Record of Performance and Dairy Herd Improvement Corporation production records of Ontario Holstein cows were merged with breeding receipts of three Ontario AI units from September 1981 through December 1985. Relationships between fertility and production in the first three lactations were investigated for 97,368 daughters of 3806 sires in 22,768 herd-hear-seasons of calving. Fertility traits were days from calving to first insemination, number of inseminations per conception, and days open. Production traits were age and month of calving adjusted 305-d milk and fat yields and fat percentage. Multiple-trait maximum likelihood was used to estimate variances and covariances. Heritabilities for the first three lactations were .18, .18, and .19 for milk yield; .20, .19, and .19 for fat yield; and .58, .52, and .48 for fat percentage. Heritabilities of fertility traits ranged from .03 to .06. Genetic and phenotypic correlations between fertility and production traits in all three lactations were essentially 0. Genetic correlations between different lactation production traits ranged from .2 to .65. Repeatabilities of fertility traits ranged from .05 to .16 in different lactations. Repeatabilities for production traits in different lactations ranged from .51 to .77. Genetic and phenotypic correlations between fertility and production in the subsequent lactation and between production and subsequent lactation fertility were also very low or zero.

Breeding receipts from three AI units were merged with Ontario Dairy Herd Improvement Corporation and Record of Performance production records. Data comprised 53,705 heifer, 41,253 lactation 1, 14,688 lactation 2, and 3054 lactation 3 records by daughters of 2150 sires represented in 15,877 herd-year-seasons of birth. Three measures of heifer fertility, three measures of cow fertility, and three measures of production were investigated. Measures of heifer fertility were ages at first and last breeding and number of inseminations per conception. Cow fertility traits were days from calving to first breeding, days open, and number of inseminations per conception. Production traits were breed class average milk, breed class average fat, and fat percentage. Relationships among these nine traits for the first three lactations were estimated using a maximum likelihood multiple-trait procedure. The linear mixed model for each trait included fixed effects of herd-year-season of birth and genetic groups of sire and the random effect of sire. Transformations of the data for nonnormality had no influence on the estimates of genetic and phenotypic parameters. The heritability of .12 for age at first insemination, which was higher than other heifer fertility traits, indicated that selection would result in genetic response. Genetic and phenotypic correlations between heifer fertility and cow fertility and production traits in all three lactations were not different from zero. There was no genetic antagonism between fertility and subsequent production traits.

were considered for the estimation of genetic parameters. Variance and covariance estimates of first lactation traits were obtained using restricted maximum likelihood technique (REML). When first lactation milk yield (FLMY), first lactation length (FLL) and average daily yield (ADY) traits were considered for REML analysis, the heritabilities were 0.184±0.146, 0.132±0.131 and 0.141±0.133, respectively. While, genetic and phenotypic correlations between them were medium to high except phenotypic correlations between FLL and ADY (-0.025). REML procedure considering FLMY, age at first calving (AFC) and first service period (FSP) combination exhibits heritabilities as 0.274±0.173, 0.506±0.233 and 0.274±0.172, respectively. Genetic correlations were -0.120±0.376, 0.225±0.423 and 0.365±0.331 between FLMY and AFC, FLMY and FSP, AFC and FSP, respectively. Phenotypic correlations were 0.057, 0.289 and 0.123, respectively. Considering all five traits REML combination heritabilities estimated were 0.238±0.162, 0.160±0.139, 0.136±0.132, 0.409±0.209 and 0.259±0.168 for FLMY, FLL, ADY, AFC and FSP, respectively. The genetic correlations were positive except FLMY and AFC. The phenotypic correlations were also positive except FLL and ADY, ADY and FSP. Almost all estimates were associated with high standard error.

Objective The aim of the study was to investigate the association of urinary albumin:creatinine ratio (ACR) with regard to the outcome of sepsis patients and to study the trends of ACR with severity of disease, organ dysfunction, microcirculation status, the use of inotrope, and mechanical ventilation use, and length of pediatric intensive care unit (PICU) stay. Materials and methods In the prospective observational study, the patients with varying categories of sepsis admitted in the PICU with stay >24 hours were enrolled consecutively. Urine samples were collected at the time of admission (ACR1), 12 hours (ACR2), and 24 hours (ACR3). Results One hundred and thirty-eight patients including 56 cases of sepsis, 31 of severe sepsis, 22 of septic shock, and 29 of multiorgan dysfunction syndrome (MODS) cases were analyzed. There were 29 (21%) deaths. ACR (median, IQR) was significantly higher in nonsurvivors [ACR1 198.9 (111.2–329.4) vs 124.5 (59.37–294.5), p 0.03], [ACR2 213.8 (112.5–350) vs 117.8 (62.6–211.9) p 0.008], [ACR3 231.8 (99.9–441.2 vs 114.4 (44.1–240.3), p 0.005]. The ACR is increased progressively with the increasing severity of sepsis ( p < 0.001). The performance of ACR operative characteristics was compared with that of PRISM and PELOD scores. In deceased, ACR was significantly correlated with blood pH, lactate, and base deficit. A cutoff value of ACR 102.7 mg/g had sensitivity 86.2%, specificity 40.4%, positive predictive value 27.8%, and negative predictive value 91.7%. The use of inotropes, mechanical ventilation (>48 hours), and mortality was significantly higher in patients with ACR >102 mg/g. The probability of death varied from 17.6 to 19% in the first 24 hours of admission. ACR was significantly cheaper as compared to PRISM score and PELOD score estimations. Conclusion Urinary ACR, a cost-effective tool, correlates with the severity of sepsis and associated morbidity and mortality in children. How to cite this article Sachdev A, Raheja K, Gupta N, Chugh P. Association of Urinary Albumin:Creatinine Ratio with Outcome of Children with Sepsis. Indian J Crit Care Med 2020;24(6):465–472.

The phenotypic and genetic correlations between fertility ratings of AI bulls for conception rate and their estimated breeding values for daughters' fertility and production traits were calculated. Genetic correlations between fertility ratings of bulls for conception and heifer fertility traits (age at first breeding, age at last breeding, and number of insemination per conception) were negative and ranged from -.04 to -.23, indicating daughters of bulls with high fertility ratings were younger at first breeding and required fewer services to conceive. In general, genetic correlations between fertility ratings of bulls for conception rate and cow fertility traits (days from calving to first breeding, days open, and number of inseminations per conception) and production traits (breed class average milk and fat and fat percentage) in the first two lactations were also moderate to high and in the favorable direction. Although heritability of both male and female fertility is low, these data indicate that heavy use of sires with high fertility ratings could have a mild positive effect on both male and female fertility. Evidence is also found to indicate that in this breed, selection for increased milk yield should not impair genetic ability of cows to reproduce.

Journal of Surgery IntroductionDuring the fifth to seventh week of gestation, midgut enlarges rapidly and as it becomes too large for the abdominal cavity, it herniates through the umbilical cord. The apex of the herniated midgut is continuous with VID and yolk sac. Superior mesenteric artery forms the axis of this herniated midgut. Around tenth week of gestation herniated midgut returns back into the peritoneal cavity [1,2]. During this complex developmental process several anomalies may occur because of the complexity of the process. Examples include bowel atresias and stenoses, abnormalities of the vitellointestinal duct (Meckel's diverticulum, patent vitellointestinal duct (PVID), umbilical fistulas, umbilical sinus tracts, umbilical cysts and umbilical polyps), failure of ceacal descent, malrotation, malfixation, reversed bowel rotation and exomphalos [1][2][3]. VID is more common in males and mostly presents in first 28 days of life. This anomaly needs to be managed urgently to prevent gangrene. Case PresentationA male neonate delivered via LSCS (CAUSE-PREVIOUS LSCS) which was unbooked delivery 34 weeks with LMP-3/12/16 and EDD-10/9/17 WITH G4P3L3A1 was admitted in Yashoda Hospital, Ghazaibad, U.P. Baby was born at preterm. Antenatal scans were reported to be abnormal showing anterior wall depressed-pouch and part of intestine coming out from umbilicus. Birth weight was 2250 g and Apgar scores were 8/1, 9/1, 10/10. On examination at birth, newborn was having respiratory distress and grunting, so oxygen was started immediately and chest x-ray and arterial blood gas (ABG) was done. Chest x-ray showed grade 2 Hyaline Membrane Disease (HMD) and ABG showed respiratory acidosis, for which child was intubated and ventilated, also received surfactant. Abdominal examination revealed a bright red 'Y' shaped loop of small intestine was protruding from the umbilical ring. It was fixed to the umbilicus, with easily bleeding mucosa and irreducibility. Rest of the abdomen was not distended non tender (Figures 1 and 2). Bowel sounds were absent. There was no bilious aspirate in the orogastric tube. Anal opening was normally placed and patent, however, he had not passed any meconium. Patient had passed clear urine twice and the bladder was not palpable. Rest of the systemic examination was normal. AbstractPatent vitellointestinal duct (VID) can present to us in many variety of congenital intestinal malformations. Patient presents with either anomaly alone or complications secondary to the anomaly. Most common reported anomaly of residual vitelline duct is Meckel's diverticulum with different presentations like bleeding, intestinal obstruction or diverticulitis. Prolapsed ileal loops through a patent VID is a rare presentation of the above. To date only fifteen cases of this presentation have been reported in the English medical literature but none reported in a premature newborn baby presenting with it from the time of birth, which to the best of our knowledge has not been reported before and therefore this the youngest r...

Systemic lupus erythematosus (SLE) is a multisystem disease characterized by loss of self-tolerance resulting in development of autoantibodies and formation of immune complexes. Multiple organ involvement can be seen with renal and neurological involvement carrying the worst prognosis. This case report is of 13-year-old Indian boy who presented with fever and rash, along with Macrophage Activation Syndrome secondary to sepsis. Patient showed improvement in symptoms with steroid therapy and IVIG.

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