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Early enteral nutrition (EN) after major digestive surgery has been receiving increasing attention. Supporting evidence has not been clear. This evidence-based review traces the development of early EN and analyses whether it is indeed an advance. We performed a PubMed search in October 2009 with the key words enteral nutrition, early feeding, and gastrointestinal surgery. Our emphasis was on earliest studies documenting the benefits or adverse effects of EN, comparative studies, documenting the benefits or adverse effects of EN, comparative studies, and randomized controlled trials. Thirty-one results were returned from which 17 were included for evaluation (1979-2009). Fifteen papers concluded that early EN was beneficial. In general, patients put on early EN and immunonutrition postoperatively seemed to have decreased hospital stay, decreased complication rates, decreased treatment and hospital costs, and even decreased morbidity and mortality; however, judicious use has been suggested. One study did not recommend early enteral feeding in well-nourished patients at low risk of nutrition-related complications and another suggested that immunonutrition is not beneficial and should not be used routinely. Early EN has been safely given after major digestive surgery since 1979. It benefits patients undergoing major gastrointestinal (GI) surgeries, with reduction in perioperative infection, better maintainance of nitrogen balance, and shorter hospital stay. Early EN may be superior to total parenteral nutrition (TPN). However, TPN is perhaps better tolerated in the immediate postoperative period. Early enteral immunonutrition should be used only in malnourished and in transfused patients. Early EN after major digestive surgery is an old advance that is now in fashion.

Background: Elevated JAK2V617F allele burden is associated with enhanced expression of downstream target genes in Philadelphia negative chronic myeloproliferative neoplasms (CMPNs) which include PV, ET & PMF. Previous studies have shown the impact of JAK2V617F allele burden on clinical phenotype of CMPNs. However, there is no data from India regarding the association between JAK2V617F allele burden and clinical phenotype in PV. Aims/Settings and Design: We aimed to investigate the effect of allele burden on clinical phenotype in 90 JAK2V617F positive PV patients and to see its influence on disease related complications. Material and Methods: Allele burden of 90 JAK2V617F positive PV patients was quantified by Real-time polymerase chain reaction (RQ-PCR). Results: 74/90 (82.22%) were males and 16/90 (17.78%) were females (median 45 years, range 35-78). Patients with age >50 years had significantly higher JAK2V617F allele burden (median 40.15%, range 0.49–91.62 %) than patients with ≤ 50 years age (median 48.59 %, range 0.56–86.74 %; P < 0.032). Patients with splenomegaly had significantly higher JAK2V617F allele burden (mean 50.24%, range 6.91–84.17%) than patients without splenomegaly (mean 33.82 %, range 0.49–71.83 %; P < 0.017). Patients with higher allele burden (median 57.20, range 43.4–72.03%) had significantly raised thrombotic events than the patients with lower allele burden (median 37.38, range 0.49–84.17% P < 0.043). 49/90 (54%) were homozygous and 41/90 (46%) were heterozygous. Conclusions: Higher JAK2V617F allele burden showed association with increased age, splenomegaly and thrombotic events. Thus, it may be considered for prognostication and setting up the treatment protocol in PV patients.

Purpose The purpose of this study is to comprehend the efficiency levels of the Indian textile industry and also its sub-sectors in the light of changing global and national business environment. It is imperative to study the efficiency levels of textile industry for an emerging economy like India, where the industry contributes up to 13 per cent in export earnings, 10 per cent in total industrial production and 2 per cent in gross domestic product (GDP). The study holds an important place in the wake of phasing out of the quota regime existing under the Multi Fibre Agreement (MFA) and the rising competition being faced from countries such as Bangladesh, Vietnam and Cambodia. Design/methodology/approach The present study attempts to have an in-depth analysis of the efficiency levels in the Indian textile industry using meta-frontier data envelopment analysis, which is a non-parametric linear programming based frontier technique. Findings The findings highlight that the Indian textile industry is inefficient and has a huge scope of improvement in terms of efficiency. It also confirms the existence of different production functions among the sub-sectors of the industry. Among the different sub-sectors, the proximity of production frontier of readymade garments is the closest to meta-frontier followed by cotton and blended yarn, man-made fibre, cloth and others. Practical implications The findings bear strong implications for the policymakers in their attempt to regain the lost competitive position of the Indian textile industry and to enhance its contribution in the economy. As per the findings, policymakers should target the relatively inefficient sub-sectors of textile industry (cloth, man-made fibre, cotton and blended yarn) to infuse more efficiency in these sectors to enhance the market share of the Indian textile industry in the global textiles market. Originality/value The current study is a unique addition to the sparse literature on managing efficiencies in the textile industry, particularly of emerging economy like India. Looking at the methodological and geographical coverage of the previous work, it was found that no study has explored and analysed the efficiencies of the sub-sectors in the Indian textile industry using meta-frontier analysis. Therefore, this study will be the first of its kind which seeks to fill such gaps and intends to enrich the available literature.

Our study emphasizes the importance of -572G > C polymorphism in increasing IL-6 levels, thereby showing its significant role in DVT in India. IL-6 -174G > C and -597G > A were neither associated with raised plasma IL-6 levels nor with thrombotic risk. Thus -572G > C polymorphism detection may be one of the connecting links between IL-6 and thrombotic risk in Indian DVT patients.

We found 5/18(27.β) δβ-thalassemia cases with co-inherited alpha 3.7 deletion and 3/18 (16β) cases with IVS 1-5(G-C) mutation. Patients showed features of thalassemia intermedia phenotype among which those with co-inherited IVS 1-5(G-C) mutation showed severe phenotype as compared to those with co-inherited alpha 3.7 deletion. So, we highlight importance of genotyping of patients with δβ thalassemia or HPFH and coinheritance with inherited factors which plays crucial role in clinicopathological profile and setting up prenatal diagnostic protocol.

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Our study suggests that JAK2V617F mutation may increase the risk of thrombosis in CMPNs. This finding could lead to risk stratification, setting up the treatment strategy in CMPNs.