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The current research was performed in the Morni Hills, a part of the outer Himalayas. Floristic assessment is critical for a plant community, reflecting both the gene pool and adaptability of the community. For this, different parameters like density, frequency, basal area, IVI, and various diversity indices were calculated by dividing the area into two altitudinal ranges, i.e. 400–600 m AMSL (AR_1) and 600–800 m AMSL (AR_2). The vegetation sampling was done by randomly selecting 30 plots in the selected area. The study showed that AR_2 (118 plant species: 31 trees, 17 shrubs, 58 herbs, and 12 climbers) had a higher number of plant species in comparison to AR_1 (106 plant species: 26 trees, 14 shrubs, 54 herbs, and 12 climbers) with Poaceae being the family with the greatest number of species. The area was seen to be dominated by Acacia nilotica (L.) willd. Ex Delile, Cassia fistula L., and Leucaena leucocephala (Lam.) de Wit in AR_1 while by Pongamia pinnata (L.) Pierre, Cassia fistula, and Oroxylum indicum (L.) Kurz in AR_2. The upper range, i.e. AR_2 was also more diverse than AR_1 because of a high Shannon Wiener Diversity Index value and a lower Simpson Index value. Whereas the population structure study demonstrated that girth class D (CBH=61–90 cm) had the highest number of tree species in both altitudinal ranges, followed by girth class C (CBH=31–60 cm). Moreover, the forest was also observed to be occupied by various invasive plant species as well as under anthropogenic pressure, hence in immediate need of proper management and conservation. [ABSTRACT FROM AUTHOR]

Introduction: Neonatal sepsis remains a diagnostic burden globally, responsible for about 30-50% of the total neonatal deaths each year in developing countries. Neutrophil CD-64 is found to be a promising marker for the diagnosis of early and late infections in newborns. Human Leukocyte Antigen-DR (HLA-DR) is a glycosylated cell surface transmembrane protein expressed on monocytes, allowing antigen presentation to T-cells and playing a crucial role in initiating the immune cascade during sepsis. Decreased expression of HLA-DR on monocytes has been associated with decreased survival in newborns with sepsis. Aim: To evaluate the role of neutrophil CD-64 and monocyte HLA-DR expression as markers of neonatal sepsis. Materials and Methods: This was a cross-sectional prospective study carried out at the Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India, between July 2016 and June 2017. Total of 70 full-term neonates with clinical suspicion of sepsis were enrolled. A 2 mL peripheral venous blood sample was collected for flow cytometry, blood culture, and sepsis screening in all patients. The expression of cell surface markers (CD-64 on neutrophils and HLA-DR on monocytes) was measured by an eight-color flow cytometer. A composite parameter was derived by dividing the Mean Fluorescence Intensity (MFI) values of nCD-64 and their respective mHLA-DR, multiplying the ratio by 100, and terming it as the sepsis index (Sepsis Index = nCD-64/mHLA-DR x 100). A region was drawn on monocytes on an SSC/CD14 plot. Gating was performed on 'not monocytes' on the SSC/CD45 bivariate dot plot, and regions were drawn on lymphocytes and neutrophils. Data were entered into a Microsoft Excel spreadsheet and analysed using Statistical Package for Social Sciences (SPSS) version 21.0 statistical software. The Chi-square test was applied for proportions, and the Analysis of Variance (ANOVA) test was applied for normally distributed data. Results: In this study, 70 symptomatic neonates clinically suspected to have sepsis were enrolled and categorised into the sepsis group and the no Sepsis group. The sepsis group was further subgrouped into Definite Sepsis (Blood culture positive) and Probable Sepsis (Symptomatic baby with sepsis screen positive but sterile blood culture). nCD-64 positivity was observed in all cases (n=19) of definite sepsis. nCD-64 revealed 100% sensitivity, 87.5% specificity, 86.36% Positive Predictive Value (PPV), 100% Negative Predictive Value (NPV), and 93.02% diagnostic accuracy in culture-positive sepsis. However, downregulation of mHLA-DR observed in the present study alone showed poor diagnostic utility. The Sepsis index showed sensitivity of 94.73%, specificity of 62.50%, PPV of 66.66%, NPV of 93.75%, and accuracy of 76.74% in the definite sepsis group. Conclusion: Flow cytometric assessment of neutrophil CD-64 may be considered a rapid and reliable marker for the diagnosis of bacterial neonatal sepsis. mHLA-DR may be beneficial for monitoring patients at a later point in time for the identification of delayed immuno-suppression in neonatal sepsis. [ABSTRACT FROM AUTHOR]

Objective: To evaluate clinically the efficacy and safety in northern India of cefepime monotherapy versus piperacillin-tazobactam in patients of paediatric age group with febrile neutropenia.Material and Methods: Children aged ≤18 years admitted febrile with chemotherapy-induced neutropenia were randomised into two groups comprising 20 cases in each group viz. CEF (receiving cefepime only) and PIP-TAZO (receiving piperacillin-tazobactam). Based on clinical and laboratory tests, patients were classified into: microbiologically documented infections (MDI); clinically documented infections (CDI); and unexplained fever (UF). They were assessed for clinical signs and symptoms as well as laboratory parameters at the time of enrolment and subsequently on days 3 and 7.Results: Incidence of MDI, CDI and UF were 22.5%, 47.5% and 30%, respectively. The mean duration of neutropenia (in days) was 5.45 ± 2.1 in the PIP-TAZO group and 5.5 ± 1.5 in the CEF group (P = 0.305). The success rate defined as clearing infection effectively and improvement of neutropenia was comparable (P = 0.705). There was a mortality rate of 20% in the PIP-TAZO group as compared to 10% in the CEF group.Conclusion: We conclude that cefepime monotherapy and piperacillin-tazobactam are equally efficacious and safe in treating patients with febrile neutropenia. Empirical monotherapy with cefepime would prevent an unnecessary extra economic burden as well as avoiding the serious adverse or toxic effects of multi-drug regimes, especially in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

We describe a case of a large simple neonatal ovarian cyst, which was managed successfully using “wait and watch” approach and serial ultrasound monitoring. A cystic lesion arising from right ovary was noted in antenatal ultrasound (USG) which was followed up with postnatal USG which revealed a large simple ovarian cyst without any complications. Patient was kept on expectant management with close clinical and USG monitoring. Cyst resolved spontaneously at 10 wk of age. A brief review of literature for likely aetio-pathogenesis and management is also presented. [ABSTRACT FROM AUTHOR]