Objective:The effect of vitamin D, which is a steroid hormone, on bone health has long been known.Vitamin D is also found to be associated with various diseases such as diabetes, hypertension, chronic kidney disease, coronary artery disease, and cancer.Neuroprotective effect of vitamin D makes it an important marker in clinical course of neurological diseases such as cognitive impairment, dementia and Alzheimer's disease.Vitamin D deficiency is also associated with increased risk of stroke.In this study, we aimed to show the effect of vitamin D levels on severity and prognosis of stroke.Materials and Methods: This was a prospective, observational study conducted in a tertiary medical center in Rohtak on 200 stroke patients admitted in Medicine ward.The National Institute of Health Stroke scale (NIHSS) and modified Rankin Scale were used to assess the severity of stroke at admission and functional outcome at 3 months, respectively.The patients were divided into 4 groups on the basis of vitamin D levels.Results: Vitamin D deficiency was associated with higher NIHSS score and independently associated with poor functional outcome.Patients with severe and mild vitamin D deficiency, and vitamin D insufficiency had 9, 6.7, and 3.9 times higher adjusted odds of poorer functional outcomes at 3 months in comparison to the patients with normal vitamin D levels (p<0.01) when adjusted for age, sex, alcohol, smoking, body mass index, NIHSS score, and co-morbidities.Conclusion: Vitamin D is associated with severe stroke and poor functional outcome at 3 months.However, further studies need to be carried out to evaluate whether supplementation of vitamin D can help prevent stroke or associated morbidity and mortality.
Plant species as modulating agents are being aggressively investigated to increase efficiency of rumen fermentation. Calligonum polygoides and Acacia tortilis are important desert plant species, which can serve as top feeds for ruminant feeding. An experiment was conducted to evaluate mature Lasiurus sindicus based complete feed (Roughage: concentrate ratio; 75:25) with different levels (0, 5, 10%) of C. polygonoides or A. tortilis leaves using gas production technique. Leaves of C. polygonoides and A. tortilis contained 59 and 25 g/kg condensed tannins (CT) and 228 and 70 g/kg total phenols, respectively. Inclusion of both kinds of leaves did not exert any influence on gas production. However, the gas production constant (‘c’) was 0.090 in complete feed and it increased significantly (P<0.05) with both the supplements when included in complete feed. The contents of CT (r= -0.643; P=0.045) or Total phenol (r= -0.619; P= 0.057) were negatively correlated with TNDFD. Ammonia-N was negatively correlated with CT (r= -0.516; P=0.127) or Total phenols (r= -0.605; P= 0.064) content. The protozoa count (105/dl) was 31.12 in complete feed and their number decreased by 25% in feed containing 10% C. polygonoides leaves, the effect being linear (P=0.026), with respect to the level of these leaves in the diets.
The study was conducted to evaluate the effect of incorporating leaves of Bawali in Sewan (Lasiurus sindicus) based composite feed on in vitro gas production (24h), degradability of dry matter, organic matter and NDF, concentration of rumen metabolites and protozoa count. Acacia jacquemontii Benth (Bawali) is an important tree of Thar Desert of India, leaves contained 16.3% crude protein (CP), 46.1% neutral detergent fibre (NDF) and 28.2% acid detergent fibre (ADF). The leaves contained 16.0 g/kg DM condensed tannins and 81.9 g/kg DM total phenols. L. sindicus based composite feed (CFM) consisted of roughage to concentrate ratio of 75:25, containing 10.3% C P. The leaves of Acacia jacquemontii were added either at 5 or at 10% level in the CFM. The gas production (GP) in CFM was 104 ml/g DM and inclusion of A. jacquemontii leaves at 5 or 10% level increased GP significantly (P<0.01). Similar effect of A. jacquemontii leaves incorporation was observed on organic matter degradability and metabolisable energy contents. The incorporation of A. jacquemontii leaves in CFM adversely affected the ammonia-N, total-N and microbial biomass production. The A. jacquemontii leaves incorporation increased the small chain fatty acid concentration but decreased the protozoa population. The study suggested that A. jacquemontii leaves modulate the rumen fermentation and further study need to be conducted.
Global warming has become an issue of great concern as the global mean temperature is expected to increase between 1.7 and 2.4°C by 2050. After carbon dioxide, methane is considered as a major contributor to global warming. Enteric methane production from domestic animals is around 65 to 85 Tg, which is nearly 10% of the total methane emission globally. In animals, large proportion (87%) of methane is produced in the rumen, while a small portion (13%) is contributed by the large intestine. The aim of this paper is to provide an update on enteric methane emission processes and mitigation. Various strategies including manipulation of ruminal fermentation pattern and/or increase in animal productivity by way of dietary manipulations, feeding of ionophores, oils, chemical inhibitors and analogues, propionate enhancers, bacteriocins, probiotics and defaunation have been suggested. The most promising areas for future research for reducing methanogenesis are the development of new herbal products, delivery systems for these compounds in the rumen and reduction in protozoa numbers in the rumen.
Abstract Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Objectives (Case) A 48-year-old male with no prior comorbidities presented to our infectious disease clinic with intermittent low-grade fever and gradual progressive swelling in his left axilla for 3 months. On further probing, the patient also gives a history of weight loss of around 7 kg. The patient belonged to a northern state of the Indian subcontinent and owned a grocery shop, where he worked. There was no recent or remote travel history, no history of exposure to animals or birds, no high-risk behavior, and no past or known contact history of tuberculosis. Still, in an endemic country like India and in this given clinical scenario, we kept tubercular lymphadenitis as the first differential and investigated the case further. Methods (Investigation) A contrast-enhanced computed tomography (CECT) of the chest and abdomen was done, showing multiple enlarged mediastinal and axillary lymph nodes with bilateral adrenal mass (Fig. 1). To further evaluate the etiology, a fine needle aspiration of the left axillary swelling was done. A hematoxylin and eosin (H and E) stain of the same showed the presence of numerous organisms of varying sizes present both intracellularly and extracellularly along with chronic inflammatory cells (Fig. 2a). Based on this picture, differentials of Histoplasma, Cryptococcus, or Toxoplasma were kept. But considering the empty spaces (halos) which probably represent the capsule and variability in the size, a strong possibility of Cryptococcus was kept. Serum cryptococcal antigen (latex agglutination) was negative but eventually, the fungal culture of the aspirated sample grew cream-colored, shiny dome-shaped, mucoid colonies on Sabouraud Dextrose Agar suggestive of Cryptococcus (Fig. 2b). The same was confirmed on Bird Seed Agar and Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (MS). Gene Xpert of the aspirated sample was negative and serum cortisol with serum adrenocorticotropic hormone (ACTH) were under normal limits. Results (Diagnosis) A diagnosis of disseminated cryptococcosis was made based on the involvement of more than two non-contiguous sites (mediastinal with axillary lymph nodes and adrenal gland). The patient was initially started on liposomal Amphotericin B (5 mg/kg intravenous daily) with which he improved clinically. Same was continued for 2 weeks and later he was shifted to fluconazole 400 mg daily. As of now, the patient is on his 3rd month of fluconazole and doing well on follow-up. Conclusion Cryptococcus (Cryptococcus neoformans and Cryptococcus gattii) is an encapsulated yeast causing invasive fungal infection, with vast majority occurring in immunocompromised host1. It has a global distribution, predominantly involving the central nervous system (CNS) and lung. Management of non-CNS and non-pulmonary cryptococcosis is tricky as looking for dissemination is key (as the initial choice of agent varies)2. Adrenal involvement in Cryptococcosis is uncommon (as seen in our case). Examination of FNAC samples for Cryptococcus is also challenging as other microbes can also closely mimic the same. Finally, in a tuberculosis endemic country like India, clinical symptoms of Cryptococcal lymphadenitis can closely resemble tubercular lymphadenitis, so empirical therapy may be risky. Figure 1 Axial CT Chest images showing multiple enlarged mediastinal lymph nodes (red arrow). Figure 2a Fine needle aspiration cytology (FNAC) from the left axillary swelling stained with hematoxylin and eosin showing numerous organisms of varying size present both intracellularly (black arrow) and extracellularly with surrounding halos in a background chronic inflammatory cells. Figure 2b Fine needle aspirate sample incubated at 37 0C on Sabouraud Dextrose Agar with gentamicin showing cream-colored, dome-shaped, shiny, mucoid colonies with smooth edge (characteristic of Cryptococcus). Sources
A man in his 40s presented with low-grade fever, weight loss and intermittent cough with scanty sputum for a duration of 1 month. There was no history of smoking, occupational exposure or any immunocompromised conditions. On examination, there were few scattered crepitations present on chest
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