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INTRODUCTION: Bicondylar tibial plateau fractures account for 10-30% of tibial plateau fractures. Despite recent advancements in the management of unstable bicondylar tibial plateau fractures, the outcomes are often poor. The present study aimed to evaluate the functional outcomes and complications of internal fixation of bicondylar tibial plateau fractures with the dual plating using two incisions. MATERIALS AND METHODS: The present study included 30 patients (26 males; 4 females, mean age 35.6 years; range, 19 to 65 years) with bicondylar tibial plateau fractures who were treated with dual plating between January 2017 to August 2019. Out of 30 patients, 5 patients had Schatzker type (V) and 25 patients had Schatzker type (VI) bicondylar tibial plateau fracture. All patients were treated with dual plating using two incisions. In all patient's similar standard physical rehabilitation therapy was followed. All complications including intra and post-operative were assessed and recorded. The patients were followed-up for over 24 months. Functional outcomes were assessed with Rasmussen's functional grading system, Oxford knee score, and range of motion of knee joint. Radiological outcomes were evaluated using Rasmussen's radiological scoring system. RESULT: All fractures united with a mean time of 18 weeks. The average knee range of motion was 1.5° - 130° (range: 0° - 10° for extension lag, range: 100° -135° for flexion). Mean Rasmussen's functional grading score at the final follow-up was 26.75. All patients showed excellent or good radiographic results according to Rasmussen's radiological scoring with a mean score of 8.5 (range 6-10). The post-operative radiographs showed mean MPTA was 84.3° and the mean PPTA was 6.2°. In the present study, complications were encountered in five patients. However, there were no cases of secondary loss of reduction, failure of the implant, malunion, or non-union. CONCLUSION: The surgical treatment of bicondylar tibial plateau fractures with dual locking represents a significant treatment option and provides rigid fixation in these fractures with good functional and radiological outcomes.

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Human milk is elixir for neonates and is a rich source of nutrients and beneficial microbiota required for infant growth and development. Its benefits prompted research into probing the milk components and their use as prophylactic or therapeutic agents. Culture-independent estimation of milk microbiome and high-resolution identification of milk components provide information, but a holistic purview of these research domains is lacking. Here, we review the current research on bio-therapeutic components of milk and simplified future directions for its efficient usage. Publicly available databases such as PubMed and Google scholar were searched for keywords such as probiotics and prebiotics related to human milk, microbiome and milk oligosaccharides. This was further manually curated for inclusion and exclusion criteria relevant to human milk and clinical efficacy. The literature was classified into subgroups and then discussed in detail to facilitate understanding. Although milk research is still in infancy, it is clear that human milk has many functions including protection of infants by passive immunization through secreted antibodies, and transfer of immune regulators, cytokines and bioactive peptides. Unbiased estimates show that the human milk carries a complex community of microbiota which serves as the initial inoculum for establishment of infant gut. Our search effectively screened for evidence that shows that milk also harbours many types of prebiotics such as human milk oligosaccharides which encourage growth of beneficial probiotics. The milk also trains the naive immune system of the infant by supplying immune cells and stimulatory factors, thereby strengthening mucosal and systemic immune system. Our systematic review would improve understanding of human milk and the inherent complexity and diversity of human milk. The interrelated functional role of human milk components especially the oligosaccharides and microbiome has been discussed which plays important role in human health.

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The human gastrointestinal (GI) tract has been bestowed with the most difficult task of protecting the underlying biological compartments from the resident commensal flora and the potential pathogens in transit through the GI tract. It has a unique environment in which several defence tactics are at play while maintaining homeostasis and health. The GI tract shows myriad number of environmental extremes, which includes pH variations, anaerobic conditions, nutrient limitations, elevated osmolarity etc., which puts a check to colonization and growth of nonfriendly microbial strains. The GI tract acts as a highly selective barrier/platform for ingested food and is the primary playground for balance between the resident and uninvited organisms. This review focuses on antimicrobial defense mechanisms of different sections of human GI tract. In addition, the protective mechanisms used by microbes to combat the human GI defence systems are also discussed. The ability to survive this innate defence mechanism determines the capability of probiotic or pathogen strains to confer health benefits or induce clinical events respectively.

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The development of insecticide resistance in insect pests of crops is a growing threat to sustainable food production, and strategies that slow the development of resistance are therefore urgently required. The insecticide synergist piperonyl butoxide (PBO) inhibits certain insect detoxification systems and so may delay the evolution of metabolic resistance. In the current study we characterized resistance development in the silverleaf whitefly, Bemisia tabaci, after selection with either a neonicotinoid (thiacloprid) or pyrethroid (alpha-cypermethrin) insecticide alone or in combination with PBO. Resistance development was significantly suppressed (> 60%) in the line selected with alpha-cypermethrin + PBO compared to the line selected with alpha-cypermethrin alone. RNA sequencing (RNAseq) analyses revealed an increase in frequency of a knock-down resistance mutation but no differentially expressed genes were identified that could explain the sensitivity shift. No significant difference was observed in the level of resistance between the thiacloprid and thiacloprid + PBO selected lines, and RNA sequencing (RNAseq) analyses revealed that the cytochrome P450 monooxygenase CYP6CM1, known to metabolize neonicotinoids, was significantly upregulated (>10-fold) in both lines. The findings of this study demonstrate that PBO used in combination with certain insecticides can suppress the development of resistance in a laboratory setting; however, the mechanism by which PBO supresses resistance development remains unclear.

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This experimental study was conducted to assess the alterations in hematobiochemical values of cattle infected with stephanofilarial microfilariae. Hematological studies of infected cattle revealed significant (P<0.05) decrease in Hb%, PCV and TEC values whereas TLC values were significantly (P<0.05) increased. There was insignificant increase in lymphocyte concentration (%), significant (P<0.05) increase in eosinophil concentration (%) and insignificant decrease in neutrophil concentration (%) in infected cattle in relation to control animal. Biochemical studies revealed that the values of glucose, alkaline phosphatase, AST and ALT were significantly (P<0.05) increased in infected cattle than control cattle. However, the value of total serum protein was not affected.

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Previously, permeability and site of intestinal absorption of propranolol have been reported using the Ussing chamber. In the present study, the utility of Single-Pass Intestinal Perfusion to study permeability and site of intestinal absorption of propranolol was evaluated in rats. Drug permeability in different regions of rat intestine viz. duodenum, jejunum, ileum and colon was measured. Propranolol (30 µg/ml) solution was perfused in situ in each intestinal segment of rats. Effective permeability (Peff) of propranolol in each segment was calculated and site of absorption was determined. The Peff of propranolol in rat duodenum, jejunum, ileum and colon was calculated to be 0.3316×10(-4) cm/s, 0.4035×10(-4)cm/s, 0.5092×10(-4) cm/s and 0.7167×10(-4) cm/s, respectively. The above results suggest that permeability of propranolol was highest through colon compared to other intestinal sites, which is in close agreement to that reported previously. In conclusion, in situ single pass intestinal perfusion can be used effectively to study intestinal permeability as well as site of intestinal absorption of compounds in rats.

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A high-rate activated sludge (HRAS) bioreactor with high shear venturi aeration was operated in the laboratory at various organic loading rates to evaluate chemical oxygen demand (COD) removal efficiency and sludge production. Organic loading rates two orders of magnitude higher than conventional activated sludge loading were investigated in the modified HRAS reactor for a period of 41 weeks. Filtered COD removal efficiency varied from 81 to 92 % for organic loading rates of 3 to 85 kg COD m(-3) d(-1). Observed sludge yield was determined to be 0.10-0.25 g TSS produced g(-1) COD removed, under hydraulic and solids retention times (SRTs) approaching less than two hours and two days, respectively. Observed sludge yield actually declined as loading increased and SRT decreased. It was concluded that high-shear forces created in the reactor due to intense aeration at high volumetric organic loading rates increased substrate utilization rate, improved filtered COD removal efficiency, and kept sludge yields relatively low (despite the very low operating SRTs).

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Novel, aerobic sequencing batch reactor technology was tested as a polishing step for anaerobically treated textile wastewater containing dye. Operation cycle times of 6, 8 and 12 hours were studied using discrete phase periods. The SBRs were able to further remove influent dye concentration of as little as 5 mg/L, and remove highly variable loadings of COD and SS to effluent levels of 100 and 20 mg/L respectively.

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This research integrates two different concepts of anaerobic biotechnology- two-phase anaerobic treatment and anaerobic granular sludge bed technology, in treatment of colored wastewaters from textile industries. Four anaerobic reactors based on upflow anaerobic sludge blanket (UASB) technology were used as acid reactors and an expanded granular sludge bed (EGSB) reactor was used as a methane reactor. A conventional single-phase anaerobic reactor, working on EGSB technology was run in parallel to compare the performances of the two systems. Reactors were operated at different hydraulic retention times. The results from the study, which span over a period of 400 days, indicated that the two-phase system produces a higher quality of effluent in terms of color, COD and suspended solids than single-phase anaerobic treatment when operated under similar conditions. Alkalinity requirement of two-phase system was also observed to be lower than that of single-phase system which is important regarding design consideration.

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Acute respiratory distress (ARD) in two nonimmune adults with imported mixed and vivax malarial infections with low and resolving parasite load is described. Malarial pulmonary edema exacerbated by hypoalbuminemia and fluid redistribution without overload occurred in the latter patient. ARD led to mortality in one of the two. ARD should be promptly recognized and managed.

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Laboratory-scale UASB reactors were started-up successfully at 20 degrees C and operated at temperatures of 32, 20, 15, 11, and 6 degrees C applying several hydraulic retention times (HRTs) ranging from 48 to 3 h during an operational period of approximately 900 days. Changes in temperature and HRTs impacted the reactor performance. However, overall reactor performance (70 to 90% COD removal) was found to be stable up to an HRT of 6 h and temperature of 11 degrees C. The performance of UASB reactor was not very stable during 6 degrees C operation, even though 30 to 50% of COD removal could be achieved. Biomass aggregation in the form of granules/bio-pellets (mean size ranged from 1.8 mm to 3.0 mm) could be achieved during 20 degrees C operation. The impact of temperature on morphology, surface structure, and shape of bio-pellets was explored. Morphological and elemental composition analyses showed the possible mechanism of biomass aggregation in UASB reactors. This study demonstrated that the UASB process could be applied successfully with some minor adjustment for the treatment of municipal wastewater in temperate and cold regions (average summer temperature 11-25 degrees C).

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The present study examined the feasibility of treating municipal wastewater by a UASB system under low-temperature conditions. Two reactors were started-up at 20 degrees C and subsequently operated at temperatures of 32, 20, 15, 11, and 6 degrees C applying several hydraulic retention times (HRTs) ranging from 48 to 3 h during an operational period of approximately 900 days. Chemical oxygen demand (COD) removal efficiency ranged from 70 to 90% up to an HRT of 6 h and 11 degrees C. The performance of the reactor was not very satisfactory during 6 degrees C operation (average COD removal 40%). Sulfate reduction played an important role in COD reduction. Digital image analysis and scanning electron microscopic observations of sludge samples revealed aggregation of biomass in the form of irregular shaped granules (mean size ranged from 1.5 to 3.0 mm). The hydraulic regime in the reactor was impacted by the change in operating temperature. This study demonstrated that the UASB system could be applied successfully for pre-treatment/treatment of municipal wastewater under low-temperature conditions.

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Survival of cases of trisomy 13 (Patau's syndrome) into adulthood is a rare phenomenon. The purpose of this paper is to report one such survivor who has had the typical clinical features of trisomy 13 confirmed by chromosome analysis of both blood and skin, and to speculate on some of the factors that may have contributed to his unusually long survival.

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PIP: The author describes the current and planned activities envisaged under the Anthropological Survey of India to survey and study the castes and ethnic groups of contemporary India. Consideration is given to the availability of data on such subjects in the census.^ieng

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Genetic polymorphism of 16 red-cell antigens, enzymes, serum proteins and Hb variants was investigated in 214 male and female individuals belonging to the Meiteis and a Brahmin caste group living in Imphal (Manipur, Northeast India). Ethnohistorical records suggest that the Meiteis are of Mongoloid origin, while the original Brahmin settlers represent the easternmost part of the so-called Caucasoids. The markers studied are: A1A2BO, MNSs, Rh-system, Duffy, Diego; Gm, Km, Gc, Hp, Tf, Cp; Hb; aP, AK, EsD and LDH. The comparison between the two groups on the basis of the markers studied showed that the Meiteis and Brahmins are very close to each other with respect to most of the loci except Gm, EsD and Hb, where significant statistical differences were found.

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Infective larvae of Bunostomum trigonocephalum exposed to gamma-irradiation at 60 kr failed to develop in the lamb. At levels of 20 and 40 kr, the infectivity of the larvae was reduced and fewer worms developed with a predominating female population. The worms developing from the irradiated larvae were smaller and the sex organs were ill developed. The females developing from larvae irradiated at 40 kr were functionally sterile with atrophied uterus devoid of eggs.

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The activity of cholinesterase was determined separately in the mature and gravid proglottids of Thysaniezia giardi and its significance is discussed. The mean values of the enzyme in mature and gravid proglottids were respectively 225.60 +/- 28.55 and 75.00 +/- 11.64 units per gram of wet weight.

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Contrast enhancement simulating an abscess or residual tumor has been described in postoperative cranial computed tomography (CT) scans. This study was undertaken to determine the cause of this contrast enhancement by using canine brain as an experimental model. Sequential CT scanning was performed with and without contrast enhancement following partial resection of the right hemisphere, and the CT findings were correlated with the histological changes. Findings indicate that enhancement of the surgical margin is related both temporally and spatially to the neovascularity following surgery. The ring-like enhancement around the surgical margin is seen best at two to four weeks after surgery, and may simulate an abscess. However, edema seen around an abscess in adjacent brain is absent or minimal in the case of postoperative enhancement during this period, and this feature should help differentiate these entities.

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Contrast enhancement in the brain on computed tomography (CT) after an operation was studied in otherwise healthy dogs to evaluate the stages of enhancement caused by surgical changes. Serial CT scanning was done with and without contrast enhancement following a partial posterior parietal lobectomy. Pathologic correlation was obtained. Contrast enhancement occurred as early as one week, with peak incidence occurring between two and six weeks. Enhancement was diminishing or absent by the eight week after operation. Separate components of enhancement secondary to breakdown of the blood-brain barrier and to vascular granulation tissue may be distinguishable.

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