and high levels of anxiety In addition, they may have medical conditions which add to their treatment complexity At the Royal London Dental Hospital, innovations have been put in place to improve the patient journey in a time where access to both out-patient and general anaesthetic services have been severely limited Long term these innovations will help us to improve our service and facilitate communication with patients/carers, general dental and medical practitioners, safeguarding and specialist medical teams It will create more flexible and creative work patterns for the dental team CPD/Clinical Relevance: This paper illustrates the innovations that were introduced to overcome the challenges faced during the COVID-19 pandemic © 2020 George Warman Publications All rights reserved

Background: Ventilator-Associated Pneumonia (VAP) is a recognized nosocomial infection and a leading cause of high morbidity and mortality. Intensive Care Unit (ICU) nurses are in the best position to put the known evidence-based strategies into practice to prevent VAP. The aim of the present study is to assess the knowledge and practices of ICU nurses related to prevention of VAP in selected ICUs of a tertiary care centre in India (2013–2014) and to find out the association between knowledge and practices. Materials and Methods: A descriptive survey was conducted in the different ICUs of a tertiary care hospital in India. Purposive sampling technique was used and 108 ICU staff nurses were enrolled during the period of data collection. The tool used for data collection was a self-developed valid and reliable knowledge-based questionnaire and an observational checklist. The descriptive (frequency and percentages) and inferential (Chi-square test) statistics was used. Results Out of the 108 nurses enrolled in the study, 82 (75.93%) had average, 24 (22.22%) had good and only 2 (1.85%) of the ICU nurses had poor knowledge. Assessment of the practices revealed that 68 (94.44%) nurses had average and only 4 (5.55%) nurses had good practice. There was no association between the knowledge and practices of ICU nurses related to prevention of VAP. (χ2 = 0.14, p = 0.710). Conclusions: Although the nurses were having good to average knowledge scores, their practices were not associated with knowledge scores. There is a need to find out the ways that would help the nurses to adhere to good practices.

The chemistry and short lifetimes of metal-based anti-cancer drugs can be turned into an advantage for direct injections into tumors, which then allow the use of highly cytotoxic drugs. The release of their less toxic decomposition products into the blood will lead to decreased toxicity and can even have beneficial effects. We present a ternary VV complex, 1 ([VOL1 L2 ], where L1 is N-(salicylideneaminato)-N'-(2-hydroxyethyl)ethane-1,2-diamine and L2 is 3,5-di-tert-butylcatechol), which enters cells intact to induce high cytotoxicity in a range of human cancer cells, including T98g (glioma multiforme), while its decomposition products in cell culture medium were ≈8-fold less toxic. 1 was 12-fold more toxic than cisplatin in T98g cells and 6-fold more toxic in T98g cells than in a non-cancer human cell line, HFF-1. Its high toxicity in T98g cells was retained in the presence of physiological concentrations of the two main metal-binding serum proteins, albumin and transferrin. These properties favor further development of 1 for brain cancer treatment by intratumoral injections.

Manufacturing activities consume a significant share of energy and natural resources and create some irreversible environmental impacts leading to climate change. A recent report from IPCC has highlighted the seriousness of global climate change. To mitigate the environmental burdens from manufacturing activities, it is necessary to identify and visualize them. Tools based on life cycle assessment (LCA) method have proven capabilities to visualize the hotspots during different stages of product life cycle and to support decision-making. This paper presents friction stir processing (FSP) of pure magnesium for bio implants and its environmental impact assessment in the Indian context. The study is aimed to visualize the FSP of pure Mg and major hotspots in the process to improve sustainability. The primary data for the inventory analysis was collected using real-time observations during each step of the process; whereas for secondary data, product catalogs and reports were utilized. The analysis shows that the production process of magnesium and energy used during electric discharge machining (EDM) have the highest environmental impacts. Additionally, in magnesium production, the direct emissions generated due to the burning of fossil fuel are the major contributors to these impacts. The steel used for FSP tool production and brass wire used in EDM for sizing of the magnesium plates, are also found to be contributing significantly toward water depletion potential. The study provides a conceptual approach including possible technological interventions to improve the process sustainability. The study suggests adopting advanced technologies of practical significance like ‘zinc coated cutting wires’ for improving the environmental performance of the process.

Development of drug delivery systems has emerged out as significant field in medicinal chemistry because of their localized action, low frequency of drug administration and sustained release of drug at the site of action for a prolonged time. Out of various reported methods, in the present work, we report use of five different polysaccharides for the development of sustained release systems for curcumin, utilizing a surfactant, cetyltrimethylammonium bromide (CTAB). Four of these were novel systems and were first optimized. Sustained release of optimized supports was studied by anti-oxidant, serum protein binding and anti-cathepsin activities. Particle size, FT-IR and SEM were used to characterize the modified supports. CTAB-modified-NCCS, -pectin-15 and Alg-5 were found to be the best supports as they released appreciable amount of curcumin for a longer time. The results have also been interpreted using chemical modeling studies.

Soils of India are generally deficient in micronutrients. The Fe, Mn, Zn, and Cu are present in different chemical fractions, and the extent to which each fraction is present is sensitive to cultivation and management practices. The inclusion of trees in major cropping systems may ameliorate micronutrient deficiencies to some extent as they increase mobilization of micronutrients in the soils. Depthwise dynamics of total, DTPA-extractable, water-soluble plus exchangeable (WSEX), specifically adsorbed (SpAd), carbonate bound (CARB), Mn-Oxide bound (MnOX), amorphous Fe-Oxides bound (AFeOX), crystalline Fe-Oxides bound (CFeOX), organically bound (OM), and residual (RES) fractions of cationic micronutrients (Fe, Mn, Zn, and Cu) were observed on the sites having poplar (Populus deltoides Bartr.)-based agroforestry system (AFS) for 10, 20, and 30 years, fodder-fodder (F-F) rotation and fallow land (FL). Total and DTPA-extractable micronutrients followed the order AFS > F-F > FL, and in chronosequence of AFS, the total content of Fe, Mn, Zn, and Cu increased by 9.8, 24.8, 50.8, and 9.2%, respectively, in 0–15 cm soil depth on the sites having AFS for 30 years over 10 years of AFS. All the micronutrients were highest in residual fraction than their other fractions in each land use system. Adoption of poplar-based AFS led to buildup of total micronutrients and their various pools in the soil. Chronosequence of AFS resulted in increase and redistribution of micronutrients from unavailable (CARB and CFeOX) to readily available (WSEX) and potentially available (OM, MnOX and AFeOX) forms in the soil.

Different schedules for pediatric use of the 13-valent pneumococcal conjugate vaccine (PCV-13) are recommended in different countries and the U.S. Advisory Committee on Immunization Practices (ACIP) has considered potential of changing from 3 primary doses plus a booster (3p + 1) to two primary doses plus a booster (2p + 1) for protection against Streptococcus pneumoniae. In this paper, we report results of IgG antibody measured by ELISA and opsonophagocytic assay (OPA) after 2p, 3p, at child age 15 months of pre-booster and 18 months (post-booster) in serum samples opportunistically available from a prior study that focused on PCV effectiveness against AOM. A total of ~ 100 sera for each of the 4 study time points (390 sera tested) from 169 children were tested. Geometric mean concentrations (GMCs) and percentage of children exceeding the presumed protective antibody thresholds measured by ELISA and OPA were calculated. 2p doses produced lower antibody levels measured by ELISA but not OPA until the booster dose for serotypes 6A, 6B, 5 and 23F only. Booster dosing at 15 months resulted in significant increases in antibody. There was no difference in the percentage of children with ≥ correlate of protection (COP) for OPA for 2p vs 3p doses except for serotype 23F. A 2p + 0 or 3p + 0 schedule would likely result in many children failing to sustain protective levels of antibody into the second year of life. We conclude that protection from invasive pneumococcal infection in early childhood would be similar for most serotypes in PCV13 using a 2p + 1 or 3p + 1 but not a 2p + 0 or 3p + 0 schedule.

Carbon quantum dots have exhibited highly fluorescent characteristics as nanomaterials. Soluble in water and easily synthesized by multiple simple techniques, there are immense fabrication possibil...

Research Objectives: The objective of the study was to assess the impact of menopause on the quality of life of Indian women. Methodology: 155 women, in the age range of 40 to 60 years, from various parts of India were included in the study based on inclusion criteria (mentally oriented women not using hormonal replacement therapy, without history of hysterectomy and medical conditions like hypertension, diabetes and thyroid problems). Menopause-specific Quality of Life (MENQOL) questionnaire was used to assess the presence of symptoms in vasomotor, psychosocial, physical and sexual domains. Menopausal status was categorized as Late perimenopausal, Early perimenopausal, Premenopausal and postmenopausal. Findings: Descriptive statistics was used to analyze the data. The average age of participants was 50.7 years with average BMI of 25.9. A largest no. of women were in the postmenopausal status (n=115), followed by premenopausal (n=19), early perimenopausal (15) and late perimenopausal (n=6) status. Most common symptom in vasomotor domain was sweating (38.06%), in psychosocial domain feeling anxious (25.80%) and depressed (25.16), in physical domain decrease in physical strength (49.67%), feeling tired (48.38%), lack of energy (47.74%), low backache (47.74%), aching in muscles and joints (46.45%) whereas in sexual domain mild vaginal dryness during intercourse (30%) and change in sexual desire (28.67%). Research Outcomes: The menopausal symptoms lasted many years after the cessation of menstruation. 25-50% of prevalence rate in various domains indicates a need to adopt multidimensional approach, for the better management of menopausal symptoms. Future Scope: Future study may be carried out with equal sample size in all the categories of menopausal status to identify the relationship between the severity of menopausal symptoms and the menopause status.

Background Antibiotic-resistant Streptococcus pneumoniae strains may cause infections that fail to respond to antimicrobial therapy. Results reported from hospitalized patients with invasive, bacteremic infections may not be the same as those observed in a primary care setting where young children receive care for noninvasive infections. Young children experience the highest burden of pneumococcal disease. The aim of this study was to determine the antibiotic susceptibility of S. pneumoniae strains isolated from children in a primary care setting in the post–13-valent pneumococcal conjugate vaccine (PCV13) era. Methods This was a prospective collection of 1201 isolates of S. pneumoniae from 2006 through 2016 in a primary care setting. Antibiotic susceptibility testing to 16 different antibiotics of 10 classes was performed. Participants were children aged 6–36 months. Nasopharyngeal swabs were obtained from patients during acute otitis media (AOM) visits and routine healthy visits. Middle ear fluid was obtained by tympanocentesis. Results After introduction of PCV13, antibiotic susceptibility of pneumococci, especially to penicillin, initially improved largely due to disappearance of serotype 19A, included in PCV13. However, beginning in 2013, antibiotic susceptibility among pneumococcal strains began decreasing due to new serotypes not included in PCV13. In addition to reduced susceptibility to penicillin, the most recent isolates show reduced susceptibility to third-generation cephalosporins, fluoroquinolones, and carbapenems, antibiotics commonly used to treat life-threatening, invasive pneumococcal diseases. Conclusions In recent years, pneumococcal nasopharyngeal and AOM isolates from children exhibit reduced susceptibility to penicillin, third-generation cephalosporin, fluoroquinolone, and carbapenem antibiotics. The new strains have a different profile of resistance compared to the pre-PCV13 era.

Diabetes and other lifestyle disorders have been recognized as the leading cause of morbidity and mortality globally. Nuclear factor kappa B (NF-κB) is a major factor involved in the early pathobiology of diabetes and studies reveal that hyperglycemic conditions in body leads to NF-κB mediated activation of several cytokines, chemokines and inflammatory molecules. NF-κB family comprises of certain DNA-binding protein factors that elicit the transcription of pro-inflammatory molecules. Various studies have identified NF-κB as a promising target for diabetic management. Probiotics have been proposed as bio-therapeutic agents for treatment of inflammatory disorders and many other chronic clinical stages. The precise mechanisms by which probiotics acts is yet to be fully understood, however research findings have indicated their role in NF-κB modulation. The current review highlights NF-κB as a bio-therapeutic target for probable management of type 2 diabetes through probiotic intervention.

To determine the prevalence of fungal infestation in paediatric chronic otitis media (COM)-mucosal disease and to study the various factors that might influence the said infestation.A cross-sectional study was done on the cited subject in a sample size of 66 paediatric patients [Age group: 1-18 years] suffering from active COM-mucosal disease. In all we had 75 ears from which swab samples were taken as some patients had bilateral disease. Clinical record was documented in each case. Three sample swabs were analysed for aerobic, anaerobic and fungal infection respectively from the discharging ear. Fungal infection was diagnosed by culture. The data was tabulated and statistically analysed for any correlation of fungal infestation with age, sex, background, duration of COM, previous antibiotic/steroid usage and intractable otorrhoea.We recorded a prevalence of 32% for fungal colonization of COM-mucosal disease in paediatric population i.e., 24 out of 75 ears. There was no association observed between fungal infestation and specific paediatric age group, sex, background or duration of the disease. However, a distinct statistical correlation was present between fungal infestation and previous antibiotic/steroid usage and intractable otorrhoea.Findings of this study lead us to conclude that all cases of paediatric COM-mucosal disease should be analysed for fungal colonization, especially those with intractable otorrhoea and there should be judicious use of antibiotics and steroid ear drops in COM-mucosal disease.

Mesenteric tear in blunt trauma patients needs a high index of suspicion for radiological diagnosis especially when presenting with subtle and indirect radiological features. Our patient had both direct and indirect computed tomography signs of mesenteric injury which we hereby discuss along with their sensitivity and specificity.

BACKGROUND: Suboptimal glycemic control is associated with maternal and neonatal morbidity and mortality in pregnancy complicated by type 1 diabetes (T1D). Prospective analysis of continuous glucose monitoring (CGM) metrics, insulin pump settings, and insulin delivery can better characterize the changes in glycemic levels and insulin use throughout pregnancy with T1D. MATERIALS AND METHODS: Prescribed parameters, insulin delivery, carbohydrate intake, and CGM data for 25 pregnant women with T1D from three U.S. sites were collected. Participants enrolled before 17 weeks gestation and used personal insulin pumps and study CGM. Mean daily total, basal, and bolus insulin doses (units/kg), CGM time in range (TIR: 63–140 mg/dL), and pump-entered carbohydrates were analyzed for every 2-week gestational interval. Linear mixed-effects regression models were used to evaluate changes across gestational ages compared to 12–14 weeks. RESULTS: Basal insulin was higher during weeks 6–12 and 24–40. Daily bolus and total insulin were higher during weeks 20–40. Pump parameters were adjusted to intensify insulin therapy from 22 weeks onward. Average TIR across pregnancy was 59% ± 14%. Between 18 and 30 weeks, TIR was significantly lower, and time above range was significantly higher compared to the reference biweek. Time below target was lower between 22 and 34 weeks. Seven participants achieved >70% recommended TIR for pregnancy. Participants with maternal complications or infant neonatal intensive care unit admissions had lower TIR. CONCLUSION: While insulin dosing changed significantly with advancing gestation, most participants did not achieve >70% TIR. Customized anticipatory pump setting adjustments and automated systems aimed toward the designated TIR are needed to improve outcomes for this population. NCT03761615

Subacute sclerosing panencephalitis (SSPE) is a slowly progressive neurodegenerative disease caused by the measles virus. This study investigated the magnetic resonance imaging (MRI) findings in SSPE by retrospective review of two cases diagnosed by typical periodic electroencephalographic (EEG) features, clinical symptoms and elevated measles antibody titre in cerebrospinal fluid (CSF). MRI revealed lesions of high signal intensity on T2-weighted images involving the periventricular or subcortical white matter in both the patients. Both these patients were given sodium valproate for seizures. However, the disease proved fatal in both these cases eventually.

Tuberculosis of the parotid gland is uncommon in ENT practice. If not associated with sinus/abscess formation, it becomes difficult to differentiate it from neoplasm of the gland. In cases where it involves only the gland (Primary Tuberculosis), then the diagnosis mainly depends on high index of suspicion of the treating physician. Radiological support, FNAC or HPE are the other helping modes to arrive on a diagnosis. FNAC is a simple process with less morbidity for the patient. We treated a patient successfully with medical treatment after FNAC. Keywords: Parotid gland, Tuberculosis, FNAC.

OBJECTIVES To study the presence of biofilms in patients of chronic otitis media (COM)-active squamosal disease and to evaluate the microflora and clinical impact of biofilms. METHODS A total of 35 patients suffering from COM - active squamosal disease was studied. Cholesteatoma sample was collected at the time of mastoid surgery and the same was used to image for biofilms by scanning electron microscope. The said sample was also analyzed microbiologically. RESULTS Biofilms were present in 25 (72%) patients including 6 cases of fungal biofilms (24%). Biofilms were detected irrespective of the micro-organism growth. No statistically significant relationship was observed between biofilms and discharging ear and complications of COM. Though univariate analysis of our data found some correlation between duration of disease, the extent of cholesteatoma and ossicular necrosis but multivariate analysis revealed no such associations, thereby implying a doubtful association between these factors and biofilm. CONCLUSIONS Biofilms are an integral part of cholesteatoma ear disease and sometimes harbors fungal isolates.

Background: The coronavirus disease 2019 (COVID-19) pandemic led to day care and school closures and children staying home for several months. When they gradually returned, aggressive regulations were implemented in New York State to reduce viral transmission.Method: An ongoing prospective study occurring in the Rochester, NY region, focused on early childhood respiratory infectious diseases, afforded an opportunity to assess the impact of the pandemic on the incidence of these illnesses in a primary care outpatient setting. Physician-diagnosed, medically attended infection visits were assessed in two child cohorts, age 6–36 months old: from March 15 to December 31, 2020 (the pandemic period) compared to the same months in 2019 (prepandemic). Nasopharyngeal colonization by potential otopathogens during healthy/well-child and acute otitis media (AOM) visits was evaluated.Results: One hundred and forty-four children were included in the pandemic cohort and 215 in the prepandemic cohort. The pandemic cohort of children experienced 1.8-fold less frequent infectious disease visits during the pandemic (p < 0.0001). Specifically, visits for AOM were 3.7-fold lower (p < 0.0001), viral upper respiratory infections (URI) 3.8-fold lower (p < 0.0001), croup 27.5-fold lower (p < 0.0001), and bronchiolitis 7.4-fold lower (p = 0.04) than the prepandemic cohort. Streptococcus pneumoniae (p = 0.03), Haemophilus influenzae (p < 0.0001), and Moraxella catarrhalis (p < 0.0001) nasopharyngeal colonization occurred less frequently among children during the pandemic.Conclusion: In primary care pediatric practice, during the first 9 months of the COVID-19 pandemic, significant decreases in the frequency of multiple respiratory infections and nasopharyngeal colonization by potential bacterial respiratory pathogens occurred in children age 6–36 months old.

Introduction: Empirical antimicrobial therapy is the mainstay of antimicrobial stewardship. The gram stain can be used to guide initial empiric antimicrobial therapy in cases where culture report is not available. This rapid test can therefore be helpful in preventing the initiation of inappropriate therapy and its adverse outcomes. Aim: To determine the effectiveness of gram stain of tracheal aspirate samples in order to predict the causative microorganism and starting appropriate initial antimicrobial therapy. Materials and Methods: This cross-sectional study was done for 208 tracheal aspirate samples that were sent to Department of Microbiology, Lady Hardinge Medical College, New Delhi, India, with a request for bacterial culture and Antibiotic Susceptibility Testing (AST) from January 2019 to June 2019. Each sample was inoculated on 5% Sheep blood agar, Chocolate agar and MacConkey agar followed by gram stain preparation and smears. The culture plates were checked after 24 hours for any bacterial growth and further identification was done by gram stain, motility and biochemical tests. The AST was performed as per Clinical and Laboratory Standards Institute (CLSI) 2019 guidelines. All data entry was done on MS excel software and appropriate statistical tests were applied. Results: Out of total 208 samples significant gram stain findings were seen in 90 cases (43.2%). Out of 208 samples 132 (63.5%) cases grew significant pathogens on culture. Out of these 90 cases, 68 (75.5%) of gram stain finding matched with culture results. The correlation between gram stain and culture was found to be 75.5%. Conclusion: Gram stain is not only a quick and cost-effective method but also easily available in most laboratories and is highly reproducible. Gram stain, a rapid diagnostic tool, can thus be very useful in antimicrobial stewardship especially for the critically ill patients.

Background The objective of this study was to determine the prevalence, proportion of encapsulated strains and antibiotic susceptibility of Haemophilus influenzae isolated from young children. Methods Children, 6 months to 30 months old, were prospectively enrolled from September 2019 to September 2020 at Rochester, NY, pediatric clinics. H. influenzae isolates from nasopharynx (NP) at healthy visits and disease isolates from NP and middle ear fluid (MEF) at onset of acute otitis media (AOM) were characterized by capsular typing, β-lactamase production and antibiotic susceptibility. Results Samples from 565 healthy visits and 130 AOM visits were collected. H. influenzae was detected 5.9% and 27% in the NP from healthy and AOM visits, respectively. In the MEF, H. influenzae was isolated in 43% of samples. Eight percent of H. influenzae isolates were encapsulated, 88% type f. Overall 39.7% of isolates were β-lactamase producing; 43% for MEF isolates. Ampicillin, trimethoprim/sulfamethoxazole, erythromycin and clarithromycin nonsusceptibility were found in more than 25% of isolates. None of the encapsulated H. influenzae isolates were positive for β-lactamase production or ampicillin nonsusceptibility. 9.2% of isolates were β-lactamase negative, ampicillin resistant (β-lactamase negative, ampicillin resistant + β-lactamase negative, ampicillin intermediate). Conclusions The prevalence of H. influenzae in the NP of young children is very low at times of health, but H. influenzae is highly prevalent in MEF at onset of AOM. Nontypeable H. influenzae accounts for >90% of all H. influenzae isolates. Type f predominated among encapsulated strains. β-lactamase production and antibiotic nonsusceptibility among H. influenzae strains isolated from the NP and MEF are common.