Empty stomach together with menstrual bleeding as predictors of committed suicides among women of reproductive age: What a primary physician must know

Background

Women of reproductive age group (WoRAG) are among the most vulnerable groups to suicide in India. The present study intended to develop a mathematical model to differentiate suicides from homicides among WoRAG.

Methods

It was a cross-sectional study based on a record review of autopsy at Patna, India, from 2016 to 2021. The cause of deaths was ascertained by autopsies and other records independently by two investigators to reduce the interobserver bias. Independent variables were tested with confirmed suicides to calculate statistically significant association. These variables were further used for developing prediction models for the suicides by multivariate logistic regression analysis.

Results

Out of total of 520 autopsies of WoRAG performed by investigators, the cause of death has been confirmed for 62. Of them, 30 were confirmed as suicides. In univariate analysis, suicides were associated with the menstrual bleed (OR 35 CI 6.9,179), gastric emptying (OR 3.9 CI 1.2,12.8), hanging, poisoning, and drowning as mode of death (OR 435 CI 37.4,5061.9). By logistic regression, three prediction models were built to predict suicide; Model I: gastric emptying, Model II: menstrual bleed, and Model III: including both. The area under the curve (AUC) for Models I, II, and III was 0.67 (95%CI 0.34,0.99), 0.92 (95%CI 0.75,1.00), and 0.94 (95%CI 0.82,1.00), respectively. The AUC of Model III differs significantly from that of Model I (P value 0.03) but not with Model II (P value 0.11).

Conclusion

Menstrual bleed, gastric emptying, and mode of death may be used as a supplement tool in ascertaining the cause of death among WoRAG in medical and legal proceedings.

A Biofloc-Based Aquaculture System Bio-augmented with Probiotic Bacteria Bacillus tequilensis AP BFT3 Improves Culture Environment, Production Performances, and Proteomic Changes in Penaeus vannamei

Experiments were conducted to evaluate the probiotic effect of bio-augmented Bacillus tequilensis AP BFT3 on improving production, immune response, and proteomic changes of Penaeus vannamei reared in a biofloc system. Penaeus vannamei larvae (PL13) were stocked in 100-L tanks at a rate of 100 no per tank to study the effect of B. tequilensis AP BFT3 with and without biofloc (BFT-PRO and PRO). Control tanks devoid of probiotic strain were maintained in a clear water system. The growth and survival considerably increased in probiotic added biofloc reared shrimp than probiotic added clear water reared ones and control. Water quality significantly improved in probiotic added (PRO) and biofloc-probiotics (BFT-PRO) system than control. Microbiological investigations indicate increased heterotrophic bacterial load in BFT-PRO compared to the PRO and control. The quality of the isolated microbes was analyzed in terms of enzyme production, and an abundance of enzyme-producing bacterial population was observed in BFT-PRO shrimp. Immune-related genes were significantly upregulated in BFT-PRO shrimp, followed by the PRO and control. The proteomic data (2D gel electrophoresis and MALDI-TOF) of muscle tissue from the experimental animals identified 11 differentially expressed proteins. The Daxx OS and Lit v 1 tropomyosin was found upregulated in BFT-PRO shrimps. Downregulation of Na⁺/K⁺ATPase was observed in biofloc with probiotic-supplied groups. The findings revealed that the BFT system's efficacy could be improved through the addition of probiotics. The addition of B. tequilensis AP BFT3 as a probiotic in biofloc induced the expression of essential proteins, reducing contracting diseases during culture.

Cellular and molecular immune response and production performance of Indian white shrimp Penaeus indicus (H. Milne-Edwards, 1837), reared in a biofloc-based system with different protein levels of feed

The present study focuses on the immunity and growth of Penaeus indicus fed with varying protein levels (25%, 30%, and 35%) in a biofloc based rearing system. A 120 days growth trial was carried out using juvenile Penaeus indicus (0.71 ± 0.01) with dietary protein level, 25% (LP), 30% (MP), and 35% (HP), and a control diet-fed with 35% acted as control group resulting in 4 treatments each with four replicates and were randomly assigned 16 tank units (7500 L each). A combination of different carbon sources (molasses, wheat flour, and rice bran in 2:1:1 ratio), yeast and a probiotic (Bacillus sp.) consortium were used for the development of biofloc. At the end of the trial, the growth parameters of shrimps viz., initial weight, feed conversion ratio (FCR), and daily growth coefficient (DGC) were computed. The results indicated that shrimp fed with medium (30%) protein (MP) diet recorded significantly (P < 0.05) improved growth performance compared to high protein fed group (35%) and low protein (25%) fed group (LP) in a biofloc system and control group (35%). The immunological parameters such as hemagglutination activity (HA) assay, serum protein, lysozyme, phenol oxidase (PO), and inhibition of superoxide dismutase (SOD) activity were observed in serum, plasma, and hemocyte lysate supernatant (HLS). The HA activity, PO activity in plasma was found to be higher in high protein fed animals, whereas medium protein resulted in enhanced PO activity in serum. Similarly, lysozyme and SOD were inhibited well in high protein fed animals compared to the low protein fed group. The vital immune genes's mRNA profiling showed a potential rise in the expressional pattern in MP and HP treatments compared to LP and control. BGBP (beta-1,3-glucan binding protein) and hemocyanin mRNA transcript levels were highly upregulated in the HP (5 fold) and moderately expressed in MP (2 fold) and LP (1-2 fold). The transcripts of peroxinectin, antimicrobial peptides like crustin showed significant upregulation in HP followed by in MP and LP and control. Likewise, other immune genes, such as SOD, prophenoloxidase (proPO), showed a similar trend in a marginal way, indicating immunomodulation in the biofloc groups. This study suggested that biofloc with high protein (35%) supplementation can substantially enhance the immune response of shrimps, although medium protein level (30%) is optimum for improving the survival, growth, and in turn economic return in Indian white shrimp.

Bio-augmentation of heterotrophic bacteria in biofloc system improves growth, survival, and immunity of Indian white shrimp Penaeus indicus

Effect of bio-augmentation of Bacillus spp in biofloc on growth, survival and immunity in Indian white shrimp Penaeus indicus was evaluated. Nine Bacillus strains were isolated and screened individually as well as in the form of a consortia. To maintain a C:N ratio of 12:1 a blend of carbohydrate sources was used. Bio-augmentation with bacterial consortium and Virgibacillus sp. produced improved growth and immunity. Shrimp survival ranged from 80 to 95% among treatments. Production was higher (35%) in the biofloc tanks with an average body weight (ABW) of 10.89 ± 1.2 g. On evaluating the immune responses, it was found that trypsin significantly (P < 0.05) enhanced Prophenoloxidase (PO) activity in Lysinibacillus, Bacillus cereus, Bacillus licheniformis and Bacillus subtilis bio-augmented groups. Laminarin induced PO activity was observed in groups supplemented with Oceanobacillus sp., Bacillus sp.and Bacillus megaterium. The lysozyme (LZ) activity was significantly (P < 0.05) higher in B. cereus and Microbial Consortia (MC), while other treatments were less effective. Total hemocyte count (THC) significantly (P < 0.05) increased in all treatment groups compared to the control. Hyaline hemocyte (HH) count was significantly (P < 0.05) higher in the control group (14.43%). Semi granular hemocytes (SGH) was higher in groups treated with Lysinibacillus, Bacillus sp., B. licheniformis and B. subtilis. The granular hemocyte (GH) count was significantly (P < 0.05) higher in Virgibacillus sp., B. cereus, B.megaterium and Oceanobacillus sp. The biofloc alone (BF), treated and augmented with B. megaterium significantly (P < 0.05) increased phagocytic activity. Highly significant phagocytic index (PI) was observed in bio-augmented groups, BF and MC. The relative expression levels of immune genes were found to be significantly up-regulated in shrimps grown in bio-augmented groups. Enhanced immunological parameters implies that bio-augmentation of biofloc with Bacillus spp. improved immunity in shrimps. Hence, bio-augmentation of probiotics in biofloc may be useful in improving culture conditions to produce P. indicus.

When do newborns die? A systematic review of timing of overall and cause-specific neonatal deaths in developing countries

About 99% of neonatal deaths occur in low- and middle-income countries. There is a paucity of information on the exact timing of neonatal deaths in these settings. The objective of this review was to determine the timing of overall and cause-specific neonatal deaths in developing country settings. We searched MEDLINE via PubMed, Cochrane CENTRAL, WHOLIS and CABI using sensitive search strategies. Searches were limited to studies involving humans published in the last 10 years. A total of 22 studies were included in the review. Pooled results indicate that about 62% of the total neonatal deaths occurred during the first 3 days of life; the first day alone accounted for two-thirds. Almost all asphyxia-related and the majority of prematurity- and malformation-related deaths occurred in the first week of life (98%, 83% and 78%, respectively). Only one-half of sepsis-related deaths occurred in the first week while one-quarter occurred in each of the second and third to fourth weeks of life. The distribution of both overall and cause-specific mortality did not differ greatly between Asia and Africa. The first 3 days after birth account for about 30% of under-five child deaths. The first week of life accounts for most of asphyxia-, prematurity- and malformation-related mortality and one-half of sepsis-related deaths.

To evaluate and compare the efficacy of combined sucrose and non-nutritive sucking for analgesia in newborns undergoing minor painful procedure: a randomized controlled trial

OBJECTIVE

The objective of this study was to evaluate and compare the efficacy of combined sucrose and non-nutritive sucking (NNS) for analgesia in newborn infants undergoing heel-stick procedures.

STUDY DESIGN

This randomized control trial was conducted in the neonatal intensive care unit of a tertiary care hospital over a period of 1 year. One hundred and eighty full-term neonates with birth weight >2200 g and age >24 h were randomized to one of four interventions administered 2 min before the procedure: 2 ml of 30% sucrose (group I, n=45) or NNS (group II, n=45) or both (group III, n=45) or none (group IV, n=45). Primary outcome was composite score based on Premature Infant Pain Profile (PIPP) score.

RESULT

Baseline variables were comparable among the groups. Median (interquartile range) PIPP score was 3 (2 to 4) in group III as compared with 7 (6.5 to 8) in group I, 9 (7 to 11) in group II and 13 (10.5 to 15) in group IV. Group III had significant decrease in the median PIPP score compared with other groups (P=0.000). Median PIPP score also decreased significantly with any intervention as compared with no intervention (P=0.000).

CONCLUSION

Sucrose and/or NNS are effective in providing analgesia in full-term neonates undergoing heel-stick procedures, with the combined intervention being more effective compared with any single intervention.

Giant piezoelectricity on Si for hyperactive MEMS

Microelectromechanical systems (MEMS) incorporating active piezoelectric layers offer integrated actuation, sensing, and transduction. The broad implementation of such active MEMS has long been constrained by the inability to integrate materials with giant piezoelectric response, such as Pb(Mg(1/3)Nb(2/3))O(3)-PbTiO(3) (PMN-PT). We synthesized high-quality PMN-PT epitaxial thin films on vicinal (001) Si wafers with the use of an epitaxial (001) SrTiO(3) template layer with superior piezoelectric coefficients (e(31,f) = -27 ± 3 coulombs per square meter) and figures of merit for piezoelectric energy-harvesting systems. We have incorporated these heterostructures into microcantilevers that are actuated with extremely low drive voltage due to thin-film piezoelectric properties that rival bulk PMN-PT single crystals. These epitaxial heterostructures exhibit very large electromechanical coupling for ultrasound medical imaging, microfluidic control, mechanical sensing, and energy harvesting.

MRI findings of cerebral malaria. A report of two cases

Cerebral malaria is a protozoal disease affecting the brain caused by Plasmodium falciparum. The hallmark of cerebral malaria is progressive decline in the sensorium leading to coma and in some cases death. MR findings reported in cerebral malaria are diffuse cerebral swelling / edema, bilateral nearly symmetrical T2 hyperintense lesions in basal ganglia and similar lesions in thalamus, pons and cerebellum. The imaging findings of cerebral malaria depend on the duration of the illness and time of MR examination. We describe two patients of cerebral malaria having mixed Plasmodium falciparum and Plasmodium vivex infestation showing bilateral basal ganglia infarcts with cerebral swelling in one patient and bilateral basal ganglia and cerebellar lesions in the other.

Strain-induced polarization rotation in epitaxial (001) BiFeO3 thin films

Direct measurement of the remanent polarization of high quality (001)-oriented epitaxial BiFeO3 thin films shows a strong strain dependence, even larger than conventional (001)-oriented PbTiO3 films. Thermodynamic analysis reveals that a strain-induced polarization rotation mechanism is responsible for the large change in the out-of-plane polarization of (001) BiFeO3 with biaxial strain while the spontaneous polarization itself remains almost constant.

Coinfection of Japanese encephalitis with neurocysticercosis: an imaging study

BACKGROUND AND PURPOSE

Coinfection of neurocysticercosis (NCC) and Japanese encephalitis (JE) has been advocated as more than a chance occurrence resulting in poor outcome. We undertook this study to determine whether the association of the 2 infections is more than a chance occurrence, to define the imaging characteristics of coinfections, and to explore the synergistic effect of NCC in JE.

MATERIALS AND METHODS

Sixty-two patients with JE were studied by MR imaging and CT. CT was done in 53 and MR imaging in 53 patients. The diagnosis of JE was established by CSF JE virus immunoglobulin M capture (MAC) enzyme-linked immunosorbent assay (ELISA). NCC was diagnosed from imaging. A control group of 385 patients was evaluated by imaging for prevalence of NCC in the general population.

RESULTS

A significantly high association of NCC with JE (19.3%) was observed in comparison with prevalence of NCC in control subjects (1.04%; P = .0003). JE lesions in coinfection were significantly asymmetric with lateralization to the side of the brain having the maximum NCC or a cyst with edema. The JE lesions in coinfections were more florid, with a significantly higher proportion of abnormal CT scans and more abnormal MR imaging. Coinfections were significantly more common in children. Significantly lower CSF MAC-ELISA units in patients with coinfection reflected low CSF IgM levels, suggesting altered immune status.

CONCLUSION

In our series, there was a strong association between JE and NCC, and, thus, this coinfection was more than a chance occurrence.

A clinically applicable reporting system for the diagnosis of facial fractures

A clinically applicable, comprehensive reporting system for the diagnosis of facial fractures was developed with three guiding principles: (1) preservation of classical anatomical terminology and nomenclature, (2) facilitation of uniform interpretation of radiographs between radiologists and (3) non-redundant diagnostic descriptions of complex fractures, in a manner that correlates with treatment modality. Twenty-two fracture types (17 simple fracture types and 5 complex fracture types) are included in the system. Each patient's fracture pattern is described by listing the component fractures present. A short narrative (modifying description) is provided after each fracture listed. Simple fractures that help to comprise more complex fractures are not listed separately, but are described within the modifying description of the complex fracture they help to comprise. When components of multiple complex fractures are present, a hierarchy of complex fractures dictates which fracture is described first. Additional complex fractures are only described separately when they do not share common components. In all other cases, the second (lower order) complex fracture is best described by simply listing the component (simple or complex) fractures that are not accounted for in the higher order complex fracture. Adoption of this reporting system should improve communication between emergency medicine physicians, radiologists and surgeons.

Electrical control of antiferromagnetic domains in multiferroic BiFeO3 films at room temperature

Multiferroic materials, which offer the possibility of manipulating the magnetic state by an electric field or vice versa, are of great current interest. In this work, we demonstrate the first observation of electrical control of antiferromagnetic domain structure in a single-phase multiferroic material at room temperature. High-resolution images of both antiferromagnetic and ferroelectric domain structures of (001)-oriented multiferroic BiFeO3 films revealed a clear domain correlation, indicating a strong coupling between the two types of order. The ferroelectric structure was measured using piezo force microscopy, whereas X-ray photoemission electron microscopy as well as its temperature dependence was used to detect the antiferromagnetic configuration. Antiferromagnetic domain switching induced by ferroelectric polarization switching was observed, in agreement with theoretical predictions.

Temporal lobe involvement in Japanese encephalitis: problems in differential diagnosis

BACKGROUND AND PURPOSE

On MR imaging and CT, Japanese encephalitis (JE) shows lesions in the thalami, substantia nigra, basal ganglia, cerebral cortex, cerebellum, brain stem, and white matter, whereas temporal lobe involvement is characteristically seen in Herpes simplex encephalitis (HSE). Temporal lobe involvement in JE may cause problems in differentiating it from HSE. We undertook this study to show the temporal lobe involvement pattern in JE and highlight differentiating features from temporal lobe involvement in HSE.

METHODS

Sixty-two patients with JE underwent CT or MR imaging or both. MR imaging was done in 53 and CT in 53. The diagnosis of JE was confirmed by cerebrospinal fluid (CSF) IgM enzyme-linked immunosorbent assay.

RESULTS

Eleven (17.7%) patients showed temporal lobe involvement with abnormal MR imaging in all. All the patients showed hippocampal involvement. Two patients showed extension of lesions into the amygdala and uncus with insular involvement in 1. The rest of the temporal lobe was spared. All patients had thalamic and substantia nigra involvement with basal ganglia involvement in 7. Six of 9 CT scans were abnormal and the temporal lesions were seen in 2.

CONCLUSIONS

The temporal lobe involvement pattern is fairly characteristic and mostly involves the hippocampus, usually sparing the rest of the temporal lobe. This and the concurrent involvement of the thalami, substantia nigra (SN), and basal ganglia allow differentiation from HSE. However, if the temporal lobe involvement is more severe, laboratory tests may be the only way to differentiate it from HSE, and it may be prudent to start antiviral therapy in the interim period.

Risk factors of Parkinson's disease in Indian patients

Epidemiological data on risk factors of Parkinson's disease (PD) are not available from India. In a case control study, we investigated environmental and genetic risk factors in the etiology of idiopathic Parkinson's disease. Three hundred seventy-seven patients of Parkinson disease (301 men, 76 women, mean+/-SD age 56.78+/-11.08 years) and equal number of age matched (+/-3 years) neurological controls (271 men, 106 women, mean+/-SD age 56.62+/-11.17 years) were included in the study. Conditional logistic regression model was used to determine the risk factors of PD. We found that male gender, family history of Parkinson's disease, past history of depression of up to 10-year duration and well water drinking of more than 10-year duration were significantly associated with occurrence of Parkinson's disease, whereas tobacco smoking of up to 20-year duration and exposure to pets had protective effect. However, tobacco smoking of more than 20-year duration, well water drinking of up to 10-year duration, vegetarian dietary habit, occupation involving physical exertion, rural living, farming, exposure to insecticides, herbicides, rodenticides, alcohol intake and family history of neurodegenerative diseases had no significant correlation with occurrence of PD in the patient population studied. Results of our study support the hypothesis of multifactorial etiology of PD with environmental factors acting on a genetically susceptible host.