Madras Medical College

Chondroectodermal dysplasia (Ellis–van Creveld syndrome), a rare autosomal recessive skeletal dysplasia, is characterized by disproportionate dwarfism, ectodermal dysplasia, polydactyly, and congenital cardiac anomalies. Respiratory involvement is recognized as a contributor to morbidity and mortality, but is under-emphasised. We report a 4-year-old male child born to consanguineous parents presenting with multiple admissions for lower respiratory tract infections (LRTIs) since birth. The physical examination revealed short stature, along with acromesomelic limb shortening, frontal bossing, a depressed nasal bridge, low-set ears, postaxial polydactyly, and dental anomalies. The echocardiogram showed an ostium secundum atrial septal defect. The radiology results showed a restricted thoracic cavity together with shortened rib bones. Through consistent supportive care, the child's health improved significantly. Currently, he continues to receive treatment from multiple healthcare specialists. This case highlights that recurrent LRTIs are a significant yet under-recognised clinical complication of chondroectodermal dysplasia, underscoring the importance of early respiratory surveillance and multidisciplinary care to improve outcomes.

Antimicrobial resistance (AMR) threatens global health, and inappropriate antibiotic use in companion animals accelerates the emergence of multidrug-resistant (MDR) organisms. Pet birds, maintained in close human contact, represent potential vectors for AMR transmission. We report a fatal case of MDR bacterial and fungal infection in a one-year-old budgerigar (Melopsittacus undulatus) following unsupervised administration of enrofloxacin and tetracycline by its owner. The bird presented with anorexia, watery diarrhea, lethargy, reduced vocalization, dehydration, and weakness. Microbiological examination (based on colony morphology, Gram staining and biochemical characteristics) of cloacal swabs revealed bacterial isolates and yeast that demonstrated resistance to amoxicillin, gentamicin, ciprofloxacin, cefotaxime, amikacin, tetracycline, and enrofloxacin via the Kirby-Bauer disk diffusion method. Despite evidence-based antimicrobial and antifungal therapy with supportive care, the bird showed progressive clinical deterioration and died. This case report demonstrates the severe consequences of unsupervised antimicrobial administration in exotic pets, including MDR pathogen selection, gastrointestinal dysbiosis, therapeutic failure, and death. Urgent regulatory intervention to restrict non-prescription antimicrobial access, coupled with enhanced client education on responsible medication practices, is essential to mitigate AMR proliferation at the human-animal interface.

The authors have nothing to report.

The purpose of this investigation was to find out how moderate intensity resistance training influences muscles growth in newbie college students living in urban areas. Forty men under graduate students were randomly selected as subjects and their aged ranged from 17 to 21 years. The selected subjects were randomly assigned into two equal groups namely experimental (n = 20) group (EG) which underwent moderate intensity resistance training for 8 weeks with 3 sessions per week and control (n = 20) group (CG) which did not undergo any special training. The thigh girth, calf girth and upper arm girth were selected as criterion variables for this study. The subjects were measured their thigh girth, calf girth and upper arm girth by a flexible tape. The obtained data were statistically assessed for any significant difference using analysis of co variance (ANCOVA). The result showed that there were significant improvement on thigh girth (56.86 ± 3.73 vs 53.02 ± 3.41, p≤ 0.05) and upper arm girth (33.86 ± 2.25 vs 29.85 ± 2.19, p ≤ 0.05) between the experimental group and control group. However there was no significant improvement in calf girth (36.17 ± 2.45 vs 34.93 ± 2.32, p ≥ 0.05) between the experimental group and control group. Eight weeks’ time is very short to increase the size of the muscles size in significant level, especially for beginners, but here it was increased significantly the thigh muscle size and upper arm muscles of the experimental groups when compare to control group. If the training duration and the intensity were increased, it would have increased the size of calf muscle as well.

Background & objectives Persistent mild inflammation is considered as a main contributor to the altered genesis of polycystic ovary syndrome (PCOS), with numerous studies reporting elevated serum levels of inflammatory markers. This inflammatory state may be attributed to genetic variants, particularly single nucleotide polymorphisms (SNP), that alter cytokine regulation. This study investigated the association of PCOS and inflammatory SNPs including interleukin (IL) such as IL-1β rs1143634, IL-1β rs16944, IL-6 rs1800795, IL-6 rs1800797, IL-6 rs1800796, IL-1RN; and tumour necrosis factor-alpha (TNF-α). Methods A total of 250 women volunteered for the study; of which 100 were diagnosed with PCOS and 150 were healthy controls. Serum levels of IL-6, IL-1β, and TNF-α were measured using enzyme-linked immunosorbent assay (ELISA). Genotyping was analysed using polymerase chain reaction (PCR), PCR-restriction fragment length polymorphism (PCR-RFLP), or real-time PCR (RT-PCR). Genotype distributions amid groups were compared using the Chi-square test. Results Women with PCOS exhibited elevated serum levels of IL-1β than those of healthy controls which was considerably significant (P<0.001). The heterozygous genotypes of IL-1RN and IL-6 rs1800796 were seen more frequently in the control group (P=0.02), suggesting a potential inverse association. Interpretation & conclusions SNPs in IL-1 and IL-6 genes may influence susceptibility to PCOS and could confer a protective role in women of South Asian Indian origin.

Parvovirus B19 (PVB19) is a clinically important cause of refractory anemia in kidney transplant recipients (KTRs). Data from low- and middle-income settings remain scarce despite high transplant volumes. This study evaluated the clinical spectrum, management practices, and outcomes of PVB19 infection across major transplant programs in India. We conducted a retrospective multicenter cohort study across 14 tertiary transplant centers. All KTRs with PCR-confirmed PVB19 infection and complete clinical data were included. Clinical features, bone marrow findings, immunosuppressive (IS) adjustments, intravenous immunoglobulin (IVIG) use, and patient and graft outcomes were analyzed. A total of 135 KTRs were identified. Median time to infection was 11 weeks posttransplant. Anemia was universal, not frequently accompanied by leukopenia (17.7%) or thrombocytopenia (14.8%). Bone marrow examinations (n=34) demonstrated giant proerythroblasts or pure red cell aplasia. IS reduction was implemented in all patients; most commonly, complete MMF withdrawal (61.5%). IVIG was administered to 90% (median cumulative dose 100g). Overall, 97% achieved hematologic recovery, with a median response time of 20 days. Recurrence occurred in 4.4%. At a median follow-up of 18 months, graft survival was 92.6%; graft loss (n=10) was primarily due to antibody-mediated rejection, and no deaths were attributable to PVB19. PVB19 infection represents an important consideration in the differential diagnosis of early posttransplant anemia in KTRs. Timely PCR testing and pragmatic treatment strategies can achieve favorable hematologic and graft outcomes in resource-constrained settings.

Oral health is critical to overall well-being, with abnormalities leading to various health issues. Pemphigus is an autoimmune disease characterized by painful blisters on the skin and mucous membranes, necessitating accurate diagnosis and timely treatment. This study aims to develop an artificial intelligence (AI) tool utilizing deep learning techniques for the detection of pemphigus from clinical and histological images, enhancing diagnostic accuracy. A supervised learning approach was employed, utilizing a pre-trained MobileNet deep learning model to classify histology images into healthy and pemphigus categories. The dataset was prepared through cropping, resizing, and labeling of images. The MobileNet model achieved an accuracy of over 92% in distinguishing between normal mucosa and pemphigus lesions. The proposed AI tool can serve as an initial diagnostic check, facilitating faster treatment planning. The implementation of an AI-based diagnostic tool for pemphigus detection demonstrates significant potential in reducing the diagnostic burden in clinical settings. Future work will focus on real-time disease detection applications.

Acute-on-chronic liver failure (ACLF) is a clinical entity that denotes deteriorates liver function in patients with underlying liver disease. Most studies indicate that the neutrophil-to-lymphocyte ratio (NLR). Neutrophil-to-lymphocyte ratio is a valuable prognostic marker in patients with ACLF. This study aims to assess the role of NLR ratio and evaluate the accuracy of NLR as a prognostic marker in ACLF and to compare the NLR with other standard scores. This study was conducted among patients with ACLF. Neutrophil-to-lymphocyte ratio was calculated by dividing the neutrophil count by the lymphocyte count. Neutrophil-to-lymphocyte ratio was compared with AARC score, CLIF-C ACLF score, MELD-Na score, and Child-Pugh classification as a prognostic marker in ACLF. A total of 109 patients were included, and the majority, (94.5%), were men with a mean age of 45 ± 11.2 years. The NLR emerged as a valuable prognostic marker. Patients with NLR >5 demonstrated significantly higher levels of C-reactive protein (CRP), alanine aminotransferase (ALT), and CLIF-C ACLF scores, reflecting greater systemic inflammation and hepatic injury. These patients also had a higher in-hospital mortality (53.1% and 26.7%, p = 0.005). The receiver operating characteristic (ROC) analysis showed that NLR had good predictive accuracy for mortality (AUC = 0.84), supporting its utility as a simple, cost-effective tool in early risk stratification. With increased NLR suggesting a higher probability of death, the study emphasizes the importance of NLR as a useful prognostic biomarker in patients with ACLF. Neutrophil-to-lymphocyte ratio is a prognostic marker to identify the risk of mortality in ACLF patients and helps in timely clinical decisions. Elevated NLR can help clinicians in prioritizing patients for liver transplantation. Kumar BS, Krishnamoorthy P, Arumaikani S, et al. Prognostic Value of Neutrophil-to-lymphocyte Ratio in Patients with Acute-on-chronic Liver Failure in Comparison with Standard Scores: A Cross-sectional Observational Study from a Tertiary Care Hospital in South India. Euroasian J Hepato-Gastroenterol 2025;15(2):118-122.