It is the only referral hospital in the southern part of Assam, also referred to as the Barak Valley, and serves neighbouring states including Mizoram, North Tripura, West Manipur and South Meghalaya.
Background and objective Acute-on-chronic pancreatitis (ACP) is an increasingly recognized clinical entity associated with significant morbidity, prolonged hospitalization, and increased intensive care utilization. Early identification of high-risk patients remains challenging because conventional prognostic scoring systems are often time-consuming, complex, or insufficiently validated in ACP. Procalcitonin (PCT), a rapid inflammatory biomarker, has demonstrated prognostic utility in acute pancreatitis. However, evidence regarding its role in ACP remains limited. This study aimed to evaluate serial serum PCT levels in hospitalized patients with ACP from Northeast India. Methods This prospective observational study was conducted over one year at a tertiary care center and included 58 adult patients diagnosed with ACP based on the revised Atlanta classification criteria and imaging evidence of chronic pancreatitis (CP). Serial serum PCT levels were measured at admission and 48 hours later. Clinical outcomes, including mortality, ICU admission, organ dysfunction, local complications, and duration of hospitalization, were analyzed. Receiver operating characteristic (ROC) curve analysis was performed to assess the prognostic accuracy of PCT. Results Severe clinical outcomes were common, with mortality observed in 12.1% (n = 7) of patients, ICU admission in 60.3% (n = 35), and local pancreatic complications noted among 82.8% (n = 48) of the cases. Admission PCT demonstrated poor prognostic performance for mortality prediction (area under the curve (AUC): 0.555), with a sensitivity of 46.9% at a cutoff of 3.46 ng/mL. In contrast, 48-hour PCT showed excellent predictive accuracy, yielding an AUC of 0.992. A threshold value of 4.04 ng/mL achieved 100% sensitivity and 100% negative predictive value (NPV) for mortality prediction. Elevated PCT levels were significantly associated with ICU admission (p = 0.034), organ dysfunction (p = 0.021), local complications (p = 0.041), and prolonged hospitalization (r > 0.95). Conclusions Serial serum PCT assessment, particularly at 48 hours, is a reliable prognostic biomarker in ACP and may facilitate early risk stratification, optimized critical care allocation, and individualized clinical management.
AmpC β-lactamases are less commonly reported and are one of the major contributors to third-generation cephalosporin resistance within hospital settings. Emergence of new variants of this beta-lactamase complicates laboratory detection and treatment options. In the current investigation, we report the presence of blaCMY-225, a new type of class C beta-lactamase from a teaching hospital in northeast India.
Bats, often silent carriers of lethal pathogens, serve as natural reservoirs for numerous viruses capable of crossing species barriers with devastating effects. Among them, Rousettus aegyptiacus (R. aegyptiacus) has emerged as a pivotal species in understanding viral spillovers. This fruit bat hosts the Marburg virus (MARV), supporting its replication and occasional transmission to humans, where it causes fatal hemorrhagic fever. However, a striking paradox remains while MARV infection is deadly in humans, R. aegyptiacus remains asymptomatic. Driven by this contrast, our study explores the codon usage patterns to reveal evolutionary mechanisms underlying viral adaptation and host tolerance. Far from being a passive carrier, R. aegyptiacus represents an insightful model for antiviral research. Our analysis revealed distinct codon usage patterns in MARV, indicating fine-tuned evolutionary alignment with the host's codon preferences. MARV exhibited low codon bias, suggesting broad compatibility with the host's translational machinery. Further, COA and PR2 analyses suggested that ecological factors shape codon selection in both virus and host. RNA modification analysis revealed frequent cytosine-to-thymine transitions, implying conserved mutational pressures or host-driven editing. Variations in RCDI values indicated deoptimized codon usage.
The combination of simultaneous fractures of both the proximal and distal end of radius is rare. Only a few cases had been mentioned in the literature. They are also termed as “bipolar fractures of radius”. The association of olecranon fracture with this combination is again very rare. The management protocol is also not very clear. Maintenance of the radius length is perhaps the main crux of treatment, since it takes part in both the proximal and distal radio-ulnar joint. Implant choices can be varied from rigid platting to percutaneous fixation. Radial head can be reconstructed or replaced depending on the fracture comminution. Post-operative rehabilitations also need to be tailored. Rigid fixation like platting favored early mobilization, while semi rigid fixation may need a period of immobilization. Regular follow up and guided physiotherapy optimizes good clinical outcome in such rare combinations of fracture.
OBJECTIVE:To identify the risk factors for intrapartum stillbirth and examine whether these are different from that of antepartum stillbirth, and investigate the survival probabilities of fetuses by gestational age in high-risk pregnancies. METHODS:We conducted a secondary data analysis of a hospital-based cohort study from India, including 9774 singleton pregnancies from 13 hospitals across six states. We conducted modified Poisson regression analysis to assess associations between potential risk factors and intrapartum stillbirth. Kaplan-Meier survival curves were used to explore survival probabilities of fetuses among pregnant women who had anemia and hypertensive disorders in pregnancy (HDP) compared with those who did not have these problems. RESULTS:There were 167 intrapartum stillbirths and 9607 live births; representing an incidence of 17.1 per 1000 total births (95% confidence interval [CI]: 14.6-19.9). Risk factors identified were illiteracy (adjusted risk ratio [aRR]: 2.37, 95% CI: 1.33-4.38), age > 34 years (aRR: 3.17, 1.41-7.36), <4 antenatal check-ups (aRR: 1.90, 1.27-2.87), <100 days of iron and folic acid supplementation (aRR: 9.10, 4.15-21.05), other HDP (aRR: 2.48, 1.36-4.25), severe anemia (aRR: 3.33, 1.82-6.63), preterm birth (aRR: 3.25, 2.26-4.69) and <10th percentile birth weight-for-gestational age (aRR: 1.57, 1.14-2.17). These were similar to the risk factors for antepartum stillbirths. Survival probabilities for fetuses among women with pre-eclampsia/eclampsia and severe anemia decreased from 34 weeks' and 30 weeks' gestation, respectively. CONCLUSION:In this high-risk hospital cohort of pregnant women undergoing labor induction or augmentation, risk factors for intrapartum stillbirth overlapped substantially with those for antepartum stillbirth, although the antepartum analysis was underpowered. Targeted monitoring of women with severe anemia and HDP from 30 weeks may reduce intrapartum stillbirth risk in similar settings.
