The patient screen and the informant version are short culture- and education-fair instruments. They reduce false positive rates, when used in combination in the community.

Low volume plasma exchange and low dose steroid improve survival in patients with alcohol related acute on chronic liver failure and severe alcoholic hepatitis -preliminary experience,

Articular cartilage defects have a poor capacity for repair. Most of the current treatment options result in the formation of fibro-cartilage, which is functionally inferior to normal hyaline articular cartilage. We studied the effectiveness of allogenic chondrocyte transplantation for focal articular cartilage defects in rabbits. Chondrocytes were cultured in vitro from cartilage harvested from the knee joints of a New Zealand White rabbit. A 3 mm defect was created in the articular cartilage of both knees in other rabbits. The cultured allogenic chondrocytes were transplanted into the defect in the right knees and closed with a periosteal flap, while the defects in the left knees served as controls and were closed with a periosteal flap alone, without chondrocytes. Healing of the defects was assessed at 12 weeks by histological studies. Allogenic chondrocyte transplantation significantly increased the amount of newly formed repair tissue (P=0.04) compared with that found in the control knees. The histological quality score of the repair tissue was significantly better (P=0.05), with more hyaline characteristics in the knees treated with allogenic chondrocytes than in the control knees. Articular cartilage defects treated with allogenic chondrocyte transplantation result in better repair tissue formation with hyaline characteristics than those in control knees.Résumé Nous avons étudié l'efficacité de la transplantation de chondrocytes allogènes pour des pertes de substances localisées chez le lapin. Une perte de substance de 3 mm a été crée au niveau des 2 genoux. Des chondrocytes ont été cultivés in vitro à partir de prélèvements fait sur les genoux de lapin blanc de Nouvelle Zélande. Les chondrocytes cultivés ont été transplantés dans le defect du genou droit et enfermés sous un lambeau périosté tandis que le genou gauche servait de contrôle avec un lambeau périosté sans chondrocyte. La cicatrisation cartilagineuse a été étudié histologiquement à 12 semaines. La transplantation de chondrocytes allogènes augmente significativement la quantité de tissu de réparation en comparant aux genoux de contrôle (p=0.04). Le score histologique est meilleur que dans le groupe de contrôle.

Background: Characterization of reticulo-endothelial activation in COVID-19 may guide treatment. Objectives: To assess reticulo-endothelial activation and its correlation with disease severity and death in patients across the entire spectrum of COVID-19 severity. Methods: Consecutive hospitalized COVID-19 patients were studied, with similar number of patients in each disease severity category. Baseline serum ferritin, sCD163 (macrophage activation markers) and plasma von Willebrand factor (VWF) antigen (endothelial activation marker) levels were studied. Clinical parameters and plasma D-dimer levels were also studied. The study parameters were correlated with COVID-19 severity and survival. Results: The 143 patients (104 males [80%], age 54 [42 – 65] years, median [inter-quartile range]) presented 4 (3—7) days after symptom onset. Thirty-four patients had mild disease, 36 had moderate disease, 36 had severe disease and 37 had critical disease at baseline. With increasing COVID-19 severity, ferritin, sCD163, VWF and D-dimer levels significantly increased at baseline, however, 139 patients had normal sCD163 levels. Of the reticulo-endothelial markers, VWF level independently correlated with COVID-19 severity and with survival. VWF level > 332.6 units/dl correlated with COVID-19 severity (odds ratio [OR]: 2.77 [95% confidence interval (C.I): 1.1 – 6.99], p value: 0.031) and in-hospital death (OR [95% CI]: 29.28 [5.2 – 165], p value < 0.001). Conclusions: Reticulo-endothelial activation markers increased incrementally with worsening COVID-19 severity. Baseline endothelial activation marker (VWF), and not macrophage activation markers, independently correlated with COVID-19 severity and death.

Introduction: Shift workers and metabolic syndrome are on the rise in developing nations. The link between Metabolic syndrome and shiftwork is not clear. This study aims to measure the prevalence of metabolic syndrome among shift workers and daytime workers and to assess the association between metabolic syndrome and shift work. Methods: Cross- sectional study was done in a South Indian hospital. Participants were selected via systematic random sampling between the age group of 25 -50 years. There were two study groups – day and shift workers. Sample size calculation was done with an alpha error of 0.05 and power of 80% to detect a 12.5% difference for metabolic syndrome prevalence between the two groups. Outcomes studied include the prevalence of metabolic syndrome and odds of developing metabolic syndrome among shift workers. The Chi-square test and independent t-test were the tests of significance used. The impact of relevant parameters on metabolic syndrome was assessed using univariate and multivariable analysis. Results: Eighty employees were studied in each group. At baseline, differences include; daytime workers were older in age, had a better quality of sleep, were less active physically, and consisted of more vegetarians. The prevalence of metabolic syndrome prevalence was thirty-three percent among the participants. The odds ratio (adjusted for relevant confounders) for shift workers to develop metabolic syndrome was 0.55 (95% CI 0.24 -1.29). Conclusion: Metabolic syndrome was diagnosed in a third of the hospital employees studied. There was no statistical difference between shift and daytime workers for the prevalence of metabolic syndrome. Increased awareness, screening, and preventive measures of the disease are recommended.Keywords: daytime, hospital, metabolic syndrome, shift work, sleep